Bonkers new rule at our GP surgery

It was Blair who paid GPs handsomely.

Yes you’re right growstuff. But do you remember the complaints about that from the general public? There were frequent complaints about it on all the media outlets. I remember that very well indeed. The public don’t want GPs to be paid handsomely, but you’re right in that it is necessary to pay them well. Look what happens when they’re not paid well. There aren’t enough of them. The public can’t have it both ways, either pay the GPs ‘handsomely’ or have too few GPs.

Good post Granmarderby.
But another reason for part time work is the number of women who work in general practice. Of course they negotiate part time hours after they have a baby, just like many other women in work do.
And yes! For example GPs practices get paid per flu vaccination given. But many Gransnetters choose to go to the pharmacy because it’s more convenient.

I don't know enough about the system Maddy to make suggestions, but perhaps you could show some understanding too.

maddyone When you were ill with Covid, how would it have been if you couldn't have been seen for a few days? Would you have thought "That's OK! I'll stay in my bed at home and be seriously ill with no treatment and maybe I'll die, but I understand"?

That's what you're expecting people to do.

People will die because they're not being seen by GPs. I'm certainly not bashing them because I know they work hard. However, when people are already down, the last thing they need is to be told to "understand". How about understanding patients? They're the ones not being treated.

Given that it seems impossible to recruit and retain GPs, solutions include recruiting more nurse practitioners, who can be trained more cheaply, scrapping some of the bureaucracy and targets, issuing repeat prescriptions for two months instead of one, giving patients more control over their health records, encourage people to be more pro-active about preventative medicine, allow direct access to mental health services, allow some medicines to be prescribed by pharmacists. There's more but I've forgotten. All of those suggestions were given to me by a friend who is a GP.

Now do you really think a person who makes an appointment and then doesn’t go is ill?

Yes! The only time I've not turned up for an appointment is when I ended up in A & E and was admitted!

I also know that I've been recorded as "not attended" when I missed a telephone call from the GP.

maddyone

GPs are not actually employed by the NHS like hospital doctors are, they are self employed. So they cannot be privatised, because they’re already private. They ‘buy in’ to a Practice and so they own it collectively with the other GPs in the Practice. The government gives the practice money, but they don’t employ the doctors or own the premises.

Yes, they can be privatised. An increasing number of practices are run by profit-making chains.

Not only that, but there are now a number of private GP practices in my area. They're owned and run by GPs who sometimes still work in the "normal" practices, but for fewer hours.

Granmarderby10

Yes growstuff it was Blair who paid the GPs “handsomely” but it soon became evident that the handsome pay rise had strings attached and these were, an exponential rise in the number of duties they had to perform.
They could not just simply “stand still” and enjoy their well paid status but would need to take on the responsibility for several other roles.
And so this is we’re it all began really. Then more and more GPs started to do part time hours due to the stress and exhaustion from it all.

I know. It was a repeat of the tactic which had worked with teachers in 1988.

Rather than moaning about how awful patients are (wrong type of patient?), maybe people should think about how they vote. If they continue to vote Conservative, they're voting for all this to get even worse.

This is the beginning of a document, I have recently received from my GP:

"This is now a uniquely challenging time, and the practice is currently seeing levels of demand that we have never seen before, as well as dealing with the effect of pressures and backlogs throughout every aspect of the health service. We are dealing with nearly double the amount of workload that would be considered normal for what was already an extremely busy practice. This effect has been seen across the UK and is not a problem unique to XXX Medical Practice. We thank you for your patience with us and beg of you to be kind and understanding.
Staff at the practice are quite routinely working, well over 12-hour days, and it is not unusual for an individual clinician to face nearly 100 patient contacts in a single day. This does mean that staff are fatigued and are at serious risk of burnout. We are sorry that this means that we are not able to give each and every one of you the time that you would like and are forced to prioritise and work in ways that may not always seem as caring and as personal as we would like.
We also understand there has been a lot of frustration recently regarding access to the practice for booking appointments, including prolonged periods of time for your calls to be answered by one of the care navigation team. We do strongly sympathise with all our patients on this matter. We continue to monitor the impact of increased pressure and demand on patient experience and review what measures we can implement to try and mitigate the challenges. To that end, and as a result of your recent feedback, we have implemented the following:
·We are moving to a brand-new clinical system provider, which goes live on Wednesday 30th November which will benefit patients and clinicians alike, resulting in an increasingly joined-up and comprehensive approach to healthcare "

At least the practice has acknowledged that it's struggling to provide what people need and do not always appear caring or personal. They are not accusing us of wasting their time, which is what you're doing maddyone.

On a positive note our GP practice is excellent you always get a call back from a GP or nurse and an appointment is booked if necessary. The reception staff are very helpful and understanding.
I do not have much experience as I only visit a GP very rarely but when I was ill the the GP booked me in within hours (probably surprised to hear from me )
My daughter has had problems with appointments by her consultants as she is a type 1 diabetic and her care is not usually done by our GP practice. She did see a GP on a other matter and he pushed successfully for her to have a blood monitor which she
wears on her arm on prescription. We did previously pay for this whilst she was pregnant as her hypo symptoms disappeared but it is expensive at £60 every two weeks.

growstuff
There is absolutely nothing in your posts that I disagree with apart from one thing. There are definitely time wasters who make appointments to see/speak to their doctor and don’t turn up. It is actually known about by the Health Service. Some people will be so ill that they end up in hospital first but it would be disingenuous to pretend that is the case for every missed appointment. And not every appointment is for serious illness ie I referenced my daughter being asked for nit lotion and sun lotion.
Your GP practice has sent out a document that lists the difficulties that GPs are working under and that pretty much applies to all GP practices across the land. They are asking for their patients understanding. That’s exactly what I was saying. People need to understand the difficulties rather than complain and show disinterest in the problems. The facts are that the vast majority of GPs are trying their best to deliver the best service, but when they read a lot of criticism in the press or on social media, it can be very demotivating for them. That’s my point. And sadly historically Gransnet has been a place where GP bashing has become something of a pastime for some posters. Whenever that happens I will defend the GPs because they do not deserve the contempt voiced by some people, and you growstuff and others are certainly not guilty of that, but sadly some people are.

I think people are interested in why things have changed so dramatically, hence them asking on here what is different now compared to pre covid.

maddyone Well, stop defending your daughter and accept that they need to understand patients. I know I don't waste GPs' time and I'm very pro-active about my own health - and so are many other people. My GP friend has also told me about a few people who are the "worried well" and factors them in. According to her, they make up a very small percent. Your daughter chose to become a doctor; ill people don't choose to be ill!

Many GPs are already retiring or are approaching retirement and many young doctors just do not want to become GPs.

Yes, I had heard that maddyone.

Our original GPs retired some years ago, we still see a couple of them sometimes; they say glad they retired when they did.
All the present ones are part-time.
The population here has expanded and we need more GPs.

I don't know the answers.

growstuff
You ask about when I was seriously ill with Covid. I didn’t at any point see or hear from my GP. My husband became so concerned about my breathing that he phoned 111 because it was out of hours. It was the evening of New Years Day. Initially I was put into the Covid Virtual ward and my son had to collect the little oxygen measuring thing from the Covid Hub. It rapidly became apparent that my oxygen levels were so low that I needed immediate transfer into hospital. I was only in the virtual ward for about half an hour. The staff at the Covid Hub called the ambulance and it arrived in about 15 minutes. I was then in hospital for the following twelve days. I think I would probably have died without the care and treatment that I received. I couldn’t fault it and that’s one reason why I don’t like the GP bashing threads. I have always received treatment whenever I’ve really needed it. This wasn’t the first time I have received life saving care and therefore I will not criticise doctors. It’s fair enough to complain about lack of funding but not about the staff in my opinion.

Our surgery does triage when you phone in, minor complaints they send to a pharmacist, or practice nurse, more serious they will see you same day, appointments with a specific doctor are going to take longer.
Went for a flu jab yesterday, communication by text, seemed like business as usual

Do people still job share?

Two part time workers to do the job of one full time, maybe?

Or are there literally two few candidates to fill the vacancies?

Too few.

MissAdventure

I think people are interested in why things have changed so dramatically, hence them asking on here what is different now compared to pre covid.

To be honest, I haven't noticed many changes from pre-Covid. My practice started showing signs of stress about five years ago. I noticed it particularly with diabetic clinics, which no longer included the full range of checks. It was taken over by nurses, and doctors are rarely involved. My practice doesn't even have a doctor with diabetes as a specialism. After I had a heart attack in 2017, I couldn't get an appointment with a GP for five weeks, even though the hospital had told me I would need one within days to sort out prescriptions and a follow-up plan. That was five years ago.

What has happened during and since covid is that the NHS (in England, at least) has introduced new working practices, which include more telephone appointments and triaging. It's supposed to be more efficient (and it probably is for certain conditions) but it does mean that patients don't get face-to-face appointments very often - and many don't like that.

Doctor turnover is very high. There are two partners (one on the verge of retirement), but the other 8 doctors are salaried and don't seem to last for more than a few months, which affects continuity of care. I'm not sure what's going on with them. I know that the NHS would prefer more GPs to be salaried, so that they can be employed by large chains - maybe in preparation for take overs by large chains.

MissA I recently heard something (on R4, so it must be true) that the vast majority of female GP’s are (or want to be) part time.
I think that most, or a great deal, of GP’s are now women.
I know that our (excellent) GP surgery bares this out.

maddyone I'm not complaining about doctors either! I've had life-saving care more than once in my life. I am complaining about people who don't seem to recognise that most patients aren't time wasting hypochondriacs. The system is underfunded and needs some radical reform at all levels, but I'm sick to death of people who don't seem to realise that patients and doctors are on the same side. Patients do understand that doctors are overworked, but doctors (and their parents) need to understand that most people wanting appointments are ill and worried. They can't be fobbed off by telling them to have more understanding.

growstuff
I am trying not to defend my daughter, I don’t think she needs defending because I know she works hard and is very professional. When a poster asked upthread if I had a doctor in my family, I deliberately didn’t respond to that as I didn’t really want this discussion to become about my daughter, who doesn’t even live in the UK at the moment and is actually living and working in New Zealand. Interestingly she says that many of the same problems in medicine exist over there too. And yes she chose to become a doctor, but that doesn’t mean it’s acceptable to criticise her and her colleagues just because there are insufficient doctors in the country. That’s not her fault and it’s not the fault of any other doctor in the country. They do not deserve the criticism that is frequently heaped upon them, when as your own surgery says, they are doing their best under difficult circumstances.

I don’t think I’ve asked people to be more understanding of doctors growstuff, I think I said, or was trying to say that patients should understand the situation. They should understand why there aren’t enough doctors and that’s why it’s difficult to get an appointment for some patients. And there are many reasons. As your surgery correctly pointed out. And as I also tried to point out.

People are talking about the system, not individual gps.

FannyCornforth

MissA I recently heard something (on R4, so it must be true) that the vast majority of female GP’s are (or want to be) part time.
I think that most, or a great deal, of GP’s are now women.
I know that our (excellent) GP surgery bares this out.

I would hope after years of study, that gps have the opportunity to work part time as and when it suits them.

I still can't grasp how that means that the service cant function properly, considering all parents of either sex may reduce their hours, or perhaps when older, have other more pressing family commitments.

MissA sadly some people do GP bash about their own GP practices, rather than the system. That’s how the thread started. The system is struggling and it is fair enough for people to be very concerned about that. In fact, it’s a good thing if people are concerned about that and complain to their MP about it. Complaining on Gransnet will achieve nothing, but possibly make doctors feel more disillusioned.

My daughter is a GP. She lives and works in New Zealand at the moment. She thought she was escaping to a better health system where she would have time and facilities to really deliver her very best care, but has now discovered that the problems are much the same in NZ. Anyway this isn’t about NZ. The reason that many GPs are part time is mainly because they are women with young children. When I was teaching lots of our teachers had a baby and then went part time. It’s the same in medicine. Women make the same choices that women in other jobs make, and choose to work part time whilst their children are young. I’ve seen it suggested before that GPs shouldn’t be allowed this choice. Of course that would result in even fewer GPs as they would choose not to work for a few years, and anyway as a feminist I couldn’t support the legal rights that other women have being removed from doctors.