What's making it difficult to see a GP these days?

VincentHanna · 2 Jan 2019 at 07:38

Eurofighter said:
Somehow I don't think the main problem is people missing appointments.

Well it's not, it's very insignificant overall. But people should always try their damnedest to make any appointment they have so as not to waste doctors and nurses time.

According to the story, missed appointments cost roughly the same as health tourism, which again is statistically insignificant and yet people still bang on about that being a huge problem for the NHS

SexyGreyFox · 2 Jan 2019 at 07:40

Eurofighter said:
Somehow I don't think the main problem is people missing appointments.

The last time I was at the Doctors an electronic message kept repeating that in that in one month 260 patients had failed to turn up which means 260 patients missed out.
You also can't blame immigrants because our surgery is all White Brits.
I'm on an 'at risk' list so if I ring at 8.30am I'll get in but my wife can be 3 weeks away.

Jokester · 2 Jan 2019 at 07:41

A lot of the GPs here just work part time.

wolfie138 · 2 Jan 2019 at 08:20

rebel rebel said:
Surely suddenly becoming stone deaf is enough of an emergency to be able to go to A&E?

You could have tried calling NHS 111.

what use is calling someone if you're deaf?

Minstadave · 2 Jan 2019 at 08:24

VincentHanna said:
Well it's not, it's very insignificant overall. But people should always try their damnedest to make any appointment they have so as not to waste doctors and nurses time.

According to the story, missed appointments cost roughly the same as health tourism, which again is statistically insignificant and yet people still bang on about that being a huge problem for the NHS

I wouldn't say missed appointments are insignificant. I'll ask my wife (GP) what their average failure to attend rate is. This seems to suggest it's around 5%:

https://www.gponline.com/10m-gp-appointments-lost-dnas-year-warns-gpc/article/1424483

I work in a hospital setting and about 20% of my clinic slots are wasted. That's a massive resource unused. Plus that's with overbooking.

GP training is still more attractive than hospital training by and large as it's short and allows far more flexible working. Medicine in general though is struggling due to not enough placements at university and drain overseas.

Minstadave · 2 Jan 2019 at 08:28

Jokester said:
A lot of the GPs here just work part time.

Nearly all GPs work part time. Doing 10 sessions (5 days) is unusual.

Rifte · 2 Jan 2019 at 08:38

Ok its been around 5 years since I was resident in the UK and it was horrendous getting a GP appointment back then at my surgery.

In the town I lived though (Bedford) there was a walkin centre that would see you if you were willing to wait. I think the maximum I waited was around 2 hours.

A GP would see you and be able to write out a prescription.

Are these still a thing?

Minstadave · 2 Jan 2019 at 08:39

Rifte said:
Ok its been around 5 years since I was resident in the UK and it was horrendous getting a GP appointment back then at my surgery.

In the town I lived though (Bedford) there was a walkin centre that would see you if you were willing to wait. I think the maximum I waited was around 2 hours.

A GP would see you and be able to write out a prescription.

Are these still a thing?

Yup still around.

heeeed · 2 Jan 2019 at 08:42

4 days (8 clinical sessions) is considered full time for GP. My day is usually about 12 hours long so my “part time” week is 48 hours long, before you consider my extended hours shifts on some evenings and Saturday mornings. I would say 6 clinical sessions is becoming increasingly more normal which is still 36 hours + extended. Part time is quite a misnomer in primary care

Captain · 2 Jan 2019 at 08:48

What's with receptionist now asking why you need to see the doctor?

I wanted hayfever tablets in the summer but the stupid bint on reception wouldn't book me in until I told her what was wrong.

Minstadave · 2 Jan 2019 at 08:49

Clov!s said:
What's with receptionist now asking why you need to see the doctor?

I wanted hayfever tablets in the summer but the stupid bint on reception wouldn't book me in until I told her what was wrong.

Cheap way of triage and sorting what can be dealt with over the phone/go to the nurse practitioner or needs to see the GP.

malachi · 2 Jan 2019 at 08:50

The usual people say "too many immigrants in the country using the NHS causing the problem" When really its not because people are living longer into old age we are seeing side effects.

Meds keeping them off deaths door for longer when decades ago they would have died. On top of that, GPs get the qualifications then leave the UK for better pay and less stress because of cuts. Who can blame them.

Kreeeee · 2 Jan 2019 at 08:56

Dis86 · 2 Jan 2019 at 09:05

Clov!s said:
What's with receptionist now asking why you need to see the doctor?

I wanted hayfever tablets in the summer but the stupid bint on reception wouldn't book me in until I told her what was wrong.

It's frustrating but it's normally just to make sure people aren't complete time wasters.

My surgery is quite bad for booking. Have to call first thing in the morning if you want an 'emergency appointment' or can book in advance but no more than 4 weeks. Which when I tried last time was told they didn't have any bookings for 6 weeks. So I asked for one of those only to be told I couldn't book more than 4 weeks in advance, called back 2 weeks later to be told...no appointments for 6 weeks. How the **** do you get an appointment then?

Minstadave · 2 Jan 2019 at 09:06

Kreeeee said:
I'm not sure that the NHS model can ever compete as there is no drive for efficiency.

That's just not born out in the evidence though.

https://www.kingsfund.org.uk/publications/nhs-myth-busters

Private health systems have a vast amount of wastage, over investigation and conflicts of interest.

Rifte · 2 Jan 2019 at 09:12

I have a recruitment business in India where I send professionals overseas into full time employment in Australia, Canada and NZ.

I used to work as an RPO for a medical recruitment company based out of Stevenage in the UK. They had access to Indian doctors and nurses via me, sure...but the real money for them was in the locum business.

They used to take EU medical professionals onto their own employment contract and contract them out to the NHS for three to four times the amount.

The NHS employees may be efficient in what they do, but in my experience the finances of the trusts are far from efficient and generally speaking wasted.

PlacidCasual · 2 Jan 2019 at 09:14

Minstadave said:
Medicine in general though is struggling due to not enough placements at university and drain overseas.

25 years ago I can remember discussing with Doctors and Lecturers the fact there were too few University places to study medicine and that the demand of suitable candidates far exceeded supply, it sounds like little has changed. At the time someone suggested to me that the constraint was largely self made I'm not in a position to comment on how accurate that is but it wouldn't surprise me.

VincentHanna · 2 Jan 2019 at 09:20

Minstadave said:
I wouldn't say missed appointments are insignificant. I'll ask my wife (GP) what their average failure to attend rate is. This seems to suggest it's around 5%:

https://www.gponline.com/10m-gp-appointments-lost-dnas-year-warns-gpc/article/1424483

I work in a hospital setting and about 20% of my clinic slots are wasted. That's a massive resource unused. Plus that's with overbooking.

GP training is still more attractive than hospital training by and large as it's short and allows far more flexible working. Medicine in general though is struggling due to not enough placements at university and drain overseas.

Sorry, I meant the money it costs the NHS overall (compared to their budget) is insignificant.

As I said, people should do their damndest to make all their appointments, it's a huge waste of time.

Minstadave · 2 Jan 2019 at 09:22

PlacidCasual said:
25 years ago I can remember discussing with Doctors and Lecturers the fact there were too few University places to study medicine and that the demand of suitable candidates far exceeded supply, it sounds like little has changed. At the time someone suggested to me that the constraint was largely self made I'm not in a position to comment on how accurate that is but it wouldn't surprise me.

The government control the number of medshool places and they've promised more. There's no problem with the number of applicants, even with the cuts and general slog of working in the NHS (get them when they're going and niaive).

Problem is it's all very late, it takes over a decade from medshool to being a qualified GP. Plus the drain away to locum working or overseas countries hasn't been tackled.

heeeed · 2 Jan 2019 at 09:29

Clov!s said:
What's with receptionist now asking why you need to see the doctor?

I wanted hayfever tablets in the summer but the stupid bint on reception wouldn't book me in until I told her what was wrong.

That’s exactly the sort of thing I would want my reception team to find out. I would sort that problem without seeing you in 90% of the times, so I wouldn’t want to have wasted a full appointment. In fact depending on what meds you’re on 90% of the time you would be pointed to a pharmacy as it is more appropriate.

Also on the other side of triage, we will still get people asking for appointments when their issues are very serious and need 999 to be called. I have multiple times had someone come to see me or I’ve rung when they requested a home visit and they were having a stroke or a heart attack.