Are local GPs going down hill or are their hands tied ?

[Em3bbs]

Bit off topic, but chemists are getting worse. I go into the local one round here and the staff are stood there writing things up or putting stock away, they look up and notice you, but make no effort to serve you, just carry on with what they are doing and leave you stood there.
Happened last Saturday, after waiting a couple of minutes I said to the guy who was stood 6 foot away but completely ignoring me if i could get my prescription please, he just looked at me and said “I’m busy”

Bloody Tory austerity.

 

[wnb]

I have a country practise, phone up seen same day or I can make an appointment later in the week.

 

[bigmike20vt]

I have a country practise, phone up seen same day or I can make an appointment later in the week.

Am very happy for you. I had the same when I lived in a village. It's sad times tbh that we live in a post code lottery for things like healthcare and education. We all (presumably) pay our taxes we should get a roughly comparable service

 

[dymetrie]

Definitely going to depend where you are and what the practice is like, but overall I'd agree that it's getting harder to see a GP, mostly due to increased patient numbers and reduced GP numbers/hours.

Incidentally, @Steeps, sounds like you live in my town!

 

[Usher]

I'm on long term medication for my eyes, however I don't have to visit the surgery for ordering the prescription, I order it online via patient access, I have a designated pharmacy so the prescription is available to collect 48 hours later.
The online service is available to all so clearly you need to sign up for the service

 

[Vexr]

I feel most for the much maligned administrative/reception teams at GP surgeries. I've worked in hospitals previously and noted that when getting in touch with GP surgeries to liaise regarding a mutual patient there can be an extreme queue to get through at any time of day.

Those employed at these practices aren't just there to be call centre workers, they have other things to do. During my time in a hospital I was guilty of letting calls go through to voicemail on occasion, as picking up would usually immediately require going in to patient records and other systems, and doing that would immediately destroy the admin work I was 3/4s the way through so I'd have to start again once the call is over.

 

[shadow_boxer]

There's huge variation between GP surgeries. This has been my experience both as a patient and GP registrar. I genuinely feel sorry for patients at some of the surgeries I've worked at. Far too few appointments at some surgeries being offered as book on the day. Sadly, as has been touched on already they starting to be staffed more and more by cheaper to hire members of the team such as physician assistants and nurses. (Some are great but they don't have the knowledge of a GP). As with most things in a climate of austerity it's a race to the bottom and what can be done for as cheap as possible. My current surgery has opted not to offer me a job but instead have hired a non prescribing nurse (not an ANP) and a part time pharmacist and are trying to fill gaps with locums. Another issue I've come across is that salaried GPs are been offered contacts well below the minimum standards outlined in the BMA model contract. Some surgeries are opting to hire trainees from abroad over UK graduates on work permit visas so their working conditions can be "controlled and dictated" by the surgery. Infuriating. Sorry rant over.

 

[2013]

There's huge variation between GP surgeries. This has been my experience both as a patient and GP registrar. I genuinely feel sorry for patients at some of the surgeries I've worked at. Far too few appointments at some surgeries being offered as book on the day. Sadly, as has been touched on already they starting to be staffed more and more by cheaper to hire members of the team such as physician assistants and nurses. (Some are great but they don't have the knowledge of a GP). As with most things in a climate of austerity it's a race to the bottom and what can be done for as cheap as possible. My current surgery has opted not to offer me a job but instead have hired a non prescribing nurse (not an ANP) and a part time pharmacist and are trying to fill gaps with locums. Another issue I've come across is that salaried GPs are been offered contacts well below the minimum standards outlined in the BMA model contract. Some surgeries are opting to hire trainees from abroad over UK graduates on work permit visas so their working conditions can be "controlled and dictated" by the surgery. Infuriating. Sorry rant over.

I have noticed this with some of the nurses, Some are great but like you said they only get part time work or get replaced by others that are not so good which I never understood why, Now this explains why.

 

[heeeed]

Another issue I've come across is that salaried GPs are been offered contacts well below the minimum standards outlined in the BMA model contract. .

If that is true shadow_boxer then they will be in breach of their GMS contract and its a serious issue. They can't offer worse than the model BMA contract. Salary can be negotiated, but terms should only be better or same

 

[tres]

There's huge variation between GP surgeries. This has been my experience both as a patient and GP registrar. I genuinely feel sorry for patients at some of the surgeries I've worked at. Far too few appointments at some surgeries being offered as book on the day. Sadly, as has been touched on already they starting to be staffed more and more by cheaper to hire members of the team such as physician assistants and nurses. (Some are great but they don't have the knowledge of a GP). As with most things in a climate of austerity it's a race to the bottom and what can be done for as cheap as possible. My current surgery has opted not to offer me a job but instead have hired a non prescribing nurse (not an ANP) and a part time pharmacist and are trying to fill gaps with locums. Another issue I've come across is that salaried GPs are been offered contacts well below the minimum standards outlined in the BMA model contract. Some surgeries are opting to hire trainees from abroad over UK graduates on work permit visas so their working conditions can be "controlled and dictated" by the surgery. Infuriating. Sorry rant over.

Are you ST3 now shadow_boxer?

 

[Buddy]

If that is true shadow_boxer then they will be in breach of their GMS contract and its a serious issue. They can't offer worse than the model BMA contract. Salary can be negotiated, but terms should only be better or same

Not if you're PMS

 

[heeeed]

Not if you're PMS

PMS should also if they signed the new PMS agreements of a few years ago. I'm sure that the vast majority of PMS will have done so unless for some reason their area team weren't renegotiating the PMS but I'd be surprised if that was (m)any.

I'm kind of amazed that anyone would offer crappy terms anyway these days. One of the biggest stresses on most practices is recruitment/retention these days

 

[Buddy]

PMS should also if they signed the new PMS agreements of a few years ago. I'm sure that the vast majority of PMS will have done so unless for some reason their area team weren't renegotiating the PMS but I'd be surprised if that was (m)any.

I'm kind of amazed that anyone would offer crappy terms anyway these days. One of the biggest stresses on most practices is recruitment/retention these days

Yes agree. The new contract has also saved the partners a few bob with crown indemnity.

 

[shadow_boxer]

Are you ST3 now shadow_boxer?

Yes ST3 and just applied for CCT, finishing next month!

If that is true shadow_boxer then they will be in breach of their GMS contract and its a serious issue. They can't offer worse than the model BMA contract. Salary can be negotiated, but terms should only be better or same

This is what amazes me too. For a few I've been the only applicant and for others I've been offered the job ahead of other candidates. The ones in question are GMS practices. Salary isn't the issue I'm coming across. It's more with the terms in the contracts being offered. Unable to get clear job plans, lack of incremental pay/review and CPD is also pretty big sticking point that many are holding firm on. Some are refusing to offer any CPD or study leave even for 8 sessions per week! Some are just looking for maternity leave cover (fair enough) but others are asking for 6 month term contracts until they can hire a physician assistnt or another nurse. Honestly, I'm fed up and won't be pressured in accepting a crap contract. Will probably locum until the right job comes up.

 

[heeeed]

bizarre. physicians associate != GP lite. I would make a very good argument its also a financially poor decision unless you intend to run a service like everyone complains about also. Come to the North East, I might have a job for you...

 

[shadow_boxer]

bizarre. physicians associate != GP lite. I would make a very good argument its also a financially poor decision unless you intend to run a service like everyone complains about also. Come to the North East, I might have a job for you...

Wrong Newcastle unfortunately! We're settled here in Newcastle under Lyme which is what makes this whole process even more mind boggling. A UK graduate, trained locally, willing to work 8 clinical sessions per week, can do joint injections and yet they're going for PAs etc. In my experience it's false economy too. The one I worked with couldn't prescribe, wouldn't see anyone aged <18, any complex patients, can't do med/chronic disease reviews....great they can diagnose a viral infection....bravo. I'd put them on par with a typical 4th year medical student. What I'm seeing locally is the GP partners are doing fewer clinical sessions and just supervising med students, F2, GP registrars, nurses and the physicians associates. Not doing any face to face reviews but managing the duty work, insurance reports/medicals etc.

 

[Sankari]

Are local GPs going down hill or are their hands tied ?

 

[tres]

Yes ST3 and just applied for CCT, finishing next month!

Excellent, good job. I'm applying for GP training at the end of the year. F2 on GP at the moment, really enjoying it but I feel the decent practice I'm at is a big part of it.

 

[heeeed]

Excellent, good job. I'm applying for GP training at the end of the year. F2 on GP at the moment, really enjoying it but I feel the decent practice I'm at is a big part of it.

the practice and your trainer matters a lot. where abouts are you currently as an F2

 

[tres]

the practice and your trainer matters a lot. where abouts are you currently as an F2

About 25 miles South from you!

and completely agree, my supervisor is fantastic.