Well, just to update my post, the meds did turn up!👍😁

There are 2 issues that I think sit behind the problem

1. THe government, specifically Mr Hunt thought it would be a good idea to cut the number of training places for Doctors and Nurses to save a few quid from his budget as he was SoS for Health. Now we are feeling the impact of those decisions are being felt as there is a drop in new staff to replace those retiring

2. GPs contract with the NHS is based on the number of patients that are registered to the practice, not the number of patients they see. It is up to the practice to determine what is the appropriate number of appointments to offer and how they are offered them

My final point is on GP pensions. Given that they are not NHS employees, they are either employees or directors of the practice they work at why do they get access to the NHS pension scheme? It’s like suggesting that all DHL staff should get an NHS pension scheme because they run the NHS supply chain.

The GP appointment system is very poor tbh.

Oh yes, I did go to the pharmacy to be re-prescribed with other medication, because of chronic sinus, they referred me back to the GP. Then reception simply sent me back to the pharmacy saying they would re-prescribe something else. Went to the pharmacy again but nothing came through so went back to the GP reception and was told to call at between 8 – 8.30am for appoints. Called at the said time but no appointments available. This “merry” go around went on for about a week as my sinus problem got worst. Tried all sort of saline drainage but nothing worked because the nostrils were so blocked even the saline water could not drain it. I dare not tried decongestant because the last time I tried the result became worst.

Now my only hope is to wait for the referral. I am currently only breathing with 40% capacity through my nostrils and need to breathe through my mouth from time to time. Taste buds all gone, smell is very weak and ringing in the ears are constant and slightly muffled and uneven. Prior to taking the nose drops I had non of the side effects apart from sinus blockage.

I intend to get it sorted or the “waterboarding” feeling never ends.

The government, specifically Mr Hunt thought it would be a good idea to cut the number of training places for Doctors and Nurses to save a few quid from his budget as he was SoS for Health.

Not defending Mr *ahem* Hunt, but most of what he carried out was planned by his predecessor, Andrew Lansley. Same brand of turd, but just for accuracy.

Given that they are not NHS employees, they are either employees or directors of the practice they work at why do they get access to the NHS pension scheme?

Because – unless they were wholly Private and charging their own fees – they are delivering a GMS, PMS or APMS contract on behalf of the NHS. Without the ‘NHS’ part, they more-or-less wouldn’t be able to Practice.

Not defending Mr *ahem* Hunt, but most of what he carried out was planned by his predecessor, Andrew Lansley. Same brand of turd, but just for accuracy.

They don’t have solutions at all.

@nickc, Only just got into the thread so sorry if context is wrong or I have missed another related post. You said something that interested me earlier

I’m getting very bored of telling my patients who are angry with my receptionists that we’re not an emergency/urgent service.

I totally get this and would never rock up at a GP surgery bleeding out of an artery. What are your thoughts on my personal experience? Since Jan I have had a issue that wasn’t deemed urgent and have tried every month to get an appointment. Each time I was met with “you are number 30 in the queue please hang up if your condition isn’t urgent” Eventually, about 3 weeks ago I developed new symptoms that could be related and were more severe, I was told to keep an eye on it and try for an appointment if it didn’t go away. It didn’t go away and after 90 minutes of waiting on the phone and ignoring all the messages about not wasting the doctors time I was able to talk to a call center person. Later that day a Dr called me and had me in the surgery that day. This week I have been into hospital for further investigations. If this had been looked at in January it would not have become a potential emergency for a GP to deal with. The point of explaining this is to ask if the system is creating the urgent requests you see by not picking things up early due to lack of appointments?

@johnjn2000

clearly your case is a bit more complicted..

i think the “I’m getting very bored of telling my patients who are angry with my receptionists that we’re not an emergency/urgent service” statement comes from patients getting angry we can’t drop everything to visit them because the’ve fallen and broken a hip, or turn up at the front desk bleeding out their neck etc etc!

DrP

@Drp, complicated or otherwise if you ignore something small it can become an emergency is my point. And the lack of appointments could be causing a lot of people to develop a more serious issue that could have been nipped in the bud early and reduce stress on the system?

But maybe that just moves the stress point up front? I dunno, all seems broken.

I’m sat in an empty waiting room at my GP. Called this morning, waited in a queue, then asked for an appointment to see the nurse practitioner, asked if I can come in at 4:15 so here I am.

Sample set of 1 so not indicative, but might provide some balance.

Edit: someone else just walked in so no longer sat alone.

The GP appointment system is very poor tbh.

There isn’t one system that every GP practice uses TBH. The maths is very simple, the average GP practice has between 5-7 reception staff, plus another couple of admin staff, and a couple of specialist referral/data management bods. we have north of 8500 pts…

I can put between 2-5 people on the phone depending on time of day, I need to put one on a prescription line, and I need another to triage the requests from the website. Looking at the phone today we’ve had 736 incoming calls and answered 719 of them. average waiting time 1min 29. I don’t think we’re particularly great or bad at the phones by comparison to any other practice – my colleagues in neighbouring practices have about the same stats.

@johnjn2000. Is “the system” creating urgent cases? Yes to an extent, the 18 week waiting list has ceased to exist in any meaningful sense, and folks’ issues are often made worse by delay. No, there’s not really anything we can do in primary care to hurry it up pr sort it out other than write URGENT at the top of the referral, sorry. However, having said that; patients telling my staff that their minor issue is life threatening in the hope that they’ll get a same day appt is not helping anyone, and it’s doubly frustrating when they say daft shit like “If I die, it’ll be your fault”

Because – unless they were wholly Private and charging their own fees – they are delivering a GMS, PMS or APMS contract on behalf of the NHS. Without the ‘NHS’ part, they more-or-less wouldn’t be able to Practice.

They are indeed, but they are not NHS employees. Each company that employes GPs should have its own employee scheme. What about companies that provide GP IT systems eg EMISWeb etc. They only exist to supply GPs with software so are also wholly dependent on the NHS for their income. Should they get access to the NHS pension aswell?

Nick, I get you, very frustrating from all sides. Your stats stated above look fantastic, our surgery is one of three in a group situation, patients of our surgery’s would be over the moon with the phone wait times.

@Drp, complicated or otherwise if you ignore something small it can become an emergency is my point. And the lack of appointments could be causing a lot of people to develop a more serious issue that could have been nipped in the bud early and reduce stress on the system?

Isn’t this a symptom (!) of a broken system, that it has to respond to short term demands even though that results in more ultimate demand – a variation of the “buy cheap, buy twice” idea?

So while you are here DrJ can I ask you about a little problem I have?

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😉

So while you are here DrJ can Iask you about a little problem I have

You can, but my username is a reference to a rapper, not a medical professional 🙂

LOL

Another huge issue we’re facing in primary care at the moment is all the extra work that’s involved due to secondary care (hospitals/specialists) NOT seeing pateints in a decent timeframe.
It used to be I’d see a patient for a condition, deal with it as best as we could, a few weeks later it gets worse so I refer to secondary care..secondary care see them, plan operation/special drug etc, and they’re better..

Now it’s:
I’d see a patient for a condition, deal with it as best as we could, a few weeks later it gets worse so I refer to secondary care… no response from secondary care..I see them again, trying my best.…. pateint told it’s a 34 week wait to see secondary care… I see them again – not much more i can do….. still no input from secondary care…I see them again – they’re asking me to write to the hospital….. finally hospital speak to them on the phone, and ask ME to perform XYZ tests before an operation..I decline this as the hospital are commisioned to perform Pre-op, not me…

So you see it’s still the same problem, but the work it’s created for me in primary care is not four-fold what it should be because secondary care is failing too….

DrP

Should they get access to the NHS pension aswell?

And what would excluding them actually achieve ie more or less people signing up to be GPs?