I’ve just been involved in a conversation on this site re the disappearance of GP’s and the probability that we may never return to the pre COVID system of face to face appointments and a friendly local GP coming to visit you in your own home All the participants in the conversation are equally baffled as to why GP’s are behind closed doors as opposed to hospital doctors, nurses , paramedics etc who are out there on the front line ? Why Are A&E department s overwhelmed with patients who have given up on their Gp’s ? Well ! I have taken on the role of Mata Hari ! During my appointment for a flu jab today administered by a nurse in my own home I made some chatty , subtle enquires . Here is the info I’ve gleaned 1 Apparently the problem with GP’s being too busy to see us started long before the pandemic (who knew 🤷🏻♀️) which has just pushed the new closed door system onto us perhaps a little earlier 2 They are dealing with new illnesses all the time and greater numbers being treated for various illnesses- she said the number of people she treats suffering from diabetes has doubled in the past 10 years 3 People are living longer . Personally I’m not sure how GP’s disappearing is going to help any of the above but hey I’m just Joe public 🤷🏻♀️ Maybe if we stop testing for diabetes etc , stop researching into cures and all agreed to be euthanised at 60 it would help 🙄🙄
Solutions for GP’s ? : I’ve just been... - British Lung Foun...
British Lung Foundation
There was a discussion on TV at lunchtime today in which a GP taking part said the same about the increasing pressures on GPs starting pre pandemic. Added to that are increasing populations with fewer GPs in practice due to some leaving or retiring with no forward planning to train new doctors to take over. Same thing happened in nursing in the 1990's hence the same problem in that profession pre pandemic too with an even bigger shortage now.
I really feel for those still working and trying to do their best under difficult circumstances.
My mum used to say that everyone should pop off quietly once they reached 70 ( 3 score years and 10) but I don't think that many fit and healthy 70 year olds would agree and she was fit and healthy at 70. ☺
Well I’m almost 69 , fit and healthy but given another 12 month of one problem after another in the news , never mind all our own personal problems , I might be inclined to agree with your mum 🤪. I suppose the experts will sort everything out eventually 🙄and I agree with you , my heart does goes out to everyone trying to do their best for others in very difficult conditions . Sadly I’m not convinced that every surgery’s recent decisions have been taken in the best interests of the patients
Aww COPD16 , things are all so depressing aren’t they and it must be so much worse for you than me with your own health problems 🙁 but we must stay positive 💪 difficult though it is . You never know by the time we’re 70 things could be so much better. Geoff is coming home today , hopefully in a much better condition than he went in 😃 The plan is to work on building him up with a view to a slightly better quality of life for both of us than we’ve had for the past two years . 🙏. Thanks so much for asking and you take care of yourself xxx
I'm glad to know that Geoff is coming home today and I hope too that he is better than he went in. I hope that he does manage to build up and enjoy life more although it may take time. I came out of hospital barely able to do much last year and it took me a long time to get going again so don't either of you be downhearted if it takes him a while too. Do let us know how he goes on. My very best wishes to you both. Carole xx
Yes we all have to be realistic about our expectations don’t we but Geoff is certainly feeling optimistic today , he’s just rang me to ask me to add steak and mushrooms to the online order (he’s planning to have steak Diane with chips and salad tomorrow ! ) and bring the exercise bike downstairs ! I think it’s the elation of coming home but nice that he’s so upbeat . I will certainly update everyone on his condition . Xxx
That's great news. He really sounds positive which must make you feel so much better. Wishing him well xx
There’s been quite a bit in the news today about GP’s not seeing patients face to face and many GP’s seem to think that’s no bad thing as they are under a lot of pressure. I must admit I had a telephone call from my GP today and that was fine, I didn’t really need to see her but if you do need to be seen it’s all really frustrating.
I’m nearly 69 too and hope to be around for many years to come. Lol. Xxx💜👍😀
Some phone consults are appropriate but sometimes a face to face is needed. Hopefully things will settle down a bit in that respect. As for turning 70, I can see you being here for many years yet Carole 🤗 xx
Totally agree as Pete generally needs to be seen not just spoken to. Let’s hope things do improve. I hope to be around for a while Carole but need to sort this wretched AFib if possible. Xxx🤗
Hello Sassy59, glad to hear all is well with you & Pete. I had an appointment with a GP , telephone & face to face. New Gp with the practice was very thorough, are concerned about some new symptoms which they feel are not due to my visual problems. I did not request the appointment the optician felt the Gp should know. Thats an example of the system working well don't you think.??
I have heard that the average income a for a GP is 100,000 pounds a year. Even if it wasn't quite that, it is an exorbitant amount. I have also heard that they are perhaps "working" three or so days a week. If there is any hope for things to get back to some normality with regards to patients being able to see doctors and all the backlog being sorted out, I'd imagine they must be working six days a week. I also do not see how avoiding seeing patients is going to help. It seems that the NHS has been on it's knees for a long time. Instead of hiding behind closed doors it is probably time for an independent party to come in and review the structure of the whole organisation. I think having free healthcare is fantastic but being sustainable is another thing in itself. I don't know how much has changed since the formation of the NHS in 1948 but I'd imagine not a whole lot. But the thing is back then, there were no MRI, CT scans or extensive laboratory work etc. so the cost of it all has skyrocketed with not much replenishment. I know the nurse must be right in many aspects of her information, but I also know the source of her information are the people who decided that GPs will be indefinitely unavailable for their patients. It has to seem to be a reasonable argument, but how long are the British public going to accept it? I must add I am no expert, I am just poking my beak in. 😑 xx
That's the point though the health service has been going to the dogs for many years now and is no longer fit for purpose.
How are you and Chom getting on?
Baby is well and still getting spoilt!
I'm going through some kind of weird virally thing but saw the doctor in Tuesday and am slowly improving. Chom is very well thank you except when he is in a mood with me. Baby is such a lucky thing. How are you doing? xx 😊
We are fine here thanks for asking and have been busy today cooking autumn recipes which was enjoyable and yesterday went to see the new Bond movie at the cinema.
Yaaayyy! Sounds like fun. Do you cook in bulk to freeze? Today I am making tonjiru. Which is basically miso chunky soup with lots of ginger, burdock root, horse raddish, carrots and pork. It's a thick broth, very good for cold weather. Ginger is good for keeping the body warm, so I use it a lot in the winter months. xx 😊
I’ll be trying that 😋 I don’t eat meat but the rest is my kind of food I make a lot of soups with lots of herbs and spices but I never thought of increasing the ginger for winter 😃 xx
It's a tonic for the tummy as well. 😁
I think most herbs and spices have health benefits , I do use ginger and I tend to use a lot of turmeric - I know it has multiple health benefits plus I love the flavour but I’ll be increasing the ginger and trying the miso soup this week 😃 not sure where I’ll find burdock root or what to do with it but I’ll find out 😂
Yes Caspiana, 100K! Many GPS work part-time in order to remain under the highest tax threshold which is still a lot compared to the working man/woman (who can't afford health insurance). 😡🤬😡
I agree too Cas , a complete investigation into the whole system carried out by an independent body is in order The nurse I spoke to had been working from the same practice for 16 years and to me just seemed to be defending their position , it also felt that it was not the first time she had had to do it and the answers were there on her tongue just ready to roll out again. I see the government have now “told” GP’s they must actually see more patients so we shall wait with bated breath xx
I can almost hear her recited speech as she's had to do it so many times. I am always so careful when I talk to hospital staff, because although they have our best interests at heart everything we say gets repeated back as they stick together, always on all fronts. So they will always say as instructed. xx 😒
Part of the problem is misuse of the NHS, because it's mostly free. Some people want to see a GP for small problems that they could have dealt with themselves or taken advice from a pharmacist.
Perhaps, the NHS should introduce charges for time wasters and minor ailments that did not need a GPs attention.
Totally agree, time wasters seem to be more prevalent these days
Someone who was in A and E told me that many of the patients were in with scraped knees and minor issues. I was very surprised. Maybe they should filter people at the door. I don't know but if time is taken up for bruises and silly things like "I put glue in my hair" that needs sorting out. 😐
I think you’re right about an independent review and a shake up. The thing is, the NHS isn’t free, we do pay for it but if we now need to pay more, I think most people would agree with that. Our surgery has recently started refusing emergency appointments after a certain time of day unless the patient can’t breathe! The receptionists say that until the previous head doctor retired they accepted emergencies as long as they were open but now the young doctors “won’t put up with it”.
It seems the Hippocratic Oath has become a relic. I don't understand it. Things are a bit overboard in Japan, but the youngest and newest doctors work the most hours because they need to learn skills and get experience under their belt. This is most professions here though. And if they won't put up with it" they'd get a slap on the wrist and told to consider their future. I don't really know what their reasons are but I'd dare say there is a big element called self entitlement. xx 😒
There was a dramatic change in the administration of the NHS which was started in the Thatcher era and came into force in the mid 1990s, imposing an internal market to identify the cost of everything. This led to the proliferation of administration posts and micromanaging at the cost of the professionals doing the work. Different departments had to invoice each other for services provided. It was thought it would prevent waste.
I trained as a dietitian around this time, and found that the paperwork and training to maintain my professional registration took as much or more time than my actual face to face patient work. I moved into part time private practice in 2002 and worked in locked ward mental health hospitals, but still had to spend more time on continuing professional development (CPD) than on my work. I retired early in 2018 because I got tired of jumping through all the hoops needed to keep going.
My dad was in the medical corp during the war , when he came home he trained to get nursing qualifications and worked for nearly 20 years in charge of a geriatric ward which he loved Having decided to go for promotion he eventually ended up in the 70’s as chief nursing officer covering four hospitals . He absolutely hated it and couldn’t wait to retire Even then late 70’s / early 80’s he said nursing was totally different from when he started when the emphasis was on hands on patient care . Obviously it was his choice to move off the wards but it was the way the system in general was moving that really upset him , he was quite depressed by the time he retired
Be careful Mata Hari was executed by the French.some say erroneously for accusations of spying for Germany,if the Nhs find you where able to visit a surgery for a flu jab under your own steam you may be the victim of one of their hit squads.😂x
😂 I’m pleading not guilty ! For the past two years they have given me the jab at home at the same time as Geoff - seemed to make sense . So they rang last week to book Geoffs jab , I explained he was in hospital and suggested she ring the following week but she said “Well we ll come to you and if he’s home we can do him , if not we ll come back “ 🤷🏻♀️ I rest my case 😂. Must admit I thought it was strange but then is it just another example of barring all patients from the surgery ? ?? No matter , I shall say this only once, tomorrow I shall be buying a trench coat and beret ! x
I had noticed, over at least the last 5 years, that how a GP and my Consultant had acted during a face to face contact had changed. My GP would still sometimes listen to my chest, if I was complaining about my wheezing. They no longer took Blood Pressures, I had to do this at home and report this. Although maybe this was a good thing. However what concerned me the most, was that the GP and the Consultant no longer did hands on examination of my tummy area, when I had obvious issues with the Crohn's and blocked intestine areas. I was left with trying to explain a problem that could have be felt by them. However, if I was in hospital, the same consultant would happily palpate over all my stomach, and then get all his juniors to do the same, explaining to them, how important this was as a help to make a diagnosis.
Anyone remember Logans run ?
Telephone or video consultation are ok if the patient is given the option. They suit busy young lives but the elderly need face to face. Our surgery introduced this system pre Covid. Unless this is sorted it’s going to cost lives through misdiagnosis.
Yes, it is very frustrating but I wouldn’t want their jobs for anything! Imagine not feeling too good yourself and having to hear about everyone else’s problems. I know it’s their choice of job but I also know that even if they are not there every day they do stay late working behind the scenes and also on the computer at home.And the receptionists job is awful, people are frustrated but can also be very rude . Things are never going to be the same again but Covid has made it so much worse.
Quite agree with you. I have been rung at 9.30pm by my GP in response to telephone enquiry. They aren't just working during clinic hours. Admittedly there are things wrong with general practice as it is at present. Individual GPs no longer 'know' their patients as they used to. Doing away with on calls at night was a bad move from the patients' point of view but I can see that it made general practice a more attractive option.
Since the inception of the NHS GPs have always been independent practitioners, they run a business, hence the practice manager. Their overheads are the same as anyone in a small business, so I think we should take 'average' earnings with a pinch of salt.
I don't think government rhetoric continually criticising them is a solution; it can only make matters worse. I forsee a GP being injured or killed the way hatred is being fomented.
No one wants to see Gps physically attacked surely but people with serious health conditions or those with worrying potentially serious symptoms that need to be seen deserve better than the current situation. I don’t know who , be it GPS themselves or the government or some other body , will be in a position to improve the situation but someone needs to do something soon
It appears to be luck of the draw regarding GPs. My daughter had to collect her son from school, as he was ill. She knew he needed antibiotics and was told that there were no appointments at her local GPs. She was advised to ring 111, who wouldn't talk to her without her 7 year old being present. When she finally rung 111 again, she was given an appointment at her local doctors, who she had rung in the first place!I personally, prefer a phone consultation as I can then avoid picking up another illness in the doctor's waiting room. I also seem to have been a bit unfortunate when I've been to the dr.s, as they seem to have a problem with diagnosis - they didn't diagnose pneumonia, even after blood tests - infection levels 275 instead of 0-5 - they didn't diagnose a skin condition - they didn't diagnose my daughter being pregnant, after blood tests and the list goes on....
I think targets and other administrative tasks have increased a doctor's work load, alongside what Caspiana has said. The same in education. We have developed or are developing such a culture of claiming compensation that a lot of time is spent evading that possibility and the real job is not getting done!
There has sent been the necessary funding for as many years as I can remember. I retired 25 years ago when the 60 PHLS laboratories throughout England who also did the hospital and GP microbiology had to regroup and the 4 NW labs started system of covering and dividing all the specific tests in groups so were collected and sent on to appropriate lab. The aim was to be more efficient and release a number of staff. There was a van that travelled the round of these 4 labs every day. This could only result in a delay, The specialised reference laboratories remained . This resulted in 10 people taking voluntary redundancy in the NW group. I was 59 so retired one year early and dont know how it worked out in practice. We had been working late for long time before that and so for years so never went home at right time . There was never enough time and losing 2 staff would not help . A few years ago this happened again when there was further saving when one of the four labs was closed . These all carried out work at a higher level than than the corresponding hospital labs, id some experimental work developing new techniques. I had had experience of the difference when I had worked at a hospital microbiology lab for 2 years. It was a new hospital but it was not satisfactory.There was never time to do what we needed. That was just one example of what was happening throughout the whole of the NHS in my lifetime from 1959 to 1996 . I think doctors have been the same and the pandemic has just made life impossible for them to work as they wish. They can only work properly by seeing people, and there arent enough of them despite what this govern ment may say . It has been a failure of all governments to appreciate this. Now what will we do when they finally have been treated with such lack of understanding that this government has shown, and they all leave the NHS. ?
I worked in a residential care home before retiring 3 years ago and working conditions weren’t good to say the least. Staff shortages were the norm due to poor pay , lack of equipment etc etc. Now it seems all the systems that have limped along for years are grinding to a halt 🤦🏻♀️
Could the new and greater numbers of illnesses be due to having less healthy life styles than in previous generations. It's already been predicted that life expectancy is going down due younger people contracting serious illnesses including mental health issues.
But, it's true that even before COVID it was becoming more difficult to see the GP.
Back in the late 1970s or very early 1980s I was working in a Social Services Department and a big report, I am sure funded by The Kings Fund, was published. It very clearly told us and the various governments coming after, exactly what the increase in longevity of our population would mean, in terms of increased need of Social and Medical Care and that this would require changes in staffing and funding. No one ever took any notice.
I really don't understand it, I got to see my GP during the pandemic face to face, but now they don't want to know. Also if they were mega busy pre pandemic the sign at my surgery new patients welcome.?? There is about six or seven GPs at my practice. It doesn't make any sense. They were queues at the local hospital A&E they were asking people to stay away, this is because no one can get GP appointment. Why didn't they just keep the nightingale hospitals open instead of wasting all that money??
Before the pandemic a survey was sent round asking for patients opinion on face to face , online and telephone consultation I remember thinking at the time are we really being asked or is this what is going to happen, not to be cynical but isn't this it the here and now , so I personally dont think it's about gp numbers I think it's down to d fashion money and again trying t.o privatise our beloved nhs
Javid didn't turn up to the annual GP conference either. Not in person or on screeñ either.
Well I have to say that after watching on the news how a doctor feels on all this criticism makes me feel a little bad as to how much they have to cope with and must admit that telephone appointments are ok for minor illness, also the time wasters really do need to be sorted out as well. The whole system needs a good shake up but like the doctor said there is no point in Boris throwing money in the pot, there just isnt enough doctors and that is going to take time to sort out. I also think surgeries need more nurses but nurses that can deal with alot more than taking blood pressure. There is only one nurse in my surgery that can take bloods, I thought all nurses are trained fully to do all these things. Cant see anyway back to what we had x
Phlebotomists can take blood and give flu jabs. I understand they cost less than nurses as they are only trained in certain procedures. Our surgery has several. The one that took my blood yesterday, part of my referral for lung transplant really hurt and it's still sore? 🙁
The nurse at my surgery always hurts and leaves my arm bruised but worse is that I have to wait 3/4 for an appointment, bring on the phlebotomists x
Ouch! Usually they are really quick and oainless
Usually the phelbotomists are great and put you at ease.
Euthanasia at 60, as you suggest, would solve many problems. As retirement age is currently 66 it would create many jobs. Also as no one is over 60, State Pension would no longer be needed. That would save over £100 billion per year meaning state debt could be cleared in a few years. As no one is over pension age Attendance Allowance would not be needed saving further funds. The pressure on Social Services for help for elderly frail people would disappear. Obviously the need for residential care homes for the elderly would disappear as would nursing homes for the elderly. The amount of housing freed up would solve the housing crisis. No more cars driven by over 60's would relieve pressure on road network.
So many problems would be solved. But I will let you go first.
I wonder what would happen if a number cruncher worked out how much this country had saved from payments to older people who died in the pandemic, and then transferred this money to the NHS, to help them recoup some of the extra they spent during this dreadful time.
Well when you put it like that I almost feel it’s my duty to sacrifice myself for the greater good 🤔 but then I’ve always been selfish so no I think I’ll carry on enjoying the good life for as long as I possibly can 😂🤣😂
And……. also we have the GPs ( and other professions) that have enjoyed the ‘time out’ and reluctant to go back to full throttle.
I think if you really need to be seen they will have you in. I rang up one day because my breathing was bad and my back hurt. I
Had a phone call back which said they wanted to see me. It was a different Dr than I usually see. She said she could hear the bottom of my lungs but not the top and she wanted me in hospital that afternoon. They did a scan the next day and that’s when they found four fractures. I was not breathing properly because of the pain. I think she was probably thinking more on the lines of my lungs as I have a nodule and interstitial scarring. Luckily there was no change there.
I’m thinking maybe the way they are taking appointment is filtering out the time wasters or people who can have medication prescribed with a phone call.
Good morning, its a very dull Sunday out there. But your post made me laugh which is good. The changing of GP services as been going on for quite some time now, on the subject of your post I agree perhaps if we stopped finding new illnesses on research , and stopped testing for illness that some people have had all there life doctors may have more time to concentrate on what they were trained for to diagnose based on symptoms present. Many are concentrating on specialty research when training rather than the bottom of the line i.e the patient in the Gps surgery. We still need doctors for the donkey work , extracting details from the patient , we still need patients for the Gp ect to learn on. I feel like the door has been shut on basic communnity services for those who where born ill too as you say once a certain age is reached it seems we are no longer entitled to the same treatment as others why?? surely we have a right to treatment to ease our problems if any is available. Even the dying are entitled to be made comfortable . But how can we go forward with no trained staff, or no interest in the more caring ,menial side of medicine. Years ago people joined the NHS because it was a secure job for a fair wage. Guess its not the same these days, just like the council. There are only so many jobs can be done in a day especially for overworked short staffed environments. Just a last thought what about going back to clinics not at the doctors for things like ante natal, injections, yearly reviews of ongoing illness , blood test, breathing tests. Sorry its a long reply.
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