Grumpy Old Lady in Pain - am I being too cynical?

[Loco99]

I had an unpleasant experience at my very recently previous practice. I’ve been back in the UK for five years and only used the practice a handful of times. I had emergency surgery recently and have just had a crash course in how the NHS operates.!

Am I being too cynical? and have I got most of the facts right? I think they behaved very badly.

They are a business plain and simple, they get money from the nhs/government for almost every thing they do (except for actually helping you on the phone!) if the lower level staff got paid enough for talking, giving you accurate information etc. you wouldn’t ever get them to shut up! and there would be dozens of them. You can find a lot of info on the web but it isn’t always specific enough and there are still people who don’t have mobile phones or computers.

The exception is online consultations with GPs and Advanced Level Nurses it is obviously very profitable for them to sit in their chairs all day and talk.

There is a major shortage of GPs so even getting an online consultation is difficult.

My husband and I are usually far too healthy and don’t take enough tablets or see them often enough to make them a lot of money so they don’t really know or care or even remember who we are! We aren’t their best customers so they don’t even remember us when they look on their computer systems.

Hospitals are supposed to treat everyone equally and try to do their very best. The staff are generally a lot kinder and more compassionate.

My ex Practice - is probably not the slightest bit worried about their reputation which they gained from their best (sickest) customers and ‘frequent flyers’

If you happen to be healthy and visit the practice only once every few years you don’t get the same treatment!

I realise this may be a tremendous generalisation- I certainly hope so.

[Koalajane]

I have to say my local GP practice is very good.

You can get through to them and will get a call back from a friendly GP. If he wants to see you after this you can get a face to face appointment that day.

I see my diabetic nurse regularly who is always fantastic and doctors and nurses recognise me outside of the surgery. I have no complaints.

[PMRpro Ambassador]

In the UK they aren't paid by the number of times you go - as far as I know they are still paid a standard amount for each patient registered with them depending on their demographic - children according to age, elderly patients according to age and so on. They have the same income for you going once a year as your neighbour who is there every few weeks. They do get payments for fulfilling certain public health initiatives - alcohol or smoking counselling for example - on the basis of tasks completed but they are then set aspiration figures for the next year.

How they structure their practice, how many employees they have in various specialisations, whether they set up an inhouse medical centre with physios and so on, is to some extent up to them and up to them to allocate funds. But NHS England has a lot of say about that.

So as far as I know, no, it isn't profitable for them to sit in a chair and talk. It might be more comfortable ...

[Charlie1boy]

Happy to say that is very much not my experience. We have an excellent General Practice, together with helpful and sympathetic staff.

However, all Practices are different - some not as good as others.

[Mrsd12f in reply to Charlie1boy]

Mine, too!

[DorsetLady PMRGCAuk volunteer]

I realise this may be a tremendous generalisation- I certainly hope so.

From personal experience - yes... most of my life very healthy until the age of 63. so didn't require much input from NHS... then 2 stints when I did - 2010-2016 [before and with GCA], and 2017-2020 [before, during and after replacement surgeries].

So during those years I would undoubtedly fall into your rather disparaging comment....best (sickest) customers and ‘frequent flyers’. I think you’ll find most of those patients would rather be healthy and not have to see a doctor.

At the age of 56 my late husband [previously in armed forces and a very active outdoorsy guy] also found himself in that category with firstly cardiac issues and then liver cancer.

Albeit my GCA had rocky days pre-diagnosis, have to say, from then on treated very well by GP surgeries and specialists alike... as was my husband. But then I do live in a very friendly rural county, that may well make a difference.. and it did all take place before the arrival of Covid which has had a a much wider impact on the NHS as well as many other aspects of life.

We all know the NHS is struggling with resources, but the vast majority of staff at all levels are doing their best.. sorry you have come across a few that aren't.

[123-go]

I hadn’t seen my GP since 2018/2019 and when I went to the surgery a month ago to make an appointment for the GP to look at the lump on my shoulder the receptionist suggested a telephone appointment🙄! You can guess my reply (polite with a hint of sarcasm). She spent a good minute scrutinising her computer and gave me an appointment for 10 weeks hence. The whole thing was a test on my part as I was thinking of changing my GP-the reason being that I’d accompanied my husband to two appointments and at the second his GP looked at me and asked, “And how are YOU?” I filled in the forms, handed them in and bingo!

[piglette]

As PMRPro says, GP practices are partly paid on the basis of the number of patients on their list, this is weighted by age. GP practises are NOT part of the NHS they are a supplier to the NHS and have a contract with the NHS as to what they get paid. This includes something called QOF (Quality and Outcomes Framework) points . The higher the score, the higher the financial reward for the practice. In fact you and your husband are ideal patients as far as your GP practise is concerned.

[SnazzyD]

The last GP surgery I worked for was doing very well because part of any surgery’s income is based on the number of patients under them. We had loads of students who are on the whole healthier so hardly visited, so they got the money without having so much of a drain on services and their time. It isn’t how much patients see the doctors. They are also paid according to medical targets set by powers above such as clamping down on high blood pressure for example.

[SheffieldJane]

This is a very good place for a rant and you make valid points but however starved of resource the system is we’ve all met the angels who hold it together.

[RachelJDH]

Undoubtedly the GP service is not what it was. Originally we had relationship with our GP who supported our family through various illnesses, serious and minor. When I came out of hospital in the early 90's after a cancer op the gp came to the house to see all the family. When my husband had stroke last year there was no follow-up after a blood clot was removed from his brain and it was a struggle to get the drugs prescribed by the hospital. People with minor ailments cant get an appointment so go to A and E and clog up the system there when much treatment cld be provided by GP surgeries. Good primary care makes a huge difference to national health and well-being but many GP' s seem to be referral clinics rather than the first port of call for medical intervention and support. My personal view only but it is very sad.

[Flivoless]

Have you ever wondered what the common denominator in your problem is?

[S4ndy]

My GP is lovely. It's tricky to get an appointment but since econsult being introduced it's been easier. I have moved and no longer in their catchment area and trying to stay with them. I am about half a mile outside their zone I've just been brave enough to tell them and so far they haven't asked me to leave but suspect they will. After 25 years of care I am very reluctant to do so. I understand the GP in this village is fairly good but I would still prefer not to change. I have got away with it for 7 months by using my old address but someone has now moved into my old property so had to tell them. We shall see.

[Glitterwobbles]

I totally agree my GP is useless never wants to see me. Won't look up results for a MRI because he didn't order it. Not interested at all.

[Suffererc]

My GP surgery is very good except when PMR tears its head then its a race to get off Pred. 😊

[Pixix]

with my 12 diseases, I am a frequent flyer! Our surgery is great & works really hard. However, because it grew a great reputation, 5,000 people have requested to join it from neighbouring practices. With no increase of staff they can’t cope with the influx! There’s a pharmacy in 5he building, too, you never see a prescription, just pickup after appointment. If you have an acute need somebody phones yiu back within half an hour & if they can’t help, you see a doctor that day. Where it falls down is on long term illnesses…the wait for an ordinary appointment is 3 weeks. I was lucky & had a 40 minutes appointment & steroid injection last week because most patients & staff didn’t turn up due to floods. We had our annual review with the nurse & my Dr spotted I was there & told me to come to his room afterwards. There’s a national shortage of certain drugs & it had held him up for weeks. I now have a direct route, bypassing the receptionists who are very well trained & polite but don’t understand why I’d like continuity of care!! We can look up our test results & our patient record & order tablets online, too. But looks as if we are very lucky!

[Nagswoman]

I wonder if your ex-practice is the one I have to use?