GP's

[Cheshire East Baggie]

The narrative that general practice is closed is widely held but the facts don’t support this. There have been increasing number of appointments year on year with the highest rates this last 6 mths.

The guidelines say that GPs should see 28 patients a day to deliver good care. I know the majority are currently seeing between 60-100… how can this be good.
They also say there should be 1 GP per 1500 to provide good care. currently in England we have 1/2100

As Derek says think about who benefits!!!

If you want to privatise the NHS downgrade the service till the public think it isn’t working.

WARNING be careful what you wish for! Once gone the it will never return!

All these stats are fine, but there's no clarity as to who is working how many hours and seeing how many patients. Are we saying that an individual doctor should see 28 people per day? What about a practice with multiple doctors? Are the statistics adjusted on the basis of total number of patients registered to a practice?

Our practice has 5 doctors listed, but there are never more than two available on a given day. The website states the average earnings of the doctors as £81k. Now that's not the going rate for 40 hours per week of GP's time. So are these people working part time, or filling their week with more lucrative private work?

And another thing, our practice only contracts blood testing on two half days per week. It can take over four weeks for "non urgent" blood tests to be done. Or you can make your own way to the local hospital - if you're lucky enough to be able to make the 5 mile trip into the middle of nowhere and manage the parking chaos. Dr. ***** ******* could simply make more budget available, ask the local Phlebotomy Dept to turn up three mornings per week. But that would hit his profits, so it isn't going to happen.

General Practice has already been privatised, into the hands of GPs who mostly don't have a fucking clue how to run a business. Some bend over backwards to provide a decent service, others have cottoned on to the fundamentals of playing the system to improve income, maximising treatment of easily measured factors (obesity, cholesterol, smoking) and fending off difficult stuff like asthma and mental health.

Managers of GP surgeries (who are all qualified GPs) could employ more doctors. It's not clear whether the problem is lack of suitable candidates or unwillingness of practices to take on sufficient staff.

The regulator makes sure they provide the right number of appointments per patient. Problem is all surgeries are seeing way more than is stipulated or even safe.

Bad analogy but ….

If you own a franchise garage that is staffed to fix 10 cars a week and payed a fixed amount to fix only  10 cars.  if you start doing extra work u won’t get paid. 
Your franchiser could care less whether I sink or swim coz hes had a offer he can’t refuse for his business. There’s no funding for extra staff even if there was funding there isn’t enough qualified mechanics to hire.
But for years u always get 12 cars to fix and u do the extra work by working late or giving up lunch just to please the customers, through a sense of dedication and professionalism.

All of a sudden 20 cars start a week turning up every week.

Do you blame the garage for taking too long to answer the phone/ for having to wait weeks to book in you mot/ being stranded without a car for weeks/ for not giving u the free valet that u used to get/ for a job that was inadequately so u had to go back?

Exactly

But this isn't answering the key question, "Why are GPs still basically closed, offering mostly video consultations, when the rest of life has been opened up?"

Whoever is driving this, the end result will be a reduction in the availability and functionality of GP services, a huge overload on A&Es and a sharp decline in public health.

[devonstroller]

I think the implementation of video consultations and online triage was well underway before covid came along. The days of walking into the surgery in the hope of getting an appointment are long gone, irrespective of a pandemic

[Sotv]

The way we pay for the NHS is an example of socialist principles in action. It's precisely because we can't take our money elsewhere that the poor service and stinking attitude of thinking they are doing us a favour by providing already paid for services continues. 
 We live in society where i am forced to pay for services i do not want or need with the threat of state violence if i don't pay, yet you're being conned into thinking we live in a free market democracy.

What services are you being forced to pay for? You are taxed by the government that you voted for and they spend the money on items that they choose to. They spend it on the education you will have received (albeit a poor one by the looks of it), your kids education (if you have them), the roads that you drive on, the security that you need, and any health needs that you have (if you have a heart attack and are unable to communicate where do you think they will take you?). They will also provide you with a small amount in your retirement to be going on with and will take away your rubbish for you each week saving you a trip to the tip on a saturday freeing you up to spend your time moaning at the football on offer. 

You are pushing the boundaries of stupidity if you consider this country a socialist state forcing you to by decree to hand over your taxes.

the fact you chose to litter your response with so many personal insults because i hold a differing point of view to you says far more about your own intelligence and ability to argue a point than anything you have said about my alleged lack of education etc. 
You don't even have the ability to read what i wrote without misinterpreting it yet have the nerve to call others stupid. 

Hits ignore button.....

[baggy1]

The way we pay for the NHS is an example of socialist principles in action. It's precisely because we can't take our money elsewhere that the poor service and stinking attitude of thinking they are doing us a favour by providing already paid for services continues. 
 We live in society where i am forced to pay for services i do not want or need with the threat of state violence if i don't pay, yet you're being conned into thinking we live in a free market democracy.

What services are you being forced to pay for? You are taxed by the government that you voted for and they spend the money on items that they choose to. They spend it on the education you will have received (albeit a poor one by the looks of it), your kids education (if you have them), the roads that you drive on, the security that you need, and any health needs that you have (if you have a heart attack and are unable to communicate where do you think they will take you?). They will also provide you with a small amount in your retirement to be going on with and will take away your rubbish for you each week saving you a trip to the tip on a saturday freeing you up to spend your time moaning at the football on offer. 

You are pushing the boundaries of stupidity if you consider this country a socialist state forcing you to by decree to hand over your taxes.

the fact you chose to litter your response with so many personal insults because i hold a differing point of view to you says far more about your own intelligence and ability to argue a point than anything you have said about my alleged lack of education etc. 
You don't even have the ability to read what i wrote without misinterpreting it yet have the nerve to call others stupid. 

Hits ignore button.....

Thank fuck for that 

[Derek Hardballs]

The way we pay for the NHS is an example of socialist principles in action. It's precisely because we can't take our money elsewhere that the poor service and stinking attitude of thinking they are doing us a favour by providing already paid for services continues. 
 We live in society where i am forced to pay for services i do not want or need with the threat of state violence if i don't pay, yet you're being conned into thinking we live in a free market democracy.

What services are you being forced to pay for? You are taxed by the government that you voted for and they spend the money on items that they choose to. They spend it on the education you will have received (albeit a poor one by the looks of it), your kids education (if you have them), the roads that you drive on, the security that you need, and any health needs that you have (if you have a heart attack and are unable to communicate where do you think they will take you?). They will also provide you with a small amount in your retirement to be going on with and will take away your rubbish for you each week saving you a trip to the tip on a saturday freeing you up to spend your time moaning at the football on offer. 

You are pushing the boundaries of stupidity if you consider this country a socialist state forcing you to by decree to hand over your taxes.

the fact you chose to litter your response with so many personal insults because i hold a differing point of view to you says far more about your own intelligence and ability to argue a point than anything you have said about my alleged lack of education etc. 
You don't even have the ability to read what i wrote without misinterpreting it yet have the nerve to call others stupid. 

Hits ignore button.....

Snowflake.

[Geralous]

The narrative that general practice is closed is widely held but the facts don’t support this. There have been increasing number of appointments year on year with the highest rates this last 6 mths.

The guidelines say that GPs should see 28 patients a day to deliver good care. I know the majority are currently seeing between 60-100… how can this be good.
They also say there should be 1 GP per 1500 to provide good care. currently in England we have 1/2100

As Derek says think about who benefits!!!

If you want to privatise the NHS downgrade the service till the public think it isn’t working.

WARNING be careful what you wish for! Once gone the it will never return!

All these stats are fine, but there's no clarity as to who is working how many hours and seeing how many patients. Are we saying that an individual doctor should see 28 people per day? What about a practice with multiple doctors? Are the statistics adjusted on the basis of total number of patients registered to a practice?

Our practice has 5 doctors listed, but there are never more than two available on a given day. The website states the average earnings of the doctors as £81k. Now that's not the going rate for 40 hours per week of GP's time. So are these people working part time, or filling their week with more lucrative private work?

And another thing, our practice only contracts blood testing on two half days per week. It can take over four weeks for "non urgent" blood tests to be done. Or you can make your own way to the local hospital - if you're lucky enough to be able to make the 5 mile trip into the middle of nowhere and manage the parking chaos. Dr. ***** ******* could simply make more budget available, ask the local Phlebotomy Dept to turn up three mornings per week. But that would hit his profits, so it isn't going to happen.

General Practice has already been privatised, into the hands of GPs who mostly don't have a fucking clue how to run a business. Some bend over backwards to provide a decent service, others have cottoned on to the fundamentals of playing the system to improve income, maximising treatment of easily measured factors (obesity, cholesterol, smoking) and fending off difficult stuff like asthma and mental health.

Managers of GP surgeries (who are all qualified GPs) could employ more doctors. It's not clear whether the problem is lack of suitable candidates or unwillingness of practices to take on sufficient staff.

The regulator makes sure they provide the right number of appointments per patient. Problem is all surgeries are seeing way more than is stipulated or even safe.

Bad analogy but ….

If you own a franchise garage that is staffed to fix 10 cars a week and payed a fixed amount to fix only  10 cars.  if you start doing extra work u won’t get paid. 
Your franchiser could care less whether I sink or swim coz hes had a offer he can’t refuse for his business. There’s no funding for extra staff even if there was funding there isn’t enough qualified mechanics to hire.
But for years u always get 12 cars to fix and u do the extra work by working late or giving up lunch just to please the customers, through a sense of dedication and professionalism.

All of a sudden 20 cars start a week turning up every week.

Do you blame the garage for taking too long to answer the phone/ for having to wait weeks to book in you mot/ being stranded without a car for weeks/ for not giving u the free valet that u used to get/ for a job that was inadequately so u had to go back?

Exactly

But this isn't answering the key question, "Why are GPs still basically closed, offering mostly video consultations, when the rest of life has been opened up?"

Whoever is driving this, the end result will be a reduction in the availability and functionality of GP services, a huge overload on A&Es and a sharp decline in public health.

Even PRE Covid it was a direction NHsE wanted practices to move into.
Currently 57% of Gp appts are face to face. Most patients don’t need f2f but because there’s been a rapid shift to triaging patients via telephone 1st it’s hard to accept. Change is always difficult when the users haven’t been taken on the journey and are not fully informed why the change is needed but I believe the current system will remain as is.
It’s up to GPs to ensure those that need a face to face get one.

[baggy1]

There is another element here that is being ignored. GPs are generally a small team working out of one location (they may be grouped together with other surgeries but each one will work in one location). If there is a covid outbreak in that one surgery then there is the risk that all of the doctors are then either infected making them ill or having to isolate - this can leave the surgery with no doctors for any appointments at all, so it makes sense in these times to make use of telephone or video calls. Well hospitals are open I hear some say, and yes they are but they have a much bigger pool of staff and agencies to pull from.

[Birdman1811]

There is another element here that is being ignored. GPs are generally a small team working out of one location (they may be grouped together with other surgeries but each one will work in one location). If there is a covid outbreak in that one surgery then there is the risk that all of the doctors are then either infected making them ill or having to isolate - this can leave the surgery with no doctors for any appointments at all, so it makes sense in these times to make use of telephone or video calls. Well hospitals are open I hear some say, and yes they are but they have a much bigger pool of staff and agencies to pull from.

The issue is, it's putting a lot of pressure on those hospitals. We've treated so many people with wasp and bee stings ffs, not reacted to them, just got stung and turned up to A&E because they couldn't see their GP. Its a waste of a GP's time too, but they don't have the emergencies a hospital has to deal with.

That's what's so frustrating for Hospital clinical staff, they've not been shielded from covid, and are still under ridiculous pressure while GP's and other care options hide from patients.

[baggy1]

There is another element here that is being ignored. GPs are generally a small team working out of one location (they may be grouped together with other surgeries but each one will work in one location). If there is a covid outbreak in that one surgery then there is the risk that all of the doctors are then either infected making them ill or having to isolate - this can leave the surgery with no doctors for any appointments at all, so it makes sense in these times to make use of telephone or video calls. Well hospitals are open I hear some say, and yes they are but they have a much bigger pool of staff and agencies to pull from.

The issue is, it's putting a lot of pressure on those hospitals. We've treated so many people with wasp and bee stings ffs, not reacted to them, just got stung and turned up to A&E because they couldn't see their GP. Its a waste of a GP's time too, but they don't have the emergencies a hospital has to deal with.

That's what's so frustrating for Hospital clinical staff, they've not been shielded from covid, and are still under ridiculous pressure while GP's and other care options hide from patients.

I do see that point as well Birdy, and as a nation we've got to learn to deal with some shit better. I snapped the bicep tendon completely off a few months ago and held off going to hospital for three days but like you say some people go with a chipped nail. Instead of looking for appointments at each juncture we need to start using 111 more for an initial triage, and if we are heading down that route, it needs to be properly resourced.

[Geralous]

There is another element here that is being ignored. GPs are generally a small team working out of one location (they may be grouped together with other surgeries but each one will work in one location). If there is a covid outbreak in that one surgery then there is the risk that all of the doctors are then either infected making them ill or having to isolate - this can leave the surgery with no doctors for any appointments at all, so it makes sense in these times to make use of telephone or video calls. Well hospitals are open I hear some say, and yes they are but they have a much bigger pool of staff and agencies to pull from.

The issue is, it's putting a lot of pressure on those hospitals. We've treated so many people with wasp and bee stings ffs, not reacted to them, just got stung and turned up to A&E because they couldn't see their GP. Its a waste of a GP's time too, but they don't have the emergencies a hospital has to deal with.

That's what's so frustrating for Hospital clinical staff, they've not been shielded from covid, and are still under ridiculous pressure while GP's and other care options hide from patients.

Think GPs would take exception to that.
One of the major issues GPs are dealing with is pressures from patients that are waiting for hospital appointments. 
When patients need specialist advice but are on a waiting list that’s a year long who do you think has to deal with the fallout and manage the patients as best as possible till they are seen?
Consultants are increasing discharging patients early and asking GPs to follow up patients that in the past would be followed up in hospital. I understand why!

Primary and secondary care are co-dependant.

Look at it as a cup and saucer. GPs are the cup that see majority Pt patients (every 10weeks they see the equivalent of the whole population!!!!)that cup has been full for some time but the pandemic has caused it over flow the tea will flow into the saucer(emergency care:hospital) because the saucer is smaller it will overflow easily with ambulances waiting outside hospitals patients in corridors.

Blaming each other doesn’t help. The government is the source of the problem and will continue to try and divide and conquer!