If you believe some newspapers it is clear what we want from our GPs - face to face appointments and nothing else. “Only 69 per cent of GP appointments across England are held face-to-face” ran a headline in the Daily Mail last year. Now, I understand - and share - the frustration of not being able to get an appointment with the doctor but surely at least a third of the time a telephone, video or online meeting would actually suit us better?
I think the poor access to a GP is driving people to A&E and for that reason alone the situation needs to improve but one sentence in your piece raises the main issue; private companies taking over lucrative contracts. Vets fee have been in the news recently and often old established and well regarded vets practices are taken over by hedge companies betting that they can extract some profits from the good name. If GP practices are allowed to go this way then the system will let down vulnerable patients. We recently moved from Cornwall where the GP service was dreadful and our surgery part of a huge business gradually taking over all the capacity in the area and using lesser qualified staff to act as if they are GPs. Our new GP in Scotland runs a very effective service using telephone triage but then offering face to face appointments if needed. I've not actually met the GP team face to face but I've been treated very effectively. Of course the current government welcome private companies gradually taking over our health services but clearly it's destructive.
Just to add some insight as a medical professional but not a GP.
One reason many struggle to get an appointment with GPs is because large numbers of GPs are now unemployed.
Thanks to government measures GPs across the UK are being replaced by non-doctors and the government are insisting that GP surgeries employ them. These non-doctors are called physicians assistants, the majority have failed to get into medical school, they sit exams with a near 100% pass rate and have had two years training; most of which is remote.
I think it would be helpful. If you got a feel of the way the health service is being structured. The doctor shortage is being managed by replacing doctors altogether. And if you don’t have enough doctors more appointments, remote or face-to-face, will
not materialise.
Working conditions are so bad, doctors are leaving en masse or cutting back their hours. Medical school applications are down by 20%. More junior doctors and nurses than are leaving the UK for countries where their medical or nursing degree is valued. Doctors and nurses from abroad, no longer want to come here.
All of this means worse care for everyone including patients with Parkinson’s but many patients are sadly unaware.
I feel blessed. 3 Years ago we moved up to a small village in Scotland, and discovered that our local doctor was an open surgery, appointments not needed, just walk in.
I registered us with them instantly, stating that my partner has PD. The following day I was visited by the doctor, district nurse, occupational therapist and physio. I was absolutely dumbfounded, and extremely grateful.
This is the system that works, the practice covers several villages over a wide area, and I know of a few here that wanted to retire nearer the coast, but won't as they will lose this practice. They have been brilliant, good to know if you have a concern, you can just walk in and see the doctor, waits are seldom more than 30 minutes.
Sadly though, the downside is that my man has been in hospital for the last 5 months waiting for a care home now as in final stage of PD, but all suitable have huge waiting lists. Meantime, I am doing 50 mile round trips to visit him several times a week - so much is broken in care sadly.
“. . . the private company which had taken over the practice was mainly concerned with numbers. . .” Is that actually a thing? Do private companies take over GP practices? Who knew?
My GP practice is generally rather good. You write an enquiry in, which obviously suits some more than others, and they ring you back. If you miss the first call, they try at intervals. Depending on what you need, you get a nurse, physio or GP and often you are told to make an appointment and the receptionist is briefed on its urgency.
After moving GP practice I was very disappointed that there was no transfer of patient data on the NHS App. I've found it very useful to compare blood test results over the last three years and can't now do this without a specific data request.
Our surgery - Woodstock - seems to be exemplary. I telephoned recently to request advice about painkillers compatible with angina medication, as I had chest pains. I was asked a few questions by the receptionist. She rang back a few minutes later and offered me a GP appointment with my registered GP later that morning.
Unlezz youre on benefits,pension, pregnant or long term sick all GP appts should require deposit. Reimbursed post appt. This will cut down those who fail to appear for appts.
I agree with all the points you make. How on earth would a single old person with soft elbows cope? And I feel strongly that the loss of a named GP to manage your care is a serious matter. For example, getting my husband referred to the district nursing service was a nightmare, passed around the GP practice and ending with a visit to A&E to change his catheter. Successful, but it took seven and a half hours. - From what I could see the blame lay squarely with the district nursing service, not the GPs, but it might have been addressed sooner had one of them taken charge. As for technology, I like the ease of getting repeat prescriptions and contacting the surgery, now that the systems are finally bedding in. The admin team at the surgery are usually very helpful.
Interesting Rory, thanks.
I think the poor access to a GP is driving people to A&E and for that reason alone the situation needs to improve but one sentence in your piece raises the main issue; private companies taking over lucrative contracts. Vets fee have been in the news recently and often old established and well regarded vets practices are taken over by hedge companies betting that they can extract some profits from the good name. If GP practices are allowed to go this way then the system will let down vulnerable patients. We recently moved from Cornwall where the GP service was dreadful and our surgery part of a huge business gradually taking over all the capacity in the area and using lesser qualified staff to act as if they are GPs. Our new GP in Scotland runs a very effective service using telephone triage but then offering face to face appointments if needed. I've not actually met the GP team face to face but I've been treated very effectively. Of course the current government welcome private companies gradually taking over our health services but clearly it's destructive.
Hello Rory,
Just to add some insight as a medical professional but not a GP.
One reason many struggle to get an appointment with GPs is because large numbers of GPs are now unemployed.
Thanks to government measures GPs across the UK are being replaced by non-doctors and the government are insisting that GP surgeries employ them. These non-doctors are called physicians assistants, the majority have failed to get into medical school, they sit exams with a near 100% pass rate and have had two years training; most of which is remote.
I think it would be helpful. If you got a feel of the way the health service is being structured. The doctor shortage is being managed by replacing doctors altogether. And if you don’t have enough doctors more appointments, remote or face-to-face, will
not materialise.
Working conditions are so bad, doctors are leaving en masse or cutting back their hours. Medical school applications are down by 20%. More junior doctors and nurses than are leaving the UK for countries where their medical or nursing degree is valued. Doctors and nurses from abroad, no longer want to come here.
All of this means worse care for everyone including patients with Parkinson’s but many patients are sadly unaware.
https://x.com/drneenajha/status/1756282391956480270?s=46&t=rRkIj82RNJU-auJmBJdVKw
https://x.com/drneenajha/status/1771610682317767047?s=46&t=rRkIj82RNJU-auJmBJdVKw
https://x.com/idrsunny/status/1772392940100309350?s=46&t=rRkIj82RNJU-auJmBJdVKw
I feel blessed. 3 Years ago we moved up to a small village in Scotland, and discovered that our local doctor was an open surgery, appointments not needed, just walk in.
I registered us with them instantly, stating that my partner has PD. The following day I was visited by the doctor, district nurse, occupational therapist and physio. I was absolutely dumbfounded, and extremely grateful.
This is the system that works, the practice covers several villages over a wide area, and I know of a few here that wanted to retire nearer the coast, but won't as they will lose this practice. They have been brilliant, good to know if you have a concern, you can just walk in and see the doctor, waits are seldom more than 30 minutes.
Sadly though, the downside is that my man has been in hospital for the last 5 months waiting for a care home now as in final stage of PD, but all suitable have huge waiting lists. Meantime, I am doing 50 mile round trips to visit him several times a week - so much is broken in care sadly.
I’ve been happy with video or phone calls and managed to get all my medication on time. Perhaps I’m one of the lucky ones
“. . . the private company which had taken over the practice was mainly concerned with numbers. . .” Is that actually a thing? Do private companies take over GP practices? Who knew?
My GP practice is generally rather good. You write an enquiry in, which obviously suits some more than others, and they ring you back. If you miss the first call, they try at intervals. Depending on what you need, you get a nurse, physio or GP and often you are told to make an appointment and the receptionist is briefed on its urgency.
Worth remembering that most GP surgeries are privately owned. They always have been since the BMA insisted on it when the NHS was formed.
The talk of threats to privatise the NHS are wide of the mark. Almost all primary care was never nationalised in the first place.
https://www.bbc.co.uk/sounds/play/m001w13g?partner=uk.co.bbc&origin=share-mobile
Lusten to this podand hear oncologist explain
After moving GP practice I was very disappointed that there was no transfer of patient data on the NHS App. I've found it very useful to compare blood test results over the last three years and can't now do this without a specific data request.
Our surgery - Woodstock - seems to be exemplary. I telephoned recently to request advice about painkillers compatible with angina medication, as I had chest pains. I was asked a few questions by the receptionist. She rang back a few minutes later and offered me a GP appointment with my registered GP later that morning.
Unlezz youre on benefits,pension, pregnant or long term sick all GP appts should require deposit. Reimbursed post appt. This will cut down those who fail to appear for appts.
I agree with all the points you make. How on earth would a single old person with soft elbows cope? And I feel strongly that the loss of a named GP to manage your care is a serious matter. For example, getting my husband referred to the district nursing service was a nightmare, passed around the GP practice and ending with a visit to A&E to change his catheter. Successful, but it took seven and a half hours. - From what I could see the blame lay squarely with the district nursing service, not the GPs, but it might have been addressed sooner had one of them taken charge. As for technology, I like the ease of getting repeat prescriptions and contacting the surgery, now that the systems are finally bedding in. The admin team at the surgery are usually very helpful.