Why Can't I Get A GP Appointment? | It's Not Your GP's Fault
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- Опубликовано: 28 июл 2024
- This is a different kind of video.
Lots of people are having problems trying to see their GP (General Practitioner) at the moment - let's talk about why, and why your GP is not the one to blame.
Timestamps:
00:00 Introduction
01:10 What is a GP?
04:30 Why is it so hard to see a GP?
06:30 Face to Face Appointments
08:00 How much do GPs actually earn?
10:45 GP Recruitment Crisis
11:50 Solutions to the problem
References:
www.bmj.com/content/357/bmj.j...
www.rcgp.org.uk/about-us/news...
www.bmj.com/content/370/bmj.m...
digital.nhs.uk/data-and-infor...
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Sorry but i cant help getting angry when my 64 year old mother is in chronic pain and literally begging for an appointment with her GP only to be told to email her symptoms into the surgery and she MIGHT get a callback if its deemed necessary.
Someone has to take accountability for this.
The difficulty is that if that GP practice can evidence (to an independent auditor say) that based on their workload this was appropriate management at the time, then no clinical wrongdoing has occurred. It's really horrible on the individual level, but ultimately the government funds provision of healthcare. Making complaints to GPs themselves or making public complaints about GPs achieves nothing except taking up GP capacity that they already didn't have. I'd strongly, strongly advise writing to your MP or local council to get more funding.
@@OllieBurtonMed thankyou 👍
All planned by the WEF and Klaus Schwab
This is happening everywhere.
My GP of 30 years was my doctor from birth untill she retired when I was 30. She owned her own clinic and had multiple staff under her. If I ever had a problem she was always there for me. If I bumped into her in public, she would stop and chat to me. She knew me better than I knew myself bringing up things like school assembly's I did in primary school I had forgotten a long time ago.
Im struggling to find a GP that lives up to my expectations now as they cant even remember my face and name let alone my medical history.
Being on the autism spectrum I rely on my GP and modern trained GP just dont have the care any more. It feels like talking to Psychopaths rather than someone caring
And it feels they are turned into Psychopaths from a industry that is one of the most profitable industries in the world. They are over worked, treated like shit, and abused to the point they snap and become a Psychopath with no empathy for other humans. They were kind people in the beginning but their new environment has molded them
My experience of GPs as an unemployed man, my GP (and the dragon receptionist) assumes I am only there for a sick line, and I am incapable of actually being ill. This got to the point where the GP refused to give me a sick line for a jobcentre appointment, took a swab but found no virus nor bacteria (I asked for my medical record) but at the jobcentre, the other claimants gave me a wide berth like the parting of the red sea and the clerk took one look at me, shivering, sweating and clearly unwell and signed me off sick touching the slip like it was toxic waste, and this was during the height of the Osbourne welfare cuts and sanctions regime.
The fact I keep getting vertigo, migraines, fevers, dizziness and spasms around my ear, which I have told them about and which is why I'm unable to work falls on deaf ears
What annoys me is the goverment are now prompting people to go the pharmacy for advice and treatment and "take the pressure of GP's" what about the added pressure on pharmacy? That is not been addressed. Generally work load has increased in pharmacy and staff levels have fallen in a lot of cases. You mention during covid it was not possible to have face to face consultations during the height of covid for safety of everyone. However Pharmacy has stay open throughout, providing a face to face service fullfilling prescriptions and selling over the counter medications and offering advice
No it isnt the gps fault. However now most gps have stopped all prebookable appointments and are now only doing on the day appointments, it is awful. 6 weeks I have been ringing and cant get an appointment.
Yes and when I do get an appointment the surgery is almost empty.
Brilliant video!
thanks ollie, this is very good and thorough video, as a GP trainee, it is true and there's more people doing part time as GP trainee and also once completing GP training..
Thanks Dr! I honestly don't blame them at all. If I am somehow able to get LTFT as a trainee I will, and if I were a GP I would 100% do 60-80%. I don't really understand why anyone would do 100% given the option unless they really need the money.
well i carnt even get through on the phone so what do u do then i been to a &e who tell me go to my
I am considerate of the pressures my GP deals with working in such a system, but that doesn't make it any less tolerable to have insufficient care. I can't get my GP to take me seriously so I am not getting referred onto departments that could actually help, all the while I live with chronic pain and fatigue. (I say live, but I have no quality of life anymore)
Whatever the reasoning behind it, patients are suffering. Doctors need to pay more attention to their patients.
Me too - fatigue & very frequent illnesses. Took me 3 years to convince them to do blood tests. Apparently they're normal. So I'm stuck with fatigue & being sickly forever. (And I've not been always like this. Something must be wrong)
Judging from your picture, it's because you're white. You should have come across the English channel on a boat. You'd get to see one of our underpaid and overworked GPs twice a week then.
could you have fibromyalia ?
@@christine-bc1kc I was diagnosed with fibromyalgia about 8 months ago (so, not long after posting here...) It took finding a new GP surgery to be taken seriously. They were appalled when I told them of my previous doctor's behaviour.
@Elly Lilly It's worth pressing your GP for support, or finding a new one. Just because blood tests are clear, doesn't make the pain any less real. I hope you find your answers.
Why can't I just speak to my doctor first because every time I ring for a appointment just even over the phone the receptionist decides I can't have a appointment to talk to my doctor I suffer acute mental health
Hi Ollie! Do you think that the recruitment of PAs in General Practice will do well to serve the extreme shortage of GP services? I believe they are cheaper to recruit and retain for the government over doctors and are hence, perhaps enticing potential applicants with a handsome starting salary, esp compared to junior doctors! Or do you think this is rather harmful in the long run and would it be best to recruit GPs in your opinion?
Hello! At this present time in 2022, I don't know the answer and am not familiar enough with the evidence base in primary care.
My general view is that the ideal scenario is you have the right number of doctors for your population/specialty, as they have significantly more training in a given area.
Given the government doesn't want to pay for that however, the question becomes how far are you willing to compromise OR how do we know when a case is suitable to be seen by someone with less medical training than that, ie a nurse practitioner, paramedic or PA working in primary care for example.
I also don't know whether these additional roles have been shown to reduce cost burden for GP practices, for example. It's intuitive that they would as they are cheaper than a GP, but evidence from the US suggests that non-doctors order more investigations than doctors and this costs their health service more in the long run.
In the short term however, I think we'll continue to see expansion of the PA role in primary care, especially with their regulation coming in. Would be very interested myself to see a lot more data on cost, outcomes, patient experience etc etc
I waiting for 4 to 5 weeks for an appointment. The GP made an excuse to cancel and ask me to book again in the next 4 to 5 weeks. They text message me to say they called. I have been waiting all day for the call but it never happened, there is no records to show on my phone they called. Now it the 8th June, the next one is after 8th july. Even though it's not my fault, I still have to wait a further 5 weeks. This is not right 😭😭😭😭
Great video as always Ollie, only thing I would disagree with is your comparisons at 8:47 in that getting into medical school is extremely competitive and the direct comparison would be extremely competitive law, finance and engineering jobs would pay upwards of £100,000 and require less training. I personally think the fact that the NHS is publically funded and government set the prices instead of the ‘market’ doctors get paid well below what they are worth, but again, its not all about the money - would you agree
Fair comment! It was difficult to know how to place it since as you say we're not working with market forces and the NHS is a monopsony employer that can set wages very low - good for the government, bad for the employee as there's very little negotatiating.
Thank you so much. This has helped me with my first college assignment. May I quote you?
Something which you didn’t mention is that training a medical student costs the NHS money, and that medical courses are by far the most expensive to run. The former is a reason why it isn’t attractive for the politicians to increase the cap on medical school places as it will increase costs. The latter is why universities aren’t racing to open new medical schools as they can run other courses and make more money per head (they are businesses at the end of the day).
It was good to hear you mention the bottleneck of limited speciality training posts for doctors. This came up in conversation at our medical school as the biggest issue in the recruitment of doctors into various specialties. You can’t suddenly double the number of (for arguments sake) neurology training posts, and expect the same number of consultants and departments to be able to accommodate them without somehow diverting clinicians away from seeing patients.
Something of note is that as the NHS is devolved in Wales, allowing the Senedd to increase the cap on medical school places by 25% in addition to a 3rd medical school (Bangor) being opened. So at least progress is being made in Wales to significantly increase the number of doctors coming through the ranks.
Also to note in Wales has been the rise in national community schemes to ease the GP burden. Pharmacists can see patients under the Common Ailment Scheme and provide OTC treatments free of charge without an Rx from a doctor (not to mention Rx’s being free in Wales). The WECS Scheme with optometrists has also been extraordinarily successful as all eye related complaints are automatically referred without GP consult. Approximately 10% of all GP appointments are for ophthalmic issues, so these appointments have been freed up.
Increasing numbers of pharmacists and optometrists are undertaking higher qualifications (including independent prescribing) to manage and treat patients in primary care. This is of course in addition to advanced nurse practitioners and physician associates.
Things definitely aren’t completely rosey this side of the border, but at least our devolved government is being proactive.
I was wondering what your thoughts are on graduate entry programmes? The UK is unusual in that medicine is generally an undergraduate degree, whereas abroad it is usually a postgraduate degree.
This is anecdotal, but a member of the family took the traditional route (so essentially had to decide to be a doctor at 16 choosing his A-Levels), but quit halfway through specialist training as he realised that he’d been too young to make such a large decision and commitment. I wonder if another reason for poor retention is that doctors were too young making such a large decision, and made the ‘wrong one’.
Great video by the way. Liked & Subscribed
Thanks so much for the feedback - and thanks re the Welsh system, new information to me and very interesting!
Totally agree re the cost of training medical students as well. I think we'll see an uptick in private medical schools opening that cater exclusively to international students or those in the UK with lower grades as there's clearly a huge amount of money to be made from both groups, in a similar vein to Carribean med schools serving the USA.
I don't have especially strong throughts on GEM programmes vs undergrad and certainly am wary of my own biases as a GEM student. Certainly since starting work I think a really key problem is that kids at 15/16 are just not informed enough of the key problems in medical careers, and maybe at that stage not mature enough to even make an informed decision. Medicine is still massively oversold and seen as a vocational career but I just don't think that is a healthy view anymore and it sets people up to burn out and fail, or indeed leave training. Unsure of solutions at this point.
also also a lot of medical graduates and doctors seeks employment in other countries
Great analysis. Super interesting. GP's in Australia seem to have it better to be honest 🇦🇺
I think in broad terms most doctors have it far better in Australia, it's certainly a comparable healthcare system with better working conditions and far more money involved. I have heard that surgical training is a bit of a disaster or at the very least quite corrupt and unstructured - not sure how true that is, or indeed for other specialties.
@@OllieBurtonMed Yes, I wouldn't like to go through surgical training in Australia, even more so as a woman. I've been told horror stories.
Very clearly outlined the issues with access to GPs. Thank you 😊
Hmm. It’s all balance. I’m not a GP (psychiatrist) but I have certainly picked up on a vast number of conditions over the years that I would miss had I not physically clapped eyes on someone. I’m the last year alone I’ve sent a few folk to dermatology with their skin malignancies and picked up on an oesophageal carcinoma the GP interpreted as a depression because they hadn’t physically seen the patient, but I had. And was able to piece together what i was seeing (a cachectic miserable person) together with the story of being miserable and depressed.
Thats a fair comment but firstly remember what they taught you at med school, 80-90% of a diagnosis is history (so for an under-resourced system it will work for the many but there will those who slip through the net, even with the current average conversion rate of telephone to f2f). Secondly how long are your appointments compared to a GP? Third, in an ideal world, all patients would have face to face and all would get longer than 10 minutes; but then it would take even longer to see a GP so you can't have it both ways.
But finally, why is it GP's who are getting all the flack? You may do f2f consultations but there are many of your psychiatry colleagues (and other specialities) up and down the country who are doing telephone only clinics, and take a guess who has to pick up the pieces when clinically important nuances are missed? It works both ways.
What you not telling people is that American private health insurance canteen & operose as taken over gps in uk , partnerships gps there are a very few of them now over the uk , canteen & operose have got no gps in there health centre they have got what they call P.A which are medical train for 2 years but they only do the basics , they are not gps , the private American company’s are treating them as if they are gps because they cost less money than a gp , they do have gp on call if they need help but the gp does about 4to 5 surgery at a time so there not based in one gp practice , it was on bbc panarama or was it channel 4 dispatches lol can’t remember one of them, 2 things he was right on 1, yes there’s not a lot of gps , 2, gps surgery are taken on to many patients, 20yrs ago my gps had about 300 now they’ve got nearly 2,000 patients and they are still advertising , I think it’s for the money as well because the government pays them per patients wether they see there patients or not .
In a nutshell, our corrupt government taxes us ever higher for diminishing services.
What you need to understand is that when a GP fails to diagnose or provide opportunities for diagnosis, or places barriers against obtaining a diagnosis, people suffer. Now I do not care the reasons why GP’s do this, what I’m concerned about is the fact this is causing barriers to patient support, care and best practice going forward. This is happening to terminally ill patients who have not been formally diagnosed and therefore are left without support, comfort measures or families being informed of the palliative end of life processes at home. That is abhorrent and the reasons GP’s don’t diagnose is their burden to bear, not the patient or their grieving families.
It's highly unlikely your local GPs desire to make it harder for people in their community to obtain an accurate diagnosis or to suffer. So if they are not successfully providing the care you're expecting, perhaps there are other reasons for this.
Exactly
You really don't think the GPs don't understand this? Any medical professional knows it's much easier, quicker and cheaper for the tax payer to catch and treat a condition earlier. It's interesting to read that you don't care about the reasons why the GPs don't provide better quality service but still blame them. While I admit understanding may not improve the situation, it will help direct where to point your frustrations and try and do something about it. In an overly simplistic summary, there are fewer doctors and more people for them to see. Combine that with the population living longer and it's inevitable patient care will suffer. Do you really think Doctors don't care about this? They're helpless. They don't control the healthcare environment and how it's run in this country. Any frustrations you have should be directed at the those who do...
In my country, you can get an appointment any time at a private practice. Of course you have to pay, but atleast the option is there.
We are starting to see that in the UK now, especially in the wake of telemedicine. I've used a private GP before which was next day and a decent service.
@@OllieBurtonMed telemedicine...how do you take sample of my blood through the phone??? i have no clue why do i pay health insurance when i didnt visit any doctor for at least 8 years...
@@thelast1090 The telemedicine is an initial consultation. (i've used it in the UK via my private healthcare). The difference is if tests need to be done, it is much quicker and easier to arrange and deal with privately than via the NHS usually. So you do get your monies worth but if you haven't used it then a) that's a good thing because you're in good health but also b) you can't really comment on how it works😅
Oh the other problem you can't go in to make an appointment they tell you to go away and ring up for an appointment then they don't answer the bloody phone when they could've done it while I was standing in front of them
GP's Don't want to return to work following covid. My Doctor was in the Bath when I spoke to her. I could hear the water splashing around. A disgrace to the profession.
She answered your phone tho didn't she could have just ignored you as she was off duty. Quite good of her tbh.
Becoming a doctor is absolutely wastage of time, money & energy. Too much time, energy & years required to be a specialist. Result --> low pay 💰, No mental peace & many other issues.
To be honest, I have found it difficult to find anything in the press, that explains the reasons for this, and its been very difficult to understand the reasons behind this, I found this video really helped me to understand and sympathise moreso, as I know in turn this is also having a cascading impact, on A&E and lives and I couldn't quite understand how advanced practice was improving the service, in that there doesn't seem to be any measurement of this and although, I can see how it could help, it still only reduces some of the capacity issues and there still needs to be more staff.
While this does outline some of the issues of getting appointments, this is not the whole picture. There are those working at gp that have used and abused the opportunities the lock down has brought to them using the opportunity to neglect their work. The issue is when you do try to report this, because you have evidence that you would like to uncover this, it gets sent to the manager of the GP and nothing gets resolved by this. This is not simply localised to the GP, this is also present in many medical fields at least from my experience. When my mentally ill partner was in a mental health hospital while she was pregnant with my child, she was abused by the staff, I had recorded the event and sent the recording to the police. They ultimately stated, the only thing they could do was let the manager of the mental hospital sort it out. Currently, there is no way to hold those accountable for their negligence or abuse, its down to those that are in charge of the facilities to do anything about it and their are those that are choosing to ignore it.
Video good. Me like.
Great video, very informative and I do think (whether we're from the medical community or not) we need to challenge the blame sent to GPs from the government, media and misinformed members of the public.
The only thing I'd suggest is also talking more about the politics, which I know can be difficult, but we're never going to address this problem if we don't talk about the austerity measures between 2010-2020 and the government's links to private healthcare.
I am a locum GP in Scotland. All my patients barring two are booked on the day. Here in Scotland I have to admit the access to GP is not as bad as England. The practice I work in usually, the duty GP assesses all patients who call on the same day, whether it is on the phone or f2f or arranged appt another day if it can wait. Some people really want f2f, I offer it if nothing else for reassurance. I always and I do mean always see patient f2f if they need it. I have had a very small minority of patients tell me that they don't have the time to come for f2f, whilst I tried to persuade them to come and would accommodate them as much as I could. Are there some bad GPs? Sure, there are some, but they are in minority. Just think when a problem is so systemic as it is now with NHS, is it because all GPs that are bad suddenly over the past few years or the problems lies elsewhere - poor funding, increased workload, hostility from press and sometimes public. UK expenditure per person is less than half of USA spends and 2/3 of Germany. We spend less than almost all the Western European countries. Right now I am in the process of migrating and leave NHS for good, as I don't see a future here in the UK.
I came across this video because my GP surgery included a link to it from their website. It is very interesting, informative, and well presented. However, I am still perplexed by the changes I have seen at my surgery.
Just before COVID really got going in 2020, I could book an appointment to see a GP on the surgery website, and I would generally only have to wait 1 or 2 weeks. If I needed something quicker a phone call would get me an appointment on the same day or sometimes the next day.
Now, you cannot book appointments via the website at all. To be seen quickly you have to phone between 8:30 and 10:30 in the morning to go on the triage list - often the list is full before 10:30, in which case you have to try again the following day. For routine or less urgent problems, you just won't be seen.
Now, I understand that COVID caused a massive upheaval, but what I don't understand is that, now that the COVID upheaval is over (is it not?), why we haven't gone back to how things were before? Are you suggesting that the reduction in numbers of GPs has all happened between 2020 (when access to a GP was easy) and now, when access is so restricted?
My dad was a GP so I have a lot of respect for them, but I don't understand why there has been such a change in just 3 years.
I would be very interested if you could elaborate please. Many thanks.
Sure, I'll try my best. So the relative number of GPs in the population has continued to worsen. Some key figures are that there are now 0.44 qualified GPs per 1000 patients, down from 0.52/1000 in 2015. Equally, each GP is now responsible for more patients - 2260 per GP, or a 17% increase since 2015.
If you want to see a GP specifically (as in a doctor), this is partially due to something called ARRS, which is a scheme that funds additional staff (from a prescribed list of roles) in general practice, as in it will pay their salary so the practice doesn't have to. This list of roles does not include doctors or nurses, and so if your practice has limited space/capacity etc, then it de-incentivises the hiring of GPs. Because of ongoing financial pressures, many practices are not able to offer the pay that they historically did, especially for locum doctors, where the going rate might have been up tp £100/hr for a qualified GP. Now it's common to see 60-70/hr - which is just subpar for a fully qualified locum.
But the long and short of it is there just isn't the staff, and practices are in very precarious positions. We know what governments of all stripes seem to want is a fully salaried model, where GPs are paid by trusts rather than running their own practices (with the independence that brings GP partners). Combine that with a general push towards a model of healthcare with fewer senior (as in consultant/GP) doctors in it, and it shines a bit of light on our current direction of travel. The political will (and spend) to have people see a GP doctor in a timely fashion does not exist, and that is not the model that the government seems to be pursuing.
More info here: www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis
@@OllieBurtonMed
Thank you.
Can’t blame the working family either. We suffer medical neglect at the hands of the government.
And our GPs
Just tell the truth. There are now too many people in the UK and the NHS, including GP Surgeries, cannot cope. Everyone knows it.
Isn't this more or less what I said?
@@OllieBurtonMed Yes, but in a brief oblique and opaque reference about 8 minutes into the 15 minute video clip.
I know this is a year old now but many of your points do still stand. One thing that’s changed in the last year significant is advances in AI.
AI can’t replace face to face appointments, it can’t look inside a patients ear for example (ear issues are one thing I’ve actually seen referred to a telephone appointment) but AI should be capable in a couple of years of replacing GPs in terms of phone appointments. As it’s just a series of questions and answers to come to a diagnosis, that knowledge will be able to be captured and the AI should be able to do initial consultations. That should free up doctors for face to face appointments hopefully. Ultimately we need way more doctors so we can get to a 7 day a week health service instead of 5, but I do believe AI can help with some of the GP burden sooner rather than later
It's okay but in my neighbourhood, the priority is for the Muslim people they have over 25 min with the doctors who are Muslim ..my go appoint was at 11 am the man who was in front of me went in at 10:45am and left 11:40 so nearly 1 hours with doctor while my appointment was 11am 40 min late and the doctor said we have only 3 min so the doctors pick they colour and people to who get better service...
My friend from an immigrant family is a junior Dr on £14 per hour, she's fulfilling their dream and she still gets yelled at for not getting paid enough. To be fair if someone told me I had to go to uni for 5 years on an intense course to then only earn £14 p hr I would say no
Thank you very much for the honest and thorough explanation Ollie. They need to make this more public and refute the fake news
My former GP locked her doors in March 2020, took no appointments, and failed to telephone for telephone appointments she herself agreed to make. In my small road 15 people have left this practice due to non existent service. Neighbours tell of wrong prescriptions being given and numerous other faults occurred. It is a disgrace that this woman be allowed to continue being a doctor, and she is in special measures from the CQC. I assume you are not an apologist for this kind of behaviour by GPs. The fact is there are poor GPs just as there are poor house painters, and not very good car mechanics. Everyone has their pressures, and portraying GPs as overworked martyrs doesn't really help.
Don’t use the minority to blame the majority. Also, you’re talking about a locked up surgery! Of all the examples you could’ve given, you talk about a GP that’s SHUT DOWN. Flamin christ
Yes everyone does have their pressures. I've worked in the care system all through the pandemic, lousy pay, up close and personal with covid and now when I'm in the middle of a bad personal health scare, I've been battling with frosty gp receptionists and a GP who is definitely hiding, and I'm told to ring 111. They tell me to consult with my GP?! I cannot even begin to explain the neglect suffered by my residents at the hands of the local GP.
Cap
Hartlepool 1970 , 2 main Hospital - comes from the the word hospitality. Also had a large victorian materrnity hospital plus critical care maternity unit and doctors could visit your home. Oh yes we also had a accident and emmergency unit. Well today we have none of these and have to travel 10 miles to Stockton on Tees. So much you get for paying the highest council tax in the country. Wow let's clap the government and local council for providing great healthcare in Hartlepool.
Lovely I’ll just forget all about the severe pain in my hip and knee and give up work.. i’ve been trying all week to get an appointment and eventually today I actually got one miles away and I had to get there in 30 minutes with no car😳 perhaps I have cancer in my hips. But Unfortunately I won’t find out any time soon
I'm very sorry about your pain Joanne, and I hope things get investigated soon. We desperately need recruitment of more GPs and increasing service funding to stop these delays from happening.
@@OllieBurtonMed I’m concerned about people slipping through the net because they give up on trying for appointments
I have to wait up to 4 weeks to see my GP if i don't accept a phone appointment.
@@joannepiasecka8449U r such a drama queen😂
Train more GP'S. Suerly thats the most logical solution.
This is 2022. Hello.
Surely would be! However not politically expedient to do so as training always takes longer than your government will be around. So while it would benefit the public, does not benefit politicians themselves.
they dont want the rubbish pay and long hours
Plus judging by the way you approached this matter I really don't feel this guy has any idea how absolutely devastating it is for people who are ill and have to wait or are turned away.sometijes their to ill to argue its disgusting what's going on .
I'm sorry for your experience. I can sympathise, I have looked after many chronically ill patients. How do you feel that the GPs themselves are at fault, if that is how you feel
bravo to you Ollie for addressing this issue, being a GP myself I agree with everything you said. Unfortunately morale is at its lowest, and abuse from public/patients at its highest for all of my GP colleagues, and ALL of my trainee cohort finished GP training last year with significant burnout. I'm exploring alternative career currently and so is many of my colleagues, if the government and general public continue to scapegoat the GP for everything, the situation with general practice will only get worse.
Unfortunately, sometimes GPs are their own worst enemy.
Speaking from first hand experience, many GPs I've dealt with have little to no experience of family domestic abuse which can exacerbate a patient's problem.
Usually very quick to diagnose mental health - quickly set it stone, unchallenged, acted upon followed by years or even decades of back tracking, meetings and complaints all while the patient may infact suffer significant and life changing consequences. Arrogance an unprofessional attitude and an unwillingness to admit mistakes adds to the mix.
I certainly agree that this is not solely a problem caused by family medicine but, like it or not, some responsibility has to be taken.
Yup, the WEF and Klaus Schwab want it to get worse. Depopulation by 2030 and a cashless society 😡😡😡
What a loads of crap my GP has a window of 15 minutes to call them each morning to see a doctor if miss that slot tough call tomorrow 😡
So why do you think that is? What forces this situation?
Haven’t you just made the argument for the current system being medically unsafe? GMC says doctors should not practice unsafely ….yet RCGP supports telemedicine and “non GP” doctor. RCGP should be supporting 100% salaried GP service admin by secondary hospital. Then you would have GPs as consultants reducing management/business side/legal secondary care protection/better communication with current consultants (you probably realise I know the system…)Family doctor was attractive, I guess, when you knew your patients.
premiums and private everything people should just shop paying national insurance then it would be fair get what u pay for
It would also mean that huge numbers of people couldn't afford healthcare
I understand the point you are making about GP services being overwhelmed by the demands made on them (I used to work in the NHS, so I try to be realistic in my expectations). However, I think you were perhaps overly defensive; unfortunately as a patient and carer, I have perceived some occasional lapses in the clinical quality of care that I have received in recent years from my GP surgery. If you had the time, I'd be really interested in your analysis of the nitty gritty of patient dissatisfaction & "GP bashing" by the media. Are there any nuances to draw out, or are the great British public just chronically unreasonable? In conclusion, well done for tackling a contentious topic - but I suspect there may be more to say!
I'm sure I was on the defensive side, and I guess this was a very surface-level analysis looking at primary care as a whole. There absolutely will be negative experiences at the person level and GPs won't always get it right - there's certainly a spectrum. I would charitably think that these lapses would be less likely if GP surgeries were properly supported and had more time/resources for patients. Certainly more nuance to draw out!
@Cathy, you seem to acknowledge that GP services are overwhelmed but not make the link to less than satisfactory care. When GP services were better funded (in real terms) about 10+ years ago compared to today, public GP satisfaction was high, coincidence?
@@artspooner I am more inclined to agree with you now, than when I posted my comment. I can only speak from my own experience and those of friends and family, so this is no more than anecdotal evidence. I fear that chronic over-work may lead to more than just "occasional lapses" in the quality of care. The causes of excessive GP workloads may be multi-faceted; underfunding, and understaffing due to the GPs who do remain working catching Covid from patients, being only two possibilities. Furthermore, I see the GP "problem" as being part of a more general culture of the NHS overworking doctors, whether in hospital or in community settings. To me, it's not just a question of the number of hours doctors are expected to work, but of the number of patients they are expected to treat within those hours.
Oh really sorry I do Not agree my Gp is just Not seeing people full stop since Covid came to a end most days there waiting rooms now are near to totally empty my GP s has 2 wating rooms one is newer say 7 years old 'the other is older well one of the waiting rooms is now totally closed doors shut lights switched off oddy the same 5 doctors still work there you ring first thing each morning told the same each day sorry No one can see you for up to 8 to 10 days them told No phone call back slots left ' its the same each day so i turned up at the surgery to see empty waiting rooms so please tell what the hell the 5 doctors are doing each day so I wrote to my local Mp he is Not interested he said its the Gps Surgery choice how they run there surgery so I rang NHS England there reply was They have very little power or control on how my local surgery chooses to see or Not See people doctors at the Gp levels are using this to there own gains plus they still get payed a wage this is beyond very wrong ! final the next thing to happen will be Ai app based doctor surgery people of the UK will have next to No path to little or No health care it begs believe want is going on behind closed doors ? ?
I'm not sure I understand the insinuation here. Are you suggesting that the GPs are refusing to see people, despite the fact that there's an 8-10 day wait meaning they're probably fully booked, and therefore seeing many people each day? They see people based on priority, the sickest/most at risk get seen first - the fact that someone is able to wait for those 8-10 days without needing to go to A&E is supportive of the fact that their triage assessment system works properly.
13:03 - I think deep down this may be the core problem - we cant train doctors as its not in the governments interest , we cant attract, or even keep doctors as we dont treat them well enough for what we pay them. Surely we need either pay or better working conditions. We cant have better conditions as there aren’t enough doctors to do that, so they need paying better or a more attractive package some how
Thanks so much for this very useful video. As someone who has been getting very frustrated at even getting a phone appointment, it puts the whole situation into some perspective. I do wish though that there could be an automatic way for older patients, over 70s to ask for a face to face appointment as a matter of course. A lot of older people, myself included find that the frustration of waiting all day long for the phone to ring from a doctor to be very stressful. I realise this is personal preference though! I now realise GPS are making the best of a bad situation now and will try to be more patient in the future.
I'm so sorry for your experience, and pleased I was able to provide some sense of perspective. The situation is extremely dire and I don't think the public at large realises how bad things are. It's chronic, wilful underfunding, pure and simple. The government has no interest in having a working NHS
@@OllieBurtonMed Thanks Ollie. Yes, I know people are getting frustrated, but it does help to understand the background a bit more. I have taken a look at some of your other videos, loved the one about "Is there a doctor in the house?". I think you will make a great doctor!
Great video 👍. I would also suggest the incorporation of AI in General Practice medicine. Lots of admin work like: writing up dictation, scanning documents and writing notes /emails can be quickened with the adoption of AI. Delegating this tasks to other people can be inefficient. Let alone digital twinning for diagnosing and coming up with correct medications / treatments quicker. Also through speeding up these admin tasks, it allows the GP to spend more time with and learning the story behind the patient.
It’s dangerous, we need more GP clinics. Some things are important yet you still can’t get seen face to face. What would happen in the future then? We get Ill and don’t get any appointments
If things continue as they are, yes. I can only advise that GPs have no control over that, the supply of GPs and therefore appointments is controlled by the government.
GP’s are patients first port of call for diagnosis and referral, and they are refusing help and support to terminally ill families. Creating barriers. They are standing in the doorway of gaining that support. GP’s are your worst nightmare when they decide they don’t see the value in diagnosis.
Care to elaborate? Do you disagree with what he said in the video?
Oh my god this is so obvious. 1st thing. We are not as developed as our European neighbours and have a too high population. The nhs is over as it works now.
Solution: other countries. Go another train then there Africa,Asia and pay them a good salary and ask the public to contribute. We can’t expect the nhs to keep working
Interesting thank you, I thought the population was shrinking? What are your thoughts on the 1000s of migrants illegally entering the country every year and using public services, I’m guessing as you’re doctor you’re ok with that?
I can't particularly comment on the immigration issue in too much detail - I think it's widely contested how many such immigrants there actually are, and then how much they engage with public services - how many of those undocumented immigrants would see a GP or go to A&E for example? Unsure. Personally speaking I think we have an ethical duty that if people are sick or unwell then we care for them. It's a big debate between resource cost allocation and rule of rescue (we stop avoidable death at all costs) - ongoing ethical dilemma that nobody has solved yet.
All of those immigrants would probably not be able to see a GP. The whole point of "illegal" immigrants is that they are undocumented, therefore they don't hold a British passport, NHS number or a document place of address in the UK.
Pensioners cost the NHS far more than illegal immigrants
This all sounds very reasonable, however it simply doesn't stack up. What needs to be examined is what changes in the NHS took place from say 1995 to now, because it's since then that it has all gone so wrong in every sense. The model of practice changed and the result, 20 yrs later, is this. We didn't wake up in this position one morning - it evolved to this and clinicians spanning this era need to be interviewed about their experience over that time.
Secondly, clinicians need to take responsibility for the proliferation of mindless bureaucracy they appear to have accepted being imposed on them by NHS England. It seems to me that Drs unions need to grasp this problem and having reviewed all bureauctartic demands made upon each category of clinician, make proposals to NHS England as to how this is best pared down, to minimise the impact on the frontline. having pared it down, there needs to be a clinicians intermediary, which vets bureaucratic demands. this would prevent the escalating proliferation of verbacge being sent out by bureaucrats.
Thirdly, there is simply no excuse for working 2-3 days a week. Before Covid, despite the increase in population, you could get a GP appointment within a reasonable time. This is far from the case now and not onlky this but every aspect of the GP service has long delays eg getting a referral letter has just taken me 6 days.
I could go on and on.
I can't suggest much re the first suggestions as those are huge scale changes that would take years. To touch on just one of the things you've said - the working 3 days a week or part time - why is that objectionable? In so much as we can't force people to work, and by not offering those flexible patterns we're simply going to lose people from the workforce. Plus with GPs being independent practice owners, it's really up to them how they choose to employ people.
I didn't know about the government missing their targets for training new doctors. There's a big part of the problem. Shine a great big whopping light on that and they'll feel pressured to make good. I can't help thinking that the Conservative party are secretly opposed to the NHS because it goes against what they believe in. Most British people love the NHS, so they have to slowly do damage to it while appearing to protect it. That's just my guess at what is going on. I kind of feel it in my bones!
33% of British GPs work full time. The remainder choose to work less hours because that’s all the time they can give or that’s all the time they want to give! It’s that simple. So if we can’t get a GP appointment some of us end up in A&E seeing overseas doctors whose accent we can’t understand. GPs are not innocent in this and silently hope no one notices their actions have jeopardised the health of our country and made the hypocratic oath look ridiculous.
Hi Ollie, this is a very well put together video. I think in regards to solutions you raised, commendable as they are, the issue is that the retention problem is never addressed by the government. The issues that NHS faces are a reflection of the issues in society at large, the downward pressure on wages and increased workload. If you train more doctors and/or GPs they for example can still migrate if working condition does not improve as you will may be aware there are many UK trained doctors in AUS, NZ and CAN. If you expand the role of other clinicians like pharmacist or nurses, they will need support or supervision which again will need to be done by a GP. I call the "plaster stick" solution, robbing Peter to pay Paul solution, for example getting independent prescriber pharmacists in GP land have led to lack of pharmacists in community and now they are facing crisis. I have to say I have no sympathy for community pharmacies because how terribly they treated and paid pharmacists poorly because of high number of pharmacist in early 2010s. In regards to solutions there are solutions, but first we need a complete overhaul of British politics i.e. a more pro-working class government (not Tory or Labour government) and dismantle this top down bureaucratic management of NHS. Here is sketch of what I mean, how much better it would be say for example local communities (whether through council or some other new body), doctors (GPs and hospital doctors), central government (one that is willing to fund health and care services), all sat together and planned how health was provided in an area. They could appointment someone with right skills and someone who cared about the community as CEO of health board (importantly accountable to the local community) and avoid the current technocrats who get eye watering salaries and do the bidding of government and ignore the people they serve.
Who wants to be treated by an overworked exhausted Dr? Not me! The public need to advocate for what we all rely on and will sorely miss if it fails
GPs arent consulants, arent they?
I don't believe they technically are, but I'm trying to make the point that it's the closest point of comparison. A GP has completed the end of their specialist training pathway (what's called getting their CCT) just as a consultant has done similar in their specialty. Its just that GP training is comparitively shorter.
@@OllieBurtonMed Is it possible possible to do a second speciality training once you complete GP? I am thinking about Psychiatry. GP feels very dead-end-ish. Also, I really dislike the fast food level turnaourd of patients. Why is it so? Is about billing for as many patients per hour as possible? This feels quite unsafe and must be quite boring.
@@NeuroScientician yes you can! You can be a GP with special interest or decide you want to do something completely different. Also there are lots of other things that you can do as a GP like medical education, medicolegal things, be a portfolio GP etc…
@@ttoyee5985 The Special interest thingy has been renamed again. I think that they are trying to rebrand it as it seems to be more or less ignored. They seems very basic, something that might work well for junior nurse or PA removal of wards and vasectomy seems to be the top offerings.
pass the buck get blood presshure at pharmacist or call 911--for out of hrs doctor at 10am all callbacks gone by 9-30 or go straight to hospital you live in a different world and still taking on new patients so we are stressed
Very good video, Ollie. We really don’t appreciate our GPs as much as we should. I definitely do not envy their job.
I will appreciate them a bit more when they get back to work like everyone else.
brexit pls
Our MP's are no help whatsoever they are as lazy as our GPs.
Great video. Just shared it on a community group where I live that always has moaners on it - could be an interesting day
Why did you take off the ‘dislike’ button just out of interest ?
Nothing to do with me, that's a RUclips thing
Well no way out.
every one is a contractor that’s why nothing is available anymore gps send 90% of patients to private clinics has a first practice
These numbers also aren't real
GP have sat on their lazy backsides for two and a half years. Shame!
No they absolutely have not, this is a lie being spread about my GP colleagues by exactly the group of people that benefit from privatisation of services.
@@OllieBurtonMed Privatisation? I'm thinking more of the thousands who have died or about to die prematurely through lack of prompt diagnoses and treatment. A large number of the general public have been affected by this incompetence.
@@independentobserver4404 I think we need to keep things in focus. GPs have a safe limit number of patients they can see per day, and most have been working far beyond that for years - the system is already well over capacity. The government controls the supply and training of GPs, there is literally no other way to make a new GP outside of government controlled training. I would advise writing to your MP if you feel services aren't good enough.
@@OllieBurtonMed LOL
@@independentobserver4404GPs hands are tied, there only human like everyone else. If they saw more patients than what is safe then more people would die.
I don't think you understand what the NHS is, we care about the population as a whole. We don't care if your family member died bcoz of a rare illness that was missed. We literally do not care.
I'm sorry. We do not have the resources to care. We would much rather 100000 people lived 5 years longer because we stopped them getting heart attacks than a random person who died because they couldn't get a GP appointment. Our priority is ALWAYS to the majority. That is the meaning of state run healthcare.
Chances are that random person would have died soon anyway.
I'm being very honest about this. That is how the service works, and has always worked.
Source: i work in a GP practice as a clinician!
Trying to diagnose over the telephone 😂😂 that's really professional got exscuse for everything but if you have money you can see a doctor no problem I wonder why
The suggestion being that no diagnoses can be made over the phone?
The Pandemic is over.
Yes it is GPs fault the pandemic is over they have no need to work from home refuse home calls if they don't work as others that have to go out to work cut their pay.
When i do after weeks of waiting the surgery is almost empty and rather than getting to see my GP i am referred to the nurse.
Now many medications are harder to get and there are longer waits for medication whats going is medication being diverted elsewhere.
Where I am in Scotland its now almost impossible to get an appointment with my GP.
We have the GPs the pandemic has left many of them lazy.
Also our insane open border policies don't help and puts a great strain on our health services.
Sorry you are making excuses for GPs
its not just me either this lack of service is happening all over the UK.
The NHS is crap. That's the problem.
Just admit. NHS is finished ! I’ve been trying for two years to see a doctor, no luck. You lot always crying for more money, yet not prepared to up your game. NHS staff swore an oath to protect the public, that is not happening in this country anymore !
I can dutifully inform you that NHS staff en masse do not make an oath, and I'm unsure why you think they would.
Secondly, I don't know the detail of your situation, but I'm unsure how it relates to our strikes. Junior doctors are on strike at present, not GPs or consultants
If you've been trying for two years to see a doctor then you clearly don't need to see one 😂
It's never the GPs fault... they do nothing and bounce patients like balls. Personal experience in the last 10 years. Totally useless. The left hand doesn't know what the right one is doing.
So, GPs are not seeing patients in their own practices because of reasons you've outlined yet they have the time and resources to see the more than 40,000 illegal migrants let into this country and being put up in four and five star hotels twice a week? Their own patients have to forego consultations and appointments whilst people who shouldn't even be in this country, have no national insurance and haven't put a single penny into our NHS get seen two times a week. How does that one work then?
Do you have any evidence whatsoever of any of the things you've said? That reads like the front page of the Daily Mail.
old rundown hotels more like
Mass immigration!
Underbeard?
He’s only 14, puberty should kick in soon 🙏🏼
Blah blah blah !!!!
Excellent insight