Anyone else feel like the NHS almost doesn't exist for them any more?

[Artaxerxes]

Jfc what a frigging ignorant opinion

My two best mates are GPs and we got pissed together last night. For reference I’m a Consultant. When I tell you we spent about three hours talking about how fucking hard their jobs are compared to mine I’m not exaggerating.

Here are some ways their job is mind bogglingly hard:

• Ten minute appointments, the shortest pretty much anywhere in the world
• Up to 48 patients a day, telephone and face to face, plus home visits
• Admin (and by this I mean clinical admin like referrals, results etc) on top
• Undifferentiated patients
• Enormous burden of risk of missing the zebra. Everyone misses a zebra at least once in a career- then you get sued and it’s fucking insanely stressful
• The sheer complexity of most LTC patients nowadays
• The worried well
• The hEDS, MCAS, fibro, functional complex patients
• The fact primary care IS now the MH service cos secondary care MH services are de facto non-existent for all but a few
• GP to kindly… do fucking everything that really should be done in secondary care (start, monitor drugs, follow up this that the other) because secondary care is rammed and the buck ALWAYS stops with GPs
• The absolute shit show that is quack PAs, paid for by ARRS, supervised by GPs so a conscientious GP in effect has to see/discuss all THEIR patients as well. The less conscientious don’t supervise closely and the PA will just make shit clinical decisions and let more people die than would have if they’d actually seen a doctor who has been to medical school and trained post-medical school for five years before they see a patient unsupervised.

Let me tell you, I have done five years med school, plus a PhD genetics, plus all my royal college membership exams (60% pass rate per exam), plus worked as a doctor for TEN YEARS, and I know for an absolute fact that I would not be safe to do a days work as a GP.

Slag off GPs at your own cost. Because you will not find a harder working, more passionate advocate for patients or the NHS than our GPs. And guess what? The Government are getting rid by stealth anyway, replacing them with PAs, advanced paramedics, ANPs, prescribing pharmacists etc etc. And like lambs to the slaughter you will go.

Pay them fucking double and be grateful.

Trying to get into see a GP properly during covid was a fucking shit show and I am ninety percent convinced this is why my hearing in my left ear is nonexistent

I don’t think I can continue this conversation without a stream of incoherent fucks so I’m out

 

[Edie]

Trying to get into see a GP properly during covid was a fucking shit show and I am ninety percent convinced this is why my hearing in my left ear is nonexistent

I don’t think I can continue this conversation without a stream of incoherent fucks so I’m out

Maybe that explains why you can’t hear the truth.

Fwiw I’m sorry you have been failed by the NHS. But I am not surprised.

Get private healthcare if you possibly can and good luck.

 

[ska invita]

Have you tried the 111 service? I called them out of hours with a very bad cough.. bit of blood coming up, and got an appointment 11pm that evening for a GP to look at it.

Yes this
My experience/guide of using the NHS is

GP - 2 week wait minimum for me, okay for blood test type things that can wait
111 - Any actual illness that needs dealing with then call 111 and if considered vaguely serious usually can get given an appointment same day, sometimes even at the same GP surgery you couldn't book an appointment at
A&E - 4-8 hour wait

To see a specialist book a 2 week appointment with GP and go in and demand a referral for whatever specialist and don't take no for an answer. Then wait 6 months.

 

[Edie]

Yes this
My experience/guide of using the NHS is

GP - 2 week wait minimum for me, okay for blood test type things that can wait
111 - Any actual illness that needs dealing with then call 111 and if usually can get given an appointment same day, sometimes even at the same GP surgery you couldn't book an appointment at
A&E - 4-8 hour wait

To see a specialist book a 2 week appointment with GP and go in and demand a referral for whatever specialist and don't take no for an answer. Then wait 6 months.

Demand a referral.

Christ. I should put that on my list of why I’d rather run through a plate glass window than be a GP.

Demand a referral. You don’t even know how stupid that remark is, do you.

 

[ska invita]

Demand a referral.

Christ. I should put that on my list of why I’d rather run through a plate glass window than be a GP.

Demand a referral. You don’t even know how stupid that remark is, do you.

Having a nice day are you?
yes demand a referral because GPs are now gatekeepers and send you out with nothing unless you ask for it. And then serious illness gets missed, sometimes fatally, and always painfully. Many experiences come to mind of me, friends and family.
Most recent for me if I didn't change GP and keep asking for a referral (twice blocked by existing GP) I would still be suffering with my condition which the GP dismissed outright. Now have full recovery.
A friend recently had her condition booted out of the surgery and only six months later got a referral after saying it wasn't going away - guess what, it was cancer. I have other examples. So yes demand a referral if you think you need one.

 

[Edie]

Having a nice day are you?
yes demand a referral because GPs are now gatekeepers and send you out with nothing unless you ask for it. And then serious illness gets missed, sometimes fatally, and always painfully. Many experiences come to mind of me, friends and family.
Most recent for me if I didn't change GP and keep asking for a referral (twice blocked by existing GP) I would still be suffering with my condition which the GP dismissed outright. Now have full recovery.
A friend recently had her condition booted out of the surgery and only six months later got a referral after saying it wasn't going away - guess what, it was cancer. I have other examples. So yes demand a referral if you think you need one.

Congratulations!
You have won a US-style medical system where you can demand any care you think you want.

Plus… a full body MRI

 

[ska invita]

For severe mental health problems another GP workaround I experienced (with a nearest and dearest) was GPs (3 different ones) blocking any sort of care at all .... instead follwoing advice from someone in the know, go to find your nearest A&E psychiatric nurse (not sure the precise name of this position but its a walk in thing in some hospitals) <got a 2 hour interview, initial diagnosis on the spot and immediate referral to the Maudsley.

 

[Edie]

Having a nice day are you?
yes demand a referral because GPs are now gatekeepers and send you out with nothing unless you ask for it. And then serious illness gets missed, sometimes fatally, and always painfully. Many experiences come to mind of me, friends and family.
Most recent for me if I didn't change GP and keep asking for a referral (twice blocked by existing GP) I would still be suffering with my condition which the GP dismissed outright. Now have full recovery.
A friend recently had her condition booted out of the surgery and only six months later got a referral after saying it wasn't going away - guess what, it was cancer. I have other examples. So yes demand a referral if you think you need one.

This post honestly makes me think that you get the health service you deserve.

You epitomise not having even a basic idea of how medicine in primary care works (the symptom that persists increases risk), you blame the GP, and you demand referrals (with not even enough knowledge to know to be careful for what you wish for).

Attitudes like yours make me want to burn it all to the ground and privatise it. Then you can demand your referral from your Primary Care Consultant PractitionerTM.

 

[Edie]

For severe mental health problems another GP workaround I experienced (with a nearest and dearest) was GPs (3 different ones) blocking any sort of care at all .... instead follwoing advice from someone in the know, go to find your nearest A&E psychiatric nurse (not sure the precise name of this position but its a walk in thing in some hospitals) <got a 2 hour interview, initial diagnosis on the spot and immediate referral to the Maudsley.

Yes. That’s how it “works” now.

To think that is the GPs blocking care is so fucking dumb I can’t even

 

[sojourner]

Edie - your attitude stinks of insider snobbery, superiority, and you are coming across as a right patronising git. Yes, you have insider information and yes you have worked hard etc, but no, that doesn't give you the right to speak to the really concerned people on here like they're shit on your shoe. Rein it in eh?

 

[sojourner]

You can explain things without being sneery about it.

 

[Edie]

Let me explain with cRaYoNs:

The NHS MH services are broken. They cannot employ staff even with enough money. They are often so poorly managed by senior leaders (often nurses promoted wayyy above their competence for a reason I’m yet to have explained) that they cannot restructure themselves to deal with the most sick. Referrals are often inappropriately triaged by well meaning but inexperienced low paid employees who don’t do clinical work. And then the wait list is two years. So effectively the only way in is via ED for those poor souls in crisis.

But yes, it’s the GPs fault. What a plank you are. Imagine being your GP when you come in all puffed up and demanding and thinking you know everything and having to be professional

Anyway, love ya ska I know your hearts in the right place and you only want to help your loved ones. Like we all do. But be careful who you blame.

 

[Edie]

Edie - your attitude stinks of insider snobbery, superiority, and you are coming across as a right patronising git. Yes, you have insider information and yes you have worked hard etc, but no, that doesn't give you the right to speak to the really concerned people on here like they're shit on your shoe. Rein it in eh?

Heard and respected guv

I’ll stop posting on this thread. I’m too fucking angry about it all anyway.

 

[SpookyFrank]

You have no idea. And I say that kindly.

I know exactly what my experience is thanks.

 

[Artaxerxes]

Edie - your attitude stinks of insider snobbery, superiority, and you are coming across as a right patronising git. Yes, you have insider information and yes you have worked hard etc, but no, that doesn't give you the right to speak to the really concerned people on here like they're shit on your shoe. Rein it in eh?

It mostly seems to be “suck it up and go private, NHS can’t help” which is erm, unhelpful at best


Also coincidentally the attitude I get from GPs and politicians

 

[InArduisFouette]

I'm a diabetic and honestly couldn't ask anymore from the NHS, diabetic clinics they run are brilliant and really supportive, staffed by people who can't do enough for you.

GP care is another matter, it has basically collapsed. My local GP surgery is intent on developing a "Netflix style" £20 a month fee so semi-private patients can jump the queue. Hardly a rock solid commitment to healthcare free at the point of need. I'm leaving the current city where I live soon enough and won't be sad to see the back of the Tory cunts. I know from friends in the South East that GP services have fallen apart under the pressures in certain areas.

That said, bad as things are, things are much, much worse in other countries in Eastern Europe. Bribes for quicker treatment are routine. In Bosnia I know someone who gave birth and beyond the actual moment of birth itself was left to fend for herself- no care, no treatment, no interest. You pay if you want the doctor to give a vague shit rather than none at all, and family members bring food and comforts. During Covid folk in Belgrade were desperate to avoid being sent to one particualr tumbledown old hospital- it's where you went to die, unofficially, as there was little treatment available. In Macedonia, hospital buildings are often in a very poor state and there's a general rule- enjoy yourself, but don't get ill.

Someone I know in Bosnia needed an urgent scan for potential cancer (turns out they were fine, thankfully, after they went private). At the state hospital a puffed up receptionist with expensive nails leafed through a big leather volume of appointments (they still exist) and offered, in July, an appointment for May next year- the first available. LOL.

Yes there are acute problems with public healthcare and GP services in the UK but there's an awful long way to fall. There's at least some residual chance of things getting better here. Ultimately, the root of the problem is an ageing population with consumerist type expectations overwhelming the system with complex problems and demands, coupled with a hollowing out of the care sector. That's before we get onto the commodification of healthcare for profit.

I think that the practice you mention may fall foul of the GMS contract with that

The NHS jumped on stopping 'courtesy' appointments with glee when the Blair / Brown labour government banned them , as generally it was an unofficial perk solely for patient facing / Health Professional staff and not for faceless adfmin and middle managers, also centralised computerised pro-forma referrals made it harder as your GP could no longer write in an actual typed referral etter

"

Dr K Smith + Dr K Smith
Anytown Park Surgery
Some Road, ANYTOWN

Dr W Brown
Consultant General Surgeon
Anytown District Hospital


Dear ( Br Brown when the referral was typed but crossed through by the GP when signing the letter ) Bill

I would appreciate it if you could see out mutual colleague Fred who has been experiencing < Signs and Symptoms >
and i would appreciate you expertise on their management

yours sincerely


Katie Smith MRCGP "


all very simple and straightforward but the crossed through Dr Brown and the reference to 'our mutual colleague' would flag this with Dr Brown's secretary / appointments clerk to facilitate an early appointment ' as a courtesy' it doesn't matter if Fred was a Porter, a Nurse, an ambulance person, a Physio or a Junior Doctor it was just a code word for another health worker

GPs drew up the drawbridge and barricaded themselves away during covid and I don’t think they ever really opened themselves up again.

they really didn't access problems existed before, and the staffing crisis has only got worse since , that is what is vcreatign the problem , also for a lot of things remote is appropriate, new Undifferentiated Work face to face every time, communication difficulties again face ot face every time ,but if you aren't being examined or having a procedure , however minor, face to face or remote makes little differnece

 

[InArduisFouette]

For severe mental health problems another GP workaround I experienced (with a nearest and dearest) was GPs (3 different ones) blocking any sort of care at all .... instead follwoing advice from someone in the know, go to find your nearest A&E psychiatric nurse (not sure the precise name of this position but its a walk in thing in some hospitals) <got a 2 hour interview, initial diagnosis on the spot and immediate referral to the Maudsley.

not all EDs have liason Psych

some places have stand alone MHUAC ( mental health urgent assessment centre, accessed by 111 / ambulance service / signoositing from UTC /ED front door )

otherplaces now have mental health 'street triage' provided by the ICB and the ambulance service ( Crisis team mental health practitoner and a paramedic in RRV that retains a back seat or a people carrier )

 

[InArduisFouette]

Demand a referral.

Christ. I should put that on my list of why I’d rather run through a plate glass window than be a GP.

Demand a referral. You don’t even know how stupid that remark is, do you.

there is one presentation where the phrase 'demand a referral' is apporpriater and that is seeking referral to a Gender Identity Service becasue you have come to the conclusion you are trans ( the waiting times are utter shit ) ...

anything else you can got wotui the idea that you need further assessment and investigation but don;t necessarily expect a referral , especially when paper pushers have inserted themselves into the referral process

 

[Thora]

My GP has been fine but all three of my kids and two of my nephews are on waiting lists (all for different things) with no end in sight. One is a 3 year old with an 'urgent' need for an op and has been told 9 month wait.

 

[Saul Goodman]

You have no idea. And I say that kindly.

My GP is shite. I've been with him for 8 years, and in that time he hasn't got a single prescription correct. One time it could have resulted in my death, had I not clocked the fuck up.
It must be all the stress of having to do a bit of work for that 150 grand a year he's on.
He's a nice fella but he's fucking useless as a GP.

 

[Sue]

I’m sorry to be harsh but the days of how good your “experience” is are over.

FWIW, saw my (excellent) consultant yesterday and she asked if I'd mind completing some kind of 'customer satisfaction' type survey about her for the GMC or something I think she said. I thought that was really weird. (I mean I could -- and did -- give her a glowing report but weird nonetheless. )

 

[brogdale]

My GP is shite. I've been with him for 8 years, and in that time he hasn't got a single prescription correct. One time it could have resulted in my death, had I not clocked the fuck up.
It must be all the stress of having to do a bit of work for that 150 grand a year he's on.
He's a nice fella but he's fucking useless as a GP.

I've no idea how effective "my GP" is; I haven't seen her in years. I've seen practice nurses, the fake doctors (whatever they're called), and other GPs that seem to be different & new every time. I mean is having a GP even a thing anymore?

 

[ska invita]

not all EDs have liason Psych

some places have stand alone MHUAC ( mental health urgent assessment centre, accessed by 111 / ambulance service / signoositing from UTC /ED front door )

otherplaces now have mental health 'street triage' provided by the ICB and the ambulance service ( Crisis team mental health practitoner and a paramedic in RRV that retains a back seat or a people carrier )

yes ... in our case case we went all the way out to Orpington IIRC, past two nearer hospitals to us... but it worked a treat

 

[emanymton]

FWIW, saw my (excellent) consultant yesterday and she asked if I'd mind completing some kind of 'customer satisfaction' type survey about her for the GMC or something I think she said. I thought that was really weird. (I mean I could -- and did -- give her a glowing report but weird nonetheless. )

I was got a satisfaction survey after a trip to hospital, it started with the standard would you recommend to tlyour friends and family nonsense It's the fucking local hospital you dicks!

 

[planetgeli]

I mean is having a GP even a thing anymore?

Yes, mine is brilliant and has kept me alive this last 18 months.

The surgery is in the middle of nowhere - and has about 8 regular GPs and 3 nurses.

And I am fully aware it puts most of the rest of the NHS to shame.

Yes, I am lucky. I'd still need my head hanging off before you got me anywhere near A&E...

 

[brogdale]

Yes, mine is brilliant and has kept me alive this last 18 months.

The surgery is in the middle of nowhere - and has about 8 regular GPs and 3 nurses.

And I am fully aware it puts most of the rest of the NHS to shame.

Yes, I am lucky. I'd still need my head hanging off before you got me anywhere near A&E...

So patchy, innit?

 

[planetgeli]

So patchy, innit?

I think patchy is probably too kind. The NHS is dying.

My sister lives in Manchester. Her experience is the polar opposite to mine.

 

[Saul Goodman]

I've no idea how effective "my GP" is; I haven't seen her in years. I've seen practice nurses, the fake doctors (whatever they're called), and other GPs that seem to be different & new every time. I mean is having a GP even a thing anymore?

There's also this ^^
I get to see my GP around 20% of the time. The rest of the time it's somebody else from his practice. The latest is a young lad who looks no older than 19.

 

[Red Cat]

Similarly to immigration, it is easier to locate blame in visible people than complex systems.

I'm sure some of the arguments on here wouldn't get quite so stuck and heated if there was a greater willingness to think about how things might be experienced on a symbolic level rather than so literally all the time

Of course people feel let down by the people with faces who symbolise healthcare rather than abstract systems when they're scared.

 

[brogdale]

I think patchy is probably too kind. The NHS is dying.

My sister lives in Manchester. Her experience is the polar opposite to mine.

More like being put on an end of life pathway (without consent) than dying.