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GPs in crisis

I try to be balanced but I am getting a little tired of Dr whinging. Lots of people have it very tough & there has to be a better more patient centric approach.

IT needs to massively improve, my GP surgery is a bit of a joke & they have been for 20 years.

I’m perfectly happy for Drs to earn well but it would nice to be able to see one. Funnily enough I can get a virtual appointment via my company private health scheme in two hours.

A guy I used to cycle with, was a consultant A&E, moved to Australia, probably to avoid upcoming pension tax & now encourages others to come & join him. Makes me a little cross but I’m just a patient so who cares.

Ultimately this is a Tory mess & I’m sick of being at the brunt of it.

How hard can it be to get the system improved?
 
Indeed that pension tax mess up is responsible for huge problems and early retirement

One big problem is the government gives so much stress no one wants to be a partner , they will do the salary GP bit but they are in such huge demand as more and patients need to be seen its overwhelming . I know a number of GPs
 
Tim Jones said:
Elective demand (ie the number of "non-urgent" patients being referred by GPs) is around half of what it was pre-Covid. Roughly 6% annual growth then, compared to a downright weird 3% now. But acuity is much worse.

The main theory in circulation is that this is unintended demand-suppression - because people can't get GP appointments, they just aren't being helped. Which is very worrying.
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Anecdotally that rings true. A family member in chronic pain gave up on trying to see their local GP. When the pain became unbearable their partner called 111 and they were rushed to hospital. The consultant stated their condition could have been fatal if left untreated for another few days.
 
Rodrat said:
Our GP surgery pretty much will only do telephone consultations
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Ours is very big on that too. My experience of them is frustrating when what's required is for the GP to actually see your body and give it a poke. They're too just a bit of a waste of everyone's time.

I couldn't understand why it was even a thing when it takes the same amount of time to see a patient in person. Only made sense when I discovered some of the doctors (I assume locums?) are at home and don't ever actually work from the practice.
 
Our local Docs are ace. Pretty much get an appointment in a few days. It’s got a big catchment area so what are they doing right that so many get wrong?
 
You get an appointment at my surgery for the same day if you see the receptionist first thing in the morning.

I've not had any hassle.

The OH, not so mobile, got a visit from a paramedic in lieu of an appointment.
 
hifinutt said:
the life expectancy here is reducing ..
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April 13, 2023 – U.S. life expectancy has declined to 76.4 years, the shortest it’s been in nearly two decades, according to December data from the CDC.
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Life expectancy across the UK has fallen to its lowest level in a decade, mainly owing to the impact of the coronavirus pandemic, data shows.

Boys born between 2020 and 2022 can expect to live to 78.6 years

Pamela Cobb, of the ONS, said: “After a decade of slowing life expectancy improvements, we’ve now seen life expectancy fall for both men and women. This decrease has been mainly driven by the coronavirus pandemic, which led to increased mortality in 2020 and 2021.”
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I blame Thatcher.
 
hifinutt said:
Indeed that pension tax mess up is responsible for huge problems and early retirement

One big problem is the government gives so much stress no one wants to be a partner , they will do the salary GP bit but they are in such huge demand as more and patients need to be seen its overwhelming . I know a number of GPs
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Problem I have re the pension tax is that having a +£1m pension pot probably should be taxed; it’s know simply given a tax free loophole for the wealthy.

Needless to say I won’t have anything like a £1m pension pot despite earning pretty well.

The workload on GPs is high though & the system seems broken. I don’t like the GP commissioning system of hospital referrals either, seems to add workload & delay.

Speaking as a patient. I have a few Dr friends, they obviously have a view on it.
 
flatpopely said:
Our local Docs are ace. Pretty much get an appointment in a few days. It’s got a big catchment area so what are they doing right that so many get wrong?
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Dunno. Population density?

2022 ONS report:

Large towns have a higher number of patients per GP compared with cities; large towns have 1,800 patients per GP, while cities (population of 225,000 or over, excluding London) have 1,700 patients per GP. In comparison, small built-up areas (less than 5,000 people) have 1,500 patients per GP.

Across English regions, the number of patients per full-time equivalent staff member (GP, fully-qualified GP or nurse) was highest in London and the South East. London had the highest number of patients per staff member, with:

2,000 patients per doctor

2,400 patients per fully-qualified doctor

6,700 patients per nurse

Not sure where York would fit into that.
 
Woodface said:
Problem I have re the pension tax is that having a +£1m pension pot probably should be taxed; it’s know simply given a tax free loophole for the wealthy.

Needless to say I won’t have anything like a £1m pension pot despite earning pretty well.

The workload on GPs is high though & the system seems broken. I don’t like the GP commissioning system of hospital referrals either, seems to add workload & delay.

Speaking as a patient. I have a few Dr friends, they obviously have a view on it.
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I don't have an issue with pensions and tax as I just see it as a form of deferred taxation that means your tax rate is based on a more lifetime average of your income rather than a year at a time. Ie. defer some income now until you're older and then pay the tax rate applicable at the time on your retirement income. If you're pension is so large you'll hit the higher rate anyway on the pension income, and it's not unfair to have a tax free allowance each year of your life whether you are still working or retired.
 
paulfromcamden said:
Dunno. Population density?

2022 ONS report:

Large towns have a higher number of patients per GP compared with cities; large towns have 1,800 patients per GP, while cities (population of 225,000 or over, excluding London) have 1,700 patients per GP. In comparison, small built-up areas (less than 5,000 people) have 1,500 patients per GP.

Across English regions, the number of patients per full-time equivalent staff member (GP, fully-qualified GP or nurse) was highest in London and the South East. London had the highest number of patients per staff member, with:

2,000 patients per doctor

2,400 patients per fully-qualified doctor

6,700 patients per nurse

Not sure where York would fit into that.
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That means there are about 3 GPs per nurse which surprises me. Wouldn't it make more sense to have more nurses to do the lower level day to day preventative/testing work that the NHS should be doing?
 
lawrence001 said:
That means there are about 3 GPs per nurse which surprises me. Wouldn't it make more sense to have more nurses to do the lower level day to day preventative/testing work that the NHS should be doing?
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I wondered about that - but thinking about it most times I've been to our local practice it's to see a GP because I want to know what's wrong with me.
As you say, nurses tend to deal with tests and jabs and treatments. I don't know if it follows that there's a greater volume of that work. Perhaps it depends on the demographic. If a practice is in an area with more wrinklies I guess there may be more chronic/ongoing conditions requiring regular treatment.
 
lawrence001 said:
I don't have an issue with pensions and tax as I just see it as a form of deferred taxation that means your tax rate is based on a more lifetime average of your income rather than a year at a time. Ie. defer some income now until you're older and then pay the tax rate applicable at the time on your retirement income. If you're pension is so large you'll hit the higher rate anyway on the pension income, and it's not unfair to have a tax free allowance each year of your life whether you are still working or retired.
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Yep can see your point, I suppose the non-contributory part of the pension is key though.
 
Practice nurses also do the interminable yearly ‘asthma review’ which is a complete waste of time.

My local practice is quite the business its purpose built over two floors & contains many paid for services. Reckon it’s quite the cash cow for the partners.
 
Minio said:
The last couple of times in the last month I have been given same day appointments with the practice nurse.

She prescribed antibiotics and could refer onwards to a specialist if required.

I'm not sure what more a GP does.
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Lots more
 
paulfromcamden said:
Have they not cured you yet then?

I always enjoy it when the GP receptionist rings me up to ask why I keep ordering insulin...
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& the answers to the trick questions change every year;) Last one took over 40 mins. A friend who also has asthma & is a respiratory consultant says they are a complete waste of time.

It used to be a 5 minute Drs appointment now it’s an inquisition by a practice nurse.
 
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