GP practice empty and unwelcoming

brook2jack

Importing gps will not fix the problem.

In NHS dentistry we've imported huge numbers of dentists. Many were given false expectations of what working in NHS dentistry would be like and either moved back to their home countries , or turned to private dentistry.

There are twice as many dentists registered in the U.K. as there was in 2006 when the "new contract" came in yet it is much more difficult to get NHS dental treatment because fewer Dentists do NHs treatment.

In my part of the world 80% of NHS practitioners are over 50 and due to retire in the next few years . It is very difficult to recruit new dentists to the area , and the rates of pay in NHS dentistry means very very few dentists can afford to buy a practice.

This is the same problem with GPS, whilst the same system remains no one will want to train as a gp, no one will want to buy into a practice and importing healthcare professionals from elsewhere will provide only a temporary stop gap until they too realise they cannot work under the immense pressures of a system on its knees .

Pennywise

littlerock wrote: »

My GP practice moved into new custom built premises around 25 years ago and it is a large and now largely empty building. At the time we were told it was going to offer all sorts of services under one roof including drop in. Clearly NHS provision locally has gone in the opposite direction with services now all split up in different places and available only by appointment.

Is this typical or local to my area? I live in outer London..

We have the same in North Lancashire. For years, there was a village surgery, a single story building with a handful of "consulting" rooms for the 2 f/t gps and various nurses. About 15-20 years ago, it moved to a huge new purpose built building, 3 stories high, with all kinds of promises about new services, such as a walk in centre, x-ray and scanners, fracture clinic, etc. In reality, the top two floors have never opened and most of the ground floor is barriered off too. Still just a few consulting rooms and services no better than the old building.

No wonder the NHS is wasting billions when they have buildings like that which are never fully used. I hate to think how much it costs, no doubt sounded a good idea under PFI at the time, but it must be costing a fortune.

funguy

GP Practices are under immense pressure at present due to a national shortage of GPs and also massively increasing demand.

This week the papers have picked up articles about the UK having 10 minute patient appointments compared to most European countries having 20 minute appointments or longer. For the UK to switch to this would mean GPs seeing half the number of patients or double the amount of GPs will be needed.

Also GPs in this country deal with over 90% of ALL NHS patient contacts. In return the funding going to GPs has fallen over the years from about 11% to 7-8% of the NHS budget. Maybe this is partly to blame for the lack of appointments?

Papers a week or so ago reported on UK GPs seeing upwards of 40 patients in a day - some as high as 60!! In other countries there are safety limits of 25-30. Do you want to be the 40th or 50th patient seen by a tired GP?

Maybe we should petition our MPs for more funding for Primary Care and GP Practices. No one wants to be a GP these days and 100s of GP Practices are closing every year in the UK. Soon there will be very few GPs to be seen.

Pennywise

How about finding a way to discourage GPs from working part time or taking early retirement? Changes to the tax laws would be a good start to get rid of the penal 62% tax rate on earnings just over £100k, and scrapping the penal tax on large pension pots, both of which hit doctors and dentists more than any other profession. For many GPs, retiring early and going part time makes financial sense, to the detriment of the patients.

littlerock

I appreciate being a GP cannot be an easy job. But a lot of the things my local surgery used to handle have gone away in recent years like mother and baby clinics. Children's centres seem to do that quite separately from GPs now.

My GP practice has really shrunk its services . We used to have two practice nurses and two receptionists now we have one of each. The practice no longer has any out of hours surgeries For that you are told to phone 111. Daily they work Monday to Friday 8:30-5.30 and are closed from 12:30- 2.00. There is no telephone triage service. Yet if it is due to staff shortage why are they actively advertising that they are inviting new patients on their web site ?

This is a nice suburban area. Is the problem the bureaucracy which is putting people off? It cannot be wall to wall work in an urban environment like I can imagine in some places. So where do young British qualified doctors work ? is it all in hospitals? I cannot imagine a hospital is a less stressful place to work given the pressure they are under. Are we short of applicants for medical school. Are we not training enough doctors?! is one issue that many young female GPs now work part-time ( all 7 do at my sister's GP) and we need to train more to compensate for this?

onwards&upwards

fred246 wrote: »

Time to try to import some new GPs. I remember talking to an Indian GP about 10 years ago. I was saying "Maybe we could have a world with no border controls". She was laughing her head off. She said India was full of doctors who would love to work in the UK. I wonder if it is still the same.

There’s an ethical issue though, the countries we poach from then end up with shortages.

I went to an Eastern European country a few years back and spoke with a local who said so many younger doctors and nurses were going to the UK that it was causing real problems in their system. Probably less of an issue since Brexit though as hardly any EU docs and nurses come here now.

onwards&upwards

Pennywise wrote: »

How about finding a way to discourage GPs from working part time or taking early retirement? Changes to the tax laws would be a good start to get rid of the penal 62% tax rate on earnings just over £100k, and scrapping the penal tax on large pension pots, both of which hit doctors and dentists more than any other profession. For many GPs, retiring early and going part time makes financial sense, to the detriment of the patients.

I honestly don’t think money is a big factor. Lots of healthcare staff who are part time or who retire early do so for their quality of life or their mental health and wouldn’t go back to full time NHS work if they were paid a million a year. If you want to keep people you need to make their working life sustainable and safe, and in a bit of a vicious circle the way to do that is to have more staff sharing the load!

Pennywise

littlerock wrote: »

Are we short of applicants for medical school. Are we not training enough doctors?! is one issue that many young female GPs now work part-time ( all 7 do at my sister's GP) and we need to train more to compensate for this?

No, we're not short of applicants - there's immense competition for training school places - some Uni's are oversubscribed several times from people meeting the minimum requirements. Huge numbers of perfectly able students are being denied places because they've not climbed the Himalayas or dug wells in Africa or spent all the school holidays volunteering in care homes - these are the kinds of hoops they have to jump through on top of the obligatory full house of a A* A levels.

At one point in time, the BMA actually campaigned against increasing the number of training places.

I think we need a different way of "vetting" students. At my son's school (in top 100 in the UK), a lot of his friends are aiming for medical school to train as doctors, but most of them don't actually want to do it - they're under enormous pressure from their families, so probably won't be as dedicated as those who genuinely want a career in the caring profession.

littlerock

Maybe we ought to look at uncoupling some types of medicine from GPs? Like physiotherapy? I wonder how much of their time is spent on patients with bad backs, bad knees etc? My sister has a dedicated NHS diagnostics centre near her which patients can go to for xrays,scans, ultrasounds, electrocardiograms and basic physio advice and treatment. She says it works a treat.

Locally to me you have to wait months for any of that even at a local injuries walk in centre. It would mean of course letting chartered physios prescribe, within limits and sign people off work . The prescription thing seems to be a big bar to removing a lot of basic " non medical" treatment from GPs.

Cyclizine

littlerock wrote: »

I appreciate being a GP cannot be an easy job. But a lot of the things my local surgery used to handle have gone away in recent years like mother and baby clinics. Children's centres seem to do that quite separately from GPs now.

My GP practice has really shrunk its services . We used to have two practice nurses and two receptionists now we have one of each. The practice no longer has any out of hours surgeries For that you are told to phone 111. Daily they work Monday to Friday 8:30-5.30 and are closed from 12:30- 2.00. There is no telephone triage service. Yet if it is due to staff shortage why are they actively advertising that they are inviting new patients on their web site ?

This is a nice suburban area. Is the problem the bureaucracy which is putting people off? It cannot be wall to wall work in an urban environment like I can imagine in some places. So where do young British qualified doctors work ? is it all in hospitals? I cannot imagine a hospital is a less stressful place to work given the pressure they are under. Are we short of applicants for medical school. Are we not training enough doctors?! is one issue that many young female GPs now work part-time ( all 7 do at my sister's GP) and we need to train more to compensate for this?

Services have been cut back as there is no funding for them. GPs are, in general, independent contractors. If they're not contracted to provide a service, e.g. baby clinics, dressing clinics etc, then they won't. Out-of-hours surgeries are woefully attended. The vast majority of patients are very young or elderly and can attend during normal hours. Getting a GP to do a poorly attended out-of-hours clinic simply reduces the number of patients seen in a day.

The practice may be closed to appointments between 1230-1400, but when do you think home visits are done, letters written, results checked, hospitals phoned? Let alone having lunch!

We are not short of applicants to medical school, but it takes a minimum of ten years to become a GP from leaving school to qualification. An ageing population, patients with complex multi-system diseases, lack of social care is all biting. Immigration is a red herring. Immigrants are generally of working age with little chronic health problems. Many of them are our doctors, nurses and other health professionals.