Is the NHS sustainable in its current form?

[JCMaloney]

The issue these days is people wake up in the morning have an aliment and are attuned to seeing what is it. Instead of leaving it a few days, popping a pain pill and taking a rest the population are insisting that a Dr checks them out and gives them something (around an antiboitic). I see this all the time and those with children seem to be worse. This isnt sustainable at all. I want to see the GP about minor things (say repeat prescription that they wont do without seeing me), Checking on bloods etc etc you spend 2 days on the phone trying to get through. Its not urgent then sitting in the waiting room 1hr. This could be sorted into a smoother system I dont want to be taking up precious time of a GP for this.

One area could be GPs doing minor checks in pharmacies - weekly pop ups for queries/coughs colds etc.
Def more phone calls in my surgery now if you want same day you have to ask the dr to call back I guess the majority are not urgent. This could be implemented further.
Drs should do weight, body check particularly on serial visitors - they have to tell people how it is, Your overweight, you are drinking excessively you are unfit and if it continues its going down on your notes so an future insurance claims etc. I think GPs fanny around they have to tell people how it is and if an obese child comes in then the parent needs to be told.
My Sister in law pops to the dr every few week with aliments - found a spot, my left leg is aching, had a headache last week, The Dr is not there for casual visits like this. These could be chatted about in a pharmacy.
The cost of the visit could be put on a poster. Reminding those people that seem to be on a constant loop perhaps again these people need to be taken aside to see if there is anxiety issues or perhaps could be better seeing a nurse.

Why anyone wants to become a GP now cant fathom it out.

Some people need to be reminded if they dont so any exercise, sat on arse all day, in front of a screen, no fresh air, no stretching etc of course they are going to have poor posture which is going to give you issues.

The biggest problem is the 'Free service' everyone wants to get better straight away with a pill straight away but dont want to seek alternatives. Or even pay 40 squid to see someone tomorrow to sort out the back ache. The GP gives endless advice on pain killers but none on stretching, seeking help themselves. Patient then returns week after week.

@Chasingmytail fancy applying as SoS for Health?? You`ve nailed it in that post.

Everyone expects "somebody else" to fix their minor ailments and many take little, or no, personal responsibility because society has "taught" them that it`ll get fixed!

 

[Muck Spreader]

The issue these days is people wake up in the morning have an aliment and are attuned to seeing what is it. Instead of leaving it a few days, popping a pain pill and taking a rest the population are insisting that a Dr checks them out and gives them something (around an antiboitic). I see this all the time and those with children seem to be worse. This isnt sustainable at all. I want to see the GP about minor things (say repeat prescription that they wont do without seeing me), Checking on bloods etc etc you spend 2 days on the phone trying to get through. Its not urgent then sitting in the waiting room 1hr. This could be sorted into a smoother system I dont want to be taking up precious time of a GP for this.

One area could be GPs doing minor checks in pharmacies - weekly pop ups for queries/coughs colds etc.
Def more phone calls in my surgery now if you want same day you have to ask the dr to call back I guess the majority are not urgent. This could be implemented further.
Drs should do weight, body check particularly on serial visitors - they have to tell people how it is, Your overweight, you are drinking excessively you are unfit and if it continues its going down on your notes so an future insurance claims etc. I think GPs fanny around they have to tell people how it is and if an obese child comes in then the parent needs to be told.
My Sister in law pops to the dr every few week with aliments - found a spot, my left leg is aching, had a headache last week, The Dr is not there for casual visits like this. These could be chatted about in a pharmacy.
The cost of the visit could be put on a poster. Reminding those people that seem to be on a constant loop perhaps again these people need to be taken aside to see if there is anxiety issues or perhaps could be better seeing a nurse.

Why anyone wants to become a GP now cant fathom it out.

Some people need to be reminded if they dont so any exercise, sat on arse all day, in front of a screen, no fresh air, no stretching etc of course they are going to have poor posture which is going to give you issues.

The biggest problem is the 'Free service' everyone wants to get better straight away with a pill straight away but dont want to seek alternatives. Or even pay 40 squid to see someone tomorrow to sort out the back ache. The GP gives endless advice on pain killers but none on stretching, seeking help themselves. Patient then returns week after week.

In reality Gp's already do up to half their consultations over the phone nowadays, where they can screen folk who need to be seen urgently or not, or by the nurse, pharmacist etc. Basically the problem is the rapidly growing ageing and/or obese population with high medical intervention demands and a chronic shortage of resources that has failed to keep pace. Couple to this the legal risks of failing to diagnose something properly, which can add greatly to additional, and often unnecessary referrals and admissions clogging the system.

 

[ollie989898]

Legalise drugs? You must be mad. Had you see the things I have you would be calling for a tax on table salt. The fact is obesity, diabetes and the usual suspects are soaring: people don't realise they are consuming the highly processed salt and sugar laden bilge the food industry is peddling to them 24/7 which is slowly killing us all. And whats more the government have allowed it to happen by pandering to big business for decades.

You aint seen nothing yet, wait until my generation hit their 60s.

Legalise cannabis? You must be off your head. A lot of people cant be trusted not to eat too much horsemeat lasagne.

 

[ollie989898]

It is worth noting that GPs have always been the primary point of care provision and are there to sign-post people to the next stage of the system as necessary. You can short-cut these in some circumstances but GPs are the first port of call for most.

It is right that people are seen by pharmacists or nurse practitioners if necessary, truth be told I think you will find a lot more nurses doing a lot more advanced stuff in time because they simply can't recruit or retain doctors at the rate required. For me, I would actually relish the chance to be a GP- they have the shortest training path and generally earn more as well at consultant level. Throw in the very nature of the job that is seeing people again and again where you are able to evaluate them holistically and know them on a personal or community level and I get the appeal- it's similar in fact to my old job in some ways. Compare that to the longer training period for other specialities and a much reduced number of slots for them and they don't seem to appeal to me as much for some reason- who the hell wants to change hips or knees all day?

Anyway, I think a lot of GPs get wrapped up in the whole business management side which I know takes up a lot of time. It's probably quite intense seeing 40 different patients a day as well and their case load will be ever more complex because as we age the list of ailments and drugs and treatments will be as long as your arm. I can imagine that if you are not from an area of have no association with it it could get very very lonely very fast or even become impersonal and be losing that feel of community as well. If you are a consultant cardiologist, you are going to be working in a department or ward with your peers and other team members so will be surrounded by a network of people.

As for diagnosis and the like, a GP does not have the level of training in all the areas. He has his knowledge and some basic tools and must be cognisant of the limits of his own knowledge and responsibilities (I very much doubt any GPs would be prepared to meddle too much with a patient who was actively on say, chemotherapy drugs). Don't be surprised if you are immediately referred elsewhere, that is what they are for.

The very nature of the job means that there will be a small number of mistakes made at some juncture and I think the system recognises that fact.

 

[capfits]

In reality Gp's already do up to half their consultations over the phone nowadays, where they can screen folk who need to be seen urgently or not, or by the nurse, pharmacist etc. Basically the problem is the rapidly growing ageing and/or obese population with high medical intervention demands and a chronic shortage of resources that has failed to keep pace. Couple to this the legal risks of failing to diagnose something properly, which can add greatly to additional, and often unnecessary referrals and admissions clogging the system.

 

[capfits]

Legalise drugs? You must be mad. Had you see the things I have you would be calling for a tax on table salt. The fact is obesity, diabetes and the usual suspects are soaring: people don't realise they are consuming the highly processed salt and sugar laden bilge the food industry is peddling to them 24/7 which is slowly killing us all. And whats more the government have allowed it to happen by pandering to big business for decades.

You aint seen nothing yet, wait until my generation hit their 60s.

Legalise cannabis? You must be off your head. A lot of people cant be trusted not to eat too much horsemeat lasagne.

Such a truism. Go to ag shows many folk look healthy, go to city centre the obese are everywhere.

I have West Indian friend who is consultant psychiatrist, much in demand, he advocates legalising drugs because those that take them and did not make it would serve as a warning to those that may take them.
I am also aware of more than few "functioning" heroin addicts. No obesity there for sure but their health is so compromised I doubt they will receive a pension.
Regular cannabis users are kidding themselves and are a liability. Psychosis takes a hold from time to time.
Heard a great one about a middle aged woman approaching her GP about a heart pain and irregular rhythms. Could not get to the bottom of it, until she finally let on she had been on her daughter's henny which involved the good old Columbian marching powder.....
Either way drug policy in UK is appalling and serves no one other than the high level pushers.

 

[fudge]

Legalise drugs? You must be mad. Had you see the things I have you would be calling for a tax on table salt. The fact is obesity, diabetes and the usual suspects are soaring: people don't realise they are consuming the highly processed salt and sugar laden bilge the food industry is peddling to them 24/7 which is slowly killing us all. And whats more the government have allowed it to happen by pandering to big business for decades.

You aint seen nothing yet, wait until my generation hit their 60s.

Legalise cannabis? You must be off your head. A lot of people cant be trusted not to eat too much horsemeat lasagne.

Cannabis is so available it might as well be legal. May I ask if you ever go out side with your eyes open?

 

[ollie989898]

Cannabis is so available it might as well be legal. May I ask if you ever go out side with your eyes open?

I dont care how accessible it is.

If you had seen what I have you would not be in favour of trivialising drugs.

 

[caveman]

Cannabis is so available it might as well be legal. May I ask if you ever go out side with your eyes open?

Don't need ones eyes open when neighbours kids have their bedroom windows wide open......... In the middle of winter.

 

[Mek]

People who call for the legalising of recreational drugs obviously have no experience of the problems caused by them.

 

[Mac10]

I went to the GP the other day and there were 175 missed appointments last month - surely time to charge say £20 to minimise missed appointments and focus the minds of willy nilly/just for chat type patients. I'd also like to see a charge introduced for drunks on a Saturday night, say.

I don't think the NHS was ever designed to cope with the population we have now - I don't think you could ever sensibly throw enough money towards it to make it work properly. I don't know the answer, but maybe to survive it will have to move to life saving and prolonging treatments only at the expense of IVF etc.

 

[Henarar]

I went to the GP the other day and there were 175 missed appointments last month - surely time to charge say £20 to minimise missed appointments and focus the minds of willy nilly/just for chat type patients. I'd also like to see a charge introduced for drunks on a Saturday night, say.

I don't think the NHS was ever designed to cope with the population we have now - I don't think you could ever sensibly throw enough money towards it to make it work properly. I don't know the answer, but maybe to survive it will have to move to life saving and prolonging treatments only at the expense of IVF etc.

It don't need more money it needs people to sort themselves out

 

[Muck Spreader]

Excellent

 

[Agrivator]

I went to the GP the other day and there were 175 missed appointments last month - surely time to charge say £20 to minimise missed appointments and focus the minds of willy nilly/just for chat type patients. I'd also like to see a charge introduced for drunks on a Saturday night, say.

I don't think the NHS was ever designed to cope with the population we have now - I don't think you could ever sensibly throw enough money towards it to make it work properly. I don't know the answer, but maybe to survive it will have to move to life saving and prolonging treatments only at the expense of IVF etc.

I guess that after having to wait a week or two for an appointment, a number of patients will have recovered( or died) and don't need to go.
In a perfect world, they would phone to cancel, but even so, if a patient doesn't turn up, surely the medical staff have more time to spend chattering or attending to those that do.

 

[ollie989898]

I guess that after having to wait a week or two for an appointment, a number of patients will have recovered( or died) and don't need to go.
In a perfect world, they would phone to cancel, but even so, if a patient doesn't turn up, surely the medical staff have more time to spend chattering or attending to those that do.

A dangerous policy- the person ringing today might have a chest infection which is a whole lot harder to deal with if it was left untreated for another week. Elderly people, in particular, could die from it.

 

[Danllan]

...I am also aware of more than few "functioning" heroin addicts...

Either way drug policy in UK is appalling and serves no one other than the high level pushers.

Yes to that last bit.

With regard to the first... I have met some too and a surprising number reliant on cocaine too. In one instance I was having some drinks in the Old Bank of England following a friend finishing well after a very long fraud case. Someone I knew fairly well, a respected Chancery Barrister who was the long-term boyfriend of a friend of mine, came into the men's room after me, went in to a cubicle and came out a minute or so later after clearly having snorted some coke, he saw me staring and, I guess, assuming that he had committed a bit of a social faux par went on to offer me some...

I'd known this fellow off and on for a couple of years, had no suspicion at all of his 'habit' and was utterly shocked. Turns out he was spending a huge amount weekly and had been for a long time. It hadn't affected his professionally as far as I am aware.

Another person, a Civil Servant, always looked very spare, but I'd no idea until told by his brother.

A dangerous policy- the person ringing today might have a chest infection which is a whole lot harder to deal with if it was left untreated for another week. Elderly people, in particular, could die from it.

Very true, but since so many people often won't use common sense, common sense dictates that there needs to be a way to 'triage' GP patients. Receptionists are a no go, a practice nurse at reception, a paramedic? It is hard to balance resources, but they are finite so must be looked after somehow.

 

[Widgetone]

A dangerous policy- the person ringing today might have a chest infection which is a whole lot harder to deal with if it was left untreated for another week. Elderly people, in particular, could die from it.

Agree, the waiting time at our surgery is 3 weeks apparently. The advice is to go see a pharmacist at Boots or wherever for immediate consultation.

 

[Boohoo]

Rang the doctors to make an appointment for a medical today, was told that appointments can only be made in person and that a £20 deposit is required. This is to try to reduce the number of no shows and wasted time because a medical, in my case for a driving licence renewal, is what they call a triple appointment. Is it time to start charging for all no shows? Maybe not money up front for NHS appointments, but if you miss an appointment you can't make another appointment until you pay a fee?

 

[Henarar]

They have a sign up in our doctors showing the number of missed appointments for the previous month, its usually around 50 for doctors apps and more for nurses