GP weekend cover

Re: GP weekend cover

Hannah Wynne Richards — Tue, 03 Feb 2015 11:24:05 GMT

The reason I stopped using VN was that they gave telephone advice, instead of simply offering everyone an appointmeny.

Wynne

Re: GP weekend cover

J G Wray — Tue, 03 Feb 2015 10:20:13 GMT

[quote user="Anthony Todd"]Why do you think that was? Can't be the cost as you would have charged too.??[/quote]

I make the distinction between calls and attendances - I think the drop was due to

a) Clients were used to making calls for advice OOH from one of their vets, regardless of whether it was an emergency or not and this stopped

b) At that time other practices locally weren't using VN - we all do now - and so a few callers moved on to another practice

We have never been paranoid about losing clients, after all OOH does not define our service, it is exceptional. We had an increase in daytime appts being filled at a time when we could provide a better service.

I'm pretty sure our experience is far from unique and anyone who has set up a new VN practice would know whether our experience was typical or otherwise

Re: GP weekend cover

Anthony Todd — Tue, 03 Feb 2015 09:41:04 GMT

[quote user="J G Wray"]In the month following our switch to the excellent OOH service from Vets Now the number of calls which went past our recorded message and on to Vets Now dropped by 75%[/quote]

Why do you think that was? Can't be the cost as you would have charged too.??

Might be that if A&E OOH made the "patient" ring for an appointment attendance would drop except for genuine emergencies??

Or a lot of the calls were not for an attendance but enquiries about hours, age at puberty, or whatever??

Re: GP weekend cover

J G Wray — Tue, 03 Feb 2015 07:58:41 GMT

[quote user="Anthony Todd"]Similarly how many OOH calls to vets are urgent or prompt?[/quote]

In the month following our switch to the excellent OOH service from Vets Now the number of calls which went past our recorded message and on to Vets Now dropped by 75%

Re: GP weekend cover

Anthony Todd — Mon, 02 Feb 2015 23:21:32 GMT

[quote user="Peter Stotesbury"]What a load of nonsense; a point with no reference to the reality of states without public health care. [/quote]

Well ,true, but it would be interesting and relevant to see just how many attendances for medical attention either at A&E or GPs were necessary and or urgent.

Similarly how many OOH calls to vets are urgent or prompt?

Re: GP weekend cover

Anthony Todd — Mon, 02 Feb 2015 22:50:33 GMT

I wonder if there is any evidence collected at all.

The crisis is blamed on immigrants, drunks,and other social abuse, lack of GP availability etc. etc.

Surely there is a need for some statistics rather than some politically correct "solution".

"If you don't measure you can't manage." [a quote, not mine]

PS A GP told me ,a few years ago, that of the 150 patients he had seen in that week only 2, in his opinion, needed his services...... one, he said was severe tonsillitis and I've forgotten the other....

Re: GP weekend cover

Peter Stotesbury — Mon, 02 Feb 2015 20:57:15 GMT

[quote user="Hannah Wynne Richards"]

If the system was privatised (in it's entirety - no subsides for those on benefits) market forces would soon sort it out - and give the rest of us a much better service!

Wynne

[/quote]

What a load of nonsense; a point with no reference to the reality of states without public health care.

Re: GP weekend cover

Hannah Wynne Richards — Sun, 18 Jan 2015 09:19:51 GMT

I'd stop all those other wastes of taxpayers money as well. I bet if I was running the country, I'd get tax freedom day back to 28th Feb in no time at all.

Wynne

Re: GP weekend cover

karen jones — Sat, 17 Jan 2015 18:28:37 GMT

[quote user="Hannah Wynne Richards"]

Taxpayers can't afford the "resources" End of.

Wynne

[/quote] We can afford to undertake cyber war games with USA, finance aid to India who can afford to send spaceships into space, waste thousands on changing TB system , the useless Sam system, changing the NHS again after saying they wouldn't .cuts in social services backing people in hospitals, short term cuts which cost a lot more in the end We can afford to look after our people if things were managed properly

Re: GP weekend cover

Hannah Wynne Richards — Sat, 17 Jan 2015 11:56:33 GMT

Taxpayers can't afford the "resources" End of.

Wynne

Re: GP weekend cover

Thomas Johnson — Sat, 17 Jan 2015 11:33:08 GMT

[quote user="Bob Russell"]

Resources should be put into GP practices to allow proper levels of cover without doctors being unacceptably stressed. Happy working GP's should result in a good service and less pressures on hospitals. Nurse run minor injury units covering Saturday pm and Sunday am/pm with GP availability where really needed.

[/quote]

I agree that the problem appears to be lack of availability of GP treatment both during normal working hours and outside of them. I think GPs are fully aware of the problem, they just don't have the resources to deal with them.

Re: GP weekend cover

Bob Russell — Sat, 17 Jan 2015 11:20:43 GMT

GP practices can and do employ part-time doctors. Working hours can be kept manageable by adequate staffing levels. I don't believe GP practice is a bed of roses and it is clear that much of the real crisis is here. Good GP availability 5½ days a week (adequate appointments to be available). Most will wait from Sunday to Monday even in this world of 'we want it now!'. I suspect people go to A&E because they suspect there will be no appointment available on the Monday so go for convenience over good sense.

Good GP cover (and nursing care) will allow patients to be discharged more efficiently from hospital. Patients in A&E can then be moved out to proper wards.

The crisis is not in A&E, it is in GP practice. A&E are just expected to pick up the pieces. Drunk tanks attached to A&E where minor injuries can be treated in a more secure environment and people can sleep the effects of alcohol off. Perhaps off to court the next day to be fined for any unacceptable behaviour.

Use the 'lowest' suitable level qualified person to do the bulk of the work (not having a dig at nurses - my mother was one of the first nurse practitioners in the UK!) but they are perfectly placed to deal with the minor issues and professionally triage the more serious cases.

Re: GP weekend cover

Hannah Wynne Richards — Sat, 17 Jan 2015 10:03:06 GMT

If every GP practice went back to doing it's own OOH, the shifts would be less arduous.

Wynne

Re: GP weekend cover

Thomas Johnson — Sat, 17 Jan 2015 09:44:45 GMT

[quote user="Sammy82"]

So a GP cannot be expected to work out of hours after doing 8-6.30 five days a week but for us vets it 's fine?

[/quote]

I don't think it's fine for vets either, when I work weekend shifts I get time off during the week. My understanding from talking to GPs I know is that they're so over-stretched that they couldn't reduce hours during the week to cover extra shifts at weekends.

There's also a difference between doing your own on call, which I did for 8 years, where you might get one or two calls a night, usually before midnight, and working an overnight shift at an out of hours centre, where you're likely to be much busier. GP out of hours cover is busy all night. You wouldn't expect a vet to work a full day, do a night shift at Vets Now, then do another full day at work.

Re: GP weekend cover

Lucy Fleming — Sat, 17 Jan 2015 08:21:09 GMT

[quote user="Sammy82"]

So a GP cannot be expected to work out of hours after doing 8-6.30 five days a week but for us vets it 's fine?

[/quote]

We don't have to do it though - we have to set up some provision which might be covering it ourselves, or delegating to a service provider. I may be wrong, but I'd venture to suggest that most GPs deal with a larger and more demanding set of patients than the average veterinarian - my dad works OOH GP shifts for NHS Grampian and that certainly seems to be the case for him compared to my on call work!

Re: GP weekend cover

Sammy82 — Fri, 16 Jan 2015 17:51:23 GMT

So a GP cannot be expected to work out of hours after doing 8-6.30 five days a week but for us vets it 's fine?

Re: GP weekend cover

Thomas Johnson — Fri, 16 Jan 2015 17:26:55 GMT

[quote user="fluffygirl"]

'If GPs already work 8am to 6.30pm Mon-Fri how on earth are they supposed to work Saturday and Sunday as well? These good people have families/life too. The 100k salary for GPs is a myth perpetuated by the Daily Mail'

[/quote]

If they're already working 5 days a week 8am to 6.30pm, and a friend of mine who is a GP regularly works until 8pm, then they can't be expected to work weekends as well. So either they need to do fewer hours during the week so they can work weekend shifts, which isn't going to work as they're already over-booked during the week; or they have to recruit more doctors, and I can't imagine the government is going to cough up the money for that.

The current system isn't working, but the solution is not going to be straightforward.

As far as pay goes, my GP friend is a partner in the practice, he earns more than I do, but it isn't even close to £100k.

Re: GP weekend cover

fluffygirl — Fri, 16 Jan 2015 17:08:56 GMT

There are some interesting discussions on this topic on t'internet, particularly after the Hinchingbrooke A&E issue. I happened across a blog on the Guardian website ('Surviving a night in A&E; a doctors story) by an senior registrar wich suggests a lot of time and resources are spent on dealing with drunks and folk with minor ailments out of hours. I also came across a Dr Rant Facebook page - on one thread someone dared to suggest that if GPs worked weekends then it would help take the pressure off the system. This is one of the replies which I thought was worth sharing:

All I know is that as a pet owner I can access general health care for my dog after 6.30pm and at weekends but the same is not true when it comes to my own health (and is considered unreasonable it seems).

Re: GP weekend cover

Hannah Wynne Richards — Tue, 13 Jan 2015 15:38:16 GMT

Thomas and Sarah. It looks as though taxpayers won't get the expensive treatments on the NHS, so what have they to lose by complete privatisation?

Wynne

Re: GP weekend cover

Hannah Wynne Richards — Tue, 13 Jan 2015 08:53:37 GMT

Anthony, 34 years qualified, and being called a modvet. Are you trying to chat me up?

Wynne

Re: GP weekend cover

Anthony Todd — Mon, 12 Jan 2015 18:36:25 GMT

[quote user="Hannah Wynne Richards"] Daily Mail - one day last week.[/quote]

Crikey, and you modvets are on about evidence based medicine and quote the Daily Moan who never miss a chance to throw things in their worst light..

I'll bet the most significant factor is the delay between the "lump" being noticed and positive medical attention ie eliminating the dismissive platitudes

Maybe correct but I'd love to see the statistics as well as the false positives etc. etc.

Re: GP weekend cover

Sarah Keir — Mon, 12 Jan 2015 18:35:25 GMT

Exactly, private insurance is perfect either.

Re: GP weekend cover

Thomas Johnson — Mon, 12 Jan 2015 15:42:49 GMT

[quote user="Hannah Wynne Richards"]

Sarah It's just been announced today, there will be further restrictions in the cancer treatments available on the NHS. 1/7th of all taxation goes to the NHS. Many current NHS patients could have afforded private insurence - if the amount stolen from them by Inland Revenue was reduced by 1/7th. This will further widen the gap between British and American cure rates.

UK = land of no opportunity, where, however hard you work, taxation keeps dragging you down again.

[/quote]

But would they have got this expensive cancer treatment if they were insured? My mum died of breast cancer 11 years ago, she was treated privately as my parents had private health insurance through my dad's employer. Her annual insurance limit was somewhere around £50,000, there were several years when it was all spent, and drugs have got a lot more expensive since then.

Re: GP weekend cover

Hannah Wynne Richards — Mon, 12 Jan 2015 15:41:34 GMT

Daily Mail - one day last week.

Wynne

Re: GP weekend cover

Anthony Todd — Mon, 12 Jan 2015 14:49:28 GMT

[quote user="Hannah Wynne Richards"]

Thomas An American woman diagnosed with breast cancer at an early stage has a 97% survival rate at 5 years in the USA, only 78% here. I haven't had the chance to research any other diseases yet, but I will if you want.

Wynne

[/quote]

Give us the reference[s] 'cos often apples and oranges are being compared.