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doctors appointments
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what happened to the good old days when you could just walk into the waiting room and wait until the doc called you?? at mine you have to tell the receptionist whats wrong then she passes it on to the "on call" doctor who then decides if you should be called back early or late and then after you telling him/her the problem whether or not you should have an appointment or if he/she will just leave you a prescription!!!
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Hi everyone - the old days are not what they were. When I started my current job, I agree that quite often, a single-handed GP had a manager/receptionists who was often his wife, who as often as not was the nurse as well. In the past 14 years I have seen general practice change from the sort of Dr Finlay model which some of you describe, to highly efficient businesses employing well qualified nurses, and professional practice managers. You would not believe the amount of targets and quality measurements every GP practice has to live up to these days - and has to demonstrate and be audited on, otherwise they don't get the quality and performance payments which some of you have mentioned as being GP salaries. The money the GPs get from the PCTs are all performance-related and have to cover staffing and establishment costs, insurance, you name it to do with the business. The new structures being proposed will mean that the funding for the NHS goes down to local level, local groups of GPs commissioning services for their own patients instead of being commissioned by the PCTs. My own GP and practice nurse will do email consultations as well as speak to you on the phone - but many practices now have triage processes where patients are filtered to try to assess urgency - otherwise they just can't cope. We expect a lot of our primary care practitioners - long may they continue.
A very late comment. I live in one of those places in Norfolk that Shaney mentions. 4 houses and a church. No public transport. And many people in this county have never left their villages and neither did generations before them. People don't have opportunities to choose where they live and can't afford to if they did want to live elsewhere.
It is pretty obvious that some people really don't appreciate what real rural life is like!!
Taxis's indeed. Not even easy to get one around here. No such thing as taxi ranks!!
It is pretty obvious that some people really don't appreciate what real rural life is like!!
Taxis's indeed. Not even easy to get one around here. No such thing as taxi ranks!!
I have been with the same doctors' practice for my whole life and have had just 3 doctors in that time. Decades ago it was always possible to see one of the 2 drs within hours, always on the same day. The practice has moved into vast premises and there are 6 doctors, nurses, practice manager and several receptionists. Surgery opens at 8 a.m. If i need an appointment I start dialling at about 7.58 a.m. and make continuous speed re-dialling a matter of course. if i cannot get my call answered before 9 a.m. then I have no chance whatsoever of seeing my GP that day. There is a system for booking appointments in advance but I haven't cracked that one yet as they move their goalposts on a very regular basis. Heaven help any receptionist who asks me for my reason to request an appointment after I have dealt with all that.
As far as doctors are concerned, I don`t think it is their responsibilty to worry about whether people choose to live in an isolated area. I was brough up in an isolated area. My grandmother never went out of our village for 20 years. My dad called a doctor out for her when she was in her late 80s as she had a pain in her leg and was hallucinating. It turned out that she had a fractured theigh bone and a water infection. My mother always used her "gumption" and only ever contacted a doctor when she knew the situation was serious. Maybe today people are so mollycoddled that the call on the medical services at the drop of a hat.
I never said he wasn't entitled to his dram and fag Sandy :)
I was just making point as to how the old style family doctors used to be .
He was a wonderful family doctor as was his son who looked my late parents .
His son was the one who was came on "home visits " to look after my Dad while he was dying from cancer .His son was that wonderful doctor who let my dad die with dignity "at home".
I was just making point as to how the old style family doctors used to be .
He was a wonderful family doctor as was his son who looked my late parents .
His son was the one who was came on "home visits " to look after my Dad while he was dying from cancer .His son was that wonderful doctor who let my dad die with dignity "at home".
237SJ
<<<<Maybe today people are so mollycoddled that the call on the medical services at the drop of a hat.<<<<
Exactly, but that is not the fault of the people, as the NHS is all the people have ever known, supported by the 2 main Governments, but this cannot continue and the people will have to take some responsibility in their own health care.
It must be paradise living in little "Hamlet Areas" but they do have their drawbacks............maybe Post Office closures and acute life saving medical care many miles away.
There are pluses and minuses living anywhere in the world...even in the rural areas and even the "Med"
<<<<Maybe today people are so mollycoddled that the call on the medical services at the drop of a hat.<<<<
Exactly, but that is not the fault of the people, as the NHS is all the people have ever known, supported by the 2 main Governments, but this cannot continue and the people will have to take some responsibility in their own health care.
It must be paradise living in little "Hamlet Areas" but they do have their drawbacks............maybe Post Office closures and acute life saving medical care many miles away.
There are pluses and minuses living anywhere in the world...even in the rural areas and even the "Med"
I have friends who live inland from Malaga, sqad, we saw them last week - they are delighted with the speed and efficiency of the Spanish health service. To off-set that, youth unemployment in Spain is 20%, half the youngsters are heading to Germany and finding jobs there, where we stay half the shops had gone out of business - the recession there looked even worse than here.
boxtops.......on the whole, the Spanish Health System is excellent.........but like most Health Care programmes has it`s questionable aspects.
In Spain...GP´s role is mainly to investigate and refer as quickly as possible to the specialists which is reflected in competitive survival rates for cancer.
Polyclinics, of which I am a huge fan, are popular in Spain.
Giving the GP´s the ability to hold their own budgets, in my opinion, is total madness.
Spain is suffering badly with unemployment as you rightly point out.
In Spain...GP´s role is mainly to investigate and refer as quickly as possible to the specialists which is reflected in competitive survival rates for cancer.
Polyclinics, of which I am a huge fan, are popular in Spain.
Giving the GP´s the ability to hold their own budgets, in my opinion, is total madness.
Spain is suffering badly with unemployment as you rightly point out.
sqad - the new consortia won't give the GPs the right to hold their own budgets for core services, any more than they do now, core GMS provisions will still be commissioned From Above from the National Commissioning Board. The budgets which are going to be devolved to the consortia are the ones for each Consortium to commission services from other providers (e.g. the acute sector). Certain essential national services e.g. cancer care will still be commissioned centrally by the NCB too.
The pace at which this is being driven through is alarming.
The pace at which this is being driven through is alarming.
Do any of us..? since it's all being devised as they go along, we keep getting instruction From Above on a daily basis, and the Bill hasn't been through the House of Lords yet, so anything could happen.
As I understand it - the NCB commissions core GP services from the individual practices (this is much the same as at present except at the moment it's the PCTs). Every practices has to belong to a consortium. The consortium will contain people who are expert at commissioning services from e.g. the secondary sector, for their local population, and the lead GPs in the consortium will decide what's going to be commissioned in a year for that population. Every individual GP isn't going to be involved in that activity, others will do it for them. Some services eg cancer are deemed so vital that they will still be commissioned nationally.
I wouldn't expect that many patients will notice much difference at individual surgery level, except that the Care Quality Commission and Monitor are going to be in charge of monitoring practices' performance and can delist anyone who doesn't come up to the mark - as I understand it.
As I understand it - the NCB commissions core GP services from the individual practices (this is much the same as at present except at the moment it's the PCTs). Every practices has to belong to a consortium. The consortium will contain people who are expert at commissioning services from e.g. the secondary sector, for their local population, and the lead GPs in the consortium will decide what's going to be commissioned in a year for that population. Every individual GP isn't going to be involved in that activity, others will do it for them. Some services eg cancer are deemed so vital that they will still be commissioned nationally.
I wouldn't expect that many patients will notice much difference at individual surgery level, except that the Care Quality Commission and Monitor are going to be in charge of monitoring practices' performance and can delist anyone who doesn't come up to the mark - as I understand it.
boxy....less GP.s and more specialists is the answer in my opinion, but if a graduate can earn as much as a Consultant, more quickly, better "family" hours, with less post graduate training and no post grad exams........why specialise.
The gap between GP´s salary and Consultants salary has to widen, to entice more people to go into hospital work.
The gap between GP´s salary and Consultants salary has to widen, to entice more people to go into hospital work.
shaney, you say that everyone should be entitled to the same level of service, no matter where they live. Does that mean i should expect home visits from my GP all the time because someone who lives in rural norfolk without a car or public transport expects it? (ps no-one has confirmed or denied voluntary car schemes in there area - in my experience the rural practices try to make sure people are not disadvantaged by having them) Would these same people expect a hospital consultant to come to their house because they couldn't get to the hospital?
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