UKC

My daughter has been trying for four days to get an appointment with a GP and finally gets a telephone appointment for something that (even if it actually happens which I wouldn’t bank on) is patently unsuitable for telephone consultation. It’s like living in a third world country. It would be easier and quicker to get health insurance and a flight to Australia or somewhere else civilised. I’m f*cking furious. It’s like a battle of wills where I think they hope you die first so they don’t have yo see you. 

A freind is dying because he couldn't get a prostate test quick enough.

Another freind has been getting exceptional care for her bone marrow cancer and hopefully will pull through.

It really does seem a lottery if you get seen or treated at the moment. 

I’m really sorry about your friend. 

Feel for you. Some (many/most?) GP practices have gone OTT. I’m trying to keep cool with ‘stuff’ but I know loads of folk who’ve had to put measures in place and crack on. I have. My GP hasn’t. 

Really sorry to hear about that. I wonder, did she or you firmly ask for face to face instead? We have the option to at least ask at our GP. Or is it possible to go to a different GP / surgery? Just thinking out loud. Or can she go directly to an NHS hospital?

Sorry because you have probably thought of all this already 

In any case I hope you get what you need soon 

Blaming individual GPs for this situation is misguided. Demand is higher than ever and GP numbers don't match up to it. It's not about caring or cracking on.

Sorry, not misguided, absolutely spot on.
 

Most GP surgeries are fine, some are brilliant but a lot, and I do mean a lot, totally dropped the ball when covid hit and retreated from patient contact. People are now vaccinated, covid isn’t quite as scary but some practices have decided they quite like avoiding all that messy face to face stuff.

I have mixed feelings about it, its easier to get an appointment at our GP than ever before but only a telephone one where invariably I have been asked to come in for a face to face.

On the one hand I like the idea of screening out the time wasters on the phone but on the other hand I'm sure things get missed.

Nonsense. Alright, as you've only said "some" then sure, across the country there probably are some that are doing an egregiously terrible job and don't care to do better. But the broad implication that the surgeries doing telephone appointments are just looking for an easy life and using Covid as an excuse is nonsense.

I know several GPs. All of them have to do telephone appointments these days. All of them would prefer to be seeing everybody in person. They actually find telephone appointments quite stressful. The simple fact is that they save time and that's necessary given the pressure that the system as a whole is under. It's far from an ideal situation but that's not in their control.

Our GP hasn't done this but our dentist certainly seems to have decided that they can't be bothered with all those pesky NHS patients.

I did get a GP appointment, I received a phone call telling me directions to a empty room and told to stand in the middle, the door opened and a full biohazard suited doctor eyes wide open entered to look in my ear which was the issue and walked out not a word in truth I think they had stopped breathing.

Received new phone call to return to car where a conversation took place.

All in with pre and post conversation it must have taken over an hour.

You say "Nonsense" cos you know several GPs. 

I say "fact" because I directly interact with a wide variety of GP practices several times a week on behalf of patients and ask half a dozen patients "when did you last see your GP" every shift I work.

If you have mixed feelings about it you should hear what 90 year old Doris, with here morbid fear of phone bills, thinks. Or 80 year old Bert who's deaf as a post and can't work his hearing aide, or 18 year old Charlotte, who's not doing well since she came out of care, has started cutting herself again and can't face telling her social worker, let alone a disembodied voice on the phone.

Things certainly do get missed (nothing beats eyes on when assessing) and once covid stats stop muddying the waters, we'll have the mortality stats to prove it.

I've had a few telephone appointments post covid, for mental health reasons, so this has been appropriate for me.

I do wonder how much time gps must be saving, as I'd imagine there must be plenty of no shows or late people pre covid, where they would essentially be left twiddling their thumbs, now they can just dial the next number. Must be a fairly big efficiency improvement in that respect. 

I'm sorry to hear you've had poor service. I'd stick a complaint in. They won't charge their ways otherwise. Hope you get sorted.

Same here.  Used to have check up and scale and polish every six months with excellent NHS dentist.

Have not been seen for over 2 years but if I wish to see same dentist in their beautiful private clinic, and pay through nose for it, I can be seen the same week.  And if I fancy a little bit of dermal filler to smooth out a wrinkle or two while Im in there, that can be attended to as well.

If you go private who's going to see you? A doctor that would otherwise be seeing someone in NHS situation. There isn't a big pool of GPs just sitting around waiting for money. 

If you really want to go to Australia, fine, ta ta. 

Out of interest, how do you know that some practices have decided they like avoiding face to face appointments? I was beginning to think that might be happening in my local practice at one point until I found out nearly half their GPS either had COVID or were self- isolating. 

There is no doubt at all that the service from our GP radically improved with the measures put in place for COVID.

Online contact followed by Telephone triage followed by face to face later that day if needed.

Appreciate that online doesn’t work for everyone but the efficiencies must be beneficial to those who phone in as well.

What I don't get is why they have staff shortages so reduced appointment capacity sure to staff isolating - when they are exclusively offering phone consultations. Surely it is within the realms of possibility to set up a phone system where by isolating staff can work from home?

Personally I have in occasion been glad of a phone appointment, an absolute godsend when you have CFS and no access to transport. Also my GP is near to home yet appointments are invariably in working hours, so are far from convenient to attend unless scheduled at the very start of the day.

That said my husband delayed calling about an ear infection until he had a rare day off, but was only offered a phone appointment. Was then offered a second appointment two days later to actually have someone peer down his lughole - in pre covid times it would have only required a single appointment. (For his 9am in person appointment, he was at in the waiting room for over an hour waiting to be seen - so much for keeping contact time to a minimum)

Because post covid, some GP practices now regularly send for an emergency ambulance response to assess their patients for them. These are for presentations that absolutely don't warrant an emergency ambulance response.

Because when I ring a GP practice for a patient (probably 10 or 15 times a block) if I'm on hold longer than 10 minutes I now drive round to the surgery, phone in hand on loudspeaker, and I physically see how many doctors have their name on the sign, how many are in and how many patients are in the waiting room. When there are no patient's waiting in a sizeable practice, I draw my own conclusions.

He doesn't, he sees the service failing and has decided that lazy existing GP's are personally, individually, to blame for that. Like blaming the local council for the consequences of savage cuts to funding from central government. Like waiting 5 hours for an ambulance and concluding that the problem is basically that paramedics just can't be arsed.

Yeah, no.

See my response above and perhaps consider which of the two of us is jumping to baseless conclusions.

The last thing the NHS needs is individuals in the system taking pot shots at an entire sub-system. It's lazy and its dumb. Bad things happen but nearly all of that is down to the fact there are not nearly enough GPs to go around made worse by a necessity to deal with covid restrictions and staff off with covid or isolating.

Failures in the ambulance service in the last year have arguably been the worst in the NHS... I'd be equally disgusted if people blanket blamed that on the staff working in that service.

There may well be better models to deliver Primary Care in the UK but if this system was funded properly and covid was over it would be much better than it is now.

Some data....

https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressu...

Don't get me started....Our GP surgery has a group of front-desk/receptionist personnel. They act in the manner of night-club bouncers, are often blunt to the poinrt of rudeness and verge on unethical ; "Why do you want to see the doctor" (paraphrase) being the frequent question asked - once I've listened to 3.5 hours of tinny music, interrupted by some unctious recommendation that all of this would be far more convenient for them if you booked an appointment via their website.

Our GP practice website has an online consultation thing and the receptionist told me to always click through to "general health query" and then you answer a couple of questions e.g. "are you currently having chest pains if so call 999" etc., then you have a free text box to put in what the issue is. Maybe your / all practices have this? It does lead through to an NHS website (i.e. not the basic practice website).

We've never waited more than a couple of hours for a response, typically a phone call to clarify the issue, leading to being seen that day after 5pm face to face, or an email and a new prescription.

I will say that the issues have been relatively mild (renewing an adult prescription, baby with ear infection) things like that. And I know babies probably get priority treatment, but the system works perfectly for us. 

I read stuff like this thread and I do think, if it is a lottery we've either struck lucky with the practice, or been lucky enough in health to not want something urgently for pain etc. (which we might not get seen quickly.)

Yeah, it's kinda both of us. No doubt you're right and a few GP's aren't trying as hard as others. (Never mind that there might be good reasons for that that aren't particularly obvious.)

Then again when you assure the OP that that is indeed the problem in this case what you're really saying is that it's all of them

Here's what I wrote "Most GP surgeries are fine, some are brilliant but a lot, and I do mean a lot, totally dropped the ball when covid hit and retreated from patient contact."

What's lazy and dumb is taking the position that "sub systems" of anything are above all criticism. Do you extend the same criteria to local bus provision, refuse collection or your local police? The Mets recently come in for a bit of a hammering on here because of the actions of a minority, can't recall you calling anyone "lazy and dumb" though. 

No shit

Reread my post, I'm making a comparison between different GP practices, operating in the same area, under the same conditions, providing a wildly variable service to their patients.

I didn't reply to the OP, I replied to another poster stating that "Blaming individual GPs for this situation is misguided".  Note "individual", the opposite of "what you're really saying is that it's all of them"

The 'bad GP' was a much bigger issue 20 years back when there were way more single practitioner practices.

Complaints about doctors are often related to serious staffing issues, made even worse by covid.

https://www.bmj.com/content/376/bmj.o53

How big is a lot? It certainly implies a system failure to me (that the good ones and brilliant ones muddled through despite the system). When you talk about GP surgeries, it's very rare for GPs to work as individuals anymore so you must really mean practices are bad, OK or brilliant? Have you made an assessment of complaint levels versus the severity of individual practice staffing issues or the differing complexity of their patient demographics?

If you look at the overall data face-to-face consultations didn't stop after the first wave and overall demand and consultations increased during covid (and that's excluding the big increase in those who go directly to A&E). The NHS was cracking under the workfrce and funding strain prior to covid.

Some ambulance services were less terrible than others in late 2021 when the pressure was appalling,  was that a bad, OK and brilliant staff or management issue or more to do with local capacity issues and demographics?

Yes I don't blame bus drivers when funding for buses is the real issue. Sure I blame the Met leadership and regard racist and misogynistic officers as having no place in the force but have defended the police in general on many recent threads and I recognise the management failures are partly due to austerity as well.

I'm sympathetic to what a tough job GPs have, and I know there's not enough of them, but ours have a system where you have to ring at 8am to get a (telephone) appointment. What happens when you eventually get through is you're told all the appointments have gone and to try tomorrow. This goes on for several days and is incredibly frustrating. When this happens day after day, the only way I get an appointment is by being very firm and asking about their complaints procedure/to speak to practice manager - an appointment often then becomes available. I feel for people who aren't able to do this.

Recently I had a hospital appointment converted to a telephone appointment; I was surprised as I thought they'd want to examine me. They then wrote to my GP saying that I might or might not have xxx but it hadn't been possible to examine me due to telephone appointment and suggested I be referred to another department for them to do it. I then got a call from the GP surgery to say the GP would call me next Thursday to discuss. Basically - someone needs to shine a light down my throat and that's not going to happen over the phone. I get that this is likely a symptom of underfunding but again it's frustrating.

I finally got to see a doctor in person and get possibly the most thorough examination/consultation of my life by volunteering for a medical trial for a new drug for a different long-term health condition I have, but presumably the doctor's time was being paid for by the pharmaceutical company - the difference was stark. 

My daughter has been through a form of triage with 111, and been told she needs an appointment within 3 days - this was after many hours on hold. She managed to get an appointment for today which was reassuring until I found out last night that it was a telephone consultation for something that can’t possibly be resolved over the ‘phone, so is wasting not only her time but theirs as well. I just can’t see how that helps anyone. 

Given the large number of people who misuse primary care and the serious and increasing capacity issues, especially in deprived areas, at what level would you set the receptionist 'guard dog' response? I used to be a bit frustrated with GP receptionists until I ended up making regular visits and saw and heard what they had to put up with.

I am trying to get a new EpiPen because mine is out of date. I have phone up the GP and they have said it has to be done through their website. On their website it appears they have 3 different systems in place.

MySurgeyApp
eConsult
MyHealthOnline

None of which seem to talk to each other, all have separate accounts and seem to be sending me in a loop between all 3. About 2 hours now trying to order a new EpiPen, and I am somewhat IT literate.

That's happening locally now I believe. 

It does have some advantages, for both patient and practice, but it seems to me that reception staff don't have the necessary skills to assess who should be seen face to face. 

As above... The use of remote appointments has been introduced piecemeal in response to a crisis situation and is inevitably poorly implemented in places. All staff need to be trained in how to use this system appropriately. 

This is a good point.  I had an appointment for a back injury and the GP noticed I had skin cancer on my arm.  I had it cut out within a week. 

Well to add to that list I think you can just simply reorder on the NHS app. You know the one on your phone with your vaccine certificate. my software daughter pointed this out to Mrs H..There is a repeat prescription service.

Clever bit of NHS technology.

Have to admit Mrs H and I have used the econsult service at our surgery quite a few times over the last couple of years and found it excellent. This included a worrying potential lung cancer possibility which was very smoothly dealt with.

That might have been true early on in the pandemic but on average the majority of appointments have been face-to-face for months. Any surgeries not doing this will have other reasons. The biggest problem is still a serious and worsening problem in capacity:

From the BMA link above (and remember 2015 was a time when Primary Care was under significant pressure and the current situation doesn't take covid staff absences into account):

"Despite there being 1,516 fewer fully qualified FTE GPs today than there were in 2015, each practice has on average 2,222 more patients than in 2015. There are now just 0.45 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015. For the GPs that remain, this means increasing numbers of patients to take care of. The average number of patients each GP is responsible for has increased by around 300 – or 16% - since 2015."

"General practice appointment bookings reached record highs over the winter of 2021 with GPs seeing more patients than ever. The December 2021 total of 29.1 million appointments is 4.9 million (20%) more than the levels of December 2019. The ratio of F2F (face-to-face) versus remote appointments has shifted with the waves of the pandemic, but the majority of appointments have always been delivered in person. Currently, nearly two thirds of appointments are F2F."

What the illustrated case above ignores is that a significant number don''t need to see the doctor in person and as such a telephone appointment is often an improvement in service.

Hi,

I can see how the system in place at our GP does help everyone… they telephone triage everyone and get through a lot of people in this way, leaving more time for those who need to have face to face time such as your daughter. Hope she gets sorted soon.

It’s a shame that as Stichplate says that more haven’t embraced this online/phone way of working as it really does seem more efficient..

Not sure that works in Wales as we have a separate system (of course!) same as the covid passwords wouldn't work in the NHS App. Also it isn't a repeat prescription as such more when it goes out of date (about a year) ask for a new one

An update to say once I had got past the idiocy of trying to get past the filtering system (3 hours in the end) I was able to write in a text box what I was after, and an hour later the prescription has gone to the pharmacy to be picked up in 2 days.

GPs are no longer the only clinicians in Primary Care. Practices now often employ specialist pharmacists, physios, podiatrists, nurses, councilors etc.  Receptionists aren't asking why you want to see a GP because they're nosy. They are trying to ensure you see the most appropriate specialist for your problem.

I'd agree. I do, however, object to the bull mastiff approach in operation at our local place.

I know three who have given GPing up, in hte last month because it's too stressful.

I think what's frustrating is the variation in GP efficiency and service provision.

I'm purely talking from experience here, but where I live the GP surgery is very 'on it' with a web-based AskMyGP system that allows you to interact with them about your problem, and allows them to triage. It works.

Where my elderly mum lives by contrast, her local GP surgeries have no such system. It's the 'get on the phone at 8:30am and find there are 30 people ahead of you in the queue' experience. She literally has no way of getting in front of a GP without spending hours on the phone.

I'm not necessarily advocating that GP systems are centralised, but the present situation - where GPs act as individual businesses from a systems/service point of view - is not fit for purpose.

Totally happy to bow to your wider experience of different practices. Perhaps I should clarify what you were actually saying in the first place. I read your original statement about some GPs having decided to hide from "all that messy face to face stuff" as implying that you thought the now-common procedure of doing a lot of telephone appointments is inherently illegitimate and, on its own, a sign of a bad GP/practice. That's what I described as nonsense and I stand by that because I know that good, conscientious, well-managed GPs are being forced to do increased telephone appointments simply as a way of coping with the national imbalance between demand and availability.

If what you're actually saying is that the broad move towards telephone appointments is generally understandable but within that a subset of GPs/practices are lazy or badly managed and letting their patients down, then we have no disagreement.

I may have misinterpreted your original comment because so many people do cry foul about telephone appointments whilst dismissing the systemic issues that cause them.

There is a proposal to centralise them and it is apparently one of the forthcoming reforms. However not all GP's want to go down that route  and become salaried employees.

No doubt a hybrid model will develop.

...and where the number of GPs 'needed' per thousand has been 0.58 wte since the 90's.  Many academics think that this should be going up to reflect the aging population, but instead it is heading down and is substantially lower than many comparable economies.

...and with regards to the 'significant number' you note, just some examples from this week's work with practices - one patient presenting with a splinter; a whole family returning from holiday who wanted treatment for their itchy mosquito bites and a woman who wanted her bruise (from her booster injection) removing....  

I work most week's on the appointment stats in practices, yet am still shocked every week by what people think needs a GP appointment and how much people load access up with queries that have little underlying clinical need.  Sadly, that isn't to say that they don't need help, but going to your GP three times a week may not be the best use of a critical service.

Make a polite but formal complaint? Nobody likes to be part of an organisation that isn't working well.

How are these people getting 3 appointments a week, whilst others have to wait weeks to get an appointment?

Managed to finally get a GP appointment for a medical in December, after them being notified a mere 8 months earlier. You'd have thought that they'd have been all over it, what with it being a chargeable service. Walked in to the large GP office in town and not a single other patient to be seen anywhere, and I sat waiting for 20 minutes. There's either a lot of time wasting hypochondriacs not clogging them up anymore, or a lot of undiagnosed ill people walking around. Or indeed, both. 

Some patients need this volume of appointments of course.  They might be on a palliative pathway or in need of changes to dressings for wound care. 

Online access such as Ask My GP is one route.  Some patients put up five or more queries a day and they all have reviewed and dealt with.  Worth noting that many of them will be identified as vulnerable (suicide risks, unstable diabetics, severe asthma, learning disabilities etc.) so they can't be ignored.  It is against the rules anyway, however frustrated a GP might feel.

One thing to recognise is that a GPs list is essentially two categories of people (this is oversimplifying).  One is people like me who haven't been for ages.  This is typically 76-80% of the list and these will attend less than six times in a year.  23% of the list won't attend at all in any given year.  Then you have people who are poorly with chronic / long-term conditions (the small proportion of the list who use up most of the capacity).  Lots of these are really poorly of course, though many (80% by some estimates) of the actual conditions are preventable.  Sadly, most of these conditions (diabetes, COPD, CVD, CKD and so on are socially disabling as well, so are often found with depression, anxiety and MH issues as co-morbidities.  This means their need for support climbs well beyond that 'needed' by the physical aspects of their condition.

In amongst this are patients who are a different sort of tragic.  Depressed.  Substance abusers.  Not a lot in their lives, including any kind of social network.  I have a practice where more than 70% of the list are on anti-depressants, but if I lived there I think I would be.  These patients do game the system - they know what flags them as 'urgent' and by the time they are called out it means you can't get through.  For a lot of what they bring in, it is questionable whether a GP is actually the right person to handle the problem, but then the services that might don't currently exist.  Of course, on one level, these people can be seen as time wasters, but a more caring approach (every GP I've ever worked with) recognises that underneath this picture is a person who actually really needs support of some sort and not giving it is a very real risk to the individual and often others.

All that in answer to your query, but fundamentally we are not funding enough GPs in primary care to even come close to meeting our worsening health needs.  Most of the ones I know work ridiculous hours (updating records at the weekend, running vaccination clinics in the evenings, trying to keep abreast of new developments while watching the football) and if they had a spare hour would devote it to doing their best to improve their populations health.

But even that wouldn't be uncontroversial. Personally, I would be delighted if my GP had that system, but elderly people or those who struggle with literacy might hate it.

Good systems and well-run practices can reduce the impact of GP shortages but fundamentally we need more GPs and better support systems to deal with people who don't really belong at the GP but have nowhere else to go.

Well said.

Missed an apostrophe though - I blame tiredness.

I would like to think that GP's have things called notes on the system so that when Doris, Bert or Charlotte make an appointment it will be in person. If they don't they should. 

Once the covid stats and the death rates due to a combination of delayed treatment and lack of diagnosis stop muddying the waters. 

Thank you for such an in depth answer on something I am reasonably ignorant to.

You replied to say that to the contrary, blaming individual GPs is not misguided, it is "spot on". 

ie: If it's frustrating for someone trying to get a face to face appointment at a particular practice, then that is the fault of the individual GP.  It seemed to me that you intended that to apply to the OP's case as well as others.  Did I misunderstand you, was that not what you were saying?

I can see how you share the frustration of many of those patients while you are in the process of seeing them face to face, trying to get them care that they need but are unable to access.  But if you intended to blame the GP in each case as it seemed you did then I don't think that's likely to be particularly accurate much of the time let alone fair.  GP's are struggling (and sometimes failing) to provide an adequate service in many cases no doubt.  And currently, through no fault of your own, so are you.  The difference is that nobody is coming on here and blaming you.

Thanks for all the replies - made for interesting reading. 

I hope your daughter gets sorted. Our GP practice is equally useless.

Before March 2020 we used to have a Saturday surgery which was brilliant - really patient centred. Of course that disappeared and I asked the surgery this week when it was coming back. The receptionist looked at me as if I was mad and said "it's not".

"Why not?"

"Covid"

I'm left with the feeling that having got rid of the patients there is a real.reluctance to have them back. 

Makes you think about insurance for those who can afford it doesn't it?

Went to the docs the other week to have an annoying mole on my back looked at.
Turned up on spec at 9am when they open without appointment, was in and out by 9:20. GP reckoned it wasn't dangerous but took a photo anyway and sent it to a skin specialist. She warned me the skin specialists waiting list was 6 weeks but he phoned me back the same day. I went there two days later - all confirmed, not suspicious. All good.
Total cost, 25€ for the GP and 50€ for the specialist so 75€ which was returned to us about 2 weeks later because we pay 100€ per month mutuel insurance on top of our annual cotisations (National insurance) Best thing about this is that if my mole was bad and I needed a million euros worth of cancer therapy the cost would still be 100 a month!

Another funny story, when my wife was pregnant we had booked the first scan at Orange hospital. We went there two hours early because our only other experience of hospitals was Burnley General. We were worried about parking, which was free and 50 metres from the reception - car park was empty. Also waiting times worried us. We sat down and the receptionist asked our names. We told her and she said your not due for another 1h30m. There was no one else booked in so she phoned through and we went straight in.

E

A cynic might suggest that's exactly what some of those in charge want you to start thinking about, yes.

Since Covid, I contacted my GP via Ask my GpP with a suspicious skin blemish.  Two photos later I was referred to Dermatology clinic - appointment within a week.  Parked at the building and was assessed. The specialist thought it needed removal.  Booked in with a surgical colleague ‘if you don’t mind waiting 20 minutes’.  Problem cut out within an hour and stitched up.  

I told them my wife was a nurse so they gave me a stitch removal kit.  The NHS can be brilliant as well.

Doctor: That looks nasty, how did it start?
Mole: It started as a boil on my bum...

Absolutely no problem.  I hope I resisted the temptation to rant.  It was a fair question and deserved an answer.

Another reflection.  Last time I had to ring my bank, it was an urgent request from them for me to contact them on the 24 hour helpline (they had blocked a pretty big transaction I needed to make).  It was about 11.30 at night, but the queue was 1 hour and 40 minutes, so I got up at 5 am instead to try again.  At this point the message said the queue was only 30 minutes, and they answered an hour and a half later.  They asked me plenty of security questions before allowing me to move my money.  I accepted - even appreciated - their security concerns, but the service standard was far short of my practices, who on pathetic budgets aim to get to everything within ten minutes.

More context from last week.  Patient rings up and demands (not politely) that a GP rings urgently along with the encouraging message that 'you useless tw*ts had better get on with it, because I'm ill'.  GP rings.  No answer.  They do some more calls and ring again.  No answer.  Protocol says put a note on the system - pass back to admin and get on with looking after patients.  An automatic text is sent if the patient has consented.  Admin get through later on to follow up.  Patient swears incessantly for 40 minutes, threatening to kill the b*st*rds who have woken him up.  Eventually admin terminate the call.  Patient turns up at surgery with a large knife and an attitude and is promptly arrested.  This is sadly relatively routine MH stuff and is a complete pain for the police as well.

This is what I have experienced at my GP practice which has worked well for me. I actually had 2 face to face appointments in a week during January.

I do appreciate that online contact is completely inaccessible for some patients. Apparently getting through to them on the phone is a lot more difficult. 

I went to one of my local hospital- St Helens- last week for an outpatient check up after a skin cancer op.

Parking was free and I was in and out seeing the consultant in about 10 minutes.

By the way this was not private.My intial op was dealt with very smoothly and quickly.

It is a very sad situation. The whole of the UK is in this position - not enough GPs and Practice Nurses (and dentists).

This is not a new issue.  It was happening before Brexit & the pandemic.

The Government has done nothing to improve working conditions in Primary Care.

Hence staff, both clinical & non-clinical, are leaving and not being replaced because no-one wants to work in General Practice at the moment.

Not only are we short of staff but the facilities (Buildings etc) are too small and not fit for  21st century primary healthcare service.