David Craig, on April 9th, 2025Wednesday-Thursday blog
I should have got suspicious when I Googled my GP practice’s website. Under the heading “Doctors and staff” the website informed visitors that: “We have a team of experienced practice nurses led by Sister ….. ” No mention of doctors. Though when you clicked on the heading “Doctors and staff” you did get a list of the doctors at the practice.
Anyway, I had been to see a private practice GP about a shoulder strain. But he noticed that I had another rather more serious health issue which needed investigation. I did then book about £780 of tests at a private hospital. But thinking I might eventually need an operation on the NHS, I decided to also try to go through my local GP surgery as I suspected the NHS would refuse any assessment done by a private hospital as the NHS would have its own ‘pathways’ that prospective patients would be expected to follow.
Step 1: E-Consult – the first step in trying to see my local NHS GP was to fill in an E-Consult online form which would then apparently be forwarded to my GP surgery for triage so the doctors there could assess whether I needed an appointment. I filled in the E-Consult form with all the relevant information and at the end a big red notice came up telling me that there was nothing the E-Consult system could do and that none of the information I had entered would be passed on to my GP. Fortunately, I am reasonably computer-literate. I wonder how 80- and 90-year-olds who have never used a computer get round this barrier to ever seeing a doctor.
Step 2: Surgery visit – I went to my local GP surgery and explained that the E-Consult system had rejected my submission. No problem, the receptionist was surprisingly helpful and filled in an E-Consult online form on her computer. She then told me that this would be submitted to a doctor at the surgery for triage and that I should get a response within a couple of days.
Step 3: GP response – After a couple of days, I got an email from a GP at the surgery asking me to briefly describe my condition. This, of course, added nothing to the information which was already on the E-Consult form the receptionist had filled in with me. Nevertheless, I wrote a couple of sentences in a reply email to the doctor which gave less information than that already on the E-Consult online system.
Step 4: I can see a doctor – the next day I got a reply from a GP at the surgery telling me I should call the surgery reception and ask for a “red” appointment with a GP at the surgery. I did this and was surprised to be offered a GP appointment for the next day. I did get to see a real GP – not the usual ‘Nurse Practitioner’ or ‘Doctor Associate’ which so many GP surgeries use to avoid doctors ever having to deal with patients. The doctor greeted me and said, “I believe you’ve had problems with your breathing“. Given all the information I had already put on the E-Consult system, I thought that was a rather lame effort by the GP. Clearly he had only glanced at the E-Consult system and hadn’t a clue why I had been told to get a “red” appointment to see him. Incidentally, the private practice GP told me that he had examined me with a stethoscope which also had an ECG function. When I mentioned this to the NHS GP, he told me that I must be mistaken as such a stethoscope doesn’t exist. I have just checked on Google and there are numerous suppliers offering a ‘dual function’ stethoscope incorporating traditional stethoscope functions and an ECG. Oh dear!
Since then things have started to move. I had a chest X-Ray at my local hospital the next working day and the results from the X-Ray should be with the GP surgery within 2 to 3 weeks. I am also booked in for some further tests at the surgery.
So, I guess I shouldn’t be complaining. I actually got to see a real doctor. Many other people never even get that far. From the little I understand about our NHS, most of GPs’ earnings come from the number of people registered with each GP practice and not from the number of people who are actually seen by a doctor. Though surgeries can increase their earnings by giving flu jabs and Covid boosters and suchlike which can all be done by nurses. So there is little incentive for GPs to see patients. In fact, it’s probably much more financially-rewarding for the surgery’s finances to fob people off with ‘Nurse Practioners’ and ‘Doctor Associates’.
Hooray for our NHS – the envy of the world – yet which no country seems eager to copy!
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If this was private care they wouldn’t be in business. But we are paying for it and it is still in business. Why do we put up with it? Because there is nothing we can do about it.
It is getting worse. My surgery always used to be busy. Now there are very few people there. I get the impression that only nurses are on duty. I went for a blood test yesterday. The surgery was built about 10 years ago and has ridiculous very low designer seating which is unsustainable for the elderly. Some chairs were added without arms but now a few have arms. There was a man at the door selling raffle tickets to raise money for equipment to enable patients to be treated there rather than needing to go to hospital. He told me that money had been raised to get the chairs with arms.
I had a heart scan last September and was expecting to be called to discuss the results. Nothing happened. I saw a private consultant and she got the information from the NHS.
The NHS reflects the state of the country. It can only get worse.
They’re all at it now. My surgery even has a resident paramedic along with all the various levels of nurse, came across a nurse “consultant” recently – apparently they’re higher than a nurse practitioner! Truth be told I’d rather see the paramedic or nurse practitioner, the doctors do so little nowadays they have no experience and all they do is either issue prescriptions, refer you to hospital or sign you up for benefits!!
And the vets have gone the same way. None of them work full time and 9/10 you will find your appointment is with the nurse and not the vet.