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I'm not really familiar with NHS processes, so when it took you weeks to be seen, did someone just take your info when you walked in and say they'd get back to

I'm not really familiar with NHS processes, so when it took you weeks to be seen, did someone just take your info when you walked in and say they'd get back to you when they could, or was your condition evaluated first (diagnostics run, etc) and an appointment scheduled for you for a particular date a few weeks in the future?

jdietrich 9y ago
The former. Access to the majority of non-emergency care is gatewayed via your GP (primary care physician/family doctor) - if you need to see a specialist, you can only do so by asking your GP for a referral. You'll then wait weeks or months to see a specialist, although you may be sent for tests before then. We have a chronic shortage of GPs and the system as a whole is severely underfunded, meaning that many people have to wait weeks just to be seen by a doctor. The average wait to see a GP is 13 days, but can be much worse in some areas, especially in winter. Some GP practices have reduced the strain by offering appointments with Nurse Practitioners, who can treat common and uncomplicated conditions. This solution is far from perfect, because there's a lot that Nurse Practitioners can't treat. Some patients are just going to a hospital emergency department because they can't get a GP appointment in a reasonable time frame. This just increases the strain on the system, because care delivered in an ED is considerably more expensive. The four hour target is actively counterproductive; When ED managers are faced with a waiting room full of people with coughs, rashes and sprained ankles, they are forced to choose between prioritising clinical need or hitting their targets. http://www.pulsetoday.co.uk/your-practice/practice-topics/access/average-gp-waiting-times-remain-at-two-weeks-despite-rescue-measures/20034534.article http://www.pulsetoday.co.uk/your-practice/practice-topics/ac...
- Scoundreller 9y ago
  > Some GP practices have reduced the strain by offering appointments with Nurse Practitioners, who can treat common and uncomplicated conditions. This solution is far from perfect, because there's a lot that Nurse Practitioners can't treat. Are the NPs not permitted to treat these other conditions, or incapable? I fear there's a turf war between GPs and NPs, where GPs are worried about losing bread-and-butter work that takes little time but accounts for a large number of visits.
  - jdietrich 9y ago
    >Are the NPs not permitted to treat these other conditions, or incapable? Both. They're cheaper because they've received much less training than a GP. We could allow them to treat a wider range of conditions, but there would be serious patient safety implications. The use of nurse practitioners in primary care is relatively new and we don't have a lot of good-quality evidence on patient outcomes, so it's reasonable to act with some caution until we have better evidence. Even in their current role, they could be missing significant clinical issues that a doctor would have spotted - we just don't know at this stage. The concern isn't about the 99% of patients who have something mundane, but the 1% of patients who have something that looks mundane but is actually very serious. There's undoubtedly some amount of territoriality on the part of doctors, but at the moment everyone is just desperately trying to cope with demand. There seems to be fairly good esprit de corps throughout the NHS, with practitioners at all levels uniting around the need to maintain good patient care against the common enemy of Jeremy Hunt.

jdietrich 9y ago

The former. Access to the majority of non-emergency care is gatewayed via your GP (primary care physician/family doctor) - if you need to see a specialist, you can only do so by asking your GP for a referral. You'll then wait weeks or months to see a specialist, although you may be sent for tests before then. We have a chronic shortage of GPs and the system as a whole is severely underfunded, meaning that many people have to wait weeks just to be seen by a doctor. The average wait to see a GP is 13 days, but can be much worse in some areas, especially in winter. Some GP practices have reduced the strain by offering appointments with Nurse Practitioners, who can treat common and uncomplicated conditions. This solution is far from perfect, because there's a lot that Nurse Practitioners can't treat. Some patients are just going to a hospital emergency department because they can't get a GP appointment in a reasonable time frame. This just increases the strain on the system, because care delivered in an ED is considerably more expensive. The four hour target is actively counterproductive; When ED managers are faced with a waiting room full of people with coughs, rashes and sprained ankles, they are forced to choose between prioritising clinical need or hitting their targets. http://www.pulsetoday.co.uk/your-practice/practice-topics/access/average-gp-waiting-times-remain-at-two-weeks-despite-rescue-measures/20034534.article http://www.pulsetoday.co.uk/your-practice/practice-topics/ac...

Scoundreller 9y ago
> Some GP practices have reduced the strain by offering appointments with Nurse Practitioners, who can treat common and uncomplicated conditions. This solution is far from perfect, because there's a lot that Nurse Practitioners can't treat. Are the NPs not permitted to treat these other conditions, or incapable? I fear there's a turf war between GPs and NPs, where GPs are worried about losing bread-and-butter work that takes little time but accounts for a large number of visits.
- jdietrich 9y ago
  >Are the NPs not permitted to treat these other conditions, or incapable? Both. They're cheaper because they've received much less training than a GP. We could allow them to treat a wider range of conditions, but there would be serious patient safety implications. The use of nurse practitioners in primary care is relatively new and we don't have a lot of good-quality evidence on patient outcomes, so it's reasonable to act with some caution until we have better evidence. Even in their current role, they could be missing significant clinical issues that a doctor would have spotted - we just don't know at this stage. The concern isn't about the 99% of patients who have something mundane, but the 1% of patients who have something that looks mundane but is actually very serious. There's undoubtedly some amount of territoriality on the part of doctors, but at the moment everyone is just desperately trying to cope with demand. There seems to be fairly good esprit de corps throughout the NHS, with practitioners at all levels uniting around the need to maintain good patient care against the common enemy of Jeremy Hunt.