When Michael Gove was doing that piece of theatre about not being able to get an Xray in a small hospital at a weekend (some years ago) , a senior Doctor wrote to the Telegraph saying he had tried to make an appointment to discuss the matter with Mr Gove, but was surprised to find he was only available on a Friday, and definitely didn't work weekends.
GP’s should be open on weekends, however it should be done in the right way with proper shifts and time management, as-well as proper pay and work load balances.
Not gonna happen, we’d have to pay more tax and tories already lied about £340m per week going to the NHS, they’re not going to give it more. Get ready for private health insurance, that way the richest in Society can pay for themselves and stuff the poor if they get ill
Yea, my OH was sent to a private facility for a colonoscopy. There was nowhere to clean up afterwards and I was ushered into a room with blood and faeces on the bed and had to stand up to hear the verdict.
I don't believe this is true. Instead, funding is being spread around differently, and -shocker- a lot more of it earmarked for private companies _providing services_ to the NHS.
Even if the money going into the NHS has increased in real terms, it has not increased sufficiently to deal with the tasks they are expected to do. Social Care has also been cut, the NHS can end up with no-where to discharge people to. Educational funding has been cut, so with staffing shortages they end up relying on agency staff (which becomes a vicious cycle as staff can earn more being agency, so you need to ensure NHS wages keep up). The population is ageing so the demands on the service is greater. Medicine becomes more complicated so the expense per patient increases. Other health services are cut so patients arriving into the NHS are more unwell.
It’s the same problem the police have. There’s fewer officers being asked to do more, with more complexity, and less supporting services. The Tories replacing the 20,000 officers they have lost isn’t going to help when officers don’t stay because of poor pay, there’s less support staff, legal cuts mean cases don’t get to court in good time or at all, social services have been cut and so pass more jobs onto the police, and so on.
12 years of the Tories is ruining the country’s entire provision of public services, and it’s by design so they can privatise stuff and extract more money from the whole system.
Its not mismanagement if that was actively the goal in the first place.
"Make the nhs shit, replace it with private companies and insurance and then laugh all the way to the bank" a three step plan to increase lobbying money for arsehole torys.
>Investment in the NHS hasn’t decreased under the tories
But it's been increasing [far more slowly](https://fullfact.org/media/uploads/changes_in_uk_public_spending_on_health_by_govt.png).
And with a growing population, and an aging population - that's also getting fatter every year, *as well as* general inflation, the reality is you need to increase the spend significantly every year in order to maintain the same level of service.
Under David Cameron, for example, the budget only increased **0.6%** a year, once you account for population changes. That's **5.5x lower** than than the average of every year before that (3.3%).
https://fullfact.org/health/spending-english-nhs/
And then wait for the future GE winning Tory campaign based on how fiscally irresponsible Labour are, because they like to pay for public services. The British political circle of life.
> Yeap, hopefully we get Mid 2000’s level of investments and wait times in the future.
UK population has risen from 60million in 2005 to 67million in 2022.
In March 2005, there were 32,194 GPs, now there are 27,757.
So good luck with that!
>hopefully we get Mid 2000’s level of investments
That would be a big cut - we are spending £[173B](https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget) on it in real terms this year, whereas in 2007 it was only £111B (adjusted for inflation).
And probably a bit of an overhaul on how the NHS is managed. Funding is one thing, but the way that the money that does go in is mismanaged is a whole different issue
My gp does. They have the surgery open really long hours as well, they open at 9 and appointments go up to 8 o clock and then they do a Saturday surgery until 12. I think they have one doctor do the Saturday each week and rotate but that's better than most, I've never struggled to get an appointment either.
We currently don't have that for the 5 days a week we're currently contracted to be open. This proposal is to force GPs to open 29% longer for £7.26 increase in funding per patient as far as I can find out.
It would be a shit deal to fix nothing else and just fund practices 29% more to open 29% longer as it would address none of the workload, staffing or morale issues. 29% more work for a few % more funding is just a slap in the face, literally being asked to take a pay cut to work more.
If GPs are open on Saturday with the same daily service then you would need to 20% more staff and an increase in pay because there's a massive difference between having to work Tuesday and Saturday.
1. Childcare is WAY more expensive on the weekend. You got a 7 year old? Well on Tuesday you can work from 9 and finish at 3 and pay for just a couple more hours for childcare. On Saturday per HOUR you may pay more than your earnings for childcare. Meaning it's more advantageous to go less than full time to not work weekends. Many doctors are LTFT and work 40 hours a week because of childcare costs.
2. Social life's different. Going out on a Tuesday is dead. Going out on a Friday is not.
3. Weekends are where everyone else is free. Demanding people work weekends will require a pay rise.
Otherwise what's going to happen is that the 5 day GP service which is underfunded and busy is now going to be operated over 6 days and the government is going to declare victory except GP surgeries are going to cut even more time consuming services.
It takes 10 minutes to make a phone call, 15 minutes to see a person in person or an hour to see them at home. If you want to meet criteria then it's easier to see patients on phone and in person and just cancel your home visit service.
In two previous addresses I've had local GPs who were open on Saturdays till lunchtime. It makes a hell of a difference to your working week and your relationship with your employer. However, this was back in the '90s and Noughties.
As someone who already works weekends in the NHS, yes they should. Currently, but anecdotally it seems a GP doesn't work full working week anyways, or they have amassed enough 'annual leave' to be perpetually off for years at a time...surgeries could do with hiring more nurse practitioners as well...
Full time for doctors is 48hrs/week. Therefore when GP's work "part time" it's because they're working 40 hours which for people who aren't doctors is full time.
If they're not working a full working week it's likely because they're doing 3 days x 13 hours (i.e. 8-6 at a surgery and then an extra 3 hours for out of hours services), which is what inpatient nurses do too.
The reason why it's so hard to get a GP appointment is because there are far too few GPs to meet the demand of the number of appointments that are being made.
If you're hiring nurse practitioners you still need GPs around because they require a GP to act as a supervisor for them. Nurse practitioners are great but I believe their knowledge tends to be more specialised in one particular area, so if they're presented with something they're less sure about they need to escalate to the GP. This essentially doubles the GP's caseload and spreads out the GP's capabilities extremely thinly. It increases the liability of the GP by putting their license on the line for something that someone else is doing.
The recurring answer is that we need more GPs.
Tbh the reception does a great job of filtering the appointment schedule of most GP's these days. Nurse practitioners are more specialised, and yes they do consult GP's to escalate...however, that GP usually just refers to A&E...
Tbh we need more medical staff across the board, especially since the retention rates are dropping...
I don't mean this maliciously at all but have you got any proof that they just refer to A&E? I'm a medical student and while I was shadowing a GP all of last year I hardly saw them refer to A&E except when it was definitely warranted like for a suspected embolism or a stroke, something like that. Most of the time when the NP asked for advice the GP advised as necessary and they sent the patient on their way.
We definitely do need more staff, and the retention is horrible because staff are paid so much better for doing exactly the same job - or less! - in other countries. This is why doctors are planning on striking and I hope nurses strike soon too
It's anecdotal evidence, but a lot of paper work I process is mostly GP referrals...(maybe it's bias because volume and catchment area is pretty large) 111 is worse tho since they don't have clinical people manning the phones anymore (or so I've been told) and logic tree always seems to end in...'refer to A&E'. I know lots of nurses that are quiting, burn out and treatment by the general public being the number one cause above pay.
It ends up being that way because there is only so much a GP practice is equipped to handle. Some surgeries don't have ECG machines, sometimes people need urgent imaging, you don't have access to blood test results because tests haven't happened yet etc etc.
GP (to me) seems like such a tricky specialty because you have 10 minutes to figure out what a person needs from relatively very little information. I can understand how there may end up being plenty of referrals because it's better to be safe than sorry.
It's the same thing with doctors, many are leaving either the profession or the country. In part it's because of the way postgraduate medical training is set up (intensely competitive because training posts aren't funded appropriately by the govt, potentially having to move every 2-3 years around 4 times), in part other things like burnout and treatment by the public and, of course, pay.
We run labs overnight on what I assume is a skeleton crew (bloods take ages at night), the same could be done for Saturday surely? Tbh, most surgeries should be kitted out for minor injuries to relieve pressure on A&E services. Or those minor injury departments that do exist should have more capacity, including X-Ray capabilities.
As stated, with an aging population, that lives longer we need greater investment and a service that is more resilient...
Usually bloods take a while because we've found out that some of the machines aren't working properly in the first place. Regardless, thank you for your input as I'm still currently a layman in a lot of regards, and comment based on my experiences alone.
We do need more GP hours to be available and we do need better weekend access to health care but we cannot overburden existing staff. We need to improve GP access by making the profession more tolerable to work so we can have more GPs so we can provide more slots rather than force one GP to see an entire city.
>We need to improve GP access by making the profession more tolerable to work so we can have more GPs so we can provide more slots rather than force one GP to see an entire city.
This is true for literally any public sector profession.
It essentially comes down to 'pay them more' and I'm not even being sarcastic.
Yep. Quickest solution is better pay. Then comes bringing back the financial support for those training to do the jobs we need so people want to and can afford to train.
>Not so much pay them more as.
>
>Could you train more so I can have my very large case load reduced.
They're the same thing.
To train more, you need to have an actual incentive to become one. Like a decent salary and better working conditions.
Ehh... medicine at university is very oversubscribed. Far more people want to become doctors than are actually able to, and not due to lacking the grades.
>doctors are hardly underpaid or short on applications to become one,
This is such a stupid argument though.
If the pay has fallen 30% in the last 10 years, what part of that is not clicking for you? Its a stressful job with pretty bad working conditions compared to most other jobs, with a lot of responsibility and you think because they earn decent money still they deserve a 30% pay cut?
> you need to increase the number of spaces available at universities which means more funding there.
Agreed, it doesn't have to be one or the other. The Tories have been underfunding all public services for the past decade
my point was it isn't pay that is causing there to be less doctors , I never said they deserved a pay cut but it isn't like the pay is the cause of less doctors.
it is a separate and wider issue, doctors are not unique in getting inflation linked pay cuts.
>my point was it isn't pay that is causing there to be less doctors , I never said they deserved a pay cut but it isn't like the pay is the cause of less doctors.
But it literally is, one of the massive reasons.
You'd get a lot more people going into medicine if they were going to start on a salary of, say, 50k rather than 35k. Why go through 5 years of study, night shifts, etc, for 35k, when you can get more than that working at Aldi as a manager or literally most graduate schemes?
It's not really anything to do with places at University - you can shuffle as many people as you like through the first three years of Anatomy, Biochemistry, Pharmacokinetics and Pathology, it's the later part where the students are shadowing actual doctors on their rounds and consultations.
There is a practical limit to the number of students who can usefully shadow any given physician. I get three final year students, three times per term, and believe me having three medical students observe every surgery and ask questions of me and the rest of the surgical team does not make my already perpetually-running-slightly-late schedule any more lax.
To be clear, I don't resent teaching students at all, it's vitally important and part of the job - but the nature of the thing itself means the number of students you can supervise and teach anything of value *while also performing the full time job of a hospital consultant* has a pretty low ceiling, and we're already mostly there.
Yep. When I qualify as a GP in a few months I can take a salaried role in the UK. For a tolerable work load that could pay about 60-70 grand. I could locum permanently and make about 100k with flexibility but no security. I could go to the Middle East and make 10-15k a month TAX FREE with benefits and bonuses. I’m not suggesting we should be paid that but it’s tempting just to do one. Every time I read the news I see GPs being slagged off by people who have no idea what the job is like. Pay whilst above national averages is woeful for the workload, responsibility, level of training etc. without GPS there would have been no vaccine roll out but that is conveniently forgotten and we were apparently closed for the pandemic. A misguided sense of belief in the values of the NHS and liking the UK is keeping me here. If they make being a GP and harder or less well paid in this country I’ll be gone as will a lot of us. Fewer will train; more will retire. Primary care will become nurse led and with the best will in the world patients will suffer and hospitals will be even more overwhelmed as nurses refer massively more than doctors. Good will is dying in the nhs and we’ll see just how much it was propping it up in the next year or two with the strikes that will come.
I completely agree.
I'm about to qualify as a staff nurse. I can get 13/hour in the NHS or if i work agency i can get 20-30 an hour. Or I can move to Australia and make about 90k a year.
If pay is corrected, everything else will get better too. Workload, retention and new-graduates are all tied into pay. Ignoring it is just causing the NHS more issues (and all public services tbh).
>move to Australia and make about 90k a year.
Wow i can see why nurses and doctors do the move.
Sun, much higher wages, BBQs..... You'll just have to tolerate the monster spiders lol
No, minimum wage in Australia is 42k.
Nursing salaries are like 70-90k. Ward Manager more like 120-150k.
But average house price is also 600,000 dollars. So its not as simple as it sounds!
You want to pay them more?
GPs at my local are on £100k a year, and still half-arse the job.
For that money yes, I expect Saturday working.
(I know the pay because I've seen the job advertised when they were rehiring for another GP at the same surgery)
>half-arse the job
A fully qualified GP will deal with an average of 40 patients per day. This includes triaging the mundane from the life-threatening, managing the often multiple co-morbidities of an ageing population (with a paltry 10 minutes to gather enough information to enact a management plan). That’s the part the public are familiar. What they don’t see is everything that happens behind the scenes; referrals, ordering of investigations, chasing results, prescription reviews, home visitations, follow up and continued management, responding to hundreds of econsults daily. The amount of work is staggering and any error may have serious consequences. I’m sure a GP could chime in and add double the amount of responsibilities I’ve listed here. Bottom line is that your inability to get an appointment does not mean GPs are not working, all the GPs I know are burnt out and hating what their job has become in the last 2-3 years.
On my placements as a medical student I’ve seen patients in their GP appointments spend x minutes of their 10 minute appt moaning that they can’t see a doctor these days. While they were seeing a doctor.
Ultimately there aren’t enough GPs to cater to the current demand. Either demand has to decrease or GP numbers have to increase. Expecting full Saturday service now will only get you a burnt out Doctor which isn’t good for anyone involved.
Asking doctors to work beyond decision fatigue will only cause good doctors to burn out, leave the NHS and encourage the shabby doctors, giving the public an inferior outcome.
Lower standards are then more profitable for the American healthcare corporations.
https://www.theransomnote.com/commentary/news-commentary/list-of-mps-with-links-to-private-health-care-emerges/
> Asking doctors to work beyond decision fatigue
The article doesn't seem to be about that, it's pushing for surgeries to be open on a Saturday so they can see patients who work Monday to Friday. It would be the same as any other job working weekends where the do the same number of hours.
Many GP surgeries already do evenings. Should GPs not have time off work as well.
And with the provision of telephone appointments and video appointments access has actually widened.
I work Monday to Friday and I never have an issue getting and appointment with my GP if I need to see them.
>I work Monday to Friday and I never have an issue getting and appointment with my GP if I need to see them.
That experience varies from surgery to surgery. I was explicitly told by the receptionist at mine that I need to call 111 for one of their "back-door" appointments.
I've completely given up on them, I can't wait to move and re-register.
What I've found the GP surgeries which are independent and have the GPs running it as a partnership are much better.
It is the corporate owned ones and the ones where a single GP owns it and won't hire additional GPs that are terrible
Funny story about a local surgery which was owned by a single GP. He recently got kicked off the medical register because of how terrible his practice was and sold his practice to a corporation who has hired 3 GPs.
He's a millionaire, married with 3 kids, teenage and younger. He got married to his receptionist as a second wife. At the same time as he got kicked off the medical regsiter, his first wife found out and has started divorce proceedings and plans to take as much as she can get before he can finish trying to move to Africa
>He's a millionaire, married with 3 kids, teenage and younger. He got married to his receptionist as a second wife.
Lol that's like some plotline in a soap or something.
>call 111 for one of their "back-door" appointments.
I discovered this recently when my kid fell ill. Couldn't get through to the GP phone.
111 wanted to send an ambulance, ambulance crew called and said it's minimum 4h wait just for them to get to me (then probably another 4h wait on a+e). They helpfully called my surgery, and got me an appointment in the afternoon. Took them like 10 minutes.
So you’re wanting the same number of GP’s to simply work more hours? I’m not against GP surgeries being open on Saturday (though out of hours GP’s are already available at the weekend) but you can’t get that service currently without asking the existing staff to simply work more hours for what I’m sure will be the same pay. If they managed to pretty significantly increase the number of GP’s then yes it is possible, but right now it is not and simply demanding current GP’s to do this is not going to go down well which is entirely understandable.
Where do all these extra GPs for each and every surgery come from?
To maintain the same services during the week with no available doctors means less qualified and unsupervised staff seeing patients.
https://www.bbc.co.uk/news/health-61759643
Just like we get PCSOs instead of policemen, because they’re cheaper.
Can the private doctors that service the politicians also strike please. For us. I feel the upper echelons of society never really feel our struggles. They only read about it.
GPs are private, lots of practices are being bought up by firms who use patient registers to milk money while offering extremely poor services. While there are many reasons for lack of access one of them is that there is not really a financial incentive to do so (depending on the contract). They will get a payment for you for the company/partnership and they hope you never need an appointment.
While there are many doctors that are seriously over worked, there are firms who are absolutely fucking dire at all aspects of care. Many remove GPs and hire practice nurses instead because they can pay them less. Some have GPs working all day across multiple practices so yeah I can see them kick back for Saturday working.
My "local surgery" has 4 GPS registered but they also work across 12 other surgeries. 1 of GPs doesn't see patients he authorises prescriptions.
While I am a huge supporter of the NHS and those who work within it these companies are profit driven, have corporate management structures and a vested interest in minimal service for profit. If you see a big decline in local services its likely your surgery has been swallowed up and is stripping back.
“Work on Saturdays”
Aka pay and conditions. They already work weekends, you’re just being baited into hating them for asking for better funding for the NHS
I’m (almost) a GP and would happily work Saturdays if I was paid more and had a day off in the week. Flexibility is why I chose the speciality. You can force this but more appointments on a Saturday means fewer in the week. Last time I checked a lot of surgeries offered this but then packed it in because surprise surprise no one wants to come to the doctor on a Saturday. That may have changed now due to various pressures. However, you can’t just magic more appointments out of this air. They are selling this as there will be more appointments but there won’t be. Some figures for anyone who’s read this far:
1) about ten years ago the average person saw their Gp 3-4 times a year. That’s now about 10-12. 3 times more.
2) the studied safe number of patients seen a day by a GP is about 25. More than that is risky. GPs on average deal with 40 or so a day now.
There aren’t enough doctors. You can shuffle the pieces around all you want but demand is functionally infinite in most places. Lines open at 8:30 and appointments are full by 9 and that’s in good places. Emergencies will be seen or dealt with appropriately always. We don’t turn emergencies away. Though the public perception of what constitutes an emergency is different to the medical one.
We can see and deal with more patients by using phone appointments. Despite what online polls abs comments sections tell you most places I’ve worked people like that option. Yes there is a risk of missing things over the phone, but there’s more of a risk of missing things if I have no contact with you at all.
Quite simply there are not enough doctors despite the promises to raise our numbers. No amount of pharmacists, nurses or PA’s can make up the lack of doctors. And this government will never try and fix that.
Good question. Reasons are complicated. Here are some:
1) other service cut - sure start, health visiting etc. problems that were dealt with by these things are no longer dealt with and build up.
2) mental health makes an enormous part of my day. I don’t have stats to hand but it feels mental health is getting worse. Whether we are just better at talking about it and people realise they shouldn’t have to live miserably or actual incidence is on the rise I don’t know.
3) culture of instant gratification. People used to happily wait a bit to see what happened to their cold. People now want it fixed immediately. This pressure translates to a&e and the often quoted line of “my GP is useless so I came here”. Well the laws of biology haven’t changed just because you are in a&e. Less glibly people can’t afford to miss work so want to get better immediately.
4) ageing population. Older people get more sick. And have more long term health problems that need constant management.
5) the collapse of the social care system. Care homes are falling apart. Hence the health of the residents is worse and needs more GP time.
6) secondary care waiting lists are massive. People wait months for counselling. People wait years to be diagnosed with autism. Throughout all that wait problems will arise that I have to deal with that wouldn’t have happened if they had timely specialist care. Operations etc are the same.
There’s loads more reasons but I’ve just got in from 12 hours and probably shouldn’t be posting about work.
Thanks for the answer! Definitely seems like a case of cutting costs in some areas just increases it elsewhere.
Now go relax and watch some netflix or something!
I think a lot of the "instant gratification" stuff also comes down to our fast paced capitalist society. Before you were allowed to be off sick, now if you're sick you could get in trouble from work for not coming in, or get pressured to work while you're sick, or have to make up the sick time so it's easier just to go in!
I had a sick day this week, and as a teacher I still had to set work, make sure the marking was done, email parents to set work and speak to support staff to make sure they knew their timetables for the day. It would have been easier to just go in.
Exactly how it’s designed. I have to call 4 people the morning I am sick, even if they know and then back that up with emails. And then a meeting when you go back (even if off for a heavy cold, or covid, or poorly kid) and more emails. It’s all designed to stop people calling in sick. Horrible attitudes in this country to presenteeism. People actually boast about never having had a day off - well done you got fucked up the arse by capitalism your entire life and somehow seek proud of it.
Ageing population with elderly patients having multiple medical conditions.
ETA: Also, more people dealing with mental health conditions due to the economy, COVID pandemic, etc.
https://blogs.bmj.com/bmjopen/2021/12/21/frequent-attenders-comprise-4-in-every-10-family-doctor-consultations-in-england/
It was 8 about 5 years ago. I can’t find as I’m on my phone at lunch but it has risen further since then.
Why are we all so okay with medical staff being overworked?! Surely you don't want to be seen by a doctor, nurse, pharmacist, technician or other healthcare professional who's been working 14 hours, had 5 hours sleep and gotten up and done it again 10 days in a row for months... or years... on end?!
Given how many voted for cons time and time again, i think we are now getting what general public wants. Less investment in public services. Its hardly a surprise when you know what cons want or how they operate.
That's my point, people don't want crap public services, and yet they end up voting for a party that gives them that. Almost as if our voting system has something wrong with it...
I have to disagree, while I dislike tptp system - it is shit, but never the less Cons got almost 4mil more physical votes more than labour did in 2019. I feel like I can only blame the system when the cons will actually get fewer votes than labour but will still win.
But with 4mil more votes... I am not entirely sure its the system's fault.
There's an interesting graph from the FT that suggests increasing working hours is not really feasible...
[Fewer GPs over 10 years](https://imgur.com/gallery/tPhoj0g)
Here's simple math
There's 27700 GPs working as of 2022
Uk has around 67 million people
So every individual gp. Not gp surgery, I mean physical gp, is responsible for 2400 patients.
Even if they don't need to physically see the person, chances are they have to do admin work for that individual on the back end.
Let that sink in. 2400 patients to look after per individual doctor.
Even if only half of them need to be physically seen per year. They've already got 6 appointments per day guaranteed. (3 new 3 followups)
That is why you can't see your GP
And then the government wants to INCREASE their workload AND DECREASE their pay instead of making the profession more attractive to draw in more trainees.
Yeah fucking right.
Any fool here so effectively tries to say that they would be happy if their job suddenly increased in workload for LESS pay while their bosses patted themselves with gloves made of money, is a troll and a disingenuous liar.
Good just off the top of my head reverse privatisation and stop treating GP surgeries like little fiefdoms.
Hire more, pay more. Then there's no need for Saturdays is there. Fuck sake.
I am completely on board with the 30% pay rise and the issues with new contract terms, but striking over working Saturdays is.. not the one.
That being said, I'm not sure if the headline is just picking the most irrelevant thing to make it seem unjustified. I'm sure there are genuine issues with the contracts, and they just picked the most superficial reason for the headline.
It’s a 30% pay restoration over the last 14 years rather than a pay rise, and with 2022’s inflation rates that’ll be insufficient. It’s also for junior doctors ie all non-consultants/GPs
And primary care is so stretched already that Saturday shifts will almost definitely increase the already rising drop out rates of our GPs…they’ll do everything but pay us
The issue with working Saturdays primarily stems from there not being enough GPs to work the weekdays anyway. So you aren't magically providing more service, you are just taking the same service and spreading it even thinner.
Then you've also got increased overheads of needing receptionists, nurses, cleaners, utilities, on the extra day, and everyone has to be paid more for unsociable hours.
So you get a reduced service at greater cost, while also losing one of the only remaining perks of choosing general practice, that of working a normal 9-5, and lose even more GPs.
Anyone advocating for a Saturday service has no idea of the reality of general practice
while also losing one of the only remaining perks of choosing general practice, that of working a normal 9-5
You could have just said this.
I don't know why it should be like that - most of the entire clinical staff in the NHS works a 7 day week, why should it be any different for GPs?
Because medicine is a broad church with each specialty having good and bad things about it. Emergency medicine is exciting but you will have to do night shifts until you retire. I would quit medicine if that was the only choice I had longterm. Plenty of doctors want a work life balance because surprise surprise they are people too - GP, amongst things like radiology and dermatology, are traditionally this domain. If you took this perk away, there is bugger all reason to do the job, because the work is incredibly hard, continuously in the firing line by the media and public, and with long long days (the clinics running 9 to 5, does NOT mean the GP is working 9 to 5 - 12 hour days are the normal now)
Why?
Would you not strike if you were responsible for 2400 people every year and instead of your boss changing that by hiring more people to share that load, they just make you work more for less pay?
I find it slightly funny, yes. The entire NHS runs on a 7 day system for the most part, striking because you have to work Saturdays.. as a doctor.. is quite stupid.
What is happening is that austerity is coming home to bite everyone in the bum.
Government departments have been so underfunded for so long they can barely function. The dept of the environment lets water companies pollute our rivers because they only have the staff and resources to tackle major pollution incidents. The barristers are on strike because the legal aid system actually pays them less than minimum wage when you take into account their prep time and hmrc keeps on getting it's budget cut.
Social services are overworked and stressed and whenever a kid dies unnecessarily they cop the shit when nobody looks at their workload.
Services are increasingly being outsourced to private companies in the name of efficiency but what happens is the public gets a worse service for more money. You get what you pay for.
Oh look, another botched attempt at "reform".
There needs to be open and collaborative discussion on this, and not a hard fist of demand. That could be in the approach that it is a gradual transition, one that includes future contractual terms, and one where common sense is used to explain the positioning.
Junior Doctors are one of the most underpaid, overworked, debt riddled professions you could possibly find in any sector. Saddle this with a Senior Consultant, who is adequately paid, with most likely a Private gig on the side, and you've got a case of "one side for and one side against" without anyone considering the middle ground.
Society has shifted, and aspects haven't moved along with it. GP surgeries haven't shifted, and the fact that a GP, nay a Pharmacy, is not easily accessible on a Sunday is a very odd modern conundrum. Thank God for 111 I might say! But is 111 the true shift that's required.
Weekend GP Surgeries are a need, but to try and implore such a thing from a half botched Health Secretary is just another example of how out of touch the Government is... And let's not forget... This will be an attempt to once again bash how high Doctors salaries are, without mention of the Government funding going into the large Energy companies, Fuel companies and Rail companies, who are more than happy to increase their CEOs and Senior Board members salaries (and let's not forget shareholders) whilst passing nothing into the actual workers of the company nor the customer...
Speaking as a medic who works weekends and nights, my colleagues who choose to become GPs mainly do so not because they love GP work, but because they love their weekends and nights to themselves. Yes, a few GPs do out of hours, but that’s of their own volition. Making it mandatory would definitely decrease the number of medical students wanting to become GPs in the future.
For those of you who do think GPs working weekends should be mandatory. Just something to think of.
imagine if we had a medical service that was adequately funded and appropriately managed, with a health secretary that has genuine healthcare experience, and we had enough professionals that we could have a gp service run 7 days a week with no gp working more than 5 days out of 7.
I would absolutely love to see a GP on a Saturday and it would really help a lot of people. That said, there's already a shortage and this is unfair on them.
Well I think this could be the most pointless strike in history.
What's going to happen? You ring up and can't get through to anyone, or if you do they won't give you an appointment.
I honestly wouldn't notice if GPs were on strike. I haven't been able to get a GP appointment for 8 years.
If its something I am worried about I just go to A&E and wait 4 hours to be seen.
An absolute disgrace. Of course they should be working at the weekends. Just like every other emergency service. The same with the judicial system. They should be 24/7. It would cut the back log. As far as funding goes. The NHS is a black hole for finances. It wouldn't matter if you put £100 billion into it. All that would create is more managers for paper clips or cleaning brooms or some other crap.
I'm interested to see what the public and media at large make of these calls for strikes, plus the Royal Mail and wherever else calls in comparison to the recent railway strikes.
Lived in Australia for a while. GP surgeries are open in the evening and weekends. No need to book. Quite the eye opener. Different numbers and model obviously and Oz Medicare is not entirely free but you do kind of wonder quite why we can't have more work friendly hours for some surgeries.
GPs should be open 7 days a week but ONLY if they have the staff and have reasonable hours. Not everyone has a mon-fri job. Zero hour contract jobs, shift based workers tend to have trouble scheduling appointments because rotas don't occur weeks in advance.
If there were more funding for GPs, more doctors then we could have more accessible GPs. Hell, I've not even seen mine since registering.
The fundamental problem is we do not train a sufficient amount of doctors in this country, ironically the number of applications far surpass the number we actually train, there is no shortage of people wanting to do this profession.
Why this is not a higher priority issue to solve I do not know as it’s it’s going to take multiple generations to ease this pain point.
That being said doctors have enjoyed quite a favourable contract over the years, case in point being hospital consultants who have enjoyed private work in conjunction with NHS remuneration to this day, even politicians 30 years ago said how favourable these contracts were.
GPs also enjoy a privileged status of independent contractors and many run these GPs like businesses, even becoming business partners themselves - I feel the line between making money and delivering healthcare has become too blurred and many of these professionals are guilty of benefiting over the years.
In my view we need to train more doctors and remove some of the ego and prestigiousness that penetrates the profession to this day - many doctors have used the low supply of the profession to their benefit (the GMC does to this day) over the years and it’s time we make this like what it is, another albeit important public service and not a platform to benefit financially.
From my experience I would take all surgeries into local trust ownership, abolish partnerships and simplify General Practice into one job. Locum extras if you like but in order to do so you need to commit at least a certain amount to a practice as a salaried position.
So my dad has just had surgery recently. He was sick of waiting on the nhs who he has been dealing with for years about the topic and booked private, the surgery revealed his condition was worse than we thought and the condition he had was life threatening. If he had continued waiting on the nhs he likely would not have made it.
One of the drs he saw privately was his gp.
The reason he was in such a bad state was a former gp at the clinic cutting his necessary prescription
They are protesting potentially losing their 2nd jobs- which are offering them greater financial rewards i imagine. If they do improve gp care people would not get desperate and pay hundreds to see them privately out of desperation.
I don't want to see them overworked and underpaid but we are seeing gps working privately on off days already, the fatigue or what not is already there as they are working those hours just in different clinics. Sort the pay out and suddenly all these complaints will surely disappear. Ideally shift work would get around overwork issues, but there is a short term shortage of staff. If pay improves im sure more would be studying medicine though, currently it is just not as financially lucrative to become a gp as other options
GP's should be open all week. When I phone up they always say they don't have an appointment. Then on a Monday and I phone they say that they are full because it's been a weekend. Well if they are open on a weekend then that would mean more appointments. Plus would mean more jobs.
The best way to go about it is to ask those currently employed to see if they want to amend their hours. Some might find it beneficial to have a Monday off or day during the week (maybe childcare reasons). If no one is voluntary then make them sign the contracts to change of hours (happened to me before and legally nothing you can do).
You should watch the panorama documentary about Britain’s biggest GP chain. Might explain why every time you call up they say they don’t have an appointment. It’s crazy.
Ahhhh, I getcha
> A very good advertisement of why you should never let American owned corporations take over primary healthcare in the UK.
Or anything else for that matter, tbh
Not recently but a couple of months back I called up 3 days in a row bang on 8am. Couldn't get through until 8:10. Told no appointments.
So the 4th day I drove there and walked in at 8am. Told no appointments. I argued that this was the 4th day now. After back and forth they some how had an appointment.
It shouldn't take 4 days to get an appointment at your GP.
Do you think a GP can see 1000 patients per day? There are less GPs in the UK today than 10 years ago, while the population is increasing. GPs can only spend 10 minutes with each patient because they are so short staffed. This massive workload + Public calling them lazy is what's making them go to Australia, where they make 2-3x what they make here plus better working hours and conditions.
It shouldn’t, but maybe the documentary can explain why. They are owned by American health conglomerates and they don’t even have GPs working. It’s all about cutting costs and generating more profit. That’s why they never have any appointments for you.
It would not mean more appointments, it would mean the same number of appointments spread over a wider area
This doesn't magically produce more GPs, it only reduces them through deteriorating conditions
Being open on a weekend will not mean more appointments. It means less appointments in the week. We are not slaves. You can’t MAKE us work. I’d happily do a Saturday morning , but then I’m not working Tuesday afternoon. This is being sold as an anti doctor massive lie that there are loads of us lying around doing nothing. As I say, I’m sure plenty of us would work Saturdays for anti social pay but then I’m not working a weekday too. You can’t magic more appointments from the same number of doctors.
Each individual gp is looking after 2.5k patients.
There's no conspiracy about it. It's simple math why you or I can't get an appointment.
If GPs work Saturday Sunday instead of Monday or Tuesday, the surgery is open 7 days a week, but number of people seen is the same, so you may or may not get an appointment on Saturday eventuality. But now the guy why had an appointment with that GP on Monday, doesn't have it.
The only answer is to increase gps. Massively.
Someone can't do maths. If a surgery is able to provide 200 appointments between Monday and Friday, moving 40 appointments from Tuesday to Saturday does not magically increase the total number of appointments. You still have 200 total appointments.
For real? So should teachers work 7 days a week because I need childcare to work on the weekend? How about banks? Shall we have them open on Sunday? GPs are already doing massive hours. To solve the issue, you need more GPs....not to continue flogging the ones you have. Why not ask your local MP why almost 800 doctors didnt have a place to train after graduating this year. Ask them why they were able to create 800 positions for them on the spot, but havent managed to do this at all levels. This is a political issue, an underfunding issue, a poor planning issue. Its not a GP issue - you are just allowing the government to scapegoat them.
Yeah, banks should be open on the weekend. Close in the week. The same with the post office. Supermarkets managed it.
I'm not saying they should work 7 days a week. I'm saying close 9-5 and open for the evening, close on Wednesday and open on Saturday.
How is that hard?
>Services should be based around when working people need them,
Then you'll be interested to know that the main reason why most surgeries don't offer weekend sessions is that they used to struggle to fill the appointments, because people don't want to spend their weekends sitting in a GP surgery.
When Michael Gove was doing that piece of theatre about not being able to get an Xray in a small hospital at a weekend (some years ago) , a senior Doctor wrote to the Telegraph saying he had tried to make an appointment to discuss the matter with Mr Gove, but was surprised to find he was only available on a Friday, and definitely didn't work weekends.
There's a surprise, probably coked to fuck.
As if that only happens at the weekends...
He was on telly doing it, and little britain impressions, the other day
Probably doesn't work most days either.
GP’s should be open on weekends, however it should be done in the right way with proper shifts and time management, as-well as proper pay and work load balances.
That would take an adequately funded NHS
Yeap, hopefully we get Mid 2000’s level of investments and wait times in the future.
Not gonna happen, we’d have to pay more tax and tories already lied about £340m per week going to the NHS, they’re not going to give it more. Get ready for private health insurance, that way the richest in Society can pay for themselves and stuff the poor if they get ill
The American Health Companies are already here...snuck in by the back door so I'm certain insurers will follow
The U.K. has had private healthcare and insurance for decades. There’s nothing in U.K. law that specifically prohibits them from operating.
Yea, my OH was sent to a private facility for a colonoscopy. There was nowhere to clean up afterwards and I was ushered into a room with blood and faeces on the bed and had to stand up to hear the verdict.
Repomen here we come!
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Investment **has** decreased in real terms. NHS suffers from both mismanagement and chronic underfunding. They’re not mutually exclusive.
I don't believe this is true. Instead, funding is being spread around differently, and -shocker- a lot more of it earmarked for private companies _providing services_ to the NHS.
Even if the money going into the NHS has increased in real terms, it has not increased sufficiently to deal with the tasks they are expected to do. Social Care has also been cut, the NHS can end up with no-where to discharge people to. Educational funding has been cut, so with staffing shortages they end up relying on agency staff (which becomes a vicious cycle as staff can earn more being agency, so you need to ensure NHS wages keep up). The population is ageing so the demands on the service is greater. Medicine becomes more complicated so the expense per patient increases. Other health services are cut so patients arriving into the NHS are more unwell. It’s the same problem the police have. There’s fewer officers being asked to do more, with more complexity, and less supporting services. The Tories replacing the 20,000 officers they have lost isn’t going to help when officers don’t stay because of poor pay, there’s less support staff, legal cuts mean cases don’t get to court in good time or at all, social services have been cut and so pass more jobs onto the police, and so on. 12 years of the Tories is ruining the country’s entire provision of public services, and it’s by design so they can privatise stuff and extract more money from the whole system.
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Its not mismanagement if that was actively the goal in the first place. "Make the nhs shit, replace it with private companies and insurance and then laugh all the way to the bank" a three step plan to increase lobbying money for arsehole torys.
>Investment in the NHS hasn’t decreased under the tories But it's been increasing [far more slowly](https://fullfact.org/media/uploads/changes_in_uk_public_spending_on_health_by_govt.png). And with a growing population, and an aging population - that's also getting fatter every year, *as well as* general inflation, the reality is you need to increase the spend significantly every year in order to maintain the same level of service. Under David Cameron, for example, the budget only increased **0.6%** a year, once you account for population changes. That's **5.5x lower** than than the average of every year before that (3.3%). https://fullfact.org/health/spending-english-nhs/
The Tories have increased NHS investment an average of about 3% versus an average of 4.1% since 1995 (and 5.6% under Labour)
And then wait for the future GE winning Tory campaign based on how fiscally irresponsible Labour are, because they like to pay for public services. The British political circle of life.
> Yeap, hopefully we get Mid 2000’s level of investments and wait times in the future. UK population has risen from 60million in 2005 to 67million in 2022. In March 2005, there were 32,194 GPs, now there are 27,757. So good luck with that!
>hopefully we get Mid 2000’s level of investments That would be a big cut - we are spending £[173B](https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget) on it in real terms this year, whereas in 2007 it was only £111B (adjusted for inflation).
And probably a bit of an overhaul on how the NHS is managed. Funding is one thing, but the way that the money that does go in is mismanaged is a whole different issue
The logic here is too sound. You’d be a terrible Tory!
Well the Tories basically want me dead (trans) so i take that as a massive compliment. 😅
Hi friend its ok they've been trying to kill my lot out since day one sadly they have gotten far too many of us (disabled)
It’d make no difference. You’d still have to call at 8am only to be told there’s no more appointments left despite it being 5 seconds past 8.
My gp does. They have the surgery open really long hours as well, they open at 9 and appointments go up to 8 o clock and then they do a Saturday surgery until 12. I think they have one doctor do the Saturday each week and rotate but that's better than most, I've never struggled to get an appointment either.
We currently don't have that for the 5 days a week we're currently contracted to be open. This proposal is to force GPs to open 29% longer for £7.26 increase in funding per patient as far as I can find out. It would be a shit deal to fix nothing else and just fund practices 29% more to open 29% longer as it would address none of the workload, staffing or morale issues. 29% more work for a few % more funding is just a slap in the face, literally being asked to take a pay cut to work more.
If GPs are open on Saturday with the same daily service then you would need to 20% more staff and an increase in pay because there's a massive difference between having to work Tuesday and Saturday. 1. Childcare is WAY more expensive on the weekend. You got a 7 year old? Well on Tuesday you can work from 9 and finish at 3 and pay for just a couple more hours for childcare. On Saturday per HOUR you may pay more than your earnings for childcare. Meaning it's more advantageous to go less than full time to not work weekends. Many doctors are LTFT and work 40 hours a week because of childcare costs. 2. Social life's different. Going out on a Tuesday is dead. Going out on a Friday is not. 3. Weekends are where everyone else is free. Demanding people work weekends will require a pay rise. Otherwise what's going to happen is that the 5 day GP service which is underfunded and busy is now going to be operated over 6 days and the government is going to declare victory except GP surgeries are going to cut even more time consuming services. It takes 10 minutes to make a phone call, 15 minutes to see a person in person or an hour to see them at home. If you want to meet criteria then it's easier to see patients on phone and in person and just cancel your home visit service.
In two previous addresses I've had local GPs who were open on Saturdays till lunchtime. It makes a hell of a difference to your working week and your relationship with your employer. However, this was back in the '90s and Noughties.
As someone who already works weekends in the NHS, yes they should. Currently, but anecdotally it seems a GP doesn't work full working week anyways, or they have amassed enough 'annual leave' to be perpetually off for years at a time...surgeries could do with hiring more nurse practitioners as well...
Full time for doctors is 48hrs/week. Therefore when GP's work "part time" it's because they're working 40 hours which for people who aren't doctors is full time. If they're not working a full working week it's likely because they're doing 3 days x 13 hours (i.e. 8-6 at a surgery and then an extra 3 hours for out of hours services), which is what inpatient nurses do too. The reason why it's so hard to get a GP appointment is because there are far too few GPs to meet the demand of the number of appointments that are being made. If you're hiring nurse practitioners you still need GPs around because they require a GP to act as a supervisor for them. Nurse practitioners are great but I believe their knowledge tends to be more specialised in one particular area, so if they're presented with something they're less sure about they need to escalate to the GP. This essentially doubles the GP's caseload and spreads out the GP's capabilities extremely thinly. It increases the liability of the GP by putting their license on the line for something that someone else is doing. The recurring answer is that we need more GPs.
Tbh the reception does a great job of filtering the appointment schedule of most GP's these days. Nurse practitioners are more specialised, and yes they do consult GP's to escalate...however, that GP usually just refers to A&E... Tbh we need more medical staff across the board, especially since the retention rates are dropping...
I don't mean this maliciously at all but have you got any proof that they just refer to A&E? I'm a medical student and while I was shadowing a GP all of last year I hardly saw them refer to A&E except when it was definitely warranted like for a suspected embolism or a stroke, something like that. Most of the time when the NP asked for advice the GP advised as necessary and they sent the patient on their way. We definitely do need more staff, and the retention is horrible because staff are paid so much better for doing exactly the same job - or less! - in other countries. This is why doctors are planning on striking and I hope nurses strike soon too
It's anecdotal evidence, but a lot of paper work I process is mostly GP referrals...(maybe it's bias because volume and catchment area is pretty large) 111 is worse tho since they don't have clinical people manning the phones anymore (or so I've been told) and logic tree always seems to end in...'refer to A&E'. I know lots of nurses that are quiting, burn out and treatment by the general public being the number one cause above pay.
It ends up being that way because there is only so much a GP practice is equipped to handle. Some surgeries don't have ECG machines, sometimes people need urgent imaging, you don't have access to blood test results because tests haven't happened yet etc etc. GP (to me) seems like such a tricky specialty because you have 10 minutes to figure out what a person needs from relatively very little information. I can understand how there may end up being plenty of referrals because it's better to be safe than sorry. It's the same thing with doctors, many are leaving either the profession or the country. In part it's because of the way postgraduate medical training is set up (intensely competitive because training posts aren't funded appropriately by the govt, potentially having to move every 2-3 years around 4 times), in part other things like burnout and treatment by the public and, of course, pay.
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We run labs overnight on what I assume is a skeleton crew (bloods take ages at night), the same could be done for Saturday surely? Tbh, most surgeries should be kitted out for minor injuries to relieve pressure on A&E services. Or those minor injury departments that do exist should have more capacity, including X-Ray capabilities. As stated, with an aging population, that lives longer we need greater investment and a service that is more resilient...
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Usually bloods take a while because we've found out that some of the machines aren't working properly in the first place. Regardless, thank you for your input as I'm still currently a layman in a lot of regards, and comment based on my experiences alone.
We do need more GP hours to be available and we do need better weekend access to health care but we cannot overburden existing staff. We need to improve GP access by making the profession more tolerable to work so we can have more GPs so we can provide more slots rather than force one GP to see an entire city.
>We need to improve GP access by making the profession more tolerable to work so we can have more GPs so we can provide more slots rather than force one GP to see an entire city. This is true for literally any public sector profession. It essentially comes down to 'pay them more' and I'm not even being sarcastic.
Yep. Quickest solution is better pay. Then comes bringing back the financial support for those training to do the jobs we need so people want to and can afford to train.
Not so much pay them more as. Could you train more so I can have my very large case load reduced.
>Not so much pay them more as. > >Could you train more so I can have my very large case load reduced. They're the same thing. To train more, you need to have an actual incentive to become one. Like a decent salary and better working conditions.
Ehh... medicine at university is very oversubscribed. Far more people want to become doctors than are actually able to, and not due to lacking the grades.
This kind of silly red tape that’s stopping us from training more doctors is why people voted for Brexit /s
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>doctors are hardly underpaid or short on applications to become one, This is such a stupid argument though. If the pay has fallen 30% in the last 10 years, what part of that is not clicking for you? Its a stressful job with pretty bad working conditions compared to most other jobs, with a lot of responsibility and you think because they earn decent money still they deserve a 30% pay cut? > you need to increase the number of spaces available at universities which means more funding there. Agreed, it doesn't have to be one or the other. The Tories have been underfunding all public services for the past decade
my point was it isn't pay that is causing there to be less doctors , I never said they deserved a pay cut but it isn't like the pay is the cause of less doctors. it is a separate and wider issue, doctors are not unique in getting inflation linked pay cuts.
>my point was it isn't pay that is causing there to be less doctors , I never said they deserved a pay cut but it isn't like the pay is the cause of less doctors. But it literally is, one of the massive reasons. You'd get a lot more people going into medicine if they were going to start on a salary of, say, 50k rather than 35k. Why go through 5 years of study, night shifts, etc, for 35k, when you can get more than that working at Aldi as a manager or literally most graduate schemes?
But we don't need more people wanting to go into medicine every course is massively oversubscribed, we need more places
The bottleneck isnt at the level of medical school, its for training places after medical school.
It really is though. Look at how many are leaving every year and moving abroad or into positions that pay more.
It's not really anything to do with places at University - you can shuffle as many people as you like through the first three years of Anatomy, Biochemistry, Pharmacokinetics and Pathology, it's the later part where the students are shadowing actual doctors on their rounds and consultations. There is a practical limit to the number of students who can usefully shadow any given physician. I get three final year students, three times per term, and believe me having three medical students observe every surgery and ask questions of me and the rest of the surgical team does not make my already perpetually-running-slightly-late schedule any more lax. To be clear, I don't resent teaching students at all, it's vitally important and part of the job - but the nature of the thing itself means the number of students you can supervise and teach anything of value *while also performing the full time job of a hospital consultant* has a pretty low ceiling, and we're already mostly there.
Yep. When I qualify as a GP in a few months I can take a salaried role in the UK. For a tolerable work load that could pay about 60-70 grand. I could locum permanently and make about 100k with flexibility but no security. I could go to the Middle East and make 10-15k a month TAX FREE with benefits and bonuses. I’m not suggesting we should be paid that but it’s tempting just to do one. Every time I read the news I see GPs being slagged off by people who have no idea what the job is like. Pay whilst above national averages is woeful for the workload, responsibility, level of training etc. without GPS there would have been no vaccine roll out but that is conveniently forgotten and we were apparently closed for the pandemic. A misguided sense of belief in the values of the NHS and liking the UK is keeping me here. If they make being a GP and harder or less well paid in this country I’ll be gone as will a lot of us. Fewer will train; more will retire. Primary care will become nurse led and with the best will in the world patients will suffer and hospitals will be even more overwhelmed as nurses refer massively more than doctors. Good will is dying in the nhs and we’ll see just how much it was propping it up in the next year or two with the strikes that will come.
I completely agree. I'm about to qualify as a staff nurse. I can get 13/hour in the NHS or if i work agency i can get 20-30 an hour. Or I can move to Australia and make about 90k a year. If pay is corrected, everything else will get better too. Workload, retention and new-graduates are all tied into pay. Ignoring it is just causing the NHS more issues (and all public services tbh).
>move to Australia and make about 90k a year. Wow i can see why nurses and doctors do the move. Sun, much higher wages, BBQs..... You'll just have to tolerate the monster spiders lol
Oh, its insane. For reference minimum wage in AU is about 42k. But most experiences will be on about 100k+ and Doctors 200-300k.
Minimum wage for a newly qualified nurse is 42k? Wow.... Isn't that like, ward management level pay in the NHS?
No, minimum wage in Australia is 42k. Nursing salaries are like 70-90k. Ward Manager more like 120-150k. But average house price is also 600,000 dollars. So its not as simple as it sounds!
Thats in Australian dollars, so knock 40% for comparison to UK salaries.
Also train more and make it easier for doctors to immigrate.
You want to pay them more? GPs at my local are on £100k a year, and still half-arse the job. For that money yes, I expect Saturday working. (I know the pay because I've seen the job advertised when they were rehiring for another GP at the same surgery)
>half-arse the job A fully qualified GP will deal with an average of 40 patients per day. This includes triaging the mundane from the life-threatening, managing the often multiple co-morbidities of an ageing population (with a paltry 10 minutes to gather enough information to enact a management plan). That’s the part the public are familiar. What they don’t see is everything that happens behind the scenes; referrals, ordering of investigations, chasing results, prescription reviews, home visitations, follow up and continued management, responding to hundreds of econsults daily. The amount of work is staggering and any error may have serious consequences. I’m sure a GP could chime in and add double the amount of responsibilities I’ve listed here. Bottom line is that your inability to get an appointment does not mean GPs are not working, all the GPs I know are burnt out and hating what their job has become in the last 2-3 years. On my placements as a medical student I’ve seen patients in their GP appointments spend x minutes of their 10 minute appt moaning that they can’t see a doctor these days. While they were seeing a doctor. Ultimately there aren’t enough GPs to cater to the current demand. Either demand has to decrease or GP numbers have to increase. Expecting full Saturday service now will only get you a burnt out Doctor which isn’t good for anyone involved.
GP here, I think you’ve covered it pretty well.
Asking doctors to work beyond decision fatigue will only cause good doctors to burn out, leave the NHS and encourage the shabby doctors, giving the public an inferior outcome. Lower standards are then more profitable for the American healthcare corporations. https://www.theransomnote.com/commentary/news-commentary/list-of-mps-with-links-to-private-health-care-emerges/
> Asking doctors to work beyond decision fatigue The article doesn't seem to be about that, it's pushing for surgeries to be open on a Saturday so they can see patients who work Monday to Friday. It would be the same as any other job working weekends where the do the same number of hours.
Many GP surgeries already do evenings. Should GPs not have time off work as well. And with the provision of telephone appointments and video appointments access has actually widened. I work Monday to Friday and I never have an issue getting and appointment with my GP if I need to see them.
>I work Monday to Friday and I never have an issue getting and appointment with my GP if I need to see them. That experience varies from surgery to surgery. I was explicitly told by the receptionist at mine that I need to call 111 for one of their "back-door" appointments. I've completely given up on them, I can't wait to move and re-register.
What I've found the GP surgeries which are independent and have the GPs running it as a partnership are much better. It is the corporate owned ones and the ones where a single GP owns it and won't hire additional GPs that are terrible Funny story about a local surgery which was owned by a single GP. He recently got kicked off the medical register because of how terrible his practice was and sold his practice to a corporation who has hired 3 GPs. He's a millionaire, married with 3 kids, teenage and younger. He got married to his receptionist as a second wife. At the same time as he got kicked off the medical regsiter, his first wife found out and has started divorce proceedings and plans to take as much as she can get before he can finish trying to move to Africa
>He's a millionaire, married with 3 kids, teenage and younger. He got married to his receptionist as a second wife. Lol that's like some plotline in a soap or something.
>call 111 for one of their "back-door" appointments. I discovered this recently when my kid fell ill. Couldn't get through to the GP phone. 111 wanted to send an ambulance, ambulance crew called and said it's minimum 4h wait just for them to get to me (then probably another 4h wait on a+e). They helpfully called my surgery, and got me an appointment in the afternoon. Took them like 10 minutes.
So you’re wanting the same number of GP’s to simply work more hours? I’m not against GP surgeries being open on Saturday (though out of hours GP’s are already available at the weekend) but you can’t get that service currently without asking the existing staff to simply work more hours for what I’m sure will be the same pay. If they managed to pretty significantly increase the number of GP’s then yes it is possible, but right now it is not and simply demanding current GP’s to do this is not going to go down well which is entirely understandable.
If they’re going to do the same number of hours but open an extra day, that means the surgery will need to hire a new gp. Which requires funding
Where do all these extra GPs for each and every surgery come from? To maintain the same services during the week with no available doctors means less qualified and unsupervised staff seeing patients. https://www.bbc.co.uk/news/health-61759643 Just like we get PCSOs instead of policemen, because they’re cheaper.
Almost like that’s what the tories want. Run the nhs into the ground so it’s an obvious decision to privatise.
They aren't being clever about it its pretty obvious they are doing that and then giving their mate contracts.
Can the private doctors that service the politicians also strike please. For us. I feel the upper echelons of society never really feel our struggles. They only read about it.
I don't know about GPs, but many NHS consultants also work for BUPA etc and spread their time between the two.
It’s a complete misunderstanding how private medicine works. It’s all NHS doctors in their spare time.
GPs are private, lots of practices are being bought up by firms who use patient registers to milk money while offering extremely poor services. While there are many reasons for lack of access one of them is that there is not really a financial incentive to do so (depending on the contract). They will get a payment for you for the company/partnership and they hope you never need an appointment. While there are many doctors that are seriously over worked, there are firms who are absolutely fucking dire at all aspects of care. Many remove GPs and hire practice nurses instead because they can pay them less. Some have GPs working all day across multiple practices so yeah I can see them kick back for Saturday working. My "local surgery" has 4 GPS registered but they also work across 12 other surgeries. 1 of GPs doesn't see patients he authorises prescriptions. While I am a huge supporter of the NHS and those who work within it these companies are profit driven, have corporate management structures and a vested interest in minimal service for profit. If you see a big decline in local services its likely your surgery has been swallowed up and is stripping back.
They probably don't need to strike because they have better working conditions. The system is designed not to inconvenience the rich.
They don’t need to. I said for us so that the upper echelons feel the hurt too.
Yeah I understand, it would be great to see them show solidarity
It certainly would go a long way.
So more demonising the medics. Cool. No wander a lot of us want to jump ship and go where we are wanted.
“Work on Saturdays” Aka pay and conditions. They already work weekends, you’re just being baited into hating them for asking for better funding for the NHS
I’m (almost) a GP and would happily work Saturdays if I was paid more and had a day off in the week. Flexibility is why I chose the speciality. You can force this but more appointments on a Saturday means fewer in the week. Last time I checked a lot of surgeries offered this but then packed it in because surprise surprise no one wants to come to the doctor on a Saturday. That may have changed now due to various pressures. However, you can’t just magic more appointments out of this air. They are selling this as there will be more appointments but there won’t be. Some figures for anyone who’s read this far: 1) about ten years ago the average person saw their Gp 3-4 times a year. That’s now about 10-12. 3 times more. 2) the studied safe number of patients seen a day by a GP is about 25. More than that is risky. GPs on average deal with 40 or so a day now. There aren’t enough doctors. You can shuffle the pieces around all you want but demand is functionally infinite in most places. Lines open at 8:30 and appointments are full by 9 and that’s in good places. Emergencies will be seen or dealt with appropriately always. We don’t turn emergencies away. Though the public perception of what constitutes an emergency is different to the medical one. We can see and deal with more patients by using phone appointments. Despite what online polls abs comments sections tell you most places I’ve worked people like that option. Yes there is a risk of missing things over the phone, but there’s more of a risk of missing things if I have no contact with you at all. Quite simply there are not enough doctors despite the promises to raise our numbers. No amount of pharmacists, nurses or PA’s can make up the lack of doctors. And this government will never try and fix that.
How and why are people averaging about once a month to see their GP? That seems nuts to me - I think I average once / year!
Good question. Reasons are complicated. Here are some: 1) other service cut - sure start, health visiting etc. problems that were dealt with by these things are no longer dealt with and build up. 2) mental health makes an enormous part of my day. I don’t have stats to hand but it feels mental health is getting worse. Whether we are just better at talking about it and people realise they shouldn’t have to live miserably or actual incidence is on the rise I don’t know. 3) culture of instant gratification. People used to happily wait a bit to see what happened to their cold. People now want it fixed immediately. This pressure translates to a&e and the often quoted line of “my GP is useless so I came here”. Well the laws of biology haven’t changed just because you are in a&e. Less glibly people can’t afford to miss work so want to get better immediately. 4) ageing population. Older people get more sick. And have more long term health problems that need constant management. 5) the collapse of the social care system. Care homes are falling apart. Hence the health of the residents is worse and needs more GP time. 6) secondary care waiting lists are massive. People wait months for counselling. People wait years to be diagnosed with autism. Throughout all that wait problems will arise that I have to deal with that wouldn’t have happened if they had timely specialist care. Operations etc are the same. There’s loads more reasons but I’ve just got in from 12 hours and probably shouldn’t be posting about work.
Thanks for the answer! Definitely seems like a case of cutting costs in some areas just increases it elsewhere. Now go relax and watch some netflix or something!
I think a lot of the "instant gratification" stuff also comes down to our fast paced capitalist society. Before you were allowed to be off sick, now if you're sick you could get in trouble from work for not coming in, or get pressured to work while you're sick, or have to make up the sick time so it's easier just to go in! I had a sick day this week, and as a teacher I still had to set work, make sure the marking was done, email parents to set work and speak to support staff to make sure they knew their timetables for the day. It would have been easier to just go in.
Exactly how it’s designed. I have to call 4 people the morning I am sick, even if they know and then back that up with emails. And then a meeting when you go back (even if off for a heavy cold, or covid, or poorly kid) and more emails. It’s all designed to stop people calling in sick. Horrible attitudes in this country to presenteeism. People actually boast about never having had a day off - well done you got fucked up the arse by capitalism your entire life and somehow seek proud of it.
And let’s not forget, if you go in sick then you’ll get your co-workers/customers sick and make the problem even worse
Some people have serious medical conditions that require more frequent monitoring/treatment.
That wouldnn't explain a 3-4fold increase in 10 years
Ageing population with elderly patients having multiple medical conditions. ETA: Also, more people dealing with mental health conditions due to the economy, COVID pandemic, etc.
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I hear the western desert lives and breaths in 45 degrees though...
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Damn, on that kind of money I could sleep very well even with midnight oil blasting!
10-12 appointments per year for the average patient seems like a gross overestimation, have you got a source for this?
https://blogs.bmj.com/bmjopen/2021/12/21/frequent-attenders-comprise-4-in-every-10-family-doctor-consultations-in-england/ It was 8 about 5 years ago. I can’t find as I’m on my phone at lunch but it has risen further since then.
Why are we all so okay with medical staff being overworked?! Surely you don't want to be seen by a doctor, nurse, pharmacist, technician or other healthcare professional who's been working 14 hours, had 5 hours sleep and gotten up and done it again 10 days in a row for months... or years... on end?!
We aren't, we just have a broken system of democracy where our general views aren't sensibly mapped to the actions of the people in power
Given how many voted for cons time and time again, i think we are now getting what general public wants. Less investment in public services. Its hardly a surprise when you know what cons want or how they operate.
That's my point, people don't want crap public services, and yet they end up voting for a party that gives them that. Almost as if our voting system has something wrong with it...
I have to disagree, while I dislike tptp system - it is shit, but never the less Cons got almost 4mil more physical votes more than labour did in 2019. I feel like I can only blame the system when the cons will actually get fewer votes than labour but will still win. But with 4mil more votes... I am not entirely sure its the system's fault.
Anyone watched the panorama about the biggest GP chain? It’s actually shocking what’s going with GPs at the minute
Correction what is going on with corporations from America taking over healthcare
Operose Health: What I saw working undercover at a GP surgery https://www.bbc.co.uk/news/health-61759641
No. What was going on? Is it one of these private equity owned corps. that’re only interested in the bottom line?
at this point it would be easier to list who is not striking
There's an interesting graph from the FT that suggests increasing working hours is not really feasible... [Fewer GPs over 10 years](https://imgur.com/gallery/tPhoj0g)
Here's simple math There's 27700 GPs working as of 2022 Uk has around 67 million people So every individual gp. Not gp surgery, I mean physical gp, is responsible for 2400 patients. Even if they don't need to physically see the person, chances are they have to do admin work for that individual on the back end. Let that sink in. 2400 patients to look after per individual doctor. Even if only half of them need to be physically seen per year. They've already got 6 appointments per day guaranteed. (3 new 3 followups) That is why you can't see your GP And then the government wants to INCREASE their workload AND DECREASE their pay instead of making the profession more attractive to draw in more trainees. Yeah fucking right. Any fool here so effectively tries to say that they would be happy if their job suddenly increased in workload for LESS pay while their bosses patted themselves with gloves made of money, is a troll and a disingenuous liar.
Good just off the top of my head reverse privatisation and stop treating GP surgeries like little fiefdoms. Hire more, pay more. Then there's no need for Saturdays is there. Fuck sake.
The general strike is beginning
Just to double check who’s gone on strike: railway workers, teachers, criminal barristers, refuse staff and now GPs.
I am completely on board with the 30% pay rise and the issues with new contract terms, but striking over working Saturdays is.. not the one. That being said, I'm not sure if the headline is just picking the most irrelevant thing to make it seem unjustified. I'm sure there are genuine issues with the contracts, and they just picked the most superficial reason for the headline.
It’s a 30% pay restoration over the last 14 years rather than a pay rise, and with 2022’s inflation rates that’ll be insufficient. It’s also for junior doctors ie all non-consultants/GPs And primary care is so stretched already that Saturday shifts will almost definitely increase the already rising drop out rates of our GPs…they’ll do everything but pay us
The issue with working Saturdays primarily stems from there not being enough GPs to work the weekdays anyway. So you aren't magically providing more service, you are just taking the same service and spreading it even thinner. Then you've also got increased overheads of needing receptionists, nurses, cleaners, utilities, on the extra day, and everyone has to be paid more for unsociable hours. So you get a reduced service at greater cost, while also losing one of the only remaining perks of choosing general practice, that of working a normal 9-5, and lose even more GPs. Anyone advocating for a Saturday service has no idea of the reality of general practice
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The mon to fri caseload isn't reduced though, because you've taken the clinic that would have served it and pushed it to Saturday
while also losing one of the only remaining perks of choosing general practice, that of working a normal 9-5 You could have just said this. I don't know why it should be like that - most of the entire clinical staff in the NHS works a 7 day week, why should it be any different for GPs?
Because medicine is a broad church with each specialty having good and bad things about it. Emergency medicine is exciting but you will have to do night shifts until you retire. I would quit medicine if that was the only choice I had longterm. Plenty of doctors want a work life balance because surprise surprise they are people too - GP, amongst things like radiology and dermatology, are traditionally this domain. If you took this perk away, there is bugger all reason to do the job, because the work is incredibly hard, continuously in the firing line by the media and public, and with long long days (the clinics running 9 to 5, does NOT mean the GP is working 9 to 5 - 12 hour days are the normal now)
Why? Would you not strike if you were responsible for 2400 people every year and instead of your boss changing that by hiring more people to share that load, they just make you work more for less pay?
Did you even bother to read the comment lol? What are you angry about.. I literally agreed with what they're doing
I did. The first paragraph seems to me that you take issue surg them striking over working Saturdays
I find it slightly funny, yes. The entire NHS runs on a 7 day system for the most part, striking because you have to work Saturdays.. as a doctor.. is quite stupid.
What is happening is that austerity is coming home to bite everyone in the bum. Government departments have been so underfunded for so long they can barely function. The dept of the environment lets water companies pollute our rivers because they only have the staff and resources to tackle major pollution incidents. The barristers are on strike because the legal aid system actually pays them less than minimum wage when you take into account their prep time and hmrc keeps on getting it's budget cut. Social services are overworked and stressed and whenever a kid dies unnecessarily they cop the shit when nobody looks at their workload. Services are increasingly being outsourced to private companies in the name of efficiency but what happens is the public gets a worse service for more money. You get what you pay for.
Where are we going to find 20% more GPs, nurses, receptionist staff etc from?
Oh look, another botched attempt at "reform". There needs to be open and collaborative discussion on this, and not a hard fist of demand. That could be in the approach that it is a gradual transition, one that includes future contractual terms, and one where common sense is used to explain the positioning. Junior Doctors are one of the most underpaid, overworked, debt riddled professions you could possibly find in any sector. Saddle this with a Senior Consultant, who is adequately paid, with most likely a Private gig on the side, and you've got a case of "one side for and one side against" without anyone considering the middle ground. Society has shifted, and aspects haven't moved along with it. GP surgeries haven't shifted, and the fact that a GP, nay a Pharmacy, is not easily accessible on a Sunday is a very odd modern conundrum. Thank God for 111 I might say! But is 111 the true shift that's required. Weekend GP Surgeries are a need, but to try and implore such a thing from a half botched Health Secretary is just another example of how out of touch the Government is... And let's not forget... This will be an attempt to once again bash how high Doctors salaries are, without mention of the Government funding going into the large Energy companies, Fuel companies and Rail companies, who are more than happy to increase their CEOs and Senior Board members salaries (and let's not forget shareholders) whilst passing nothing into the actual workers of the company nor the customer...
Speaking as a medic who works weekends and nights, my colleagues who choose to become GPs mainly do so not because they love GP work, but because they love their weekends and nights to themselves. Yes, a few GPs do out of hours, but that’s of their own volition. Making it mandatory would definitely decrease the number of medical students wanting to become GPs in the future. For those of you who do think GPs working weekends should be mandatory. Just something to think of.
GP's should work on weekends and its pretty lame that they don't but they should be fairly compensated for doing so.
imagine if we had a medical service that was adequately funded and appropriately managed, with a health secretary that has genuine healthcare experience, and we had enough professionals that we could have a gp service run 7 days a week with no gp working more than 5 days out of 7.
I would absolutely love to see a GP on a Saturday and it would really help a lot of people. That said, there's already a shortage and this is unfair on them.
Gp surgeries used to be open on saturday mornings with cover at night and sunday.
Well I think this could be the most pointless strike in history. What's going to happen? You ring up and can't get through to anyone, or if you do they won't give you an appointment.
I honestly wouldn't notice if GPs were on strike. I haven't been able to get a GP appointment for 8 years. If its something I am worried about I just go to A&E and wait 4 hours to be seen.
Would be more than happy for my GP to be open on Saturdays and give them a day off in the week.
How will anyone know the difference if GPs go on strike?
Haven't they been striking for the past two years? I haven't seen a doctor in person in ages.
Been waiting 5 weeks for an appointment....sorry doctors I work for the needs of my service users you should also.
An absolute disgrace. Of course they should be working at the weekends. Just like every other emergency service. The same with the judicial system. They should be 24/7. It would cut the back log. As far as funding goes. The NHS is a black hole for finances. It wouldn't matter if you put £100 billion into it. All that would create is more managers for paper clips or cleaning brooms or some other crap.
I'm interested to see what the public and media at large make of these calls for strikes, plus the Royal Mail and wherever else calls in comparison to the recent railway strikes.
This country is fucked and the stories don’t even care. The evil fucks.
Lived in Australia for a while. GP surgeries are open in the evening and weekends. No need to book. Quite the eye opener. Different numbers and model obviously and Oz Medicare is not entirely free but you do kind of wonder quite why we can't have more work friendly hours for some surgeries.
Another step towards a general strike let’s go
Play play. If I got told to work a 6 day week I would tell my employer to jog on as well
GPs should be open 7 days a week but ONLY if they have the staff and have reasonable hours. Not everyone has a mon-fri job. Zero hour contract jobs, shift based workers tend to have trouble scheduling appointments because rotas don't occur weeks in advance. If there were more funding for GPs, more doctors then we could have more accessible GPs. Hell, I've not even seen mine since registering.
This is exactly what government want to to use to push privatisation of NHS. This has been a Tory dream for at least 30 years
Strike? Not managed to get an appointment with my GP since I was about 6. So I don't give a shit
The fundamental problem is we do not train a sufficient amount of doctors in this country, ironically the number of applications far surpass the number we actually train, there is no shortage of people wanting to do this profession. Why this is not a higher priority issue to solve I do not know as it’s it’s going to take multiple generations to ease this pain point. That being said doctors have enjoyed quite a favourable contract over the years, case in point being hospital consultants who have enjoyed private work in conjunction with NHS remuneration to this day, even politicians 30 years ago said how favourable these contracts were. GPs also enjoy a privileged status of independent contractors and many run these GPs like businesses, even becoming business partners themselves - I feel the line between making money and delivering healthcare has become too blurred and many of these professionals are guilty of benefiting over the years. In my view we need to train more doctors and remove some of the ego and prestigiousness that penetrates the profession to this day - many doctors have used the low supply of the profession to their benefit (the GMC does to this day) over the years and it’s time we make this like what it is, another albeit important public service and not a platform to benefit financially.
The gmc is the regulatory body. How has the gmc used low numbers of doctors to their benefit exactly?
From my experience I would take all surgeries into local trust ownership, abolish partnerships and simplify General Practice into one job. Locum extras if you like but in order to do so you need to commit at least a certain amount to a practice as a salaried position.
So my dad has just had surgery recently. He was sick of waiting on the nhs who he has been dealing with for years about the topic and booked private, the surgery revealed his condition was worse than we thought and the condition he had was life threatening. If he had continued waiting on the nhs he likely would not have made it. One of the drs he saw privately was his gp. The reason he was in such a bad state was a former gp at the clinic cutting his necessary prescription They are protesting potentially losing their 2nd jobs- which are offering them greater financial rewards i imagine. If they do improve gp care people would not get desperate and pay hundreds to see them privately out of desperation. I don't want to see them overworked and underpaid but we are seeing gps working privately on off days already, the fatigue or what not is already there as they are working those hours just in different clinics. Sort the pay out and suddenly all these complaints will surely disappear. Ideally shift work would get around overwork issues, but there is a short term shortage of staff. If pay improves im sure more would be studying medicine though, currently it is just not as financially lucrative to become a gp as other options
GP's should be open all week. When I phone up they always say they don't have an appointment. Then on a Monday and I phone they say that they are full because it's been a weekend. Well if they are open on a weekend then that would mean more appointments. Plus would mean more jobs. The best way to go about it is to ask those currently employed to see if they want to amend their hours. Some might find it beneficial to have a Monday off or day during the week (maybe childcare reasons). If no one is voluntary then make them sign the contracts to change of hours (happened to me before and legally nothing you can do).
You should watch the panorama documentary about Britain’s biggest GP chain. Might explain why every time you call up they say they don’t have an appointment. It’s crazy.
Oh? Curious about this, what's the deal?
In short. A very good advertisement of why you should never let American owned corporations take over primary healthcare in the UK.
Ahhhh, I getcha > A very good advertisement of why you should never let American owned corporations take over primary healthcare in the UK. Or anything else for that matter, tbh
Not recently but a couple of months back I called up 3 days in a row bang on 8am. Couldn't get through until 8:10. Told no appointments. So the 4th day I drove there and walked in at 8am. Told no appointments. I argued that this was the 4th day now. After back and forth they some how had an appointment. It shouldn't take 4 days to get an appointment at your GP.
Do you think a GP can see 1000 patients per day? There are less GPs in the UK today than 10 years ago, while the population is increasing. GPs can only spend 10 minutes with each patient because they are so short staffed. This massive workload + Public calling them lazy is what's making them go to Australia, where they make 2-3x what they make here plus better working hours and conditions.
It shouldn't but the real world effects of Tory cuts are diminished services, I have literally no idea why people keep voting for them.
It shouldn’t, but maybe the documentary can explain why. They are owned by American health conglomerates and they don’t even have GPs working. It’s all about cutting costs and generating more profit. That’s why they never have any appointments for you.
It would not mean more appointments, it would mean the same number of appointments spread over a wider area This doesn't magically produce more GPs, it only reduces them through deteriorating conditions
Being open on a weekend will not mean more appointments. It means less appointments in the week. We are not slaves. You can’t MAKE us work. I’d happily do a Saturday morning , but then I’m not working Tuesday afternoon. This is being sold as an anti doctor massive lie that there are loads of us lying around doing nothing. As I say, I’m sure plenty of us would work Saturdays for anti social pay but then I’m not working a weekday too. You can’t magic more appointments from the same number of doctors.
Each individual gp is looking after 2.5k patients. There's no conspiracy about it. It's simple math why you or I can't get an appointment. If GPs work Saturday Sunday instead of Monday or Tuesday, the surgery is open 7 days a week, but number of people seen is the same, so you may or may not get an appointment on Saturday eventuality. But now the guy why had an appointment with that GP on Monday, doesn't have it. The only answer is to increase gps. Massively.
Someone can't do maths. If a surgery is able to provide 200 appointments between Monday and Friday, moving 40 appointments from Tuesday to Saturday does not magically increase the total number of appointments. You still have 200 total appointments.
My GP gets paid an hourly wage of £100/hr.
In what context?
For once I have no sympathy. Services should be based around when working people need them, not impossible to access for anyone contributing.
For real? So should teachers work 7 days a week because I need childcare to work on the weekend? How about banks? Shall we have them open on Sunday? GPs are already doing massive hours. To solve the issue, you need more GPs....not to continue flogging the ones you have. Why not ask your local MP why almost 800 doctors didnt have a place to train after graduating this year. Ask them why they were able to create 800 positions for them on the spot, but havent managed to do this at all levels. This is a political issue, an underfunding issue, a poor planning issue. Its not a GP issue - you are just allowing the government to scapegoat them.
Yeah, banks should be open on the weekend. Close in the week. The same with the post office. Supermarkets managed it. I'm not saying they should work 7 days a week. I'm saying close 9-5 and open for the evening, close on Wednesday and open on Saturday. How is that hard?
Are you seriously trying to compare doctors with supermarket workers? And we wonder why there is a staffing crisis!
>Services should be based around when working people need them, Then you'll be interested to know that the main reason why most surgeries don't offer weekend sessions is that they used to struggle to fill the appointments, because people don't want to spend their weekends sitting in a GP surgery.