Rant thread

[ckn]

3 minutes ago, BryanC said:

Have you tried a smear of Vaseline up each nostril? Works for a lot of folks.

Thanks, tried that years ago, it's my eyes that get the biggest hit each year rather than my nose.  My nose gets runny but only because my eyes are over-producing.  A few years ago I couldn't get along without prescription eye drops but the most recent over-the-counter stuff does the trick as long as I give it time to build up.

[BryanC]

Shame. Must ruin any odd bits of nice weather we get.

[ckn]

15 minutes ago, BryanC said:

Shame. Must ruin any odd bits of nice weather we get.

Not really, again it all depends on how well I prepare.  A few regular weeks of treatment and I rarely notice it.  By the end of June or mid-July the hayfever I get has gone.

[Phil]

Watching the athletes at the commonwealth games, they’ve worked hard, given up some of life’s pleasures and existed of a fairly paltry national lottery grant in lots of cases. Their real pleasure at just being there and their dignity in victory and defeat.

And then the next item on the sports news, the namby pamby, overpaid, falling over boys of football, no sportsmanship, no dignity, just money money money.  Sickening.

[graveyard johnny]

7 minutes ago, Phil said:

Watching the athletes at the commonwealth games, they’ve worked hard, given up some of life’s pleasures and existed of a fairly paltry national lottery grant in lots of cases. Their real pleasure at just being there and their dignity in victory and defeat.

And then the next item on the sports news, the namby pamby, overpaid, falling over boys of football, no sportsmanship, no dignity, just money money money.  Sickening.

footballers doing abba songs? that is sickening pal

[Phil]

Daily mail readers respond to an article about Hitler 

[graveyard johnny]

5 minutes ago, Phil said:

Daily mail readers respond to an article about Hitler 

and such a lovely moustache too, showing us  a playful side like oliver hardy or chaplin

[ckn]

The system for getting GP appointments has to change, this is just stupid... Our GP surgery phone line is automatically routed to a "closed" message until exactly 8am on a computer that gets its time synchronisation from the same international timing resources that keep most electronic devices accurate.  It ticked over 8am and I hit dial, there couldn't have been more than a second of delay before I pressed the button.  "You are number 26 in the queue".

If that's me being as clued up on the system as I am and getting that, what about the older folk who aren't that clued up or are slower in dialling?

10 minutes in and I'm number 7 in the queue.

[tonyXIII]

I know what you mean. I long for the good old days when my mum would take me to Doc Murphy's. No phone call, just go. We'd sit in his waiting room, get our lifetime's worth of cigarette smoke and, when it was our turn, we'd walk into the Doc's surgery to find ourselves shrouded in a fug of pipe smoke.

A different world. But I do agree that the system of booking appointments is poor (or, it was poor when I last lived in the UK).

[ckn]

3 minutes ago, tonyXIII said:

I know what you mean. I long for the good old days when my mum would take me to Doc Murphy's. No phone call, just go. We'd sit in his waiting room, get our lifetime's worth of cigarette smoke and, when it was our turn, we'd walk into the Doc's surgery to find ourselves shrouded in a fug of pipe smoke.

A different world. But I do agree that the system of booking appointments is poor (or, it was poor when I last lived in the UK).

I got an appointment with a locum as the permanent GPs are all fully booked.  I could have taken the phone appointment option with a permanent GP and got one for today but it's hard to get them to check blood pressure for themselves over the phone!

And that's me calling at 8 on the dot, 5 minutes later and there wouldn't even be those locum appointments left.

[gingerjon]

2 hours ago, ckn said:

The system for getting GP appointments has to change, this is just stupid... Our GP surgery phone line is automatically routed to a "closed" message until exactly 8am on a computer that gets its time synchronisation from the same international timing resources that keep most electronic devices accurate.  It ticked over 8am and I hit dial, there couldn't have been more than a second of delay before I pressed the button.  "You are number 26 in the queue".

If that's me being as clued up on the system as I am and getting that, what about the older folk who aren't that clued up or are slower in dialling?

10 minutes in and I'm number 7 in the queue.

Ours doesn't have the queue or the automation. But at 'around 8' the line opens.

You can only book appointments on the day and to do so you have to be able to phone at 'around 8' and keep phoning.

The family record is just shy of 200 calls between 8 and 8.30 with me and Mrs Ginger each calling to get an appointment for her as, without it, she wouldn't have been able to breathe by the end of the day and we'd have been off to clog up A&E.

 

 

[ckn]

1 hour ago, gingerjon said:

Ours doesn't have the queue or the automation. But at 'around 8' the line opens.

You can only book appointments on the day and to do so you have to be able to phone at 'around 8' and keep phoning.

The family record is just shy of 200 calls between 8 and 8.30 with me and Mrs Ginger each calling to get an appointment for her as, without it, she wouldn't have been able to breathe by the end of the day and we'd have been off to clog up A&E.

 

 

Most GP surgeries have upgraded to a call queue handing system. It’s funded by MHS England money so shouldn’t be difficult to get. 

[gingerjon]

7 minutes ago, ckn said:

Most GP surgeries have upgraded to a call queue handing system. It’s funded by MHS England money so shouldn’t be difficult to get. 

To be moderately fair to our surgery they have had to take on thousands of extra patients whilst having fewer GPs themselves as some other places have closed. They are absolutely chasing their tail at the minute so I suspect that it's part of a long list of things to do.

[Spidey]

Since I’ve changed surgery’s about three years ago I’ve not had an issue getting an appointment with my GP. I’m unsure on what’s different at my current GP but had the same issues described at the previous two

They do have two early morning starts (7.30) a week to help with people in FT work which I’ve used frequently

[gittinsfan]

4 hours ago, ckn said:

The system for getting GP appointments has to change, this is just stupid... Our GP surgery phone line is automatically routed to a "closed" message until exactly 8am on a computer that gets its time synchronisation from the same international timing resources that keep most electronic devices accurate.  It ticked over 8am and I hit dial, there couldn't have been more than a second of delay before I pressed the button.  "You are number 26 in the queue".

If that's me being as clued up on the system as I am and getting that, what about the older folk who aren't that clued up or are slower in dialling?

10 minutes in and I'm number 7 in the queue.

Had a very similar experience.Eventually got through to be told I could see my own doctor in 3 weeks.

[Billypop]

5 hours ago, ckn said:

The system for getting GP appointments has to change, this is just stupid... Our GP surgery phone line is automatically routed to a "closed" message until exactly 8am on a computer that gets its time synchronisation from the same international timing resources that keep most electronic devices accurate.  It ticked over 8am and I hit dial, there couldn't have been more than a second of delay before I pressed the button.  "You are number 26 in the queue".

If that's me being as clued up on the system as I am and getting that, what about the older folk who aren't that clued up or are slower in dialling?

10 minutes in and I'm number 7 in the queue.

The only way to get close to guaranteeing an appointment at my surgery is to turn up at quarter to 8 (at the latest) and join the queue to make an appointment. Appointments are only available the same day. Getting to the surgery has on occasion been a challenge (at one stage I was so bad I couldn't even put the bins out) so heaven knows how elderly disabled folk are supposed to achieve that.

Experience with attempting to book an appointment by phone is similar to ckn's. One time when I simply couldn't make it in person I got automated "surgery is closed" messages until bang on 8. Then I got engaged until 8:17, then I got to number 12 in the queue. I finally got through at 08:32 to be told that all appointments had gone, and no I couldn't book one for the next day, I'd have to ring in. Or get there in person.

Since ringing in hadn't been too successful the previous day I managed to get to the surgery via taxi, getting the taxi driver to drop me off at the top of the slope so I wouldn't have to climb a flight of stairs. I joined the queue behind 5 others - this was at 07:35 and the surgery doesn't officially open until 8. I was allocated an appointment at 10:10 with a locum I've never seen since and had never seen before. I elected to wait in the waiting area as I didn't exactly feel sprightly enough to make an extra two taxi trips. 

Withing two minutes of the appointment I was back in the waiting area waiting to have a portable ecg fitted and waiting for an ambulance. I was whisked off to A&E and ended up in the HDU (High Dependency Unit) and on drips for two days. I don't think the 24 hour delay did me any favours. 

You may well ask why I didn't escalate on the first day. The simple answer is I had become somewhat accustomed to feeling under the weather and in my own mind was just going to see the doctor to get a sick note for work.

  

[ckn]

Too many people to quote but the GP "busyness" is made up of a lot of indicators.

First up, find out how many GPs are registered at your surgery and how many patients are registered there.  You can get that here, you may have to log in as a Guest but that's a very simple bot check.  If it throws you to a main page after login then simply click Report, Common Information Reports, Organisation Data then Practice List size and GP Count  (See pic below)

That'll give you an option, click on October's CSV.  Trust me, CSV is SO much easier if you have Excel on your machine. Then search for your practice.

If the Patient Number (column K) divided GP number (column L) >2000 then your practice is overloaded.  1700 is considered a good and safe amount per GP but 2000 is acceptable at a stretch if the practice adapts well.  Bear in mind that this uses prescribing data so may not be 100% accurate, the NHS England GP lists go out of their way to make this information hard to get.

That's a really basic indicator though, here's things that make it harder for the practice per patient, in decreasing complexity:

- Is there a nursing home in the practice's catchment?  If so, they get treated and funded the same as any other patient and often take 20-30 times the GP effort per year as a typical patient.
- Is there a care home in the catchment?  If so, that's 5-15 times the effort per GP per patient.
- Is the local hospital in special measures or regularly breaching waiting time targets?  Add 25%+ per patient appointment load.
- Has the local area closed its urgent care centres or walk-in centres?  Add 10% appointment load.
- Is it a rough inner-city or deprived area?  If so, that's about a 20-30% increase of patient activity.  This figure decreases the more affluent an area.
- Is it an extremely rural area?  If so, that's a 10-15% increase.

So, Barking & Dagenham has a 2000 patient per GP average list size but is one of the most deprived places in London, plus there are a higher number of nursing and care homes than most areas of England, the hospital is in trouble and the area's walk-in centres are grossly overstretched.  Effectively this works out at a weighted 2800 patients per GP once you build the complicating factors in.

The higher Patient:GP ratio, the harder a time you'll have getting in for an appointment.  1700 would allow you to do most things relatively easily, 2000 means you're getting very crowded, 2250 means patients start to lose out and so on.  Some areas have this down to as low as 1200 because they've good access to GPs, use hospitals well and use other professionals, such as nurse practitioners, well.

When GPs go for interviews when looking for a new practice, that list above is usually a good indications of the questions they'll ask; it can be abysmally hard for GP practices near nursing homes to get GPs to apply and work with them due to the effectively very large unpaid workload of these hard-to-treat and dying patients.

[Billypop]

plan ahead - try planning behind
ogay - used to sound like ok
dude
like
let's be honest, or to be honest or to be fair
all good
good job, or better pronounced gerd jarb
comprises of
fist bumps
high fives
yeh yeh yeh; spoken like a goat
bro
blood...may be UK Only
Unervisity, or uni for short
tellervision or telly for short

[Bob8]

6 hours ago, Billypop said:

plan ahead - try planning behind
ogay - used to sound like ok
dude
like
let's be honest, or to be honest or to be fair
all good
good job, or better pronounced gerd jarb
comprises of
fist bumps
high fives
yeh yeh yeh; spoken like a goat
bro
blood...may be UK Only
Unervisity, or uni for short
tellervision or telly for short

Being a rugby player in the USA made me part of the Bro culture.

There were also distinct nerd groups, who seemed to be snooty and annoying.  Some of them group up to be screen writers and warp our view of American social groups.

[Wiltshire Rhino]

SWINDON F*****G TOWN! 

 

Thank you for listening. 

[Bleep1673]

On 10/04/2018 at 8:11 AM, ckn said:

The system for getting GP appointments has to change, this is just stupid... Our GP surgery phone line is automatically routed to a "closed" message until exactly 8am on a computer that gets its time synchronisation from the same international timing resources that keep most electronic devices accurate.  It ticked over 8am and I hit dial, there couldn't have been more than a second of delay before I pressed the button.  "You are number 26 in the queue".

If that's me being as clued up on the system as I am and getting that, what about the older folk who aren't that clued up or are slower in dialling?

10 minutes in and I'm number 7 in the queue.

My Doctors does not allow you to book an appointment. You have to turn up at 08.15, and request an emergency appointment, thus taking a space from someone who might really need an emergency appointment, so they go to the local A&E instead, and block a trolley from someone else who might also need it.

[ckn]

1 minute ago, Bleep1673 said:

My Doctors does not allow you to book an appointment. You have to turn up at 08.15, and request an emergency appointment, thus taking a space from someone who might really need an emergency appointment, so they go to the local A&E instead, and block a trolley from someone else who might also need it.

My GP's online booking system:

They used to have a fair few appointments you could book long in advance but they've all gone now and you have to take your chances with the daily lottery of appointments.

 

[Bleep1673]

I turned up today to get an appointment, and there were 28 other people waiting at 0810 when I turned up. I went home.

[ckn]

1 minute ago, Bleep1673 said:

I turned up today to get an appointment, and there were 28 other people waiting at 0810 when I turned up. I went home.

A typical GP is expected to see 35-40 patients a day.  28 patients isn't that much really if you've more than one GP in a practice  If you have 2-3 GPs, one will be unavailable for half a day due to telephone and home visits, if you have 4+ then you're losing at least a full GP a day to other tasks so that figure doesn't scale. 

[Shadow]

I was in a quandry as to where to post this, should it go in the “Nice Tories” thread, the “Russians” thread, “Syrian Chemical Attacks” or even “Let it Snow Let it Snow Let it Snow”

In the end I put it here because I’ll need to use a different route home and that will now be gridlocked.

http://www.bbc.co.uk/news/uk-england-hampshire-43796426