Joint pain - not getting far with GP

Unfortunately this seems to be a quite common experience these days. What stage of osteoarthritis did the x-rays show? I presume that should be on your notes, even if you were not told. Physiotherapy can help a lot if the osteoarthritis is mild to medium. Once it is end stage (bone on bone), then physiotherapy doesn't do much more than keep the muscles and ligaments in good condition whilst waiting for replacement. However at all stages physiotherapy has some use, so persist on getting that.

In the earlier stages of my knee OA, my knees would stiffen up after walking. Doing stretching exercises at the end of each walk, and sometimes in the middle as well, would really help release that stiffness and pain.

Some NHS physiotherapists are excellent, but it seems that others do little more than give you a leaflet of generic exercises rather than tailor to your individual needs. I've had both. I ended up going privately to an osteopath after the first 2 very cursory NHS physiotherapist consultations.

A friend had a a very dismissive GP and inadequate NHS physiotherapy consultation. She ended up going to a private physiotherapist, who had been recommended by friends, who was excellent, and who really pushed her GP to do things, as well as working with her, tailoring the exercises, which really helped her.

I just want to second all that @Trish9556 has written.

I made a big difference to the way I was able to access treatment via a GP when I registered for access to my online medical records.

Being able to see my blood test results and not just be told by a receptionist that its all "Normal" when it actually wasn't but the note from the lab said "If no symptoms, but if symptomatic then…" made such a change for me as I did have symptoms I just hadn't been able to see a GP to report them.

I wrote to the practice manager about it and suddenly I was in front of a GP who then had to record my symptoms and then make a referral to rheumatology and later on it was how I found out I had sub clinical thyroid disease that needed treatment.

They don't offer treatment for sub clinical thyroid if its asymptomatic but again they'd not seen me unless you count the very bored paramedic who for some reason they had employed permanently at the surgery who's main diagnosis for all women of a certain age is-menopause or perimenopausal and then cheerfully says- I know nothing about the menopause so go see the lovely menopause nurse (shes not lovely but thats a whole other discussion)

These days you have to be very proactive about your health and the online access is such a help in that it puts you back in the driving seat, you can quite an "informed" conversation with a GP if you have your information.

I'm in my 60tys now Mike and as long as I can remember the NHS has been telling patients its too busy, too stressed, too many patients, the guilt trip never stops but to get health care that is appropriate you have to stop listening to their problems its not like we patients on the ground can change government policies or reverse funding decisions yet all too often we are treated directly by medical staff as if its all our fault or even as if its appropriate to take what tiny amount of time they allocate us for lectures about their problems.

Its also really easy to change GP's surgeries these days its just an online form for most of them so if you're not getting a good service from yours then look around and see if there is another surgery that offers a better or more appropriate service.

GP's are contractors to the NHS, their surgeries are businesses that act as third party providers of NHS treatments so they get to individually decide how that provision will run and who they then employ so one surgery might rely heavily on Advance nurse practitioners and Health care assistants so they only have to employ 2 actual GP's but another surgery might decide to run with 4 GP's and not so many ANP's and offer specialised clinics etc.

It all comes down to money Mike, GP partnerships are in my opinion the worst as they can opt out of providing a duty doctor (and they often do) and these are the GP surgeries that don't offer on the day appointments and send every patient referred for one via NHS 111 to A&E .

Mentioning NHS 111 I also want to say its a very good service and if you are feeling unwell or in pain with something you'd normally contact your GP about then NHS111 can triage you over the phone and send through a message to your GP to see you within the day or book you in to an appointment at urgent care or dispatch paramedics/ambulances etc.

I don't personally have any sympathy left for GP's as I've personally had some horrible appointments and some very bad treatment, I've also seen several get suspended, struck off, and on one occasion do something so phenomenally stupid whilst he was on holiday he made the national news, what I haven't seen is any of the ones I've been a patient with go all out to ensure I got the right care so until that happens for me I will continue having a very cynical view of them, but any time they want to change that I'm willing to revise my low opinion of em.

I hope this helps encourage you a bit Mike to be your own advocate and push through all those invisible barriers that seem to be going up every where in the medical profession at the end of the day most of us are just a number on a list to them so make sure they remember your number.

You matter and they are never going to knock on your door and say, we were just wondering how you're doing?

kind regards to you.

@MikeW So sorry to hear about the crappy service you are receiving. Sadly Welsh NHS made a name for itself in being the most inefficient & incompetent in the country. @Trish9556 @Lizbeth I completely agree with you, a lot of it is down to human nature collectively in a society above a population of 4million. The NHS is famed for its overblown bureaucracy and extreme inefficiency resulting in little benefit for each £1 invested, much of it siphoned off by suppliers who know how to game the system and staff who have no vested interest or pride in the success of the system, so don’t care as long as they get paid and their union protects them from getting sacked however incompetent. A handful of competent clinicians still young enough to have ideals work tirelessly to keep it afloat, mostly in hospitals. If you are a mediocre to incompetent ambition-less GP you go to work for an NHS contract, knowing that you have no competition as the bright talented sparks all go private because they know their talent will bring them customers. The incompetent and mediocre, however can’t keep any customers in the private sector and quickly go bust, so they opt for NHS.

So in effect, the NHS attracts the dregs, and if you are really crap, you set up your GP shop where there is a dire need for GPs with few willing to work there, then you need no competence, as long as you haven’t been struck off, you can get a contract.

My own RA was misdiagnosed by not 1 but 3 NHS Consultants. My NHS GP initially referred me to a gastroenterologist, who then referred me to another, who then referred me to an endocrine specialist. None of them could figure it out and this is Greater London. During covid. I had even been to the hospital in person.

At the end of my tether and in pain I booked a private GP appointment, and a young 30something Italian GP from the EU saw me, over a VIDEO consultation, and told me “I am 99% confident you have RA. I can refer you to a London private rheumy, who can see you in person and do the necessary blood tests to confirm.” The private rheumy duly confirmed with blood tests and sent the results and I was finally referred to the still relatively useless rheumy dept in the greater London area, and then I asked to be moved to a central London hosp, not because the meds or consultants are any better, they are not, but hospital operation outside central london is awful, and with a chronic condition you need a high degree of competence both in systems and organisation. A few years ago they did try to get a proper IT system to chart all regular blood tests and other tests to spot trends of decline, but the NHS in its wisdom, decided they could build a better custom system from scratch than licensing one used by all the top healthcare providers around the world, and receiving feedback and suggestions from that global community. They spent £12 Billion on this NPfIT project, and delivered absolutely nothing, and the cost is rarely if ever talked about. The select committee declared the NHS didn’t have the competence to wisely spend such a large some of money in a project so the money pie is divided up amongst the trusts to spend as needed by each Trust. If they mess it up only that Trust fails. That NPfIT dwarfs all the millions wasted in dodgy PPE scandals. Oxford hospitals and central London hospitals were smart enough not to try to re-invent the wheel and wisely licensed a proven global product called myCharts, produced by Epic. It’s like buying a license for Microsoft Office for your company, instead of being stupid enough to indulge in the cost of re-inventing your own version of Office. The NHS app and the various apps that each UK hospital creates with money that exceeds the licensing cost are a mediocre joke compared to a ready proven global product. I am just surprised they still buy drugs and replacement joints from external proven manufacturers and don’t try to make their own overpriced clunky version. In short, the problem isn’t the amount of money the NHS gets, but how inefficient it is at delivering benefit per £1. No wonder NHS choices is a winner, the private facilities have to be good to compete for private and NHS contracts. There is no bottomless taxpayer pocket to pay fees or unions to protect mediocrity. I have had 2 NHS Choices u/s steroid injection appointments and they were fantastic.

@MikeW Please take the advice from others here who have suffered and get a private appointment via choices. The NHS has negotiated contracts with these private providers, you might as well use it. Notice the vast difference immediately on even seeing the receptionist, who can be promptly be sacked for mistreating patients (unlike nhs, where the patient gets blamed for failing to swallow their pain waiting for the receptionists to finish gossiping amongst themselves before turning to you… yup seen this in hospitals a lot). Oh the pleasure of checking in at a hospital dept which offers a self service ipad check-in… (a few NHS hospitals have this in some newer depts, but the unions hate this). Both patients and hosp clinicians however, love this.