Doctors appointment

My GP practice is like many here severely over worked and staffed by semi retired and part time GP’s. Looking at the latest list we no longer have a single full time GP all are part time. Appointments are a nightmare we have a large elderly population who seem to require a large proportion of the scant appointments and so the system of calling as soon as surgery opens for an appointment that day (for the very few non pre booked appointments) usually yields no joy. I have sat by my phone at 7.55am and rung on the dot at 8am (opening time) to find the phone already engaged and by the time you do get through on repeat dial all appointments will have gone!
I had started to forget GP, and instead go to the walk in GP in town, which is open 7am to 11pm 7 days a week and you don’t have to be a patient. This worked well as most of the elderly don’t want the late evening slots and usually the place is full of young families and working people who like me can’t see the GP because of the lack of appointments.
Unfortunately the local NHS has now ear marked this walk in for closure! And states that if you can’t see your own GP you will have to go to the out of hours at the hospital! This is a separate nightmare due to erratic bus services and being out of town. I don’t have a car so we’re I to need to visit there a taxi would cost me £16 return?

I feel so lucky - our surgery has online booking and it is very rare to have to wait more than a day to see a GP, as long as you are not fussy who it is or at what time.

Jen pax - very very bad! humptydumpty- you are one of the lucky few. Don't move house!

This week I have to have clips removed by the practice nurse from the site of my op. I rang the surgery yesterday from my hospital bed and was offered Tuesday or Wednesday am or pm. No complaints!
My surgery is generally good on this score.

Our system is like humptydumpty’s, but the “window” for getting same day appointments is brief - a few appointments for that and the next two days are released just before 8 a.m. and can be gone 10 minutes later! I once saw “mine” disappear as I dithered between two doctors
God help those without computers.
On the plus side you can also use it to order prescriptions and, as I have just done, to check blood tests. I was told after a full blood test and ECG on Tuesday that I would be summoned if anything needed discussion, but instead of just waiting and worrying I looked them up two days later and saw the detailed results.

Just had to hollow laugh at HAZBEEN about the fact that your surgery closure meant some people had to now go to one 5 miles away. Living in a country village of 2000 people, our nearest surgeries have always been 6 and 8 miles away. There is a bus to two local towns only 3 days a week, but only one return journey, so timings very limited. Gloucestershire, not Outer Hebrides btw.
(But we can always get an appointment if we will accept whichever doctor is free, or are able to sit and wait).

And our village runs a Helpline, manned by volunteers, with volunteer drivers who will take someone to surgery or hospital appointments.

The big megapractices are a problem in our part of the world too.

There is a big megapractice (25000 patients) co sited with DH’s practice.

The partners have fallen out and plan to return the list to the health board.

The other practices in the area simply can’t cope with a huge influx of new patients and none of them are prepared to take over the (crumbling) megapractice as it is. The other practices know they don’t have the capacity to run a second list.

The health board has no idea what to do and 25000 patients are going to be left with nowhere to go until the board figures something out.

The scale of the problem can be understood if I tell you that the board suggested to DH he take the megapractice list on as a sole practitioner until he could recruit some salaried GPs to work with him. They estimate he would need to recruit ten to fifteen to deliver a decent service.

Without a bloody Tardis I have no idea how one guy can look after 25000 patients, but as far as the board are concerned, there would still technically be a practice so their problem would be sort of solved. Recruiting that mant salaried GPs in our area is practically impossible; he’s been trying actively for two years to get another full partner for the existing practice with no luck.

Obviously he has refused to take on this impending disastet, but where does this leave all those patients? The service is just disintegrating

My DD2’s surgery runs a similar system. She has to ring after 8.30 for an appointment, and they’re usually all gone by 8.45. Horrible for the poor receptionists. No appointments can be made more than one week in advance. It doesn’t really work.

Our surgery has a triage system. If possible you’re deflected to a practice nurse by the receptionist. I can usually see her within a day or two and she can make a doctor’s appointment really quickly. If it’s something only a doctor can deal with, it’s a telephone appointment (very punctual and efficient) by a doctor who will then make an appointment to see you if necessary. My doctor arranged my knee x-ray by a phone appointment last October. I saw him to discuss the result, and he agreed to refer me. I haven’t seen him since. I didn’t need to. New knee now in place.

Oh, actually I did see my doctor in between. I went to the surgery pharmacy ask for stronger pain killers and he happened to walk past and overheard. He just said “yes, do it” and continued on his way. Love my doctor!

I've rung to get appointments for my husband twice recently and never been offered a doctor's appointment - he's seen the practice nurse the following day. When he went last week which was 10.45 am there was hardly anyone in the waiting room - it would normally have been packed - he even asked if the doctors had left as no one seemed to be called in to see one. Neither of us know who our doctor actually is - we've been registered with the practice over 30 years so all the original ones have retired years ago and we've never had a regular one since.

I fully appreciate the pressures our doctors and hospitals are under - the whole system is falling apart and a far cry from the one set up in my parents day with a promise of care from the cradle to the grave. The company I work for have been striving for some years to help with this using tools and processes to improve efficiency - not removing people - and did some amazing work with two well known hospitals a few years ago but unfortunately the cash strapped NHS meant that the funds weren't there any more. They have just been called back by one but it's a mere drop in a very big ocean. Sadly I don't see it getting any better in our lifetime.

I live in The Outer Hebrides, our GP surgery is 10miles away, I think we are so lucky, when I hear some of the problems others have, we are 1 doctor short which we have been for a long time, When I get through to the receptionist they always know who they are talking to, They have an online booking system which works well. we can take as long as we need to discuss as many topics as needed in a consultation. up until now, it seems to work well

Oh!
I have just worked out where you must live newist!

Oohh newist totally off the point but am doing today’s Guardian crossword and theme is Hebridesn islands ( both outer and inner ) learning a lot

newist, DH was very nearly the new doctor at your practice but he pulled out of applying at the last minute.

I was all up for the big move to the country

Shall we all head to the Outer Hebrides lol!

muffinthemoo that is horrendous!

muffinthemoo, what a shame, its a lovely place to live. Mawbroon, yes the clue is in the name.
There are some drawbacks living here, but the kindness and help from the GPs especially if you are older, is so precious

The surgery I go to is always fully-booked for ages in advance. To get a ROUTINE appointment, there is a wait of 4-5 weeks, always. It is sometimes possible to get an appointment the same or next day if you say that's it's "urgent".......something I'd never do. Anyway, if something was urgent, there's A & E for hours of waiting or the walk-in centre for more hours of waiting and then to be told to go to A & E for hours of waiting.

LynneB59 Urgent to me means it won't wait 5 weeks. Leaving illnesses that long means they will potentially get more serious. We rang and were triaged and told to come in that afternoon.

According to Clare Gerada, who used to be Chair of the RCGP, the NHS will be short of over 15,000 GPs by 2021, and the NHS facing a £30 billion 'black hole'. We currently have about 35,00 GPs and numbers are falling constantly as the older generation are retiring early because of the pressure. Younger GPs, more of them women, don't want to work full time, so continuity of care is difficult because they are only in on certain days a week.

There is wastage, I recall an advert for a 'five a day facillitator' on £35k whose entire role was to encourage the eating of five pieces of fruit or veg per day in the CCG area. Then there are the 'pregnancy coordinators' which while perhaps more useful, always made me think their job was to arrange that everyone gave birth on the same day! More seriously, there are over 600 health quango chiefs on six figure salaries. www.telegraph.co.uk/news/2017/03/05/600-health-quango-chiefs-six-figure-salaries-amid-cash-crisis/

Surgeries are desperately trying to cope, people with co-morbidities struggle with 'only one problem per appointment' and since they will see a different GP each time, the first few minutes is spent looking at their history.

Some patients are put off by the receptionist's question 'is it urgent?' or even worse 'is it an emergency?' It you are in pain, if you have a problem that hasn't gone away, if you are seriously worried about something, that is 'urgent' don't hesitate to tell the receptionist 'it is not a blue light emergency, but yes. I feel it is urgent'. She is then permitted to make you an appointment, it is just a way of getting through the triage.

Much better is the telephone triage set up by some surgeries, hopefully increasing, where every caller needing advice is allotted a call back the same day (or next day if calling later) by a GP who will assess the need for an appointment. They can sort out medication reviews and minor problems quickly over the phone, but if you need to be seen, they will make that appointment for you same day or next day.

You won't be seen by the same GP each time, (unless you are registered with a single handed practice, and these are being forced to merge or close by the CCGs). I think we have to accept that because of so much part time working that is inevitable, but you will get your problem addressed promptly. This is one such system www.kingsfund.org.uk/sites/default/files/media/harry-longman-steve-laitner-transforming-general-practice-kingsfund-jun13.pdf

Online appointment booking is coming, practices with the EMIS clinical system can offer the full works if they choose to, also SystmOne, Vision sites are still getting there, but if you use triage for most of them, there won't be that many available to book online, because of all the reasons above.

I don't think the NHS in its current form and level of funding is sustainable. In the past 70 years so many more expensive investigations and treatments have become routine, and the result is that we have to change to rationing, taxation, or private treatment. Rationing we are experiencing already, private GP services are quite frankly frightening, see www.digitalhealth.net/2017/06/digital-gp-service-found-unsafe-and-ineffective-by-cqc/ Would the general public vote for an NHS tax, and how could it be arranged that the money didn't just create more quangos?

My GP’s surgery is hopeless at booking appointments. Have just had a letter booking an appointment at a hospital miles away from my home and at a unit I strenuously avoid because of its unhappy associations for me as it is where my husband died. The letter stated that I had CHOSEN the venue but I didn’t!

We now also get routinely letters about booking GP Surgery clinic appointments that state in bold print that ‘’if you do not make an appointment, your prescription will be affected’’.

Heavy handed I’d say.

I've just read this and it rings a bell.
We had the same experience as the OP, back in March. We had newly arrived and I urgently needed a new prescription.
But after a little pleading they fitted me in.
I felt really sorry for the office staff, there were others before and after me with similar problems.

Contact the Practice Manager and tell him/her to book your appointment!

On the other hand, I phoned my practice for an appointment and was told that there were none available so I asked for a telephone appointment only to be told there were none available till the following week.

I told the receptionist that I was a type 2 diabetic with blisters on my knee. Doctor phoned back within 30 minutes and was in the surgery within 2 hours!