Dr's phone calls when you work

@Hateam that's a silly response as you know. It's your work that's the problem. Either look into contacting your GP via the NHS app, works seamlessly in my experience, or check whether they are part of the nationwide Patchs system where you can contact them, or address the childish rule, imo, that you cannot simply tell a manager, or whoever, that you will need to take a call from your GP... obviously there are many, many jobs where that is simply not possible, not keast public facing roles for health care professionals, bus drivers etc., hence there are various different ways of contacting your GP, which ask the question 'are there any times you are unable to be called?'

My GP surgery is very good. They use the online system (which grates on me because it's often hard to make the pre-set categories 'fit') but once you've submitted it, they are very quick to triage call back and often see me if face to face needed, the same day.

I do agree though that not knowing when they're going to call is a real pain when you're working or have children to taxi around and you don't want to talk openly about something on hands free. And that's from someone who has a lot of flexibility in my work and home life. I can imagine that it's incredibly difficult for some professions (such as teaching). I'm just not sure what the answer is. I also think that the online system disadvantages the most vulnerable - older people and disabled. So essentially if you're young, able bodied/ minded and tech savvy you'll get an appointment relatively easily, but if you're anything else then you must join the phone in melee and fight to be seen/ heard. I think a lot of people are getting excluded from access to proper care.

It’s no wonder productivity is so low in the UK. It recently took me over 6 hours of my time just to make an appointment to have a coil changed - on hold on the phone to GP surgery, told it was now being done by a separate clinic, phoned them three times on hold for over half an hour, go through, told the person I needed wasn’t there and to phone back tomorrow, on hold again etc etc. Finally got called back when I was driving and couldn’t stop, start the whole process again. When I finally got to speak to them, they didn’t have access to any of my medical records so I had a 45-minute interrogation about my sexual history, sexual orientation, drug use etc etc (despite me telling them I was a very boring middle aged person who just wanted a coil change, they told me they had to go through all the questions on the computer before it would allow them to book anything). I was only able to do this as I waited till the summer holidays (also a teacher) but very nearly still ran out of time to make and get to the appointment. When I first had it fitted 8 years ago, I phoned up, made an appointment with a GP at a convenient time, after that appointment I was booked into the first available fitting appointment without having to make any phonecalls. Things have changed beyond recognition and so much time is wasted on bureaucracy at both ends.

In my surgery, you can request a certain time eg as I am a teacher, I ask for after 4pm. I am still at work then planning and marking etc… but not with students most days (sine days do extra revision near exams).

They try to accommodate this and so far have and i have had good care. But I agree, it’s not ideal for everyone maybe but it does feel efficiently run in general to me.

It also depends what kind of condition you had, my colleague has a heart condition and needed to see a GP face to face to be advised if she should attend A and E. She was told by reception apparently in no uncertain terms to take her blood pressure at home etc…which she had been doing, hence the phone call. She had to be quite firm and insistent that she had a condition that could be quite serious and had been advised by her GP that she needed a face to face visit if she was getting certain signs and symptoms. She was trying to avoid clogging up A and E unnecessarily. I know triage is necessary and part of the process and can be done really well. But it must be tricky for say 10000 patients on your books. Overall, though, new system has worked ok for us with things like skin conditions and someone on my household was struggling a bit with minor mental health issues and was signposted to other agencies really well that have helped a lot.

Thank you for what you are doing @MumblesParty No system is perfect unfortunately (I know this from more than 20 years in state education!) but it is great that all the professionals can hopefully continue doing as much as they can to help patients who are mostly afraid or frustrated possibly ?? But it is so hard sometimes as a professional. I may be a slight Pollyanna here but it ‘is better to light a candle than curse the darkness’. That’s what I have attempted to do during my career so far, though getting a bit more jaded now at times… I try not to read certain newspapers/ media outlets about the state of the NHS and judge for myself.

it has always been difficult to book an appointment. call at 8.30, could be in the queue for ages
now log on at 8
in both cases you cannot always be at work.
dh went in person at 8 and got great service.

My GP surgery is great
They do evenings and weekends
I can ring at 6pm and get seen before 8pm
Or a Saturday or Sunday morning

I tend to get tonsillitis fairly regularly and typically it hits on a Friday which used to mean I was having to go to OOH at the hospital by Sunday. Now I just ring my doctors and get seen

I almost always call within 15 minutes of the scheduled call time, and a lot of the time the patients don’t answer.

@taxguru it’s interesting what you say about Blair. He brought in the QOF points system, where GPs had to prove they were checking blood pressures, advising re smoking, maintaining people’s cholesterols etc. The government thought this would save money, because they assumed GPs couldn’t be bothered to do these things, and therefore no GP would get full points. Unbeknown to Blair, us GPs were already doing all these things, for free. So every surgery in the country got full points. Big shock to government when they had to pay us. I’d would advise caution if you want to pay GPs by the hour. Most GPs work twice as many hours as you think they do.

@TeenToTwenties funding would help to an extent, but at my surgery we have not more room. We already extended once into the car park, built 3 new consulting rooms and put GPs in them, but it’s still not enough.

We had a system that worked. You rang up, explained the issue and were given either a doctor or nurse appointment. Sometimes a few days ahead but you got an appointment. None of this having to ring up every day.

I went for a blood test recently. While I was waiting a man came out and said the doctor wanted to see him again in a month. The receptionist told him he would have to ring up on the day. Ridiculous.

I know the convo has moved on, but just wanted to share that I'm a teacher and I just answer the call.

I call in at 8am, ask for a telephone call and let them know when I'm not teaching (break, lunch, non -contact). 75% of the time, the dr calls at one of those times. The other times, i just excuse myself for a minute and take the call. I'm lucky that I mostly teach seniors and they're all very supportive, and understand that I need to take the call.

My school would rather that than me be off all day.

Can you really not see the obvious?

Some of my phone calls last less than a minute - it's obvious they need to come in from the start.

Some last 5 minutes, just sorting out a straightforward issue.

Some last 20 minutes, properly dealing with a problem.

There is variation in length of F2F appts, but not by that much. And also I will look down a list of calls and start with those who look like they'll need to come in - ones that clearly won't will be done later.

It simply isn’t true that people have not come up with constructive suggestions. It isn’t GP bashing or ‘moaning’. It’s expressions of frustration and often fear at not being able to access the care that we need. Earlier in the thread I questioned why, if you can give a time for a face to face appointment you can’t give a time for a phone appointment. That would work for most people.

We have thousands of unemployed GPs and many more who, like me, have dropped sessions due to burnout. The shortage is of a functional system for GPs to work in, not of GPs.

We have a shortage of GPs. There are no "more". To solve the crisis, we need to get the GPs we have to work more shifts in the NHS. That means we have to incentivise them.

I didn't say pay them more, I said fund them better (ie pay more gps, not pay gps more)

Not "obvious" at all. Give them pay rises and they may choose to work fewer hours. That's already what is happening. Despite having lots more GPs than 20 years ago, we have fewer GP "hours" because most now work part time!

It's exactly the trap that Blair fell into 20 years ago when he "cured the GP shortage" by paying them more and letting them opt out of anti-social hours. We've been suffering the entirely foreseeable consequences ever since.

I'd suggest a graduated pay scheme, where they get more "wage per hour" for working more hours. So, say, the first shift per week, they get £1,000, the second shift, £1,100, the third shift £1,200, ..... the tenth shift of the week would earn them £2,000, to "incentivise" them to work more shifts. Obviously, at the same time, change the stupid tax cliff edges so that they wouldn't have to pay a stupidly high marginal tax rate on the higher shifts (i.e. scrap the loss of personal allowance and free childcare on wages over £100k per year) and change the rules of the lifetime pension allowance tax penalty (all of which have just encouraged GP to work fewer shifts as the "marginal" benefit of working more has sometimes been tiny, if not negative!).

The answer is obvious. Fund GPs better so there are more GPs and more appointments available so the 8am rush for appointments is no longer an issue.

No one is saying GPs don't work hard; this is a 'system' bashing thread not a GP bashing one.

Everyone loves to moan about GPs.
But not one single person on this thread has come up with a viable system that would work for everyone.

Every post has either been “my GP surgery is crap because xyz”, or “well I would want this that etc”.
It would be the easiest thing in the world to establish a system that suited one person. Or even 100 people. Or even 1000. But try finding a system that suits 10000 people, of all ages and lifestyles.

Until someone proposes a system that would meet the needs of everyone, I will continue to roll my eyes at these GP bashing threads. In my 25+ years as a GP I have worked harder and harder with every passing year, and read more and more moaning on MN. Pointless echo chamber of angry people who just want to whinge, and have no desire to make sensible suggestions.

What has happened is the GP's surgeries have decided what is good for them and tried to implement it. The specific appointment phone call is fine in theory BUT they almost always never call at the agreed time. They call when it suits them.

I rarely use the GP but when I do I find they call when they call. For people like teachers, retail workers it really doesnt work.

It's not just them phoning back at random times. They aren't even using the "preferred" phone number option. Whenever I book a call for routine reviews of a long term chronic condition (so not urgent), I specifically tell them to use my mobile number. Almost every time, no call, but then when I get home, there's a message on my landline answerphone! It's so annoying that they can't even do the simplest of things right. Then because of their error, you have to go through the whole rigmarole again and wait another few weeks for the phone call. I've even started to phone reception a couple of days beforehand to "remind" them I need to be called back on the mobile and they confirm that's written on the notes, but even then, sometimes they still call on the landline. It's maddening. Not only that, but it's wasting the surgery time too, i.e. wasted appointment, then wasted receptionist time booking a new appointment, etc.

Haven't read all the responses so apologies if this has already been said.

I'm a hospital doctor and completely take on board people's frustration with accessing primary care/NHS services in general. I'm lucky in that I have a fab GP practice and it's quite straight forward to book appointments (can phone any time of day or use e-consult) but I know this is a rarity.

That said, we need to be realistic about how flexible GP surgeries can be especially given lack of resources. I've got two kids at a state primary school and whenever there is a parent-teacher meeting (twice a year) or I have wanted to meet one of the teachers outside of this to discuss my children, or I have wanted to see my kids in a school play etc. I have had to take annual leave to do so - I would not expect teachers to be able to make themselves available just at times that suit me because that's not realistic.

Admittedly parent teacher meetings are easier to plan/foresee than sudden medical issues, but surely if we're going to expect GPs to be more flexible we should also expect employers in general to be more understanding of their staff's need to get routine medical care?

Here in the US we have a system called MyChart. Pretty much every doctor's office in hospital in the country uses it. When you go to the doctor you can download the app to your phone if you want and you can utilize the app to do things like request prescription refills, ask simple questions, or schedule appointments.

At my doctor's office when you want to make an appointment you have to choose from a drop down menu and you can choose from things like "I'm currently sick," or "I would like a medication review," or "something else."

Depending on your answer, you then are taken to a list of available appointments so for instance if you're sick the appointments are usually available the same day or the next day whereas if it's for something else like a physical then the appointments are further out.

It seems like with the number of people utilizing the NHS at a system like that would be valuable for you all.

ETA: One thing that I really like about it is if you have something going on and you feel like you might need to see the doctor but you're not sure you can just ask a question and someone from the doctor's office will respond and either answer the question or say we need you to schedule an appointment to come in. I would imagine a lot of the people who are taking up the appointments that you all are talking about are ones that maybe don't need to see the doctor but they don't know that they don't need to see the doctor or they're not sure.