If you are a GP or work at a GP…

My GP surgery is fantastic. I’ve always been able to get a same day appointment even sometimes calling in the afternoon I’ve had a doctor call me to triage, often bringing me or my child into the surgery that afternoon. They do have practice nurses and a good relationship with the local pharmacy. The receptionists are good at directing people to the best resource but will book a GP call if you really don’t think another professional can help.

I know there are serious issues at another local surgery so it’s not all easy street but the way the surgery functions beyond mere patient numbers must have something to do with it.

Mine was great before Covid - online appointments or phone at 0800 or 1300 for a same day or next day appointment
Now it is awful. We dont have e consult, you play fastest finger on the trigger to try and get through at 0800 - usually number 30 odd in the queue and then no appointments left when you do get through. They have also stopped people turning up at the surgery at 0800 who try to get an appointment that way.
I have some serious chronic conditions and need regular check ups but I havent had one for 18 months as I cant get an appointment.
Mine is a huge practice with GPs, PAs and ANPs but there are too many people on their books
It is also not helped that local schools are demanding children have proof they are ill when off school sick so parents try to get appointments for the proof

My previous surgery was amazing, never a time when I couldn't get an appointment. Had doctor, nurse and physio appointments to book on the day or in advance every time I needed. Open 7am - 7pm too.

My current surgery nothing like as good, more of a rural village surgery, so fewer staff which I presume is the issue (although also fewer patients presumably?)

3 weeks for a phone apt, not seen a GP since before Covid, am not sure if they even doing face to face anymore

It's unsafe because you can have an unlimited number of patients waiting to see a limited number of staff, who get tired, who reach the end of their safe capacity to see people.

I've been trying to get an appointment for over a week. Breast issue similar to yours so I was hoping an online consultation would highlight the need for a speedy appointment - NHS have always been good like that in the past.

Anyway. I did online consultation, waited all day for them to call back, which they did at nearly 6pm when I popped to the loo (typical) so I missed it by seconds. Called them back immediately and was on hold for 15 mins, then was told the doctor had gone home, and to call back tomorrow. Called them the next day, but got no call back. Called reception towards the end of the day, and they just told me to wait for a call which didn't come.

Played this game for a couple more days, then decided to just ring up and ask reception for the next available appointment, whenever that might be. They told me they were emailing me a link and I would have to book through that. Guess where the link took me...? Back to the same online consultation form. Tried again. Two days now and no call back.

It seems you aren't allowed to just book an appointment without having a telephone conversation with a doctor first - why?!

I have been told the only way to reliably get an appointment is to phone them at 8am on the dot and tell them it's an emergency, even if it's not, to try and get seen on the day. The problem is this means I have to call in sick to work, as I have no prior booking to show my boss and I have no idea what time the appointment will actually be. There's no guarantee of getting an appointment at all - I might be stuck on hold for half the morning to no avail.

It's an absolute nightmare and I genuinely don't know what to do. I can't afford private. It sucks.

I worked at a GP for a while (non medical staff). The problem we had is that there just weren’t enough appointments. The first few people would get through at bang on 08:00 and that would be it for the day. All telephone. Only the GP themselves could book an in-person follow-up if they felt it necessary. No advance or routine appointments. No e-consult. We would have people crying and shouting on the phone if they didn’t get through in time and there was nothing we could do. I don’t last long.

That’s a fair point and not one I’d considered. To be honest, my concern didn’t need a GP - I’m struggling with my hearing after having flu and just needed someone to check my ears for signs of infection - a pharmacist probably could have done it if such a service was available (I think it is for children but not adults?). So on that basis I can see why an ANP would be a better use of resources than me taking up a GP’s time? Or do you think cost wise it works out about the same when you account for GP supervision?

Thing is ours was like that
I remember when they apologised because they were offering a non-urgent routine appointment because it was 2days away.
When dd1 had pneumonia in 2009 they came round twice a day to check on her. When ds was seriously ill, they phoned to check I was okay. When my back went, they didn't have an appointment available, but said to come down and they'd see me anyway.
They were never running particularly late, and we're always cheerful.

This was true until they merged in about 2019, but since COVID it's impossible to see a doctor. You may, if you're lucky get a telephone call, but more likely a rather dismissive text.
In my family we've got issues that aren't being dealt with because it's far too much effort just to get onto the triage list-and most of the time even with something fairly urgent you tend to get a text which has only rarely been helpful-along the lines of "your prescription is at the pharmacy" is great. Anything else has at best been unhelpful.

Why is is not safe ?

My GP has 'open surgery' (turn up and wait) every day.
You will always be seen.

It is regularly rated as the highest 'satisfaction rating' whenever they do these things.

Why is it any less safe than any of the other systems? Seems pretty unsafe to be offered an urgent appointment for 9 days time to me. Or to be told to keep ringing first thing, but the phone lines are all full and by the time you get through all appointments are gone.

It's complete chaos for the staff, very professionally unsatisfying and not safe.

mine aren't too bad for some things, twice in last few years I've been seen same day for breast lumps.

Years ago my old gp practice had a system 4 days a week where you could just turn up, be put on the list of preferred Dr or ask to go on quickest list and just sit and wait. Would often have to wait an hour or two but would always be seen on the day. I miss that system.

Ours used to be like that. Then they merged.

I asked for an urgent appointment (explained why and it was ugent. Next day was pushing it) a couple of years ago for my dd... They sent me a text offering a phone consultation in 9 days time.

Last two times I contacted them. One was to say that my mental health was struggling and would like referring for counselling, but I did not want the (unusual) version they had given me last time. I got a text telling me to rerefer myself to the people I'd used previously.
Then asked for a call about something I had been to the pharmacy about and They said to go to the GP. I said that in my message. One sentence text back "go to a pharmacy".

I don't mind phone calls. I don't even mind texts. But they have to properly read the messages. Result for both the above is I have done nothing, which is unhelpful.

But I don't think a text for anyone asking for counselling because they're struggling mentally is ever appropriate. And that should be obvious.

Funding. The issue is Funding. My GP surgery is funded 100 quid per year per patient. That's not a lot, particularly if you're in an area where people have a LOT of medical needs. It has to cover salaries, heating, electricity, rent, equipment, cleaning etc etc. The surgeries may want to take on more GPs to help with the backlog and availability of appointments, but can't because they simply can't pay them.

My GP uses e-consult and switches it off if they’re busy. It was available less than an hour this morning.

My GP used to be amazing. Same Dr running the surgery for 30years. You could either do an e-consult at any time of the day, or phone up at any time and get an 'emergency' (kids got earache etc) appointment either that day or a routine within a week or two. Then after the first wave of Covid he retired, and the surgery merged with another practice and now it's utter shit. Can only do econsult from 8-8:01 in the morning (no joke - it is only available for one minute) otherwise it's sit online the phone for ages to maybe if your lucky get an appointment, but they are usually all gone by 8:15.

Except this is part of the issue - doctors unemployed in favour of apparently cheaper ANPs, but the supervision time is never costed, so the doctors that remain are more stressed and have less time to actually see patients as they are supervising ANPs.

Thankfully my G.P surgery is excellent. They’re so popular that they have a catchment area, I’m very fortunate.

My daughter has a lot going off medically, one of the Drs called her out of the blue to see how she was coping, amazing 🤩

Mine is good-to-great and it makes a real difference even though I don’t have to go often.

It’s the number of patients per GP that's the issue. Have a Google, there are numerous stats and articles about this, in areas where it’s high, not surprisingly it’s more difficult to see a GP, patient satisfaction is low etc. My GP surgery is the bottom 10 as rated by the patient satisfaction survey, it also has some of the highest numbers of patients per GP in the country.