No wonder you can't get a GP appointment

[Intherightplace]

Currently all first GP appointments at our surgery are telephone. Which is OK for most things, even good, more efficient for both GP and patient. However, for some things a telephone appointment is never going to be any use. For example, if I'd been able to explain to "someone" that I needed an appointment for a dodgy looking mole, surely they could have seen that a face to face appointment was necessary?

Anyway, I waited 3 weeks for my telephone appointment. GP said she couldn't do anything by phone and she'd need to see me (like it was my fault, I hadn't seen her!). So that's one completely wasted appointment.

10 days later I had the f2f appointment. Buzzed the door, not allowed in before they've checked you out. Receptionist said she'd tell doctor I was there. 10 mins later the doctor herself came to collect me from the door. Now this is a large medical practice, it's a fairly long walk, involving 2 flights of stairs and she was wearing heels she could barely walk in

I was with her literally seconds before she said she'd refer to a dermatologist. So, at least 20 mins of her time, for a few seconds with the GP to do something she probably could have done at the telephone appointment, if that was going to be the level of the examination.

Either way, she could have dealt with other patients in that time. Why on earth are the admin staff still working at home? There are usually loads behind the large reception desk, but only the one answering the buzzer currently.

And why not just refer the first time and save everyone so much wasted time?

I think that the triage system is not a good thing. Nurses are just not trained to the same level of drs. A triage nurse saw my husband for an emergency appointment. Clearly when something is an emergency, something is usually pretty wrong with the person. My husband could barely walk. She diagnosed a virus and didn't refer him on to see a Dr. She didn't even bother to take his blood pressure or listen to his heart rate. He was so confused and thought that he had been seen by a Dr, as we had been led to believe, so I didn't question the decision as much as I would have. Hours later he collapsed. He ended up in a coma on life support for weeks with Sepsis. At the stage that he was seen, he didn't just have Sepsis but was in the latter stages of Septic shock. Over four years later and he's still not fully recovered after she sent him home with a prescription for diocalm.

You have to have a phone call with the dr first at my local surgery. Infuriatingly they won't give a time for this but seem to expect that you will be available to take a call at any time. When pushed recently I was told it would be some time during the afternoon. I avoided making any work calls all afternoon but gave up waiting in the end and then noticed a missed call at 18.20 🙄.

No further follow up from the surgery to see if I still want an appointment.

It’s not always like that though. I called the GP surgery about my son recently and the receptionist arranged for a call back that morning. The GP called and then asked us to go in straightaway to be seen in person. Through examination and multiple prescriptions later and we were on our way. Less than four hours from calling the receptionist and having medication.

@MzHz

I genuinely don’t understand why every surgery seems to think they have to reinvent the wheel!

Surely there is some kind of association or group that identifies best practice in terms of organisation of a good surgery so that they can implement policies and systems that are more universally understood and successful.

This really isn’t rocket science I don’t understand why gp surgeries have to make things so hard for themselves and for patients

Not all Gp surgeries are the same. It depends on area and their local CCG who make the changes and plans and tell the surgeries how they need to be run. It also goes by their PCN groups. Eg our surgery is ina group with 5 others who all do the same yet other surgeries in the area are completely different and don't have appointments apparently until October.

@mibbelucieachwell

Even before covid I've often thought that some processes seem inefficient. Eg blood tests ordered by the GP. Why don't gps just do the blood tests there and then instead of requiring the patient to have to bother the receptionist to make another appointment with a nurse who has to come out of her room to find you in the waiting area and walk you back to her room. GP could do it in seconds.

Because it makes no sense getting a GP to do a blood test at £70 an hour when you can get a HCA to do it for £9 an hour

I got seen in person the same day this week about a breast lump but after telling the receptionist the problem I had to have a phone appointment before being told I would need to go in (well, obviously). I've had a referral to the breast clinic but the in-person appointment was a bit pointless, it was basically just to check I wasn't making it up.

@Bargebill19

Ours has now stopped repeat prescriptions by telephone. Smart app or via the post box stuck on a the wall only. Ok for most - but not for the housebound and those without smart phone or the app. The app requires you to take in ID to get a passcode to access the app the first time. - but you can’t get in the surgery to get the passcode with your ID. So even if you have a smart phone and can use it, if you’ve not set it up before the pandemic - you are stuffed if housebound.

They will have exceptions for housebound, disability and vulnerable patients. Either set up for the chemist to order especially if they are blister pack patients or they can still ring. They do at the surgery I work in anyway.

@toocold54

YANBU I do wonder who’s making these rules for the GPs. It just means A&E’s are more overwhelmed because people are having to go there to be seen when they can’t get an appointment for weeks.

Their local CCGs are who makes the rules and decisions who then tell us what we have to go along with.

Because it makes no sense getting a GP to do a blood test at £70 an hour when you can get a HCA to do it for £9 an hour

But it wouldn't be any addition time for the GP, you've already got your 10min (or whatever) slot and it would take moments, as opposed to a whole appointment with the HCP and the associated admin of making the appointment.

@unsure111. No no other way around it. Pharmacy is in house at the surgery. Next nearest pharmacy is under a different health authority. You have to either be able to walk/drive to the surgery and deposit your paper slip in the post box or do it by app. That’s it. They even dated that on all the local Facebook pages.
Basically it’ll be up to family / friends / a plea on Facebook for someone to help the housebound who didn’t get a smart phone and app 18 months ago.

I know exactly what you mean OP, and it's frustratingly difficult to get an appointment. I was ill a few weeks ago - a cut on my leg got infected and I felt truly awful (raised temp, it went yellow, headache etc). I tried to get an appointment and couldn't get one for 3 weeks with my GP, I asked about a minor injury unit locally but apparently we don't have that. I went to a private GP, was seen the same day, they could see I was ill so the nurse kindly got my prescription for me there and then. Ok it's cost me £70 but it sorted it quickly. I feel sorry for people who can't afford it - we seem to be building a system like we have for dentists where it's NHS in name only, but you can't get an appointment so go private.

I'm overdue for a meds review and can't get either my meds or an appointment - the time slot is only half an hour each morning.
I went into the surgery and was told to use an online service, which turns out to be an app that only works on a non Android smartphone or tablet. Which I told them I don't have.

I'm also waiting for a hospital appointment for a suspicious lump, current waiting time for the first appointment is 44 weeks.

It just seems there are so many little inefficiencies which could be resolved fairly easily at practice level, if anyone wanted to, but all they want to do is tell you why it has to be like that.

Meanwhile my dh had a telephone consult for breathlessness which has been a problem for years and I told them it was not urgent, and that's why he wasn't seen last year. Doctor referred him immediately as an emergency to the local hospital, where he stayed all day, in a room with a dying woman (because he had just come back from Europe - they insisted this was important enough to override his quarantining), whilst they did three ECGs(?) on him and various other tests and then sent him home at 8 p.m. saying he was fine. All because the GP won't see him face to face. A&E is massively overstretched because slightly dubious phone consults are being referred there, all the doctors were livid about it.

@Azilliondegrees

I had a referral to dermatology put through via econsult with photo attached. Pretty quick and easy. Care does seem to vary between practices.

pre covid my brilliant gp looked at a skin issue on DS, asked me if I was ok if we took a photo, she emailed to derm. to see if he agreed with her assessment, and (as they did), done and dusted without a need for a referral that took ages. Great for lots of simple rashes etc (not for moles I am guessing). saved the NHS paperwork, and derm appt and us as well.

@Intherightplace

It just seems there are so many little inefficiencies which could be resolved fairly easily at practice level, if anyone wanted to, but all they want to do is tell you why it has to be like that.

It's not even just GP surgeries. It's the entire NHS. Hundreds/thousands of "little inefficiencies" that add up to a massive amount of wasted time and money. But no one cares. They only care about their own targets and don't give a stuff about other services/other depts etc.

Mine has been very good during all this hoo haa.
BUT why oh why did they decide that now was a good time to 'upgrade' their online services.

My NHS app has lost its link to my GP so I can no longer order my repeat prescription online so have to go through the whole e-consult thing (including 3 e-consults to work out why it didn't work).

I have to go to the surgery with photoID and re-register.

I was going through a very bad time with husband and honestly felt unable to cope (I’m usually a very coping type of person). I phoned GP but only able to get phone appt in 4 weeks….receptionist suggested I fill in an e-form, which I did and got a phone response. I tried to explain that I could not speak from home (where husband is) and didn’t feel comfortable talking about extremely personal things outdoors in public.

They wouldn’t give in…phone or nothing. Absolutely impossible for anyone to see me. I’m too worn out and worn down to fight about it so just getting through day to day with help of two good friends.

But do they not understand that not everyone can talk about personal things at home.

It's not even just GP surgeries. It's the entire NHS. Hundreds/thousands of "little inefficiencies" that add up to a massive amount of wasted time and money. But no one cares. They only care about their own targets and don't give a stuff about other services/other depts etc.

I realise that and it must be very frustrating for staff who genuinely can't change things, but GP practices could if they wanted to.

I had a lesion on my arm I was worried about, got message from GP asking for photo. I replied saying due to being covered in freckles a photo really didn't show the issue so they made me an appointment.

@FreshPrincessOfLondon

I would have thought a better system would be you take a photo and send it to the doctor and then she assesses from the photo.

A friend's GP works like that now for rashes etc. Seems sensible although relies on patients being able to use IT. Saves a lot of time and hassle.

This is what happened to my husband in the first lockdown. He found a lump and had a phone consultation with the GP, during which he sent him a photo.

The GP said there was no point in seeing him in person because all he would do was refer my husband for blood tests and a scan so he made the referrals without seeing him.

He had the blood tests a couple of days later and the scan a week or so after that, so everything was done quickly and fortunately there was nothing to worry about.

We have an e consult system which is good in some ways. You have a limited number of characters to write down your problem. You can submit a photo and you get an answer within two working days. The downsides are that they ask a lot of questions that seem irrelevant and probably the doctor may not ask. But they can't seem to ask what the doctor does want to ask so both times I have had a reply starting with "you don't say whether.....' Why they can't phone or e mail to clarify I don't know. Also I was only allowed to fill in the online form during GP opening hours so was trying to do it quickly before work so maybe didn't put things as clearly as I would have with more time the evening before. Anyway I was satisfied with the outcome both times and didn't have to go to the surgery, although it is a bit impersonal.

@TheOrigRights

Mine has been very good during all this hoo haa. BUT why oh why did they decide that now was a good time to 'upgrade' their online services.

My NHS app has lost its link to my GP so I can no longer order my repeat prescription online so have to go through the whole e-consult thing (including 3 e-consults to work out why it didn't work).

I have to go to the surgery with photoID and re-register.

Have you tried Pharmacy2U? Once you’re up and running it’s so mega easy to reorder meds

I wouldn’t ever have tried this out of not for the pandemic- it’s something I’m going to keep doing even when life is more normal

I am under surgery A my daughter under surgery B. Surgery A fairly pleasant until lockdown then they are all going to die if they speak to you let alone see you.

Surgery B no probs they can deal with anything. It’s just the contemptuous attitude at surgery A since lockdown. Even to ask a question you have to listen to a 7 minute announcement explaining why you shouldn’t.

When I phone the GP I have to listen to the 5 minute long recording about how COVID means everything is different. Ends with ‘listen to government advice. Only go outside if ESSENTIAL’

No wonder no one can get in or an appointment if they think we’re still in January!