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?

@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.

I don't think our current Govt are really interested in the NHS working efficiently for most people. I think they see profit in more people feeling 'forced' to take out private health insurance. I think C-19 crisis has accelerated that and given something to 'blame' for their own ends.

It makes no sense for a GP to do the blood tests . They should have a drop in service with their HCAs and nurses doing them.

@Carriemac

It makes no sense for a GP to do the blood tests . They should have a drop in service with their HCAs and nurses doing them.

Maybe they should but you need an appointment at the hospital for a blood test here.

@BoredZelda

This is such a good point and if it was implemented would save so much time. Is it a case of some doctors think this is a nurses job?

As a nurse once said to me, who do you want taking your blood, someone who does it every day, hundreds of times a week, or someone who does it twice a month? I’d never want a GP to take my blood.

Yet, once when I went to the nurse for a blood test, she couldn't find the vein and went to ask one of the GP's to come and do it!

@Carriemac

It makes no sense for a GP to do the blood tests . They should have a drop in service with their HCAs and nurses doing them.

That’s what our surgery has. Works really welll.

Econsult forms have worked well for us here, we’ve had referrals sent and prescriptions pinged to the chemist often without even a call back. On one occasion where ds did need a f2f we were asked to just pop down when we could and the dr would pop out between calls. (Building layout has allowed them to have 2 consult rooms off of the entrance hall so patients don’t even make it near the reception or waiting room.)

DD did have a pointless physio call, it really needed a hands on app, but she was referred to an adult only who couldn’t touch, even by phone, kids.

My surgery doesn’t do blood tests. They hand out forms and you need a blood appointment either at a hospital or different clinic depending what trust the blood form is issued from.

I called my practice today, booked a GP appointment for three weeks time, she asked if I'd like it sooner but it was the most convenient spot. I also managed to book a smear for next month.

Managed to book child an occupational therapy appointment for next month but was offered one in 10 days time at the earliest.

GP surgery seems to be working really well with the new system round here and I hope the GP's have a more manageable workload now.

@Mrs08 absolutely with you on that one - hence why my msk issues have worsened. Thankfully I can see the hospital physio in person but the phone calls with the surgery physio we’re a waste of space.

Nobody is making rules for GPs. The partners of each individual practice will decide & set their rules which is why people are seeing such a difference in levels of service

At our practice there are less admin staff on the front desk for sure - but nobody is working from home. They are all "out the back" as it makes no sense having 5 people there to meet the public when the public are being encouraged to only come in for a booked appointment. The number of staff manning the website & phones has increased.

Dr's have to be careful who/what symptoms they see in person. For example a GP can do maybe 24 telephone appointments in a day. Of those they will on average invite 4 or 5 in for examination. The risk of seeing all 25 in person is that the GP will be "pinged" sending them home for 10 days. Assuming that includes 8 working days that is then 200 less appointments available to patients. A large practice with 3 GPs isolating & that is 600 appointments down. We were in that situation recently.

It really isn't a case of GPs considering themselves special or being lazy. They are trying to make things work the best they can.

Depends how you look at it, surely?

I had same problem, dodgy mole. Had to send pic in, phone app where she said she couldn't tell from pics, given face to face app where the doc had a good look with a magnifier and referred me to hospital. I now have a upcoming hospital appointment. I was well impressed, whole process took no more than 3 weeks.

For this problem, what's wrong with that?

So much moaning! Shame cause it detracts from the actual problems currently facing some patients...

But even if isolating they can still do phone consults? Can still WFH surely?

@Niceicebaby

But even if isolating they can still do phone consults? Can still WFH surely?

In some cases. Only if symptom free & isolating. Not if actually unwell.

And who sees their patients who they think need a face to face appointment? It's far from ideal or efficient.

Took me 3 months to get an appt to have my implant replaced which was frustrating.

@Thelnebriati

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.

I'd maybe suggest you write snail mail (recorded) to your GP, your Practice Manager, and the CCG Chair, and ask for your meds and an urgent referral action.

Because it's bloody disgraceful, @TheInebriati.

I've grown used to trying to circumvent these shit systems over the last 17 months. It's not fun.

Our GP surgery trialled video consults at beginning of pandemic. Very effective.

We have econsults with ability to add photos. They are triaged and if appointment needed booked for phone or face to face. Usually within 48 hrs.

We can book bloods, smears and book space for duty doctor or mental health triage online.

If you need access to online services for first time/forgotten details you can collect letter with log ons from surgery if you take ID.

You can request meds online/via email/dropping repeat to letterbox at surgery.

Routine appointments are available.

Carers can attend appointments if necessary.

Waiting rooms are reconfigured to allow for social distancing.

You are greeted at door by a volunteer who checks appt time, if too early are you able to walk in car, fit and able wait outside, need to wait inside asks you to sanitise and book in with reception.

Volunteer also directs to prescription letter box, asks people to fill in form for samples before they go into receptionist.

I really don’t know why all surgeries can’t do this. It’s ridiculous. It works really well. Yet still people moan!

*wait in car.

@SpindleWhorl thank you, that's good advice.

Oh god I could have written this!!!!

This is a long one, sit down and get yourselves comfy.......

Weird looking "growth" on my leg, clearly needs looked at. Process goes like this:

March
Step 1) attempt to ring surgery starting at 8am when they open.

Step 2) engaged; keep trying.
Step 3) eventually get through at 8.20; all same day appointments gone.
Step 4) can't book an advance appointment more than 10 days ahead (not released) and all the ones in the next 10 days are gone. Receptionist doesn't know when they next block will be released, ring back tomorrow at 8am.

Repeat steps 1-4 EVERY DAY for TWO WEEKS!!!!

April
Step 5) get stroppy and demand an emergency appointment.
Step 6) see doctor who determines "it's nothing it'll go on it's own"

June (growth has now quadrupled in size)
Repeat steps 1-4 for two weeks, AGAIN!

Growth is now angry, red and weeping; get stroppy (again) and repeat step 5.

Step 7) see a nurse, a student AND a doctor who've "never seen anything like it" but let's have a go at shoving some silver nitrate on and see if it falls off in a few days.

Step 8) growth falls off, lose about a pint of blood, watch growth come back with a vengeance and double in size.

July
Repeat steps 1-4 for a week until EVENTUALLY secure appointment with nurse practitioner.

Step 9) nurse practitioner concurs it needs to be seen by a dermatologist (no shit Sherlock, I could've told you this in March ) writes up referral on computer system, gives me printout so that I can ring up and make my own appointment
Step 10) ring up to make appointment "it's not on the system yet, a secretary needs to everyone what the nurse put on the system into a letter then upload the letter to the system". WTF?? Ring back tomorrow.

Repeat step 10 for the next 5 days......

Step 11) YAY I HAVE A DERMATOLOGY APPOINTMENT!!! (It's now August BTW)

Step 12) Dermatologist "you've had this since March?? why didn't you come sooner??"

FUCK MY LIFE!!!!!

(I do now have an appointment for the "growth" surgically removed under local anaesthetic..... 22 weeks after I first tried to make an appointment with my GP)

Why not refer the 1st time? If they referred every patient who wanted a mole checked out then the dermatology department would be crippled. GPs are the gatekeepers to the NHS, part of their job is to know what needs to be referred and what doesn’t. If every single patient who wanted a mole check just got referred then the waiting list would go through the roof and then the monkey of patient who really did have a mole that needed rapid treatment would have to wait longer.

Sorry I meant minority not monkey ! Typo

@Wineandroses3

Why not refer the 1st time? If they referred every patient who wanted a mole checked out then the dermatology department would be crippled. GPs are the gatekeepers to the NHS, part of their job is to know what needs to be referred and what doesn’t. If every single patient who wanted a mole check just got referred then the waiting list would go through the roof and then the monkey of patient who really did have a mole that needed rapid treatment would have to wait longer.

I think you're missing the point that in both mine and the OPs cases neither of us could even get to see a GP in the first place!!!

I don't mind the GP telling me I need to book an appointment with the nurse to get bloods done, but it was annoying that I couldn't have the bloods taken and then a vaccine given. Had to have a separate nurse appointment for that, because the nurse whose job it is to stick needles in you isn't allowed to stick other needles in you.

Our phone message says you should initially use econsult if you can, but I have failed to find out where I can do that. You used to be able to email them, and I would have liked to do that to give them an alternative number when my mobile broke, and was expecting a call from the nurse in a couple of days. But you can't mail now, unless it's somewhere with the econsult form that doesn't appear to have any links from their website. I don't know if she ever got the phone message, but I never got a missed call on my alternative number (work desk phone.)

However, booking repeat prescriptions online is easy. You can also do it by letter, but not by phone (they have never allowed prescriptions by phone at ours.) And when they discovered my vit B12 levels were low, they just texted me to say they had sent a prescription through to my usual pharmacy. (I was a bit surprised, as I had thought they were testing iron and sugars, so wasn't expecting anything about B12...)

I haven't had any GP appointments since the start of covid, but the nurses are much more likely to be on time for appointments these days, so some things have changed for the better.

I don't know anyone who has needed them as a GP, so I don't know how they're doing there these days. They're obviously signing prescriptions, though.

@CorianderBee

Took me 3 months to get an appt to have my implant replaced which was frustrating.

But not a medical emergency as other forms of contraception are available. And we have been in a pandemic.

@BoredZelda

...and don't get me started on over the phone physio ffs

DD has had weekly video physio sessions for the past 18 months. Way more convenient for us all.

Oh God, this!! A friend of mine was given "phone physio" and told to do stretches for a back problem. When he saw someone privately they did an MRI straight away and discovered that the reason he was in agony and could not even stand up was because he had slipped two disks in his back and needed immediate surgery. No amount of stretching was ever going to make it better. He suffered for months unnecessarily.

The NHS is a disgrace. They are perfectly content to take a huge amount of money (I pay 15x what I do for private healthcare for my whole family towards the NHS each year) but let people suffer in pain. We'd only ever use it for GPs or A&E and both are absolutely useless.

I have to say that since moving to Ireland, where you pay for GP appointments, after spending most of my adult life using the NHS in the UK, has felt entirely worth it to me because of the ease in getting immediate appointments. My GP also waives fees at times I'm having B12 shots at the moment, so she just squeezes me in first thing and doesn't charge and will always phone back within an hour if I call for a phone consult. It's fully worth 60 euro when I do pay.

I love and admire the NHS, and had good GP/midwife service in London, but when I moved to the Midlands, making a GP appointment usually got you a slot three weeks ahead, or you could show up before 8 in the morning, queue on the street until the surgery opened at 8.30, take a number and then wait for anything up to two and a half hours to see whatever GP was free when your number came up, having had to take half a day off work. Sitting in that waiting room, it was also impossible not to realise that there were a lot of people who didn't need to see a GP -- who booked a regular slot for an ingrown toenail because they were lonely and wanted the company.