To expect a good service from the local GP surgery

[Aliensstolemychildren]

Today I took my son who is poorly with tonsillitis to the doctors - I phoned to make an appointment and subsequently turned up on time.
However I waited 1 hour after my appointment time to get seen, no apologies, no information and while this is not a record it happens every time. The appointment lasted less than 5 minutes to issue antibiotics.

Why do doctors surgeries run like this? GP's get paid a fair wage for what they do and considering we can put a man on the moon, split the atom, understand DNA sequencing - somehow my doctors surgery cannot run to time!

I thought doctors were supposed to be very bright - can't they sort it out?

DS has gone back to school but he's still coughing and not 100% TheOne. He had all of last week off so he's panicking about attendance now.

I have got rid of everything apart from the chest infection, still rattling. So I'm back to the GP tomorrow.

But I must admit I don't know how they can be running late first thing as sometimes seems to happen.

What really annoys me is when I book the very first appointment and the doctor turns up 10 mins plus late for work, there is no way they are ever going to be on time then. Also I cannot remember a single occasion in the last 20+ years when I have actually been in with the doctor for 5 mins - I'm in and out with the antibiotics/eczema ointment/ear drops within 3 mins at the most, but theperson in front of me is always in there for aeons.

Ours do that higgle. You get a 8.45 appointment when the GP doesn't get in until 9am.

There used to be a sign up saying how many people had missed their appointments that week, but they all seemed to be there whenever I went.

I used to work for a surgery where one GP would insist on appts booked from 8.30am. He would wander in nearer to 9 with his hair still wet from his swim. Not subtle

How do you know who hasn't turned up? Especially if the GP is behind? I remember being a student and sometimes getting to the health centre 15 mins early (due to gap after lectures) and being straight in because the last couple of people haven't turned up.

I'm biased though: ours are usually fab. On the rare occasions when I have had to wait, I have always had an appology on the way in with a brief explanation (emergency home visit etc). Although maybe our health centre is particually good about this: one morning I got a phone call explaining that there had been a big emergency first thing, appointments were going to be over an hour late and would I be able to rebook or was it an urgent appointment. As it was a checkup, I rebooked for a few days later, but I was very impressed that they hadn't just let everyone come in and sit for hours getting stressed.

I meant it was always heaving MrsHoarder. It's a good job 64 people missed their appointments. They would have nowhere to sit.

I have never got in early ever.

As others have said, the appt times are all of equal lengths and the receptionist doesn't usually know what the patient is coming in for so cannot book a double appt for something that may take longer (I feel sure there have been other threads on MN complaining about Drs receptionists wanting to know what the problem is before they will give you an appointment - and that never goes down well either .... lose:lose situation).
A good surgery, however, will make provision for a child/adult who is too poorly to wait a long time - especially if it is a village/local surgery. Our GPs will always see a fractious,poorly child out of turn. My DD is disabled and vulnerable in Drs waiting rooms clogs up too much space in her wheelchair The receptionists are quite happy for me to ring and check if morning surgery is running on time so that I can get her there just in time for her appt rather than waiting - I only do this if she is poorly and do not abuse their courtesy for routine check ups. They will always squeeze a sick child in at short notice and ask others in the waiting room if they mind giving priority to the sick child. I have never heard anyone object.
Does your surgery have a Patient User Group that you could get involved in? That way perhaps you could discuss practical suggestions for improving the service.
If its any consolation - hospitals are worse than GP surgeries. I was in a waiting room at our local hospital once for an orthopaedic clinic. It was running late and everyone in the waiting room got chatting. Turn out that 5 people had been sent exactly the same appointment time. Seems this is common practise for orthopaedic clinics at the hospitals in this area.... absolutely no chance of being seen on time there!!!

Maybe its an overbooking policy then?

Sorry your surgery is so rubbish about this, there are better ones out there (although this may be a regional thing? I hear rummours that London is getting worse for this.)

If my consultant is one and a half hours behind schedule at 10.00 am, and oldmum thinks it's because he was operating, then he is routinely operating when I have my appointments, because he's always late. As he's always late, I wonder why the appointments schedule isn't adjusted accordingly.

I've a large DNA stamp on my file (did not attend) for an appointment that was missed. It was missed because it was arranged without my knowledge after I'd gone on holiday, so didn't get the letter until I was back and had consequently missed it. I'd been expecting the consultant to write to me and not arrange an appointment. His words were "I will write to you". Had I known this, I would have let the receptionist know I was going away on holiday (it was August). Perhaps the consultant speaks in shorthand and "I will write to you" means "I will write to you with an appointment in one week's time."

So, I'm always a little cheesed off when they very helpful screen in the reception area tells me that 298 people missed their appointments last month, at the same time that it's telling me my consultant's clinic is running 90 minutes late. As Sparklingbrook says, it's a bit of a relief really that so many people have missed their appointments, otherwise I'd be there all day.

You are getting a good service though aren't you? You received advice from a medical practitioner and a prescription for medicine to treat the complaint - all of it ostensibly free - I appreciate we do pay indirectly via taxation and NI.

They may be running late because of home visits or because they are the police Doctor or serve a prison and have been called away to an emergency there. GP's have a multi-faceted role in today's society

and whilst I appreciate that waiting when there is no obvious sign for the delay is frustrating it's better than them announcing that they are running late due to a patients nervous breakdown for example (as happened to me - was in with the Doc for over an hour - didn't mean to be - just became overwhelmed and unable to cope when explaining what was wrong)

Direct your concerns at those people who don't turn up for appointments or who request a home visit when they could get but prefer the Dr to pop in for some non urgent ailment they've exaggerated or those people who's prescription ran out yesterday but didn't bother requesting anew one in time and have to take up emergency appointments for a medicine review ........ I'd hate to work as a GP or in a surgery

Llanbobl well said. You'll all miss it when it's gone that's for sure.

Im a GP. Generally I run to time, but it only takes one patient and suddenly the whole morning has gone to pot and Im 45 minutes late. Its very hard to cover all a person needs in 10 minutes also.

Where I work, the main problem is that my patients come in with a list of issues to discuss with me. While it is reasonable to deal with 2-3 problems, some come in with 8 and frequently people "save the best to last" so to speak, and will often leave the most serious symptom till the last question. Therefore I spent 8 minutes discussing their fungal nail infection and viral cough but as Im about to close the consultation, they mention that they have crushing central chest pain (classic symptom of a heart attack). You can't then say - "times up. Bugger off and have a heart attack on your own". You have to deal with it.

Another common problem is if we have to admit someone to hospital e.g. said heart attack. You physically cannot see the patient, examine them, give immediate necessary treatment, make a diagnosis, call an ambulance, spend 20 minutes waiting for switchboard to answer at the local hospital, bleep the on call team, speak to the on call team, write up referral letters/notes etc and pack the patient off in 10 minutes. Its bloody hard to do in 30 mins and if you are already 20 minutes late it soon adds up.

Also, there are constantly nurses knocking and asking for advice, secretaries with questions, receptionists asking for scripts to be signed, emergency telephone calls, plus the necessary bath room breaks.

This is all compounded if you are seeing the duty doctor for an emergency appointment as their whole clinic will be dealing with these sorts of things.

Lastly (sorry to go on) but some GPs are just crap at time management. They may be great doctors, but they can't organise their time.

Generally though, the minute Im over 10 minutes late, I always apologise to the person for keep them waiting. Thats just good manners IMO.

Our old surgery was appaling; two week wait was standard, even if you told them it was urgent it made no difference.

I've had an afternoon antenatal appointment there where the waiting room was full of pregnant women because the midwife hadn't turned up. No explanation and no apologies, receptionists didn't even make any effort to find out where she was.
After an hour I had to get back to work, told the receptionist I was leaving, expecting a response to the effect that I should rebook as the care was important.
They just said "yeah, right" and that was it.

So glad that we moved house... one we've got now is very good apart from one receptionist.

In Ireland any time I went to the GP I had to wait at least 45 minutes and I had to pay 60 euros for the privilege. On purely that basis YAB incredibly U. Doctors aren't lazy, they do their best and are often so busy they don't get to eat lunch or even have a cup of tea all day. You would also be complaining if they would only see you for 3 minutes so they could keep to their schedule. It's just the type of situation where you can't always plan things easily. One blood test or urine dip can make the whole day late, and as someone else mentioned if a person comes in crying their eyes out wanting to talk about depression or other mental health issues then a good GP would sit with that person for at least 10 minutes. I'd rather a good, free, but slow health system any day over a passable, fast and expensive one.

My DH is a GP. His official surgery hours (when appointments can be booked) run from 9-11.30, then 3-5.50 (ie 'should' finish at 6). Three days a week he is also duty doctor, which means that anyone who calls in on the day needing to be seen as an emergency will be added to the end of his list, until everyone who needs to be seen has been seen.

Even if he spent 10 minutes with every patient he had an appointment for, he needs 2-3 minutes after each session to write up the notes on the computer so next time that person comes in, they don't have to spend time repeating what happened last time. If he does this during the appointment, people complain that he was busy looking at the computer and not at them.

He then has 5-10 phone calls most lunchtimes to people who couldn't get to the surgery but may not need to be seen in person, which will take time writing up. There's also at least one visit every day. Given the nature of the town we live in, and the size of his catchment population, it can take half an hour to get to someone's house, and half an hour back. It might be a terminal patient who needs reviewing and can't be rushed, or it might be a mental health crisis where he needs to call out extra assistance before he can leave, or it might be someone who turns out actually not to need a visit at all and who could have come to the surgery but chose not to.

If his first patient of the day is someone suffering depression, or heart disease, or it's a new baby check, or any number of other things that take more than 10 minutes, he will be running late from that point on unless there's a run of simple repeat prescriptions. This does not happen very often. There are days when he's not been able to get back from his lunchtime visits in time to start the afternoon surgery; what should he do, say "sorry, can't make it to you, you'll have to wait until tomorrow"? Should he say "I'm diabetic and haven't had a moment to sit down and eat my lunch yet, do you mind waiting five minutes for your appointment?" He can't do either of these things because everyone expects their doctor to stick precisely to the time limits.

It's impossible to predict what will happen on any day, but I'd much rather a doctor who spent the necessary time with each patient, and ran late sometimes or always, than one who was exactly to time but didn't deal properly with their patients' concerns.

am laughing my ass off at the suggestion we make patients cups of tea while they wait!
Is that instead of answering the phone to sick people, helping organise appts, sort out the bloods and samples to be collected, action the stream of requests for repeat prescriptions, code test results, type referral letters, chase referrals that have been "lost" by the hosp - the list is endless.

And would you like me to use my own mobile phone to txt patients???

Surely its obvious that if you are kept waiting its because of an emergency or unforeseen circumstances? Are we unable to see how this can then cause delays?

i think a bit of patience and common sense could go a long way. I would agree that some receptionists are crap though-communication is the key

I don't mind waiting for the doctor, however when i running late the receptionist says next time you will have to rebook

Were you in the surgery where I work?

In the space of 4 hours this morning we had to call 5 emergency ambulances for patients; 3 for chest pain, 1 for a gastric bleed, 1 for a very sick child.

This led to us (all the GPs as well as the nurses) running approx 1 hour late.

It's unfortunate but that's the way primary care goes - it's unpredictable and varied. I get allocated 10 minutes per appoinment for example; a woman comes for her smear which takes me maybe 8 minutes, then she bursts into tears and tells me she's worried about a lump in her breast. Or an elderly man comes in for his asthma check (15 min appt) but it turns out he has a raging chest infection and needs a nebuliser, assessment and admission to hospital.

We're not sat behind closed doors reading Heat and drinking cappucinos.

Apart from the frustration at waiting for over an hour with no information etc - my only thoughts are that there must be some way of doing it better.......I agree with everybody that doctors should see people for the length of time needed and give everyone excellent care - but as primary health care is unpredictable in this way I would have thought there is a better way of doing things.

Maybe our surgery is just very poor, but the problem is that you put off going to the doctor because you have to take a whole morning away from work just to have a 5 minute appointment for antibiotics.

FWIW our surgery charges £25 for missed appointments but doesn't compensate me for turning up on time and being kept waiting.