to think that the reason a lot of people dont go to the doctor when they should

[GnomeDePlume]

is because they cannot get an appointment time which is remotely suitable for someone who goes to work.

If I want to see a doctor then I can either make an appointment for the middle of April (earliest time when bookings can be made) or take pot luck on the day. The pot luck which is available today is 3.30pm, no alternatives available. This would be great someone wanted to take a DC to the doctor outside of school hours. Sadly it is totally useless to me as I would have to leave work at 2.45. My employer is strict, I cant take an afternoon off to go to the doctor.

So would it be so very difficult for the surgery to work out that only offering appointments on the day at fixed times or in over a fortnight's time is not serving a large proportion of the patients well?

My friend is a GP and she says that the reason the system works like this is because the vast majority of patients are the elderly, followed by small children and they can generally fit in during the day. Like some others upthread, she takes the view that if it is urgent you probably wouldn't be at work anyway and if it isn't urgent, well it isn't urgent and a forward appointment would suffice.

Gastrognome - it has done both. Our service is soooooooo much better then in 1998, but others have found is soooooo much worse. It really is a luck of the draw with how the practise is run, and where you live.

Hackmum, if you are worried enough about a breast lump then you have the choice of either waiting or taking time off work. If you are in pain from an ear infection that does need to be treated quickly, then that is another good reason to take time off work.

I just think we are so lucky to be able to see a doctor on the same day we need too, it seems ridiculous to complain that same day isn't good enough and it should be right time too.

Carabos the problem is that the patient group becomes self-selecting. The only people who can get in to see the docor are the retired and small children with a parent at home. Everybody else just has to shuffle along with over-the-counter remedies.

My town doesnt have a hospital (nearest is a good 45 minute drive away).

Every now and then there is a flurry in the news about men not going to see the doctor until bits actually start falling off. Of course they dont, they cant work out the labyrinth that is the appointment system.

I'm a contractor since being made redundant so dont have a kindly employer to let me have time off. I could possibly make an end of the day appointment by working through lunch but appointments in the middle of the day are only any good to people who are at home already.

They don't have to shuffle along with over the counter remedies, they are choosing to. They can choose to take time off work if they want to as well.

And if over the counter remedies work, then they don't need to see the doctor anyway.

I think it's a bit patronising towards men to say they can't work out the system, of course they can work it out, it's not that bloody hard. People need to take responsibility for their own health and well being and stop expecting someone else to accommodate their every need. Men are perfectly capable of deciding if they want to see a doctor or not, and if they do, they may just have to take a little time off work. No big deal.

YANBU. My surgery now has appointments right up to 7pm for 4 days a week and is open until 1pm on a Saturday. I've been there for over 10 years, and I've now moved nearly 3 miles away with another Doctor's surgery on my door step but I refuse to change because they're so good.

We have to pay for GP here (?60 per visit), but it is still pretty much geared in favour of SAH folks. 9-5, 1.5 hr for lunch, difficult to get phone calls, and many have a short week (half day or full day off per week).

No covereage between 5-6pm (so even GP type emergencies need A&E), 6-10pm is out of hours GP service in local hosp (?80), with an on call service from 10pm to 8am (I think it's ?90 for that one, had to use it once), again no coverage 8am-9am.

And DD, llittle angel that she is, will regularly have an ear infection show up late in the afternoon or in the night, so we have ended up at the out of hours service a NUMBER of times (luckily, there is a late opening pharmacy close by that we can usually get any scripts filled at).

What we have ended up doing is having DD registered in a GP near the house (as I needed one when she was small, it's not terrible for getting to from work when she was in creche near office, and now she's in school in that area again, AND, very IMPORTANTLY, means we are registered with the out of hours service in our area rather than the one in the city centre). I once had to attend that GP practise as an emergency patient (mastitis when on mat leave) so I could, conceptually anyway, use the local OOH service.

DH was using a walk in clinic in city centre near his office, and has used the clinic I go to also. He registered with a GP near home (different to DD's, but handier for him) so he can also, conceptually, use the local OOH service.

I need to attend GP regularly for asthma scripts and other needs - not usually urgent (but I'd end up most winters with at least one chest infection needing ABs). So I go to a practise in the city near my office - which means if I needed OOH services I'd have to come into and across the city to a very large and very busy hospital. But it does mean that I can generally arrange my appointments for early morning or during lunchtime (they generally have one doc on over lunch every day) if regular, non-urgent needs, and can dash over from work during the day to fit in with one of the emergency slots if I DO have an urgent need.

When we lived in our previous house, the local GP was not involved in any co-op schemes and didn't operate appointments, but had evening surgery himself 3 nights per week and still did house calls (we left 10 years ago). Officially evening surgery finished at 8pm, but usually he'd wander out about 8.30 to close the front door to stop any more arrivals and stay there until he'd seen everyone already in the waiting room. There are some parts of modern life I am not so keen on....

The GP system really doesn't seem designed for people who work full-time.

The company I used to work for paid for us to use a private GP surgery (2 minutes walk away) which was fantastic. You could phone for an appointment, and they'd usually say you could pop down in half an hour - or make an appointment for a time convenient to you. Never had to wait, often they'd see you early if you were there.

Since leaving there, honestly I haven't even bothered to register with an NHS GP. I get birth control pills via an online service, and if I was ever ill I guess I'd go to a walk-in centre. If I needed regular GP treatment I'd be tempted to go back to the private practice as a self-paying patient, the convenience and pleasant environment is well worth paying for IMO.

(it's about £60 for a consultation IIRC, not as much as you might think!)

If I want to see a GP I have to either make an appointment for several weeks in advance or phone in each day between 8.15-8.00am hoping to get a same day slot. If I don't get one I have to do the same the next day and the next. I am usually travelling to work between 8pm- 9pm so it really isn't practial. I have a long term condition so I need to see my GP fairly regularly and sometimes urgently. I can't always wait several weeks. I have taken to using my walk in surgery at the local hospital. Although I might have to wait a few hours, at least I know I'll be seen that day.

Added to this the last time I had an appointment I had to wait nearly 2 hours . Parking is very difficult as well and maximum time you can pay for around here is for 2 hours

The whole system is crap. I'm thinking of joining a private surgery even though I'll be paying through the nose because of my long term condition.

IMO the answer is to have fewer patients on GP lists. Train more doctors - students are clamouring to do medical degrees and medical shools are turning away many, many potentially excellent would-be doctors

gnome I don't disagree with you. I think the system is rubbish and should reflect the purpose that the NHS was originally set up for i.e. to keep the working population working. It's not beyond the whit of man to have GP surgeries staffed and open to suit their users - the supermarkets seem to manage it.

Our GP service is utter shite. You can book routine appointments for any day you like, but you'll be waiting 2 weeks min. Emergency appointments are available daily to those that run the phone gauntlet at 8.30 and 1pm and then survive the receptionists grilling as to why you need an emergency slot.

The GPs themselves are great, when you get near them..... but they all seem to work 3 days a week so only ever one GP consulting. No late evenings, no saturdays, no walk in centres.......its becoming a requirement that we all have to develop psychic skills and predict our illnesses two weeks in advance.

Where I work the GPs do a late clinic each, once a week, so there are five late sessions Monday to Friday from 1800 to 1945.

I reckon we could be like Asda and open 24/7 and we'd still be full every day.

Ouraged - now that I am a contractor (that's all the work available at the moment) I only get paid if I am at my desk. There is no working from home, no flexible working. Get well or get paid.

Women who have had children will generally have had quite a lot of experience dealing with the complexity of their local surgery (clinics, random HCPs, Monday for this, Tuesday for that). For many men, if they havent had this experience, they expect to phone up and get an appointment within a reasonable time and are left baffled by the system.

Any road up I am off to the pharmacy counter at boots to experiment with a new cocktail of OTC remedies. Tonight I shall be trying anti-allergy remedies. Bottoms up!

Have you got any walk-in clinics near where you work?

NHS walk in clinics

I am really lucky in that my current practice will basically fit you in some time that day if urgent or that week if 'medium-urgent' (if that makes sense!).

Freddos the problem with your argument is that I don't think in a civilised country people should have to choose between work and health. It is massively stressful and really not a good service. fwiw I have lived in Switzerland and France as well as the US and the idea that 'we are so lucky to get same-day appts' isn't really true - I think most decent healthcare services (Canada, France, CH, etc) will do that for you.

I am a university lecturer and during term, if my GP were like this, I would have to:
-decide I was 'going to be ill' next day
-email all students night before and cancel classes (not good practice!!!)
-hang onto phone from 8am and hope an appointment came up

....And if it didn't, do the same again the next day!

It is not always easy to cancel work at the last minute. Employers and colleagues get pissed off. Yes, sometimes it is unavoidable, but it is poor that this is the default option. There are conditions which need to be addressed in less than 3 weeks but are not 'emergencies'.

Walk In Clinics are great if:

• You can get to one. They aren't in every town by any means.
• You don't mind sitting for 3 or 4 hours to be seen.
• And you don't mind the bum-faced receptionist pulling a face when you say you haven't got a GP.

Not forgetting the genius that depending on what your problem happens to be, they will refer you back to the GP anyway...

I live in Egypt, and the drs are really set up for working people here. My dr doesn't start work until 8 :00 pm. She says she sometimes starts work during the day but I have never managed to get a daytime appt. I am 30 weeks pg, and often want to be lying on my sofa at 9:00, not walking home from a dr's appt.

Jamie, thanks for the link. Unfortunately the nearest walk-in centre to my work is 25 miles away. I dont live in the middle of a big dark forrest it is just that outside of the cities provision of most services is pretty poor.

Tbh, if I feel ill enough to warrant an appointment at the docs, i'll take whatever is going.

yanbu. I've had employers who didn't let people take time off for GP appointments, it had to be done with annual leave.

My current employer does let us take time off for GP / hospital appointments and we don't have to make the time up. I generally get them at the end of the day so it doesn't chip into work but all the same it's easier than having to work an extra hour the next day or use up holiday.

RevoltingPeasant, I know what you mean about the terminology. I phoned up the doctor's for an appointment and was asked if it was an emergency. Now in my books an emergency means an absence of pulse or presence of arterial bleeding.

This is part of the problem. If you arent in the doctor going club you dont know the code.

The trouble is that no matter how much GPs and the NHS give people demand more. Why should a GP alter the hours they work because you won't alter yours?

I work in a deprived area where many patients don't work and have multiple health problems yet the number of appointments that are wasted because people don't turn up are amazing.
One clinic this morning had 6 patients booked in, 3 did not turn up. Those appointments could have been used for others. It is infuriating when someone doesn't turn up then rings for another appointment later the same day with no apology or explanation yet we can do nothing as we can't turn them away in case they are genuinely ill. If so much money was not wasted on DNAs it could be put into other things, like more early or late sessions.