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?

In response to ephiny, gps are paid about £60 to look after a patient for a whole year. The average patient consults 4-5 times per year. The government used to pay practices to open at evenings and weekends but have now reduced the funding so much that it cost GPs more to put on a clinic than they are payed.

Where I work half the appointments are 'prebookable', a further 1/3 are book on the day and the rest are for the duty doctor to book. Someone wanting a more urgent appointment than they can book via
reception can talk to the duty doctor and are offered a suitable appointment. I'm sure it doesnt suit everyone, but we have used multiple different systems and this seems the best so far.

In response to your comment about being contract, I do know what you mean. Dh is contract and doesn't get paid if he's not at work, but he also has a long term condition that requires lots of appointments. Some of them are at hospital so will always be at 'regular work' hours eve with the GP surgery opening late.

But as he receives excellent care, we don't really feel like we can complain. He is contracted to do a certain number of hours each week, so if he has appointments he has to get in to work early or stay late or through lunch hours. Or we have to put up with a reduced pay packet the next week. It's just the way it is. We are still very fortunate with the NHS.

I realise it maybe difficult to go in early and stay late with child care arrangements, I work part time so that's not a problem for dh. But if it's a problem than the other parent will need to step in or you pay for extra childcare if you need to fulfil your contracted hours. I don't see why that should be a problem for ocassional medical appointments, it's not like you have to do it regularly.

At one point, I had a surgery whose appointment line was only open between 9am and noon. It took me a week of phoning, once, to book an appointment.

Not sure I understand you NightFallsFast- the £60 I mentioned was the fee charged for per consultation for the private GP practice I used to go to (though in my case it was covered by my employer), nothing to do with NHS funding or GP salaries .

Basically trying to say that it's really quite affordable, so might be worth trying for some people if there's a practice in their area. Not sure how common this is outside London though, as I think a lot of the demand comes from the big American/multi-national City firms who provide cover as an employee benefit.

Maybe it's a gap in the market though! I'm sure lots of people would be willing to pay for a more convenient service if it was offered. I get the argument that we shouldn't complain too much about the NHS service as it's 'free', but that doesn't really mean much if it's the only option available.

I understand you were talking about private GPs ephiny. I was trying to highlight why there might be such a difference in standard of service, as private GPs are paid 4x as much per consultation.

Just as another comparison, each call to NHS direct costs the taxpayer £80.

Oh I see what you mean, sorry. No I don't blame the GPs at all for any of the problems, I know most NHS staff are doing the best job they can with the resources available.

YANBU OP but you should shop around for a different surgery. Mine are unbelievably helpful. Admittedly I can't always see my Dr if I need an appt that day but they will pretty much always fit people in. They even do early appts starting at 7 am some days!

Nightfallsfast Crikey! I didn't know that!

I work in a surgery. We are open from 8am- at least 6pm Mon-Fri, have surgeries until after 7pm on several days, do one Saturday a month etc etc. It is still hard to get an appt at the moment as there are a lot of people taking hols and some docs are sick! However, you can book up to 4 weeks in advance for routine appts, so more choice of times if booking ahead. We have to keep some each day to "book on the day" and some for "Urgents". The docs have to stay late until all urgents have been seen - so they can get cross if the problem was NOT urgent (veruccas etc) and a lot of people play the "urgent" card.

We DO have a boundary. If you need a home visit you need to be near your surgery and no-one plans to be ill enough to need a Home Visit but believe me our docs have to make lots EVERY day. If we didn't have a boundary we would have to stop registering those that move in who live next door as we only have a finite number of appts available so can only have a max number of patients, so when they move away they have to re-register.

Getting a doctor doesn't work for working people,which pisses me off as we're the ones paying for it - at the very least I'd expect them not to be closed when I can get to them.

We have zoning where Ilive so we don't get a choice, and my best option would be a doctor near work which is not allowed. TBH its often quicker, given the commuting, and all the crap around rescheduling stuff for the inevitable apointment at midday rather than first thing, to go to the local A&E

The docs have to stay late until all urgents have been seen - so they can get cross if the problem was NOT urgent (veruccas etc) and a lot of people play the "urgent" card.

The reason working people play the urgent card is otherwise its so sodding hard to get seen , we can't sit on the phone for 30 minutes while at work, nor take the morning off in the hope we may get an appointment.

The system as it is, is optimised for people with time on their hands, not the people paying your wages.

YANBU, I put off going to the doctor alot of times when I was working full time. However, I did make numerous emergency appointments and was seen on the day. The few times I needed appointments during the work day, my manager was pissed off.

Luckily my surgery introduced after hours appointments on Tuesdays and on Saturdays so my last year of working I made two appointments; one on a Tuesday and one on Saturday.

My GP's surgery will not allow yo to book appointments in advance. You have to ring at 8.00am. I am a teacher and am usually in the car at 8.00am getting my son to breakfast club and my daughter to nursery. By the time I rrive at work the convenient appontments for me are gone.

If I'm ill then I'm at home but I am currently stressing about my periods. I am probably peri menopausal but I feel the need to get a period 'MOT'. I can't get an advance appointment and it is too hard to get a 'same day' appointment. So, I bumble along feeling worried about my periods but the problem isn't urgent so..........

I'm lucky in that we have a small walk-in clinic at work, which staff are allowed to use. I do have a long-term condition which needs semi-regular checkups, but as these tend to be booked a couple of weeks in advance, I can arrange them around work.

The nightmares start when DD is ill and needs an appointment. The non-routine on-the-day slots disappear if you ring up later than about 9:45. If I am at work, DH or MIL has to take her, which normally involves DH lying to his boss about why he can't come in. DH's work has a system whereby you are allowed an hour off for appointments, which is fine as long as your surgery is close by.

GPs have lives too you know.

Should I get up at 5am and leave my children so I can get to work and see some patients before they go to work, then spend the day at home while my kids are at school, and go back to work in the evening when they come home from school, so I can see patients who've been woke during the day?

Those of you who think your GP should be available to suit your exact hours - can I ask what your jobs are? Do you do anything that someone might possibly want in the evenings? Because really that could apply to most jobs.

The fact is that most services are only available during the working day, and people just have to work around it. I see my dentist/optician/hairdresser in annual leave.

The only services that can be offered round the clock are those that are run on a totally profit-making basis, where each customer seen earns more money. Medicine doesn't work like that.

But you may get your wish. If the government continues to damage the NHS then perhaps you too can pay per consultation, and pay for each test you have, and per minute of the doctor's time that you have. And then you can pick your chosen time, but of course market forces will dictate that you pay more in the evening. And don't forget that you'll keep on paying when you're a pensioner and not earning and have to see your GP far more often.

Funny how no one ever moans that they can't see a solicitor at 8pm, or get their hair cut at 6am, or go house hunting at 9pm. It's always doctors who get complained about.

Catchment areas still do exist. When I registered I had to show recent utility bills as proof of address.

Been working not been woke

Stupid iPad!

Velma - Doctors can potentially save lives...solicitors or going hunting () can't.

My surgery offer out of hours appointments to people who work full time - they did their market research and found that it was highly needed. They have 1 doctor who sees all the patients in the out of hours clinic. They are all on a rota, so one doctor stays after 6pm or on Saturday each week. It's not rocket science. I don't understand why you're taking it so personally.

This subject has come up quite a bit just recently. All those saying "well my surgery does XYZ so I don't know what the problem is" are very lucky. At my last GP you had to call at 8.30am for an appointment. By 8.35 there were none left so you'd got to wait until the next day and try again. If you wanted to make a non-urgent appointment - well I never did figure out how to do that. They certainly wouldn't let you on the phone.

I tried to change surgery. The 2 nearest GPs wouldn't poach patients from other surgeries, and the others in the town said we were too far away. The nearest walk-in centre was 14 miles away. So I just didn't bother going to the GP.

We moved house and my new GP is fantastic. You can ring at any time of the day to make an apppointment and you can generally get same day if you need it. You can also book an advance appt with your own GP by internet or phone. We also have a walk-in clinic in the town. So I could now say "I don't know what your problem is" except that I do, and it's awful to be in that situation.

My family tell me they are so glad we moved here because it turned out I had bowel cancer. I went to this GP several times before I got referred, but had we stayed in our old town it was so hard to see the GP I doubt I'd have bothered. They told me the tumour had been growing for 2 years (so before we moved here), and it had started to spread by the time it was detected. I wonder how far advanced it would have got had we not moved and it gives me chills.

Velma - actually more and more services are available outside 9-5. You might find the Primary Care Foundation helpful - they've done a shedload of research on urgent care and helped a number of surgeries to look at their appointment systems. Matching staff rotas (including receptionists and call handling) to predictable demand makes life a hell of a lot easier for everyone, staff and patients.

I agree with Velma. Are we prepared to pay more for unsocial hours GPs? And there could be more money available for English GP services if the Welsh and Scottish stumped up for prescriptions and hospital car parking

I don't think anyone is saying that GP appointments should be available 'around the clock' . Just being able to make an appointment would be a start in many cases!

It's not generally that people don't want to take a morning/afternoon off work to go to the doctors, more that they don't want to book a day off on the chance of possibly getting an appointment that day when they phone up in the morning, but maybe not getting it and having to then book another day, on which they might not be able to get one either.

It's a ridiculous system, especially for people who work or have other commitments and need to be able to book these things in advance. Which you generally can do when it comes to booking a haircut or a solicitor's meeting, or a house viewing!

Our surgery offers lots of late appointments. It actually has become quite hard to get an appointment during the day. It is a nightmare having an appointment at 7.30pm if you are elderly and have to walk to the surgery on a dark and icy pavement. Thankfully our surgery are now having more day appointments.

There is a walk in centre that is open until 11pm if you are a working person who needs to see a doctor in an emergency,

I actually think its quite fair to prioritise the elderly as they are often in the most pain.

For myself, I'm not expecting late night appointments. I just prefer it to be possible to call and book the appointment itself between 9am and 5pm!

I think you'll find it was research and patient demand surveys that led to the Advanced Access system in the first place. This is the system where by most appointments are "book on the day", leading to the 8am phone rush.

In the past we offered pre-bookable appointments, which enabled people to book an appointment about 2-7 days later, depending on the popularity of the GP they wanted or the time of day they preferred. People who felt their problem was urgent that day came at the end of surgery and had shorter slots which they sometimes had to wait half an hour for. But no, that wasn't what people wanted, according to Tony Blair. People wanted to be able to book an appointment that day, regardless of the degree of urgency of their problem. So GPs were forced to block their pre-bookable appointments and keep them free for the book-on-the-day people.

Sootie, if your life is ever hanging in the balance to the extent that you can't wait until the following day to see a Dr, I would strongly advise you to go to A&E.

No system will suit everyone. Most patients are elderly or young children for whom normal working hours are suitable. We have to consider the majority. I have had elderly people complain about being offered appointments at 4pm in the winter because it's dark and they don't want to be out then. Also parents with young children not wanting appointments after 5pm because it's tea then bath then bed. You have to look beyond your own personal circumstances. Setting up a system when your target market is the entire population is very hard.