Doctors Surgeries

[pumpkinsweetie]

We all wonder why A & E is filled with people.
Aibu to think not being able to get a doctors appointments is unbelievable & stupid?

I changed doctors recently due to this and it seems i have signed up to another idiotic gps.

Dd has been complaining of a stomach ache for more than a week. I have tried calpol, i have tried lactulose thinking it was constipation. She has no temperature but has become down, stopped eating & even got sent home from school yesterday.

So i did what any parent does and phoned for an appointment at my new gp surgery and these were the words spouted by the roadblock of a receptionist.
"We only have prebookable appointments available, the earliest being 2 weeks friday"- wtaf i thought to myself still being polite i said "sorry but that is too far away i need a closer appointment"

Receptionist "can't do that sorry, ring back tomorrow at 8am but i doubt you will be able to get through on the phone"
I was left puzzled by this and her next sentence astounded me all the more "if you would like to come in before 8, say 7 and wait in the waiting room in the possibility you may get an appointment, which you may not could you do that"

Wtaf, i have kids to get to school and no car, how the hell is that possible. Again being polite i said i'm rather worried about her and i know something isn't right so i will phone in the morning anyway. Receptionist says nothing and we end the conversation on the phone.

My dd 7 is really not well and i will not stand for this. If i don't get through this morning i shall be turning up after school run and sitting at the surgery until i see someone.

We have the same system as Cogito which normally results in same day appointments.
This system is great if the world stops when either you or your children are ill but when you have other children to get to places, trying to talk to a dr on the phone or fitting in an appointment at very short notice can be a nightmare.
Having said that at least it normally means same day appointments which is better than the old system which meant a 2 week wait for an appointment was the norm.

We have the same system as Cognito: ring up and ask to go on the duty doctor's phone list. A GP then rings everyone back, talks to them for about 1 minute and decides whether they need an urgent appointment, a prescription left on reception (for obvious illnesses) or a non-urgent appointment.

I have never had to wait over a day for DS to be seen although a couple of times he has been given a prescription instead which I was happy with.

And non-urgent appointments are usually in about 2 weeks time, which is great when I need a repeat prescription/to talk about a long-term issue and want to schedule time off work.

Phoned and after 10 mins got through and we have an appointment for this morning. Different receptionist today, much nicer.
Think the problem may have been the receptionist rather than the surgery, as she was clearly wrong in telling me i wouldn't get through.

Glad you got through, these ring at eight systems do annoy me, I am a teacher so no flexibility in morning (now part time so a bit easier) and I can never get through. It annoys me that my surgery at least doesn't have a call queuing system so at least you know that someone will answer rather than the endless engaged tone.

When I was a child, our surgery operated a system of; turn up at 7.30 am to make sure you get a decent place in the queue for doors opening at 8 am. People queued outside. Then, sit and wait for your appointment - could be anywhere from 3 minutes to 3 hours. I used to suffer from terrible tonsillitis and can remember standing outside in the cold, vomiting into the flower beds, knowing that even when we were inside, the wait could be endless. The receptionists wouldn't allow parents to book an appt unless they had the child with them. So, I agree with Sirzy. I'm only 25 and left the practice 9 years ago, so we're not talking donkeys years ago! It was a very poorly run surgery.

OK, I am a practice manager and this is something which will never, ever go away while we are still lucky enough to have the NHS.

Granted, some surgeries operate a 'book in advance only' system, which is frankly ridiculous, because I don't know about you but I like to see my GP when I'm ill, not two weeks after I get better. That said, there is a need for some pre-bookable appointments - for follow-ups, etc.

My surgery operates a system where the large majority of appointments are book on the day, with only a few for follow-ups. We are still usually booked up by about 8.30am (at the latest).

This is because there is a simple problem of demand outstripping supply. We simply cannot see everyone who needs an appointment.

The triage system, whereby a GP calls you back to establish if you need to be seen, works very well in areas of particularly high demand. You may be amazed to know that it can cost up to £20k to implement. I was flabbergasted. We're a small business at the end of the day, and that sort of investment can't happen every day of the week.

The surgery where I am a patient has the same system as ours, and if I need to see a GP I just call at 8am, and keep on calling / holding until I eventually speak to a receptionist. I've never called too late and have always got an appointment. If I am asked "Is it an emergency?" I reply, "Well I'm not going to die but I do need to see a GP today".

Mum my old surgery was a town centre practice. You had to be queuing by at least 7.30 for open doors at 8.00.
Then you took a number and if you were VERY lucky, a seat, in a cramped waiting room with at least 50 other sick people.
Then you wait.
It was the norm to still be there at 1 PM. 3pm on a bad day! If you didn't arrive with something contagious then by the time you left you had something! The GP were just interested in getting you through ASAP and you rarely got a decent consultation.
Any appointments were booked weeks in advance. It took me 2 years to manage to get an appointment for a smear test! Thank God I didn't actually have a problem!
Open surgeries may well work in small turn community's, but in towns they do not.
My new surgery does the ring at 8 for a same day appointment thing. Far far better! Their appointments are split in 2. If you don't get in in the morning you ring again at 1 PM for the next lot. The waiting room is virtually empty when you get there and you're seen within 30 minutes.

OK, I am a practice manager and this is something which will never, ever go away while we are still lucky enough to have the NHS.

Wouldn't it go away if we doubled the number of GPs? Relative to other countries, there's no shortage of wealth in the UK, so either we are not spending enough, or we are not allocating resources properly, if GP service is inadequate. I don't know any other country in the world where it is often impossible to see a GP when ill, for people who can afford it.

Yes of course it would. But that would mean doubling the amount of money given to primary care in the NHS. I'm not sure that money is available.
And in some areas (Wales, where I live, for example), we can't get enough GPs for love nor money. They just don't want to come here.

I'm not sure just throwing money at it is the solution, we also need to change people's attitudes. I know people who run to the GP for every cough and sniffle and then complain when they are told there have a virus or its just a cold until that point then we are going to have problems but people aren't going to change that easily!

Glad you got an appointment OP, hope things are better soon. If you're struggling discuss with the practice manager or GP, they need your feedback.

I think there would be appointments for everyone who needed them if people used other services appropriately rather than using the GP as the default for everything.

I think it's all about the management of your surgery. We have a system at ours whereby you can pre-book appointments, but only by calling Friday afternoon, if something comes up inbetween, you can call on the day and usually they will fit you in that day, there are a variety of clinics throughout the week and you can always get a telephone appointment. The practice nurse is prebookable all the time, and there are evening slots available. This only works, because a) it is a training surgery, so you won't see the same GP all the time, and you may be seeing student GPs and b) there is a fantastic, nurse led, walk-in centre up the road for the times where the surgery is really busy and they just can't fit you in. It's not ideal, but it all works together nicely.

But I also agree with sirzy if people didn't insist on going to the GP for every single bloody sniffle and blemish, there would be more appointments.

Our local trust recently ran a great 'signposting' campaign (not sure if it was a national thing tbh) with adverts on local radio, in the paper, posters etc. It basically told you where you should go for what. Turn over in our pharmacy went up almost overnight and my GP surgery said the demand for appts also dropped; people were going to the chemist for advice on minor ailments (colds etc) rather than clogging up the surgeries. I think a lot of people are unaware that a pharmacist is there to do more than just dish out pills. It would be great to see more campaigns like this to help point people in the right direction, be it the chemist, the GP, the walk in clinic, the dentist or A&E...

Sirzy is absolutely right. It's also usually these people who use the opportunity of an appointment to talk at length about minor, unrelated ailments they've had for years without doing anything about them.

I thnk that the NHS is a privilege, not a right (well actually it is a right but that in itself is a privilege IMO). Unfortunately there will always people who insist on getting their 'money's worth' out of it.

Ours isn't great either. For some unknown reason, after fifteen years of having a variety of meds on repeat prescription, I have stopped getting a repeat form. Appointments are two weeks ahead and if I go in before my meds run out I'm being ushered out and told to come back when they have. So once again I'm sat here this morning with severe eczema over both hands after running out of my creams three days ago. In three days it's spread over both hands, cracked, blending and at high risk of becoming infected. It's so bad on my right hand that I can't actually bend two of my fingers without the skin cracking open and bleeding badly. This morning I noticed it starting to appear on my feet where within two days it will have spread up both legs.

I have been trying to get through to the gps on the phone this morning for three HOURS. They have one phone line so if someone is on the phone you get the engaged tone. The is no queue so you have to hang up and redial and inevitably someone else gets through before you. It's bloody awful. I could just turn up but if previous experience is anything to go by I'll be sat there for several hours with a toddler and a 7mo who will be hellish in the tiny "silence please" waiting room.

No other surgeries are accessible by bus from our house and have spaces for new patients, it's awful.

I have no clue what to do, plus it's raining and kids won't enjoy the 40 min walk to the bus stop in pouring rain.

I know this is a giant moan but I'm feeling very sorry for myself!

Wallace that sounds awful. I think you need to speak to the practice manager and make a complaint.

Yes you should complain about that Wallace, it is very poor. You should be able to collect your script a couple of days before your meds run out. It's necessary for GPs to carry out a medication review from time to time but you should never have to run out of long-term, much needed meds.

Also almost all surgeries I know have at least five or six phone lines. I can't imagine how they cope with just the one. Ooof, my mistake, clearly they are not.

I've got a whole host of other things I need referrals for and to be assessed as well. It's a big enough battle getting bloody steroid cream though so I'm putting it off. We moved you see, so all the discussions I'd had with a previous GP have somehow disappeared into the abyss. New GP seems unwilling to cooperate. I need to be urgently reassessed for food allergies - have OAS which worsened during pgcy so I was given an epi pen. It expired and I need to talk to GP about getting a referral to be fully tested again to see if I still need one or if I can go back to carrying portion and steroids.

I have asthma and a dust allergy which has worsened and need the brown inhaler on repeat again. ATM I just have the blue and I'm not managing the asthma esp with colder weather.

I have stress related IBS and anxiety and ATM have no meds for that. Not good at all. All these things should be on repeat prescription. But they're not. If weather better tomorrow will turn up early, take a load of toys for DCs and demand to see someone. It's not on is it!?

That should say piriton and steroids

There is too much work/demand for too few GPs. The only way to rectify things is to increase GPs or reduce demand. The population is getting older with more complex health needs, medications and treatments are getting more advanced, there is more preventative medicine, things are being treated by GPs that would have been done in hospital 5 or 10 years ago, expectations are higher and often people have little in the way of family support and turn to their GP.

Not enough doctors are being recruited to GP training. It's not an attractive option for many, especially given constant government interference, increasing workload, decreasing remuneration, likely future 7 day working and constant bashing of GPs in the media. GP surgeries are small business with partners, many younger doctors don't want to buy in to a partnership when things are so unstable. Also in the past many chose GP over a career in hospital medicine because they wanted work to fit in with family life, which will not be the case with the new 7 day working. Many GPs are leaving the NHS to work in New Zealand, Canada and Australia where pay and conditions are better.

As someone above said, some areas of the country aren't able to recruit GPs. Many practices have been advertising for months or years with no suitable applicants and are drowning under the workload. GPs have to protect themselves from making mistakes and from burn out by limiting consultations. No-one can work in a high stress, high risk environment for 12 hours straight and have as good decision making at the end of the day than the beginning.

Unfortunately this means for some patients that there will be no GP with lots of free appointments in their area. Sometimes GP surgeries have a full complement of staff and are just dysfunctional, and if that's the case it's worth moving surgeries. Everyone values things differently in a surgery, some prefer a sit and wait system, some telephone triage, some on the day booking, some book in advance, some want to see the same doctor every time and for others it does't matter. This makes it very difficult for a stretched practice to suit everyone's needs.

Sorry to hear that wallace make sure you make a complaint, you shouldn't be suffering like this.

My dm had something similar happen last year to her asthma meds she takes. It worried her ever so much because without those drugs she would have a severe asthma attack. She went into the doctors crying and it had turned out the man at the asthma clinic had decided she no longer had asthma. Bloke didn't know her history, she has had it since 13. Surfice to say, doctor was pretty much livid and put her straight back on the meds.

Different appointment systems will work in different surgeries - there is no "one size fits all system". It's very dependent on the practice population.

I work in a surgery with nearly 10,000 patients. We have a mixture of prebooked and book on day appointments - the mixture will depend on which doctor it is, how many other staff are in and which day it is. For example we have maybe a 60/40 split Tuesday/Wednesday/Thursday but then an 30/70 split Mondays and Fridays. We regularly audit our bookings and patient feedback and see what is working and what isn't. Demand can be unpredictable. If all appointments are filled by say 1400 anything after that time will be a Sit and Wait appointment at 1730, which could mean GPs are there seeing patients until 2000.

For the OP - do phone back, if you can't get through then go down there and wait to be seen. Don't go to A&E - you'd be there even longer than you would wait at the GP surgery and it's an inappropriate attendance. I understand your frustration but the best thing to do is go to the GP.

NightFallsFast if I could get my thoughts in order, I could have written your post. However I can't so thanks for saying it anyway!

Some of you may find this an interesting read

Wallace - when you do get through to your Practice Manager to complain, you could suggest that they set up an online repeat prescription ordering service - my GP has it, and it was an amazing help when I was on antidepressants. Instead of having to drive to the surgery twice - once to put in a repeat prescription request, and then again to pick it up, and go to the chemist, I only had to make one trip, to pick up the form.

I imagine it was much easier for the practice too - instead of a load of handwritten forms to decipher, they would get a nice, neat list from the computer that they could just push straight over to whichever GP was doing repeat prescriptions that day.