To think it is no wonder people go to A and E unnecessarily

[Keremy]

I have a series of medical problems and history of a lot of operations and pain.
I have been in agony for a week and unable to sleep. All I need is tablets I previously had on repeat prescription but haven't had in a few months as I haven't needed them but obviously I can't get them without seeing the doctor because of time frame which I understand but I can't get an appointment!

Our doctors has a system where you call when they open for appointments that day. I've called, I've been in but no luck.

I want to cry.

I'm sorry but having to wait 3 weeks for an appointment isnt frustrating. It's downright dangerous.
Who on earth can plan an illness 3 weeks ahead unless it is something chronic and a review of what is going on???

OP if the OHO doesn't work and the push doctor isn't for you either, then I would go to A&E. Because you don't have the choice!

I recently visited the U.K. over Christmas (expat who lives in the US) and was turned away from two walk-in clinics, and thus had to go to A&E on Christmas Day, as if developed a chest infection from flu and desperately needed antibiotics.

Twenty years ago, even after I moved to London and couldn't find a GP with room, I could still reliably visit my old GP in my parents' village, but the system has changed so dramatically, that such a thought would be ridiculous.

The NHS is in bad shape. But I would rather have an NHS as in bad shape than no NHS. It needs to be fixed but the question is how? More money maybe? But how?

I'm not bashing the Nhs at all. My Mum worked for them for almost 45 years, both my cousins and aunt and two of my closest friends still do.

I know how bad things are.
Doesn't mean I can't be frustrated when I'm in awful pain.

They should be able to offer you an emergency appointment

In my personal experience it's a postcode lottery. Used to live in a lower middle class area of town, lots of young families. 4-6 week wait for appointments. Clearly young children / pregnant women are more likely to need appointments but they still just count as a 'head'.

Now I live in inner city, lots of young people, can get same day appointments (not cancellations, just free appointments). The young single types are presumably healthier and also would have to be really ill to need a during the day appointment (I'm a SAHM so can have one). But they count for the same head count as the families and young children.

My friend who lives in an area with lots of deprived families and high unemployment also finds it easy to book an appointment. More money poured in to the area.

I think head count for GP surgeries should take into account the demographics of the area. People over 60 and under 16 (? Or 12 maybe?) should count for two heads not one, as frequently they do need more care.

can you email them for a repeat prescription and title it URGENT- mine always stump up with the goods. their website will have an email address

keremy did you find any booty in any of your hand bags?

They count me and DH as heads and we never get to see them.
Doesn't seem fair.

The only time I have not been able to get an appointment and needed one, I simply said to the receptionist that in that case I would have to go to A & E. They squeezed me in. I would not say this unless it was totally necessary, but if it is, then tell them.

From experience my Mum said the main problem with the NHS is senior managers and ward managers brought in on big bucks who have no experience of running a ward.

That and they are now used as a social worker.

So they are flooded with people with drug issues, alcohol issues and the elderly who need social worker rather than a gp or hospital but there's non available.

My surgery is nothing like these described here. I can book appointments online, usually within a day or two. I once booked an appointment on Sunday evening for the following afternoon. Or I can get a same day appointment if I phone in the morning. If DS needs to see a Dr they will always give him a same-day appointment.

I have needed a prescription for pain relief when I didn't have a repeat. The receptionist left a note for the Dr, who wrote the script and faxed it to my nearest pharmacy that day.

I have to use a GP in a town about 10 miles away because we don't have one where I live. The nearest OOH is over 20 miles away. There is a campaign to get a GP in our village which looks like it might be successful but I won't switch, my surgery is too good.

OP, I hope you can get your meds soon. I know how desperate it is to be without. I can't understand why surgeries vary so much. Is there a postcode lottery with good and bad funding from PCT's?

No mowgeli :(

What is so frustrating is that the system used to work perfectly fine.
When my children were young the surgery where we lived had 4 GPs who all worked Mon to Fri, Sat morning and one doctor was available for. I think, an hour on Sunday morning. They also worked a rota system whereby each doctor was on call for evenings and night call outs, on one week in four.
Thankfully I never had to call one out in the evenings or nights, but imagine how reassuring it would have been for someone frightened and in pain, to be seen by a familiar doctor from the surgery, rather than some strange locum?
So, this is why so many people are enraged by this current situation - we can remember when it was so much better.

At our doctors you generally will wait 3 weeks for an appointment (6 if you want to see a specific doctor).

But, there is always the possibility of:
-an emergency appointment
-a same day call back (followed by a same day in person appointment if doctor thinks you need it)
-a nurses appointment
-the walk-in in town
-just turning up in an emergency (dh did this once when his back totally gave way during school pick up. They squeezed him in within 20 min. A friend did likewise when her daughter went into anaphalaxis - seen within 20 seconds)

So the 3-6 weeks for an appointment thing can be misleadingly negative.

Susannah I think that sort of system probably worked fine when there were more GPs, each with less patients, and when people were more sparing in calling the GP at all. I think a GP these days who was on call nights for a week would probably not get any sleep at all.

Batteriesallgone It is a post code lottery. My experience different to yours though. When I lived in North Yorkshire there was never a problem with appointments and hospital spaces. Mainly a sparsely populated affluent area. So people generally in good health and no doubt by looking at the houses prices many in private health care. You could even get an NHS dentist no problem.

Where I live now in a bit of a deprived inner city area it is hard to get an appointment, its always rammed. Your only hope is to keep ringing from a minute before opening and hope you manage to get through. By 8.45 its too late. They only take appointment on the day so you cant book the day before. People seem to be generally more unwell and unhealthy, I assume mainly linked to poverty and associated lifestyle. They do a really good job at my doctors but they are under so much pressure. Plus there are lots of patients there that speak little or no English which makes the job extra hard and often causes misunderstanding, more difficult consultations and missed appointment etc which is an added frustration to the staff (although considering how hard they are working I bet the occasional missed appointment is a blessing).

Keremy I know your not bashing the NHS, it is very frustrating the way its working at the moment. I does need fixing but I sometimes wonder if the torries in power want it to break?

Interesting 1DAD. As someone else said maybe it depends where PCTs decide to concentrate funds.

It is generally 3 week wait for appointment here (inner London) but our surgery have a "rapid access" clinic each morning. You turn up and will be seen but only for one ailment, you can't use it for routine follow ups etc. Am sure some mornings are busier than others, I took DD once and didn't have too long a wait. Seems quite efficient.

I've often waited for the surgery to close so I can use the ooh service which, upon giving your life story, will let you go to clinic.

Its a bloody nightmare. You're expected to be psychic and book appointments weeks before you get sick. I get its not their fault. The NHS is on its knees. That doesn't make it any less maddening though

1Dad2Kids,

I struggle to believe those NHS costs, unless it is appallingly run. How can one person 'stepping into' A&E cost £124?! It is being logged onto a computer and a few minutes of nurse/doctor time (maybe 10 of each at most), unless further treatment is required.

Equally how can a call to 111 cost £16. You will probably on line for no more than 10 minutes being triaged via a semi-skilled operative using a computer programme.

1Dad I agree. My aren't live in a rural area. They never have any issue to get an appointment on the day. They've never waited (and see the GP they want to!).

At my surgery, you can book up to two weeks in advance, no more. If you want to see a specific GP, you will wait two weeks. Otherwise, you are seen within a week, usually a couple of days at max. If it's an emergency, you can ring in the day and mainly, you can get to see someone (nurse or GP).
Now go a few miles down the road and there is a totally different organisation in that surgery. It's hard to get an appointment, you need to wait one or two weeks etc... same demographic of population.

Which tells me that yes the demographic has an impact (but then surely, yu would need LESS GP that wealthy area and more in the ot so wealthy one as the needs are different??). But how a surgery is run also has a massive impact....

larry that amount is based on a department of health tariff. But it's not hard to believe that walking into a hospital (£ for baseline running costs) seeing a receptionist, then triage nurse, then doctor (£ for wages) could add up to that, even in an economy where these costs have been stripped to the minimum. Try walking in to an ER in the US! Even in socialist, cheap healthcare Canada I had a tourist family member charged £2000 for the privilege of walking in, having a limb X-ray and seeing 2 members of staff for 'maybe 10 minutes'.

The problem with the NHS is a combination of woeful underfunding, an aging more complex population, and a lack of personal education/responsibility about health.

Where I live (not in the UK), GPs are starting up 24 hour home visits on request - but you'll pay for them! Even going to the doctor for a simple appointment will set you back £20-£50.. but they're still fully booked, and I can have a 2 week wait to see 'my' GP. Plus, I pay more in tax for my 'state' healthcare than I would in the U.K. AND I pay for private cover, or else I'll get stung for another huge amount as compensation..

You want a better service, either get out there and lobby the government to fund it better, or be prepared for it to be privatised, and get your wallets ready!

Take the total cost of running the 111 service per day and divide this by the total number of calls. This will give you the cost per call. I reckon £16 is about right.

A&E is more complicated because more serious cases will obviously incurr more cost than straightforward one - but even straight-forward ones require a percentage of reception staff, triage nurse, usually a doctor, cleaners, lab costs etc. And you need to provide, equip, clean and staff a building before you can even see one patient so not surprised even basic attendences are expensive.