To ask about face to face GP appointments?

[Newyearnewname20]

I’ve had an ongoing problem with my skin for the last 3 months or so. Each time I’ve contacted my local doctors’ surgery (am based in London) about it, they’ve said they’re not doing face to face appointments, and I’ve had a phone appointment instead.

The surgery hasn’t said why they’re just doing phone appointments, but I’m assuming it’s because of Covid restrictions still in place? Not really sure though.

I’ve now had 2 phone appointments, each with a different doctor. The doctors disagreed on what my skin problem could be, they each prescribed me different courses of medication (so I’ve now had 2 separate courses of medication).

My skin problem still hasn’t cleared up, and I’m none the wiser about what could be causing it.

I’m getting really fed up of the problem (it’s making me v self conscious), and I just really would like some continuity of care form the same doctor and to be examined face to face.

I guess I’ve got a couple of AIBUs really! The first is - AIBU to ask if your local doctors surgery is doing face to face appointments, or if you’re having to do phone appointments too? Second AIBU - would I be unreasonable to ask for a face to face appointment?

Thanks all.

The problem as said is above is not enough GPs combined with a high level of demand and necessity for appointments . This was worsened by covid but was always going to come to this . Full telephone triage is the only way some practices can cope .

Our practice is fully staffed and our patients are offered a choice as to whether they want to come in or telephone.
The practice down the road which served 15000 patients was sold to a company and have one GP in house ( from 8) and several GPs who are working remotely so there is very little chance of a f2f appt there .
I feel sorry for the patients but due to the size of the practice it cannot be absorbed by local practices so effectively they don’t have a GP and very little chance of this resolving . It is totally shit for them but not really due to covid . Was predicted by most local GPs as all the GPs there were approaching retirement and had not been able to recruit despite intensive efforts .

Ps Local GPs did not ignore it by the way , was highlighted and CCG / LMC aware but ultimately little they could do

Pretty much the same where I work, though some things (rash, anything children, abdo pain) are booked directly F2F and one of our locums requested that all their appts are F2F unless the patient really wants a call. It ends up being about 50/50 telephone and F2F.
For some, telephone appts are a lot easier. However there should definitely be the option and it's not okay that some surgeries are refusing completely.

I'm a practice nurse and pretty much all my appointments have been F2F all the way through the pandemic, because my job is generally hands on. We never stopped doing smears like some surgeries did (against the official advice).

The surgery I'm a patient at, however, is like PP and you get a call first at some time during the morning or afternoon session and if you don't answer then you're dropped.

Still phone appointments, which I prefer or e consult, but GPs will see people face to face if needed. In our surgery it is listed as due to ongoing covid issues, which actually means some of the GPs that usually work there have been seconded elsewhere atm, so it is a capacity issue really

Phone appointments are good if you have time to sit and wait. Our surgery do the online triage thing which I actually find quite good because I can write everything down and not feel rushed. It's especially good for MH concerns/Perimenopause stuff that I find I can clam up about it person. I'm better at typing out exactly how I'm feeling.

I had to take mil for a FTF appointment recently. It was the first time I'd been inside our surgery since early 2020. I was shocked at the change. It was very obviously not set up for many FTF appointments. The waiting area was stripped of it's long bench style seating around the edges and there were probably only about 6/7 hard plastic chairs dotted around in a huge space around the size of a school classroom. No tables, no magazines or toys (obviously), no leaflets, no plants. A sign on the loo to get key from reception. Even the blood pressure machine had disappeared. It was a bit sad really. I feel for the elderly and more vulnerable who need FTF appointments that sit there alone. It feels like an unwelcoming space now.

FWIW, our PNs and HCAs appts are almost entirely F2F as a PP said. One fluctuating issue relates to when the HCP has active COVID themselves and is able to work in which case they'll tend to do the telephone consults and the colleagues in the practice do more F2F. Currently finding COVID infections in staff are higher than a few months ago.

I haven’t needed F2F so not sure current policy at my GP. For my daughter who had a bad flare up of eczema there is a service where the Dr requests photos via a secure app.

I’m personally finding it much easier not to have to go in as was a real hassle with work. Working for us but appreciate there are times when F2F may be required.

This is how is goes when I phone my surgery:
me: can I have an appointment with a GP please?
receptionist: what's the problem
me: explains problem
r: I'll put you on the list and a doctor will
call you back
me: what time will that be please?
r: before 6pm (ie at some point in the next 10 hours)
me: Is it possible to call after 4pm? I can't answer my phone at work
r: I'll make a note of that for the doctor
me: finishes work at 4, checks phone to see missed call from surgery at 1pm. Calls surgery back to explain.
r: I'm afraid you've been taken off the list for today because you didn't answer the call. You'll need to call back in the morning to be put on tomorrows list.
Repeat ad inifinitum.

I will make an effort to call when requested but it's done in between prioritising other things so isn't always possible.

I'm afraid this is more of a damming testament to our society's attitude towards self care. It shouldn't be up to an already overstretched healthcare system to cater to the 5 minutes a day that you have free time. Our workplaces should make reasonable adjustments for you to be able to have a doctor's appointment if it's needed. I know the struggle and it's not your fault but when did we accept not having time to take care of our health needs as the norm?

Not all jobs have the flexibility to take the calls at any time. I can't take a phone call from a Dr in a classroom full of children and nor can I walk out and leave them to take the phone call.

Our drs you have to phone at 8am or 2pm, then you get a triage call from a nurse who may or may not then arrange a phone call from the dr who then may or may not decide to call you in.

When my dc had a life threatening medical condition that should have seen them immediately in hospital, it took more than 24 hours to get through that process. Once we saw the dr he was amazing and we were lucky he was thorough and picked up on what was actually happening, but getting to the point of actually seeing him was incredibly frustrating. The triage nurse tried very hard to fob us off without even speaking to a Dr.

The problem isn't lazy drs though. The entire nation of GPS didn't wake up one day and decide they couldn't be bothered. I know they are working really hard. The phone call we got was late into the evening, the dr was obviously putting the hours in. The problem is systemic. There aren't enough GPs.

But that's my point they should be. It would be quite easy for even a teacher to ask that the surgery calls reception if they can't have their phone on and then you go somewhere private and use your phone for 10 minutes whilst receptionist/TA watches the kids. It's still a damn site more convenient than you having to take half the day off for your f2f appointment or even getting more sick and having to go on sick leave for ages. This is the kindof reasonable adjustment I refer to. People get sick. Work places have to make contingencies for this.

Yes you're right there aren't enough doctors. The government and media seem hell bent on diverting attention from this focal point and it works! Look at the amount of vitriol that's spread about 'lazy GPs' now because that's what the media wanted you to believe. The latest is extended hours which is that basically GPs are going to be expected to operate at evenings and weekends. This is fine in principal but there aren't enough bloody GPs to fill the weekday need so how on earth are they actually going to manage this?! By spreading them even thinner?! It's again diverting the attention. Meanwhile doctors and other HCPs are left with no real alternative but to leave which just perpetuates the cycal

Absolutely no reason for surgeries not to offer face to face appointments.

I would make a complaint to the practice manager.

There are definitely some issues that can be addressed with just phone appointments but this should not be the norm.

If your surgery is only offering phone appointments they are failing their patients.

Move to a new surgery but try a complaint with the current one first...

Cycle* 🤣

COVID infection rate still high and ill patients still being hospitalised and dying so perhaps not a surprise waiting areas seem to have distancing still built in rather than having magazines sharing virus. We have two colleagues working from home as caught COVID again. This in the middle of Summer and ambulance services stretched locally worse than I remember when we had to call an ambulance and sit with a patient during the day on a weekday. Roll on Winter pressures.

@Nahimjustaworm I am usually very supportive of GPs ( daughter of one ) but that is ridiculous. Schools are also hugely struggling and you cannot just leave a class of five year olds while you discuss confidential medical issues in a corridor .

Anyway it’s not necessary , my surgery always allocates you a time for a call back, it’s not ‘anytime between’ it’s 3pm or 11.00am or whatever . Occasionally they have called at a different time but always stress that they will call back at the appointed time anyway .

so much of these problems are nothing to do with GP hours or whatever they are to do with practice management, which is obviously down to the partners but also the practice manager. Good use of technology/ comms , an understanding of systems and time management practices , efficient and appropriate use of databases etc my ds works in systems in the NHS and he says it’s a constant battle to get people to use technology appropriately, often down to poor training.

my surgery had extra phone lines put in in 2018. They give patients options , you can book appointments online and choose phone or f2f . And they are always really helpful if you get stuck with the systems because they understand it pays dividends in the future, consequently people feel much more supported .

But then the GP could be sat on the phone for half an hour while all that gets sorted out. Schools are struggling to find enough staff to cover classes as it is, there aren't always people available to cover at the drop of a hat. Also the whole lesson would be disrupted for 30 children at least. Not many school admin staff would feel able to walk into a y6 maths lesson (never mind GCSE or A level or a lecture hall full of students) and take over teaching the lesson.

Taking planned time off for an appointment is actually easier because cover can then be arranged in advance for it.

What if you are a surgeon and you are operating on someone? You can't drop that to take a call from your GP. Or as a GP if you are with a patient yourself? You can't stop what you're doing and take a call surely? I'm sure there are lots of jobs that make dropping everything at a random time to take a call extremely difficult.

Or the GP could call after 4pm. Just put the patients who request that on the end of the list?

Again, to be clear, I'm not blaming the GPs. If there were enough of them then we'd all be able to get appointments at times that work for us and this whole conversation would be moot.

I submitted an econsult form yesterday morning for a itchy swelling on my hand. I got a call this morning asking me to come in for face to face at 3.15 today.

Same as mine - best of both worlds I think as sometimes you don't need to be seen face to face. I have asthma and flare ups need to be seen unless I feel like I just need steroids

It's a nightmare isn't it? My GP is the same. I have an ongoing issue that needs someone to physically look at it. So I booked an appointment online - telephone pre-book able being the only option. Then I waited 2.5 weeks for that telephone appointment. It was yesterday. The GP then said yes, let's get you in we need to see you in person. So they, and only them, then have access to the face to face appointments. I not the receptionists can never see these secret appointment diaries. So she booked me in for the first available one, another 2.5 weeks from now.

So that 5 weeks wait, in pain, to see a doctor. The irony being that I only need to see a GP to be referred to a specialist using my private health care, as I've given up trying to get relief/treatment on the NHS.

GP surgeries doing this are failing their patients. And they are now effectively using highly trained GPs as receptionists/appointment bookers.

FFS I'm not saying discuss your medical issues in a corridor or leave 5YO's unattended. I'm saying people get ill and workplaces should make reasonable adjustments for this. If we simply told our workplaces that we need these adjustments and the default was that within reason we get this when we need it rather than we have to bend over backwards or be made to feel like a pain in the backsidejust to meet our basic health needs then we'd all be much happier and healthier. That's my point

But FTR as a GP I would call someone at a requested time providing it isn't ridiculous. I've also done appointments later in the evening when I'm technically supposed to have finished or early am before my start time to accomodate patients so plz don't call me ridoculous

We used to be able to make an actual appointment though, so you could make an appointment for 8am or 5pm around your working hours. There was not an expectation that you’d be available for a full 10 hour period.

I have called my GP every morning since Thursday last week (when school broke up). Can’t do it during school time as we have two lines at school at 8am to 10am is when they are most busy for obvious reasons.

Every day I am told that there are no appointments available “try again tomorrow or go to the walk in at (three buses away) local hospital.

I tried a private doctor who was disgusted and has written to my GP telling them they need to see me and what action they should be looking at but I can’t see (or even speak to) a GP. I can’t afford to keep paying.

I’ve tried changing practice but other local surgeries aren’t taking on patients if they have a surgery in the area already.

Some days I wish I could just take all my painkillers and not wake up… it’s horrible to realise that’s how I genuinely feel ….

But for the majority of people it's ridiculous to say you need to be available 10 hours. You need to be available for the 10 minutes you are called. You have your phone on loud and answer when it rings. If you are in a job where you can't do this you make plans so that they can accomodate this. If they can't perform the pretty easy adjustment of pulling you off duty for literally 10 minutes then you tell them that regretably your only choice is to be off for the whole day to await the call. They'd soon make this adjustment if you said that... I've managed to have phonecalls whilst at work. It's a bit awkward but manageable and definitely better than ducking out of work for several hours for an in-person appointment

My GP practise are terrible. They cover a large area so there isn't really an opportunity for me to switch or else I really would!

If you need an urgent appointment you ring up in the morning. They literally NEVER offer a face to face appointment in the first instance. Recently my son had tonsilitis and I had to send photos of his tonsils in before they would see him 😳😳😳.

Anyway, you ring up they offer a call back within 2 hours. So it's a waiting game already.

If you're lucky enough to be allowed to seen in person which is always difficult they offer one appointment but if it isn't suitable you have to redial and see what the next available appointment is. This morning I rang (for a face to face which I always authorised to have on Friday but not been offered a time I can make) and they offered me 1:45 which is just such a difficult time for me. Anyway they literally said I'd need to rejoin the queue as they can only offer 1 app 😳. Took me 40 minute to get through.

It really is SUCH a farce and does not suprise me that people are put off calling their gp or being misdiagnosed.