To think we should be able to pre book a doctors appointment?

[Meltinthemiddle]

I rarely go, in fact the last time I went was 3 years ago. I've had a few ongoing health concerns which are now starting to effect me and my job, so I called to try and pre book an appointment to fit in with my work hours happy to wait a few weeks even (can't just have time off) and they have told me I now have to ring up at 8am everyday. Today was the first time I was successful ringing, number 2 in the queue first thing and yet even then they seemed to struggle to get me in. She also asked if it was urgent which it isn't so names me feel bad taking the appointment, but it's ongoing and affecting my quality of life. I now have to wait for a doctors call, and he may the treat me over the phone or bring me in. The thing is luckily I have a day off mid week, but when I worked in a school this system would be impossible due to no phones allowed. Its not a fair system for people who work.

Oh, I know that some people have had problems.

But it worked well for MIL. It was on par with the private service we use.

This system is a nightmare, my old surgery did it and it's fine if you're really ill and need to see a Dr ASAP but no good if you've got a non-urgent issue, need a review of meds etc. I had an appointment this morning which was made through logging an econsult over 2 weeks ago but the timescales for that were absolutely fine in this case and if i'd had to keep phoning for appointments on the day I probably wouldn't have bothered and kept on suffering.

@Sarahcoggles
Don’t be so silly, of course this country isn’t ‘over’ populated. Serious question, where did you get that idea from?

You watch the same news as everyone else, you hear that there have been cuts after cuts after cuts to the NHS. You here doctors and nurses talk about the NHS being in crisis because of lack of funds, I guess you also go on holiday to countries with the same resources as us that still managed to have a decent and civilised approach to health care and yet you come to the conclusion that we are over populated??? The truth is that if anything we need MORE people in the U.K. to do full jobs. And yet you come to the opposite conclusion.

Dog whistler.

Well my GP called me back and she was lovely, suggested blood tests first which apparently is now a drop in clinic based on one of the hotels up the road from me. Have no idea if I needed a doctor to refer me for this or if could have just turned up 🤷‍♀️. I haven't been to the doctors in years it's all so different now 😕 she then said she will check them next week and message me to come in.

Trying to get through to my surgery first thing in the morning, as they advise to do, is infuriating and very time consuming. If I remember rightly, the last time I phoned them when they opened at 8:30am, I literally stared at the time on my phone, and as soon as it ticked over to half past, I started the call .. I was number 17 in the queue!

They text me a few weeks ago to say I’d missed DS’s appointment for his jabs .. which I hadn’t been notified of. After spending 20 minutes waiting in a queue, I was then cut off. I spent another 15 minutes waiting to get through because now I was at the back of the queue again, and was told that the letters were all late because of the Royal Mail strikes, and we’d have to wait nearly three weeks for the next appointment. Fine, no big deal for us. But, they knew the strikes were happening and letters may not arrive on time, they have my email address and contact number, why didn’t they text or phone people to let them know their appointment slots so they weren’t missed?! Instead, multiple appointments would have been missed, meaning nurses having their time wasted, and now the surgery has to deal with the usual day to day appointments plus catching up with the missed ones.

I appreciate this wasn’t a normal situation for them because of the strikes, but surely at least some of this waste of time could have been avoided 🤷‍♀️

Mine does a system where you have to phone at 8 for an appointment that day. You can't ask for a certain time. If they want to call you it can be at any point that day. I'm a teacher. I'm at work before 8. I can't answer my phone at any point. I can't just randomly nip out for an appointment. It's shit

We used to have 3 separate GP practices, but a few years ago they merged into one. The plan was that they were going to have a new health centre, but it was to be built as part of a housing development that was granted planning permission in approx 2009, but has yet to be started.

The new combined practice has sold one of the former surgeries, and reduced the number of GPs. However, the population of the town has increased by 50% over 30 years, as a result of a lot of new homes being built, and there are actually fewer doctors now than there were 30 years ago.

You have to ring on the day for an appointment, and first thing in the morning you can expect to be on hold for 40-60 minutes before you get through. And unless you've got a problem that requires a physical examination, it'll be a telephone appointment. This is really difficult for people who work in jobs where you can't just down tools to take a call imo, especially as they don't give you a specific time.

There is an online system, where you can have an "e-consult", but I've never used it.

My surgery used to offer a percentage of pre bookable. It was great for non urgent stuff. They stopped due to Covid and have never reinstated them.

Yanbu.

I work in a GP surgery. Our appointments can be booked up to a week ahead and you can book on the telephone or online - some are available online from 6.30pm so bookable by people who work all day but who are home in the evening. We also have eConsult. We have an on-call doctor every day who does the urgent stuff. There are some appointment slots which are reserved for doctors to use for follow up.

We've tried really hard to build an appointment system that works for as many people as possible but it only works when we're fully staffed. We're currently trying to recruit several clinical roles and we're lucky if we get two applicants.

Of course. And many medical conditions require it. Not allowing it is a complete nonsense.

I keep getting messages on my repeat prescription slips asking me did I know that there are evening and weekend appointments in our area please ask for more details. Do you have that?

Out of 48 European countries, the UK is the 9th most densely populated, and has the 2nd fewest doctors per capita.

We are too densely populated. In other words, for the size of the country, we have too many people.
But even if you like living somewhere that's rammed, you still need more doctors per capita for it to be sustainable.
A large number of the UK population need to become doctors overnight, to even it up.

How would you suggest we achieve that?

Obviously you can disregard my opinion on general practice in the UK if you like, but I would hazard a guess that having been a UK GP since 1992, and senior partner of a 10,000-patient surgery, I probably know more than you.

@Sarahcoggles
Out of 48 European countries, the UK is the 9th most densely populated, and has the 2nd fewest doctors per capita

I don’t understood what you are trying to prove with these statistics.

1. The U.K. is the 9th most densely populated in Europe. How does this statistic tell me that the U.K. is ‘over’ populated? It doesn’t at all, it just shows that it is quite densely populated.
2. The U.K. has the second fewest doctors per capita. What relationship Is there between this and the statistic above? None. The lack of doctors is a totally separate issue.

I wouldn’t normally do this as I think it’s childish but since you started it by trying to impress me by the fact that you are a GP I will tell you that I have a PhD from a top 5 university and specialise in quantitative research methods.

This is nothing to do with methods of research, it's basic maths. Too many people, not enough doctors. Hence the people who want to see a doctor can't all see one. What's not to understand?

@Sarahcoggles @Byfleet
More sparsely populated does not equal better access to healthcare.
Ask anyone who lives in the Scottish highlands. It is also more expensive to deliver healthcare and all other public services in rural areas. During the original covid vaccine roll out they had to send a nurse to one of the smallest islands to vaccinate 4 elderly people. Not surprisingly they had to wait longer than on mainland!

Bottom line is we need to train thousands more GPs across whole of uk. Nothing to do with density of population!

@Sarahcoggles

The U.K. is quite densely populated, yes. But please show me the evidence that it is ‘over’ populated.

There are not enough doctors, true. But again, what exactly is the relationship between this fact and the fact that the U.K. is quite densely populated? There is actually no causal link between these two facts at all. You are trying to show a correlation. You cannot prove causation.

Some more facts. Malta is far more densely populated than the U.K. and yet it has 4 doctors per 1,000 population whereas the U.K. has 2.8. Countries make choices about their health services. Malta has chosen to provide this level of care. The U.K. has chosen not to. No country has its hands tied over the level of healthcare they provide. No country shrugs it’s shoulders and says they would love to provide more doctors, but they can’t because it is ‘over’ populated.

One factor in the lack of doctors in the U.K. is that it is difficult to recruit them. As a GP you must be very aware of this. There are not enough doctors. Why is that?

Too many people, not enough doctors.

@Sarahcoggles I know nothing of quantitative research - and I’m not great at maths either - but I can see how not enough doctors and too many people is not the same thing… they are definitely two separate things. Or, if we were to find enough doctors, would that mean we are no longer too densely populated?? Although the population would be more/the same.
DH bought two pizzas for us all to share yesterday and it wasn’t enough unfortunately. That means we didn’t have enough pizza - not that we have too many people in our house. Maybe next time I’ll kick out one of my kids, rather than buying an extra pizza, then the portions will work out 😂
Being under resourced in something doesn’t mean you need less people - it means you need more resources.

I have some ongoing conditions and when we were all moved to new big city practice, found out my named GP and I write notes to them if I need anything, they then action it and I get a call back from the surgery.

This seems to work well, it isn't something they suggested to me though.

You aren't being unreasonable! We have a similar system at our doctors. I loved discussing my piles and a request for referral to make sure it was piles in the middle of the park as that's when I got my call back!!

You ask why there aren't enough doctors. Well threads like this have certainly influenced my decision to take early semi retirement, reducing from full time to half time. Doctors and nurses are slated in this country, overworked and threatened with litigation if they make mistakes. It's similar to teachers. If you slag off a profession enough, no one wants to do it any more.

And I may not have a PhD in whatever, but all I know is that our list size has gone up and up and up, and we can't recruit any more doctors. But even if we could, we don't have the space to house them. We have extended the building twice and now there is no space left. There are more and more houses being built in the area and we simply don't have the capacity to provide medical care for all those people.

Even if the council built and opened a massive new health centre (if they could find the land!) they'd be unable to staff it.

Hence my original statement that you so clearly disagree with. Too many patients, not enough doctors. You can't train people to be doctors if they don't want to be!

Same here.

Phone up at 0830 and wait in a queue for 30 mins or more (this is when I'm doing the school / nursery run) and get an emergency appointment on the day. Or nothing.

If you want seeing you have to jump through hoops and frame something as an emergency.... even if it's something that's been bothering you for a while and an advance-booked appointment would be more suitable.

The only way I got my child seen recently was by emailing the practice manager complaining and threatening to escalate the complaint. Even then I had to have a phone call with a Gp first (despite it being something that needed seeing in person).

Oh and the doctors can call at any time. You must be available to take the call all day. If you miss the call you mightn't get another one.

It can be viewed either way.
If you invite 30 people to your house for tea and only buy 2 pizzas, there won't be enough to go around.
Either you didn't order enough pizza, or you invited too many people to your house. It doesn't matter either way.
But as it happens, this country is very densely populated, which doesn't help. On other threads people have often said that keeping elderly people alive at all costs well into their 90s is one if the reasons the NHS can't cope, and I'm inclined to believe it's true.

@Sarahcoggles
Too many patients, not enough doctors. You can't train people to be doctors if they don't want to be!

You are right. This is the crux of the problem.

You say there has been lots of new building in your area. Increased health provision as well as schools, transport etc. should have been planned at the same time. The fact that it wasn’t is to do with poor planning and lack of funds for public services. House vendors, landlords and developers have made plenty of money out of the growth in your area and kept it for themselves. This is the way the system has worked for a long time now. It’s nothing to do with over population.

When you say ‘you can’t train people to be doctors if they don’t want to be’ you are absolutely spot on. There are not enough doctors and a large number of those already trained are going part time or dropping out because the work is so stressful and demoralising. Why is this?

1. Working in the NHS is very hard. Increasingly so. That’s because it is underfunded. GPs are not paid enough for the work they do. Hospital doctors have such heavy workloads that they burn out.
2. Potential new recruits are put off coming in medicine because of what they hear about the above. People who are already doctors are going part time, retiring early or leaving entirely. People from the EU are not coming here anymore. Not only because of BREXIT but because the U.K. has an increasingly poor reputation as a place to live or work.

None of these issues has anything to do with over population. Many other countries have higher population density but they prioritise public services rather than letting already rich people get richer.

That used to be the system and it worked pretty well. If you needed to see a GP or nurse for something routine you would call and book an appointment at a mutually convenient time. If you needed to see a GP fairly urgently (that day) then you would call and get an appointment.
The shit that is going on is dreadful. I don’t blame GP’s . I blame the Government for privitising GP’s and Care Homes.

And @Sarahcoggles you can fuck off with your Pro Brexit shit. We don’t have enough doctors, nurses and care staff because of people like you who vote ‘To get our Borders back’ So many Doctors left and so many won’t want to work in this 3rd rate laughing stock shithole we have become.

Sorry for the rant but the GP situation is really, really worrying.

@Sarahcoggles I hadn’t read the full thread before I posted. Apologies to you as a GP. I have no doubts that your workload has increased immensely due to COVID.

I am so, so sad that our healthcare has really come down to the lottery of who can stay dialling the GP longest and who can actually take that call.