Refused doctors appointment - so annoyed

[hopelessmeringue]

bit of a rant here but I could bloody scream.

The doctors surgery was closed most of last week and the previous week and were only seeing emergency appointments due to sickness. I phoned on Wednesday and Thursday at 8.30 and all the appointments were gone. Asked if I could book in advance but no that’s not possible, it’s only on the day and there’s no advance booking. Phoned on friday and there were appointments but the receptionist said she will pass along my information to the doctor and they will just send a prescription to the chemist. I said I really would prefer to have an appointment instead, and that I don’t mind if it’s with the paramedic, nurse, doctor etc but they said no that’s not possible because it’s a problem I’ve had for years so they can treat me without seeing or speaking to me. It’s a pre existing condition that has been at bay for the last few years and now is starting again, so I would like an appointment rather than just a prescription of something I had 3 years ago. She completely refused to make me an appointment and said the doctor will send a prescription straight to the pharmacy. Unfortunately with Christmas etc, I won’t actually get the prescription now until it reopens after Christmas as the pharmacy don’t even have it yet and it usually takes 2-3 days for them to receive it from the doctor, then 3-4 days for them to make and check it. I asked if I could collect a paper copy for the chemist myself but that’s not possible either. Eventually she just hung up and I tried to phone back to speak to someone else and couldn’t get through. I tried to phone again today to check it’s gone to the chemist and also to ask again to see someone but still haven’t got through.

AIBU to be frustrated by this? I’ve taken the last week off work to try and get an appointment and I don’t have any more leave now until April. I genuinely have no idea what to do! I know I’ll get the prescription at the chemist after Christmas but it’s a condition that hasn’t always been easy to control and I wanted to actually speak to someone about it as it’s been at bay for a few years and now it’s starting again. And if it doesn’t work and i do end up needing an appointment it’s going to be a nightmare getting it off work- I’ll have to start the calling on the day thing all over again and it could take days to actually get through and get one.

I could bloody scream

what do you want the doctor to do if they triage 25 patients and only have 10 appointments?

we have a lot of gps leaving and not the same amount joining, there is a shortage

If you are sick then you will need to take sickness time to go to appointment annual leave isn't relevant

Can't you make an appointment without telling the receptionist what it's for? Ours always asks and I tell them is private and I dont want to discuss it with her.

I didn't even know you could make an appointment to be treated by a Paramedic either! How does that work? Do they spend days in surgeries rather than on ambulances? We don't have that option where I live! (UK)

I have a chronic condition. I needed a routine review the other day (as with anything, you can't have an indefinite prescription, you need it to be rechecked every so often). My appointment lasted six minutes, and I'm all sorted. I'm not saying it only took six minutes - I know there was additional time in issuing the prescriptions, for example - but it wasn't massively time-consuming.

If I'd been refused an appointment, my condition would have started to deteriorate. I need that prescription for a reason. When my condition is left unchecked, it can lead to hospitalisation (something that would shock a lot of people who aren't specialists in this field). If it ever gets that bad, I would need to be re-referred to see a consultant, to undergo lots of expensive treatments to get my condition back to a manageable point, and only then be re-released into the care of my GP.

It's so much cheaper to just let someone like me have the review. Oh, and from a selfish point of view, it's a lot less disruptive to my life to not be hospitalised.

I'm obviously not blaming you, @PinkDaffodil2, but it seems like the system is broken if people can't make appointments for regular reviews. I can understand setting aside certain days for emergency appointments only, but people who are under regular care need to be able to make those regular appointments so they stay under regular care and don't end up very sick and ultimately costing more in time and resources.

I'm confused what exactly you think would have been any different if you'd been seen f2f? The prescription wouldn't have been provided any quicker. I'm afraid with the unsustainable demand on the service your need to be placated with an appointment that ultimately wouldn't change much (it would seem) takes less priority than someone with a potentially harmful and more acute problem. In an ideal world you should absolutely both be seen but the line has to be drawn somewhere and this is what decades of shitting all over the NHS has done. Did you voice your concerns to the pharmacist that you needed the medication urgently? If so the only thing I'd say is that they should have maybe done more in assisting you to get the medication quicker as there almosy certainly was a way

I absolutely believe you OP. Those that think it doesn't add up obviously have a much better service.from their GP than the OP or me. I could have written the OP. I've had to fight to see GPs when the GP has told me they want to see me but the receptionist doesn't think it necessary. It will also take 10 days for a prescription to be made up if it's a repeat. That's to do with the pharmacy though so as long as i know it's been issued i can go in and wait but as they don't even look at them until then if they don't have the medication it's a further wait. Sometimes it's been a 2 week wait on repeats. I'd change but they're all like this locally. We can't book advance appointments either so it's a same day roulette on the phone.

And the NHS app - not all parts are enabled for each surgery it will depend on the surgery systems.

This is the state of the NHS. The people in it are doing the best they can but it is broken.

You often hear from Tory voters that the NHS is badly managed, if just needs reorganization, often involving a switch to a combination of private and tax based funding. Surely we can't pretend that won't be more expensive though? In every healthcare system that has been privatised, or in every public service/utility that has been privatised, it ends up more expensive. I can only presume that Tory's are happy with the extra expense. But if they are, why not just spend that money on the NHS now, to see what happens? Some of these problems do seem due to incompetence, but all of it could be improved with adequate funding. There's incompetence in private systems too. Instead of completely dismantling our health service, can't we just see what happens if we fund them to the save level as a private system? My guess is we wouldn't actually need to fund them quite as much as we'd be paying for a private system, to see vast improvements in care. Private systems seem really good at creaming off profits, but not good at actually improving services efficiently. Yes some health services abroad are excellent, but that's because that level of service is funded appropriately, via insurance or a combination of tax and insurance. The provate providers are raking in enough $$$ that they can both profit and provide good care. When you experience a really well run health service abroad, it's most usually one that is MUCH more expensive per capita than the NHS. I don't understand how people can think, given all the evidence to the contrary, how we can have an improved health service under a privatised system, yet not pay more for it. And if Tory voters are happy to pay more for it, why are they so unhappy to pay more for the NHS?

@anotheruser173 im glad you got your appointment - the system absolutely is broken and there’s no right way to go about it.
When I’m triaging similar requests some I’m managing in a quick call rather than a proper appointment - though the 5 minutes quickly add up. The last few days there absolutely hasn’t been time for even this. So it gets ignored till next week (except next week the staffing / demand situation may be worse). The acute demand has gone up so much, and lots of people are actually very unwell, many being managed at home when they would usually be in hospital. Increasingly for routine requests / med reviews I’m looking at the notes and if it seems reasonably safe I’m extending the review date by a month or more, issuing another prescription, asking the patient to arrange bloods / BP check if due by text message. Calling those where there’s clearly a pressing clinical need.
It’s obviously not as safe as doing things properly but hopefully will get us through the worst of this winter, nearly all my appointments were the very going or very old acutely unwell the last few days. I’m used to being busy and managing risk, but this is a different level and a different type of exhausting, I don’t know what the answer is

Does your GP subscribe to Livi? It's a video based service, you submit all your symptoms and a GP calls you back. I've only attempted to use it once for my daughter, and it told me the particular issue couldn't be dealt with! But I'd consider it for anything that isn't regular medication.

And I hear you on the pharmacy! Ours takes 5 working days for repeat medication and 2 working days for non-repeat. I get all mine sent to Tesco instead who turn it around much quicker, but daughter's still defaults to the local one despite me asking it to be changed.

Our surgery is doing the same with prescriptions, have to be reviewed every six months even if it’s cancer drugs - like mine! Only my breast cancer surgeon can change my drugs or stop them, the GP has no remit to do that. Totally pointless blocking my prescription and forcing me to try and get an appointment, just to say “oh yes you still need to take this for another five years”!

OP I had a similar situation to you during COVID. An ongoing chronic condition where I needed to check something with a GP. The experience was the final straw that led to me changing GP, after spending repeated hours on the phone trying to get through their new yet terrible phone system. I changed GP - a hassle - but the new one has transformed my experience as a patient. You can book appointments online (ok, sometimes none are available - but often some are), there is an online form you can fill in and where you always get a response (this would have solved the issue I left my previous GP over), and - as many others have said - 2 day turnaround for repeat prescriptions which then go to a local chemist who fills them within 24 hours. Can you change GPs? I know not so easy for others (I'm in London) but if you can it's worth it - I stuck with what I now realise was terrible management because of loyalty to a GP but it was not worth it. The system is clearly in crisis, but some practices seem to manage this much better than others. Good luck.

Sounds completely awful on so many levels.
I do realise its a problem getting a doctors appt but havent realised that getting a prescription medicine is such a problem.

(In my home country you get the prescription from the doctors - either a paper version or a text message and have a chance to go round pharmacies if you need to. If they dont happen to have it in stock, they will order and have it ready the following morning, unless there is a big nation wide problem with the said medicine).

E-Consult is pointless! All that happens is you get a phone call from the receptionist to book an appointment! I could've done that myself.

It seems so random. I wanted to slightly tweak the dosage of a medication I've been on forever to something that is still a normal dose. I tried filling out a form online. On the form I wrote, "I would like to amend dosage from x to y for z reasons" and they insisted I speak to a GP. I said to the GP, "I would like to amend dosage from x to y for z reasons". The GP said sure, sounds sensible, go ahead.🤔

Could you though, or would you have been on hold for hours? Evidently someone thought you needed an appointment after reading what you put in your e-consult form. If, based on what you've put on the form, you didn't need an appointment, the receptionist wouldn't have rung you to make an appointment. That's what e-consult if for, so they can triage you, if they rang you back, it's working just as intended.

@helford - Time wasters, i m friends with a recently retired GP, this is what he says, look at the waste with 999 calls?

Also, e consult still takes up considerable time.

I'm not sure I understand the point here - is the suggestion that there are people endlessly redialling surgeries for no reason ? They've no reason to be ringing and aren't put off by the effort of trying to get through ?

I'm sure e consult takes up a lot of time and has to be triaged .Also sure you're correct about shortage of staff .
E consult is quite a thing for many to navigate but surely helps with a fairer distribution of scarce resources than the lottery of daily ringing ?
But I suppose using e consult puts more of a burden on already breaking GP's .Ringing every day might lessen that but to me it then puts more of a burden on those who are not well and didn't choose the life of being a patient .The stress of which they can't manage by confining to a part time week .And yes I do know that GP's nominally working part time hours are in fact putting in a whole working week .

@Hayliebells I'm not an idiot thank you! I know how it works. I don't have any issue getting through to my surgery thank you. I've also used E-Consult a few times, and once for something recurring & minor that just needed a prescription but sure enough, the unqualified receptionist takes it upon herself to book me in! Even the doctor said it was unnecessary and tried to tell me to use E-Consult in future! He was angry when I told him I had and then had been booked in my receptionist! So please don't assume you know the full story and post patronising responses!

Your surgery sound like they’re not using E-consult properly! My surgery seem to be able to use it in a sensible way, so I don’t think it’s a waste of time! Sorry if I offended you!

OP, hope you got sorted in the end? Did you get your prescription? I think it's awful you could not get an appointment, maybe you should just say it's for something else and then when you see the GP you can explain?

It's probably a case of the receptionist saying that, but it's not actually true. We've had to do this in the past at our doctors surgery, to get past the receptionist who is not in any way medically qualified.

Some patients with long term conditions have a system where e.g DH contacts an IBD nurse if there are issues with meds etc, this should help such patients as well

When ordering meds online, there is a box for comments which could be useful here.

Our e consult doesn't work with ongoing issues reviews. You have to be so careful with it. I've been told to go to A&E with something daft because I've ticked some box somewhere. It's not that intelligent

It's not a straightforward answer, given the way GP practices are structured, but I think there has to be some resource-sharing from outside your geographic area.

The vast majority of appointments can be dealt with via video call or phone call, which makes it possible to use NHS clinicians who are based elsewhere in the country and wouldn't be able to physically locum at your practice. For a lot of conditions, you don't need continuity of the same medical professional; you just need to speak to someone who is qualified and with the authority to write a prescription.

If you can get the simpler things dealt with by GPs, nurse practitioners and prescribing pharmacists in geographic areas that aren't as badly hit, you free up the local GPs for the more complex cases and F2F appointments.

Obviously, this approach doesn't work if everyone is struggling all over the UK, e.g. during lockdown.

I'm a big advocate for avoiding F2F consultations where they're not clinically needed. I think it makes keeping to time easier, and also protects the clinician from picking up contagious things from the patient. Sometimes a doctor has to be in front of a contagious patient to provide adequate treatment - often they don't. If we can reduce the odds of our doctors getting ill, why wouldn't we?

@Orangesandlemons77 I know, that's what I used. All I said to the GP was exactly what I wrote in the box, but it still gave me the message 'use the phone system to book a GP appointment' so had to go through that whole palaver. Why have an econsult system if its just going to tell people to book an appointment?

Report them to health watch, they are really good and follow up with these things

In some areas surgeries seem to be really struggling. Ours sent out a text before Christmas saying they won’t be seeing anyone for routine appointments until the new year. If its urgent you phone on the day, its a triage system and you won’t get an appointment unless its urgent. It’s not right, but I don’t claim to know what the answer is.