If you are a GP or work at a GP…

[Merryoldgoat]

What is preventing you from offering the service you want to?

I’m curious because my GP is excellent but I don’t understand why the way they are isn’t standard. And whilst there are obvious geographical issues I know people in my road who use a different surgery and have a terrible time getting an appointment.

Monday I filled in a triage form online as I have a lump in my breast.

I had a call within an hour to make an appointment (was offered female doctor but wasn’t necessary for me), had an appointment yesterday morning. Called this morning to say my referral had been processed and if I’ve not heard in a week to call them.

This seems unusual given what’s in the news.

Is this unusual? Are my doctors especially good? I was able to access face to face appointments throughout Covid if necessary, have never waited more than a day for an appointment if it’s non-routine.

If your surgery can’t do this what’s stopping you?

I’m just curious as it seems to be so different even with less than a mile between surgeries.

Mine are similar to yours. Face to face where necessary and I had a swift onward referral during lockdown. I had a face to face appointment tomorrow morning that I don't think I can get to due to the weather. I've just called them and they've been happy to move it to next week.

Mine are also good. Easy to get appointments (especially urgent ones), happy to do phone appointments where appropriate.

I think we're very lucky.

I think given what you are reporting that is usual.
I've had friends at various surgeries around my area report to the dr with similar and had similar responses.
I hope your referral comes through quickly and it's nothing to be concerned about,

DP contacted his GP yesterday for an issue with an old injury. He's getting seen on Friday and will likely be referred to the hospital at that appointment.
He recently needed an op, pre op showed an issue with his blood. He was referred to haematology that day and had appointment that week and for 8 weeks after.

I think when it's something that could be serious they are very good....for more trivial things possibly not so much.

Mine are awful! We used to have a 3 partner practice but when one retired the others sold the practice to a 'group'. The group is massive with a huge catchment area and there are not enough doctors or nurses to deal with the number of patients. Getting an appointment is difficult, repeat prescriptions take a week to approve (website says 3 days if requested using the NHS app or 5 days via a pharmacy or the surgery), and if you do get to see someone it's very rushed. I wish we still had the small practice.....

There will be different priorities depending on what you need an appointment for. Lump in breast is fairly urgent while medication review may need to be bumped to the end of the queue.
It also depends on how your surgery is staffed and how many active patients they have on their books. I moved 3 miles down the road and my current surgery is much slower than my previous one, likely because one of the surgeries in the area was permanently closed 3 years ago and the other one is closed for new referrals as they picked up their patients. So we are attached to an out of area surgery which is picking up the slack.

Like everything else that runs separately from each other it varies significantly even within the same area.

i have good experience when I can get an appointment but it was impossible when they stopped doing advanced appointments.
i have managed after two letters to the practice manager be allowed advanced appointments (which I use but only for specific reasons) after I had a health scare directly from being unable to get an appointment because calling on the day all slots were full for two weeks straight. Now I can get phone/face appointments again I really rate mine.

friend at another surgery in the same town always has at least a two to three week wait for an appointment except in circumstances where they have experienced symptoms that have rung alarm bells recently and a gp called back the same day (without friend having an appointment from call earlier that day but the symptoms must have worried surgery so they decided to call about it)
apart from that friend has had a hit or miss experience. Sometimes good but other times not great at all.

another friend who lives 6 hours from me has what can only be described as a horrendous gp surgery! So many awful experiences. Hard to get appointments. Rude, uncaring and disrespectful gp’s and other staff. Was put on an inappropriate medication that triggered a cardiac attack which put her in hospital for two weeks and on and on.

another friend who lives about 2 hours away can get an appointment easily and always gets seen by nurses, physio etc really quickly. Loves her gp who she sees regularly.

Too much demand for the professionals we have, and I spend half my day sorting out failings elsewhere in the NHS rather than doing what I am actually trained to do.

Not a GP and don't work there, but, from experience, 'targets' don't help.

One example my friend gave me of her GP Practice - wanted to get something checked out (not urgent, but has been there a while and probably ought to get it checked). Phoned for an appt but none available this week. Explained not a problem, happy to wait a couple of weeks if need be. But they won't make appts in advance because it means they have too many people on their waiting list. So have to keep ringing every morning to try to get an appt. Wastes her time, the Receptionists time, and of course makes all other arrangements more complicated as then have to 'jump' when an appt available.

I have to say, my GP surgery is excellent, and (just like the Relationships board) you don't get people posting / sounding off - be it on here or any other social media - when things are going well.

I think this might the difference between a "red flag" issue and a general chronic illness.

If you needed a review for your eczema, say, you might still be waiting in ten weeks.

I also have a very good GP though, particularly around seeing the children in a timely manner if needed

I called at 9.30 this morning and was offered an appt with a nurse practitioner at 11.30. Brilliant service!

It’s the number of patients per GP that's the issue. Have a Google, there are numerous stats and articles about this, in areas where it’s high, not surprisingly it’s more difficult to see a GP, patient satisfaction is low etc. My GP surgery is the bottom 10 as rated by the patient satisfaction survey, it also has some of the highest numbers of patients per GP in the country.

Mine is good-to-great and it makes a real difference even though I don’t have to go often.

If you needed a review for your eczema, say, you might still be waiting in ten weeks

Nope. My son had something like this and he was seen within a week.

DH was seen within a week for a non urgent eye issue.

Thankfully my G.P surgery is excellent. They’re so popular that they have a catchment area, I’m very fortunate.

My daughter has a lot going off medically, one of the Drs called her out of the blue to see how she was coping, amazing 🤩

Average is 2.2k per GP fte

We have 9k patients and 4fte GPs so pretty much on the average.

Except this is part of the issue - doctors unemployed in favour of apparently cheaper ANPs, but the supervision time is never costed, so the doctors that remain are more stressed and have less time to actually see patients as they are supervising ANPs.

My GP used to be amazing. Same Dr running the surgery for 30years. You could either do an e-consult at any time of the day, or phone up at any time and get an 'emergency' (kids got earache etc) appointment either that day or a routine within a week or two. Then after the first wave of Covid he retired, and the surgery merged with another practice and now it's utter shit. Can only do econsult from 8-8:01 in the morning (no joke - it is only available for one minute) otherwise it's sit online the phone for ages to maybe if your lucky get an appointment, but they are usually all gone by 8:15.

My GP uses e-consult and switches it off if they’re busy. It was available less than an hour this morning.

Funding. The issue is Funding. My GP surgery is funded 100 quid per year per patient. That's not a lot, particularly if you're in an area where people have a LOT of medical needs. It has to cover salaries, heating, electricity, rent, equipment, cleaning etc etc. The surgeries may want to take on more GPs to help with the backlog and availability of appointments, but can't because they simply can't pay them.

Ours used to be like that. Then they merged.

I asked for an urgent appointment (explained why and it was ugent. Next day was pushing it) a couple of years ago for my dd... They sent me a text offering a phone consultation in 9 days time.

Last two times I contacted them. One was to say that my mental health was struggling and would like referring for counselling, but I did not want the (unusual) version they had given me last time. I got a text telling me to rerefer myself to the people I'd used previously.
Then asked for a call about something I had been to the pharmacy about and They said to go to the GP. I said that in my message. One sentence text back "go to a pharmacy".

I don't mind phone calls. I don't even mind texts. But they have to properly read the messages. Result for both the above is I have done nothing, which is unhelpful.

But I don't think a text for anyone asking for counselling because they're struggling mentally is ever appropriate. And that should be obvious.

My surgery doesn’t use them. We have nurses who do immunisations and asthma reviews but it’s a dr or nothing if you need an appointment.

mine aren't too bad for some things, twice in last few years I've been seen same day for breast lumps.

Years ago my old gp practice had a system 4 days a week where you could just turn up, be put on the list of preferred Dr or ask to go on quickest list and just sit and wait. Would often have to wait an hour or two but would always be seen on the day. I miss that system.

It's complete chaos for the staff, very professionally unsatisfying and not safe.

Why is it any less safe than any of the other systems? Seems pretty unsafe to be offered an urgent appointment for 9 days time to me. Or to be told to keep ringing first thing, but the phone lines are all full and by the time you get through all appointments are gone.

Why is is not safe ?

My GP has 'open surgery' (turn up and wait) every day.
You will always be seen.

It is regularly rated as the highest 'satisfaction rating' whenever they do these things.