Online GP systems do not stop the 8 am scramble, do not facilitate a GP call back or enable more serious patients to speak to a doctor

[H8484peful]

So we have had the new online system for some time and I’m amazed at what the government are promising with its rollout everywhere.

At our GP it opens when many are commuting and closes during the afternoon and also at any given time for the rest of the day when it’s “ overwhelmed”. It’s hugely difficult to get in the queue if you don’t have constant access to your phone during the day and hugely difficult to get appointments if you’re not in the queue early.

The receptionist now refuses to do anything as regards appointments other than talk you through the form( obviously only when it’s open which it often isn’t).

The triage system sends everybody with med queries to the pharmacy regardless of what the query is. They then decide if you can access a doctor for your query. I recently had to argue for a doctor to look at a medication suggested by the hospital for me to get from my GP that came with no details as to dosage or time frame. I was already on another medication. Said GP said I’d done the right thing to push for a GP to look at it. It took some time and a lot of calls discussing my personal details to get this with staff consistently saying computer says no, it’s not how the new system works.

Appointments are often weeks in advance for a GP and you’re triaged off to less qualified staff for most things.

You have zero say re appointments even if you put times on the form. They ignore it and you then get something unworkable and you have to submit another form if you want an alternative time.

Paperwork and referrals are often lost in the system.

You absolutely can’t ring and request a GP call back.

It’s a GP rated as Good.

The elderly, busy and vulnerable are going to put at huge risk and patients absolutely aren’t going to be getting what the government is promising. How on earth is the government not aware of this?

Our surgery has it and it does usually close early afternoon but at least you can do it next day unlike trying to ring at 8 am. I've used it twice for myself and both times a GP has rung within about 2 hours instead of giving me an appt. Which was unexpected and unusual but great. I have to make dhs appts which is fine for now but he will struggle if I die first but not much I can do about that.
I can't see how the government's plan will gain so many more appts, where are they getting the doctors from to do all the triage?

Surely one DR per surgery will decide whether if warrants a GP or something else and pass on to the right place.

I’ve just checked and my GP is no longer closing the forms when they are overwhelmed, as per the news it and the admin request are open all day.

Our GP used to be fab with this, but recently they’re closing the forms earlier and earlier

I needed to fill one out recently as they refuse to deal with the issue in person or over the phone. The forms open at 8am, which is when I’m driving to work. Got to work at 8:30am and thought I’d fill it in before I started work, but they had already closed them down for the day.

It took a few days and I ended up staying home until they opened the forms so I could complete it, making me late for work.

They then didn’t reply in the time frame and I had to remind them twice.

Or a surgery full of GPs working very part time.

They’ve had it for a fairly long time now.

I despise the 8am call on the day procedure, because I simply cannot wait in a queue for hours only to be told that I’m too late, on the off chance that I even get connected to the reception line.

I now attend the surgery in person and I am usually able to get a phone appointment arranged simply because they want me to go away.
unfortunately the elderly and infirm are prioritised.

I had to involve my MP recently due to continuous stonewalling and rudeness from the trainee doctor I spoke to.

once my MP asked them to explain why I could not get an appointment despite 3 borderline FITS, I was suddenly given a face to face with an actual doctor

Oh god, I never want my surgery to change.

Call at 8am, you get through after about 15 mins and there is always an appointment the same day, with the only doctor in the practice (we live in a massively populated town, I don’t know how he swings this, but he’s there 9-6, mon to fri. There are other drs in the building, but he has a specific practice list of his own patients).

The receptionists don’t even ask you a reason for the appointment, you are just booked in. I asked the doctor about that once and he said, “if a patient of mine needs to see me, they need to see me. I don’t need you to give a reason to book in.”

He looks very old. I dread the day he retires.

It is very difficult though.

i am severely disabled.

i get very ill very quickly when I get infections.
i usually put in an e-consult, but last time I put one in and they didn’t have time to reply to it.
then I put a second one in the next day.

by that point I was in a lot of pain and had lost my ability to talk. (I have a neurological disease). I put in an e-consult saying “help I am in pain please reply I sent one yesterday” but no-one got back to me.

my DD loaded me up in my wheelchair and took me to minor injuries where they diagnosed a chest infection and started me on antibiotics.

I do understand doctors are overloaded. I used to be a teacher and we had the same situation.

i would like to be seen and treated before my pain gets so bad it interferes with my brain and I lose talking and walking.

Which means that this GP wont be able to do the work and see the patients they usually do, reducing the number of available appointments.
See how that works?
How many hats do you feel we should be wearing at any given time?

I think we need to get over the notion that only a GP can see us when we are in need of medical attention. I think we need a proper push to rebrand them as health centres and medical centres. A broad well-trained team with the ability to escalate when needed is the model we will see moving forward. We don’t need health centres full of GPs, we need them full of clinicians that meet the requirements of the population. Mental health practitioners, nurses, first contact physios, pharmacists, paramedics, physiologists, phlebotomists, social prescribers, social workers, benefits advisors, radiographers, midwives, health visitors, health care assistants, physician associates, OTs, dieticians etc. all are part of the community team that can and do deliver amazing services. There will always be a need for a GP but not seeing one doesn’t mean you aren’t getting the best and most appropriate care.

Using the triage forms means that trained staff can ensure you are seen in the most timely manner by the most appropriate member of the team available.

I wouldn't know how to start accessing this. I seem to remember attempting it for DS, and getting told it wasn't possible for minors, so gave up.
I can, however, Google a phone number.

@Cantseetreesforthewood go to your health centre’s website and it will be clearly signposted and isn’t only for adults.

Ours has the form open during their opening hours. It is a bit frustrating that you can't fill it in at a time that's convenient for you, even where you don't expect them to get back to you until opening hours, but I think that might be for patient safety. On the whole I think it works well, though the form is a bit repetitive and probably wastes a bit of patient time unnecessarily. I do prefer it to the 8.30am phone hunger games shenanigans we had previously.

Your surgery sounds very badly managed, OP. It sounds like they're not managing the system well. I'd be tempted to write them a letter on the lines of your OP, send it to the practice manager and ask them to sort it out so the system is actually usable for patients.

Oh, I would very much highlight the issues older or less tech-savvy patients may have with the system as they've implemented it and remind them that this is a patient safety/safeguarding issue.

Our surgery opens at 8 am. There is a scramble -even phoning at 8.01 means you're number 14 in the queue. However, once we get through, we get sent a questionnaire. Then that is triaged. Most times, if I phone just about 8 am, there is an appointment for 10.30. I think they reserve the very early ones for acutely unwell chest infections/potential hospital admissions.

My only issue with the questionnaire is that it asks questions such as 'what do you think the cause is?' which I worry some people will find hard to answer. I have confidence to say 'no idea' or to give a rough stab at potential diagnosis because I was a nurse. However, it is helpful to be able to give some background for the GP with DDs, without having to say it in front of them.

When DD2 got poorly last Monday, the GP triaged her for 10.30 am, did blood tests, overrode the system to book her an appointment on the Wednesday for bloods and a consultation, warning me that they were squeezing us in between patients so couldn't guarantee a time. Then they phoned on Friday morning to say the results of Wednesday were worse, so could we go in that afternoon for a double appointment. We went to the hospital for bloods following that appointment, then NHS 111 phoned me at 01.30 to ask me to take DD2 to A&E because the lab had contacted them to say the results were bad. We've been in since. The GP sent a text message yesterday to say that she had tried to contact the medics to discuss the results and get advice, but had been told she was in hospital and she hoped it was all ok. Pretty good service, imo.

The only issue I have is that because the Government said that GPs have to give an appointment within 2 weeks, routine issues can only be seen 2 weeks after you request the appointment. Appointments are released at 2pm each day and when they're gone, they're gone. You can't request a specific doctor, it's whoever is free that day. So if you want a specific doctor, you have to keep trying until you see an appointment with the doctor you want. That makes it hard, especially for people who work in the afternoon with no opportunity to use their phone.

Well, Babylon tried it and it worked brilliantly.

It was (and probably still is) a private service. BUT they trialed it for NHS patients in London and Birmingham.

I was an NHS patient of the Birmingham service. So you’d go on the app, put in your problem and it would come up with a list of people for you to chose from - mental health nurse, physio, pharmacist, GP nurse - depending on your issue, although, a GP was always an option. You’d then be able to chose a time slot, usually from 6am to 10pm, with one of those people or a GP. If it was deemed you needed a face to face for examination rather than a video call, or you needed bloods, they had clinics for that and it was fast, usually same or next day.

They got closed down for NHS patients as they weren’t meeting the face to face quota set out 🤦🏽‍♀️ which was ridiculous as the whole point was getting to speak to a medical professional really quickly via video call.

My axa plan has the same system as that, also excellent, although I have to pay £60 a go if I want to use it, unless it’s for certain symptoms.

Do you attend my gp surgery? I have just had a frustrating time trying to get advice for a potentially serious problem. I tried ringing you the surgery and, after a long wait, was told that they no longer give out appointments by phone and that I had to use Anima. I could hear the smirk in the receptionist's voice as she was telling me this. I asked her about the fact it was likely accepting no new requests and was told that there were no urgent appointments left but l could still fill in the form. I asked what would happen if a patient did not have a computer, only to be told that they would be "encouraged"/helped to go through the Anima form. Very Big Brother. I duly filled in the form, which is not particularly straightforward, giving as much information as l could. I know times change and that medical science has improved out of all recognition since I was a child, but we have lost so much along the way. I can remember the days where you went to the doctor's surgery, took a number and waited in a queue until it was your turn. You saw the same doctor and they knew you and you knew them. That personal touch made a tremendous difference. Meanwhile, I will wait to see if my Anima form will get a response...

Except it’s not working like that. I fully accept I don’t need to see a GP for everything however I do expect to see one when I do need to and in a timely fashion which isn’t happening on this system. Also your list is hysterical

“Mental health practitioners, nurses, first contact physios, pharmacists, paramedics, physiologists, phlebotomists, social prescribers, social workers, benefits advisors, radiographers, midwives, health visitors, health care assistants, physician associates, OTs, dieticians etc. all are part of the community team “

Trying to see any of those is nigh on impossible, where on earth do you live?

Also I don’t agree with physician associates and do not believe we should be bumped over to a PA as opposed to a GP, they have very different training.

The gov is stating

“Alongside requesting non-urgent appointments, patients will also be able to ask questions and describe symptoms and request a call back.”

It does not happen.

“online GP booking will help free up phone lines for those who need to get through to a doctor urgently, as well as relieving pressure on A&E units. “

it does not facilitate this.

…will help modernise general practice by making online access as easy as calling or walking in to your practice, ensuring the phone lines are available for those who need them most and making it easier for practices to triage patients based on clinical need."

No it doesn’t and they just replace the phone and walking in anyway. They don’t offer both just an online booking form.

I live in north Hampshire. The only problems I've had in being able to see the nurse or phlebotomist has been down to my own schedule. I've also not had to wait too long for hospital referrals, gynae, ENT and MRI.

I think it does depend a lot on where you live.

Absolutely awful where I am.
After failing to get an appointment for an ear infection in June 2024, my ear drum perforated and then failed to heal properly. Still took 3 months to get an appointment and I've literally just been signed off from the ENT team, 15 months later, after multiple hospital appointments and 2 courses of antibiotics.
All of that would almost certainly have been avoided if I could have seen a GP in the first place.
I've also seen reception staff either refuse to help people having difficulties with the form or being very rude / short tempered when they have .

Our surgery allows people with no internet to phone,

It works pretty well at our GP, much better than having to ring 100 times at 08:30 to try and get through.

I suppose the question OP is do you have an alternative? The service is stretched, there is not enough appointments for everyone who wants to see a GP, no matter what system you set up that will still be the case.

Must be very GP dependent. Our old practice was phone or in person and was impossible with kids to get appointment whereas new one easy to get through and get offered same day appointments. I would hate to fill out a form and get a call back (often in a work meeting) or be allocated an unworkable time

Our surgery does not have this form system. For an emergency appointment you still have to call at 8am and hope you are far enough up the queue to get through before all the slots are gone. For a non urgent appointment, the lead time is 4-5 weeks, even if a GP has asked to see you and even if, as is DH's situation, you have incurable cancer.

The only other possible surgery for us is in special measures already, so we're stuck.