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?

We already have staff that see appropriate patients. They are already care navigated to the appropriate person by reception.
Physios, ANPs/ACP's/Pharmacists- we have all this.
We dont have enough of ANYBODY that we can spare someone to sit there and sift all day.
Its not creating EXTRA appointments no matter how you shuffle it- its extra work.
Plus- there is a safe limit on how may patient contacts you should have in a day. This is sneaking them in by the back door - you wouldnt want to fly on a plane with a pilot who had done extra hours... why should clinicians get squeezed to the point its dangerous? That's clearly no good for anyone- and its not a defence in a court of law should you make a mistake....

I had a phone call to offer me an appointment with a gp later this afternoon so that is a relief. I knew that l needed to see a doctor for this particular issue but am perfectly happy if I am directed elsewhere for other ailments. For example, in the summer I had a bad flare-up of eczema. I wanted a prescription for a particular ointment. I knew that I did not need to see a doctor or nurse so I was.happy to upload photos so that it could be verified and the ointment prescribed. Even this was complicated because, while the doctor was quite happy to prescribe the ointment, she wanted a little more information. Anima would not let me answer so l ended up emailing the surgery, which was ridiculous for a one word reply.

We've had online booking for a long time. Although I assume they switched it off as there are never any appointment now. But they used to be for 6 + weeks ahead.

Same experience as OP I am afraid, we cannot book an appointment on the online system at all, I have only ever seen 1 appointment available on there and that was 5 or 6 years ago, we just have the call at 8 and you might be lucky approach. Once I see a GP they either issue a fit note, tell me I am fat or send me to casualty as they don't deal with urgent cases/dressings/queries/women in general. More than happy to seek advice from pharmacy, eyecare etc. if non-urgent and to have a telephone appointment - I have had those they just told me to call the next day and make an appointment (at 8) or go to casualty.
I am relieved to find that others have better experiences, a glimmer of hope perhaps!

I appreciate that there is a maximum number of patients you can deal with, but I would have thought by showing the actual number of requests and need then the care board (or whomever is in charge of these things) can then support further staff to meet the demand? While demand is deliberately managed down by shutting off systems people are still missing out, aren’t even able to send up a flat and will be missed by the system. It is not a true reflection of the size of the need.

in a system that feels like a lottery (ringing at 8 am) some people will choose not to play and not receive the care they need. With a system that is an overly complex technology some people will decide they can’t manage and not present. Our EDs would be far less busy if everyone was able to access healthcare in a timely manner, but for numerous complex and simple reasons people do not.

Messaged GP at about 11am on Monday as felt shit and realised my B12 was 6 weeks overdue, text message offering apt yesterday at 5pm - all sorted.

Our surgery has had online triage for about 18 months and it works well

I can see there's a lot of expectation to be able to use the online system to "book a GP appointment".
Unless you've been told by another health provider to do that specifically, that's often NOT appropriate. If a consultant said we needed to do that, I'd put in a message saying exactly that.

In the last few online messages I've had, only one led to a GP appointment instigated by me - with DD to discuss a referral for ADHD assessment. I did this under the option "are you messaging about yourself or someone else you care for" and I put "someone else" and explained who it was.

The others have been
See practice nurse/NP - most of them.
Phone call with pharmacy - at least twice
Go to local pharmacy - once
Prescription issued because you've had it before but it wasn't on repeat - a couple of times.
I have, as it happens, got a GP appointment next week which was initiated by them. I think it's probably to discuss an increase in my asthma symptoms which I discussed with the pharmacist and got a stronger inhaler, which has been working, but I know they often want to check with asthma.

We know the size of demand/need.
We are not stupid 🙄
There are not enough adequately trained/qualified/experienced staff- there are unfilled vacancies.
And if there were- we can't afford to pay them. Staffing costs come out of the individual practice budget - not some massive national pot.

So ours is switched off now as per usual which is completely at odds to what the government is proclaiming.

Message says they have reached capacity and access will be switched back on when capacity is available. So that’s for everything even the lesser qualified staff such as nurse and pharmacy appointments.You can’t book anything. You can’t ring to enquire about anything that is on the system ( eg medical info , test results, referrals , lost letters etc) either.

Real helpful for those who work without access to phones and commute to work.It’s a whole lot worse than before as previously I could ring after getting in from work, explain I could never get in the queue at 8am and they’d sort something out that worked to my schedule for a couple of days later. Now it’s this farce and often a need to resubmit the form as they just give you any old appointment that often really doesn’t work.

You need to be able to fill in the form to be triaged to lesser qualified staff!!!

And the gov is actually proclaiming more access to GPs NOT bumping off to other staff. So let’s have some honesty from them.

Having easier access to your GP isn’t happening if a) you can’t book anything and b) you’re triaged off and barred from seeing the GP for an increasing number of reasons .

So has mine and it’s really not working well.

I've taken to lying about what the issue is in order to bypass receptionists who, while kind, are not trained medical professionals and should have nothing to do with my GP care. I recommend it as it tends to get you an appointment sooner

I think our online system is excelllent. I have had a recent example where I submitted the form, the GP triaging phoned me asap and said my daughter needed to go straight to a&e. I’ve had other occasions where my children have been seen very quickly due to online triage. It works very well at my practice.

And this is my worry re the online system. Literacy abilities vary as do written English skills, how you describe your symptoms in online forms will have an impact. The elderly can underplay symptoms. Neurodiverse people can be very honest, rule focused and literal. My dc are dreadful re pushing for things.

So what would you like to see happen? They can’t magic more GP’s so in
the short term so the here and now.

Would you prefer to keep it as it was before, phone up at 8am to get told no appointments left regardless of how in need the patient is? No ifs buts or maybes, simply “Not today” because surely that doesn’t help either?

I think we must have the same system as your practice. Our GP was put under CQC special measures as it was impossible to get an appointment and literally everyone was referred to A&E!

Our online system opens at 8:00am and closes at 2:00pm Mon-Fri, BUT crucially, it closes as soon as it is ‘full’, which is often within about ten minutes of opening so absolutely impossible unless you are hovering on the link at a minute to it opening!

It is farcical…….

I had a look at my GPs appointment booking today at two points during the day. There was literally one appointment offered for next week and that was for a telephone call and not f2f. If you couldn’t make that then bad luck. In the old system all the appointments went up at 10.30 am and you had a variety of doctors and appointments to choose from. It was much better.

I used online form for our gp. Recieved texting asking for photos. Then phone call from doctor very quickly. I thought it was very good, a lot quicker than waiting for the nurse to call you, who then had to decide if you needed to see a doctor or wait for doctor to ok your meds

Our surgery used to do E-consult for minor stuff that could wait, but they had a few near misses with seriously ill patients who were happy to wait, so they stopped it. Now you can only use it during opening hours so that they can monitor it for those sorts of requests, and you shouldn't be using it for clinical issues.

ANPs are great, but unless you know someone is ill, you don't know they're not ill. DH was seriously ill with pneumonia just before Christmas and the ANP he saw, after asking for a doctor, wanted to send him home with oral antibiotics and an inhaler because she thought he had flu. Fortunately, I'm an ex ITU nurse and said that I thought he was a bit more poorly than that. He had a CRP of over 600 and his extremities were shutting down by the time he got to hospital. He was admitted pretty quickly once they got the results and x-ray.

Ours isn't great either. It opens at 8am and shuts as soon as they're at capacity. It's not unusual for it to be shut by just after 8 when it's a Monday and I don't think I've ever known it to be open past 9.30am and that was a shock when I went on at that time and it was still open. Once shut you can't even send in admin queries.

if you need an appt that's usually pretty good and will be sorted quickly.

if they want to call they text to say they'll call anytime up to 6pm. If you miss it they try again two mins later. If you miss that you get told to call reception. Reception give you a lecture (because how dare anyone work or not be able to drop everything to answer a phone at a non confirmed time) and they tell you econsult again the next day.

if you want a non urgent appt it's a fucking nightmare as they only do on the day bookings for GP appts so again you get told to try again the next day.

I assume a lot of people must have complained as they changed the form recently so now we only answer around 10 questions and you can fill in a section about good/not good times to call. Before I swear it was about 50 questions long, especially if it was for a child.

But oral and aural English skills also vary. Some people will underplay symptoms, some will br very honest, rule-focussed and literal. This won't change because you're being asked the questions by a receptionist answering the phone, rather than filling in a form.

Some people will prefer to use the phone. Some of us much prefer an online form. No system will work for everyone's preferences.

However, whether written or verbal, the questions should be well planned to help as many people as possible - that's true of any sort of form or questionnaire. This thread suggests that different offerings give very different experiences. That's more of a design issue.

There are no questions on online forms you just summarise which can vary hugely for people. My autistic dc are hate phone calls and won’t speak aside from yes /no but if the system says phone call, a phone call it is. There is no o room for flexibility. Everybody just says the system says no.

Of course if it’s serious you need to go to A&E 🤦‍♀️
we’ve had for ages and have zero problems. On the day appointments, you can phone to book still. And most importantly you can actually get through!

No you can’t phone to book still!!! You are told to fill in an online form.

They are selling this to us by saying getting through to your gp easier and requesting same day call backs ( neither of which happen) will cut down A&E numbers.

Im a GP receptionist and our surgery is rolling this out in November, we haven't been given a choice as its forced upon us :( im dreading it, its hard enough trying to get patients seen too and the extremely high amount of abuse we already get feom understandably frustrated patients i fear this is going to make things worse as receptionist will only be able to go by the form questions too 😭 my work colleagues surgery has already rolled it out and she did the form for an ear infection and it told her to go to A&E or "if you do not want to go to A&E click here and a gp will triage tour symptoms and get back to you within 3 days 🤦🏼‍♂️🤦🏼‍♂️🤦🏼‍♂️🤦🏼‍♂️