GP would like suggestions on how to improve access to your doctor for your under 5's.

[Apatosaurus]

Hi, my DH has just been made lead Child Health GP at his practice. He is thinking about re-organising the accessability/availability for parents with under 5's to see their GP, and has asked me to canvas MN opinion for him.

Currently the surgery runs the usual 10 min appt system on a phone-in-the-morning, first come, first served basis. He is aware that lots of worried parents with poorly kids are not been seen as quickly as they like (ie given afternoon appts or told call back tomorrow).

He is thinking about starting an open under 5's clinic as an alternative to the usual phone and book system. This would mean that every day you could attend the surgery with your child, at a specific time and would be guarranteed to see a doctor. No appointment necessary. The down side is of course that you may have to wait in a queue if there are lots of sick kids needing to see a doctor that day.

He would like to know if you think that's a good idea (or if people prefer the usual appointment system), and what time of day to run the clinic (I was thinking 10.30am ie pre lunch & nap time). Any comments or suggestions would be really welcome.

TIA.

Personally I prefer to have an appt time as I wouldn't fancy just turning up with a poorly child not knowing how long I might have to wait.

I like the idea of a morning and afternoon clinic. How many times has your child gone downhill through the day but by the time you decide you need an appt morning surgery has been and gone and you have to wait til the following morning?

At our surgery when you phone they get the triage doctor to call you back. They offer advice over the phone, arrange prescriptions or give you a time to come up and be seen. It's brilliant, and the surgery think so too. They told me that the doctor can speak to a dozen parents in the time it takes to see two, and it means they only get to see the people who really need seeing.

although i drive alot of mums have to wait for buses etc to get to docs and so they phone in morning and are told can you get here now? which answer is No so if they had a take a number system all day with stop for lunch that would be used to full i think i certainly would i hate having to say its urgent to receptionist they never believe you and you feel guilty as if you are lying

I should have said that the clinic option is just that...an option ie if you want to phone and make a normal 10 min appt with your GP that will be available as well.

So Betty do you think and early arvo clinic would be better ie wait and see with your child in the moring and then go along after lunch if your child isn't any better?

I'd like the best of both worlds Apatosaurus -would it be possible to have two shorter clinics ?(one morning one for those that wake up with ill children who know they need to see a GP and can't/don't want to wait til later, and an afternoon one )

I like the idea of telephone consultations too (as in surfermums post) -quite often you're left in situations where you're not quite sure whether its worth bothering a doc about something, but with a phone chat you could get advice and then, only if necessary, make an appt.

Surfermum, Dh's surgery does phone consultations as well. He chatted with me about statistics of attendance and under 5's attend their GP on average 24 times per year (6 times as many as the 10-60 bracket).

Most parents want their child looked at as so many LO's have a rash, ear infection, chest infection etc, etc. These things are easy and quick for a GP to examine and advise/treat but do occur frequently, hence the need to make clinic time for them, and for it to be readily accessible for parents.

Our surgery has a children's clinic from 10:30-11 where you just turn up which I have found to be fabulous and I probably take DS to that more than I would actually make an appointment because I always feel he should be just a bit sicker to make an appointment! But this feels less formal plus I don't have to wonder how long it's going to take me to get through on a morning or if I have to ring a bit later I won't get an appt. till afternoon which was when he napped till recently. I've actually only been twice, but I've never waited more than 10 mins.

Waiting till the next day was the option when I rang on an afternoon, but I didn't think it could wait and got an appointment in the next hour. I think they prioritise children anyway.

If you are desperate to see the doctor our surgery also has an end of hours thing where if you're desperate you can turn up and wait your turn. Don't know how long that lasts for as the one time it was offered for me (agonising gallstone pain) I decided not to go and just stay away from the fats!!

Thanks goblinqueen, good to hear of one that is already up and running and that you have had good experiences of it. Suprised that it's only half an hour long though (DH was thinking an hour minimum for his...but I guess it's very dependant on numbers and how well it is liked! ...or how well DH is liked for that matter !!

My mum is always telling me that when we were babies, her GP's had a 'turn up and wait' clinic (I think it was from 8.30 every morning) and she loved it - keeps saying how fab it is and it is a shame GP's don't do it now.

Her reasoning is that if a baby is ill over night, you know you can see the doctor by a certain time without having to wait for the surgery to open, then try and get through on the phone, then wait for an appointment etc - said it was good for peace of mind knowing that the clinic was there.

Thank's CeeBee. Dh is on a mission to improve parent/surgery relations at the moment (due to several complaints re lack of availability). He's hoping the clinic idea might help.

24 times a year? That's once a fortnight?

We hardly ever go, but I think I'd prefer an afternoon clinic. Naps, etc go out of the window if your child's sick and needs to see a doctor. If I could get an appt I'd still prefer that to sitting and waiting, but would go to a clinic if there were no appointments left or child became sick through the day.

Yup 24...I did the face too but apparently thats right. Some parents take their kids a LOT more than others but DH thinks that's fine as most of the time it's a quick examination and reassurance/advice.

I personally would perfer a drop in system.

Where we live I don't have a GP but have a pediatrician and we have a mobile no for him so I can text for an appointment or ring to discuss whether I need an appointment. When my children have had contagious things he has made appointments for me at the end or beginning of the session so I don't spread them to other sick kids. I can can drop in and he'll try and fit me in and at certain times there's no one there so its a in out thing. However I hardly ever go to the Dr with the kids so I don't see much of him (4 times with 2 kids in 2 years). I'm a rarity here, first sign of a cold and there off to the Drs claiming they've got some fatal illness, so perhaps he knows when he sees me I have a genuine concern or just fussing.

The other differences I've noticed have been, the Dr is far more thorough with the checks. When my DD has a throat thing he has taken a swab and tested it in the surgery while we waiting so she got the right medicine. Hardly ever gives antibiotics and often suggests things non medicine based for example. Its very humid here so lots of ear nose and throat problems. He suggested buying a machine that the child breaths into to clear the lungs, works a treat. For friends he has suggested various herbal remedies. Also when medicine is given they alway weight the child and the medicine is given based on the childs weight.

My one thing I wanting to suggest though was when we lived in the UK and I used to call the Doctor I'd get the receptionist and she'd always ask if it was an emergency. Drives me crazy, I don't know and she's not qualified to judge so its a stupid question. Can't they rephrase the question to something like do you need an appointment today or wait till..... or can the nurse help. Much more to point really I think.

Have had a drop in type system and an appointments system. So far I prefer the drop in.

Drop in system worked as such: surgery hours for drop in were 8:30am to 12 noon. Surgery waiting room open from 8am. You turn up, tell reception your name and you wait; everyone seen in order they arrive. Longest wait I even had was about 40 minutes, normal wait was 20-30 minutes.

Currently have appointment time. Very often sat waiting for an hour and sometimes longer. Nightmare. Have never been seen on time or even within 10-15 minutes!

I would think keeping appointment times short. Anything taking longer than allocation 5 or 10 minutes to be referred to an afternoon appointment slot, no messing about keeping everyone waiting then. Or longer consultations being aked to wait until end of surgery after allocated 5 minutes are up.

And better waiting room areas for childrn. OK, most have toys and books. But this is in middle of normal wiating room where other adults are waiting. A cornered off area, or even a smaller little room with more interactive toys/activities would be ideal.

MaryPop, totally agree re nosey receptionists (I have to go through them as well just to speak to my DH and often get the 'is it important...his clinic IS running 20 mins late you know' hmmmmm

The open clinic would completely do away with speaking the the receptionist...just turn up and wait your turn.

What about in the morning a GP surgery and in the PM have a nurse available to see those general things then and there. Then, if necessary refer to a DR. As has been said before more things are minor and we Mum's just want somebody to say everything is OK. I've found when my DD has been sent home from school by the time I've got her home its too late to see the Dr. I'm thinking really when my DD has had either a ear or throat infection in the UK. Because its 10.30 by the time I've got home it too late for an appointment and I not been able to get antibiotics for the infection until 6 or 7 waiting in the evening with 2 children one of whom is ill and tired and wants to be in bed and the other hungry and bored and tired and driving everyone in the surgery crazy.

Going on a bit aren't I sorry.

Getting rid of Dr receptionist can only improve the experience of going to the Doctors. In the UK generally unless I was nearly dead i would not go mostly because I hate dealing with the receptionists and there santimonious attitudes. here's still generally don't go but if I'm sick I am more likely to go. I'd lived here a year the first time I went to Dr and a got a telling off because I hadn't come to visit just to say hello! That conpletely confused me.

What about an information area for parents, maybe on certain days it could be combined with the baby Health clinics.

Shut up MaryP0p, this is 4 in a row now!

Take into account the school run ...? The HV once said that the best time to get people at the clinic was straight after they had dropped their older children off--that way they could do a round trip.

There you go, Mary, I saved you from yourself.

MaryPop...on a roll there, all your memories of NHS GP's flooding back there!

DH was just having a lurk (man he reads sooooo slowly!) and says thankyou very much to all...he's ruminating on things now!

We don't have school age kids yet lionheart so what post school run is that 9.30 ish. A good idea though...less strapping poorly kids in/out of cars seats.

Nightmares actually, I think a case of can't miss what you never had while I was in the UK. My son had an acident on the slide and i had to take him to AandE for a xray on his toe. Arrived and finished within an hour and 1/2 and the Italians were complaining how long it all was. I was estatic thought I'd be there all day.

DH and I were wondering where you were MaryPop!! (I went for USA he went for somewhere in Europe so he wins)!