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.

Sorry Apatosaurus. Oh and the hospitals are soooooo clean, though the Italians are generally phobic about dirty so doubly so in a hospital or school.

Yes, I think 9.30ish, otherwise there's a big um and aah about whether to go home and go out again twenty minutes later or go to the surgery early and wait around ... (it matters more in the Winter apparently when going home means taking off and then putting on loads of kit).

Thank you lionheart that is a really excellent and valid point, getting poorly baby in & out of coat/hat/gloves combo plus in/out of car is a bloody nightmare. Have shouted this down stairs to DH...he is making interested ruminating noises.

When my children were at nursery, it was fantastic to be able to get in as early as poss in morning at doctors, so having seen doc, it was obvious whether or not child could go to nursery and i could/should go into work that day.

eg in days before youcould get conjunctivitis stuff from chemists, an appointment seeing doctor early in morning meant a day closer to being able to put child back in nursery and me back to work (not htat i actually like mu job that much but i was just really busy there...)

We have a fantastic doctors who, if it is child, or else just plain urgent will always squeeze you in that day.

I sound a little strange now don't I? Sorry when we came over had terrible trouble getting my son properly vaccinated because of the crap service I got from the Dr's surgery. The repercusions we that my son is now 5 1/2 and has only this week finally got all the vaccinations he is suppose to have because the UK surgery wouldn't allow me access to information before or after moving. Plus since being here I am so impressed at how well organised and clean and without stress things are here I get a little cross for my friends in the UK and generally for people who both work for the health service and use the health service and that they have to suffer for want of another word 'crapness' Its really nice and I think positive to see someone (your husband) tryng to actually sort out problems and improve things rather than going along with the this is how we've always done things attitude. I'm sure lots of people are but you don't generally see it.

Plus on a lighter note, anything that gets rid of dr's receptionists is okay by me!

funny that you mention it but DH is also thinking about re-organising the immunisations service (another thread I know, and for another (braver) day)

Here the Dr doesn't do but its don't in a hospital outpatient unit. All the children in the town go to the same place and theres is a Dr and 2 nurses there always. Its open every morning from 8.30 till 12. DS went last week they did it all and we waited 1/2 hour in the play area while the nurses/dr kept an eye on him and finished. They are specialist in this alone and honestly DS didn't even cry when she did it she was so good. However because the UK Dr would give any info they refuse to do it. Without his Vaxs he can't start school so I was stuck between a rock and a hard place. I couldn't even go back to UK to get it done because we are no longer residence aren't on the patient lists.

I think it's only half an hour long because it's specifically for children (under 12's) so all the doctors present are available and one nurse. I just looked at the website anyway and it says they plan to be done in an hour, so I guess the getting on the list is the first half hour of it. I've only ever been in the first half hour. Hmmm... wonder if adult patients are there in the second half hour, definitely not in the first.

Our receptionists are lovely, but in the last two practices I was in the receptionists were fairly obnoxious. I wish they'd get sent on customer service courses or something!

I will really miss this practise when we eventually move! I like the computer touchscreen sign in for when you turn up to appointments so you don't have to talk to a receptionist or stand in a queue with people wanting other things!

DD's now awake and destroying stuff so better go. Will be back later this evening.

Thank you to all for your helpful posts.

Oh and our practise has that thing you can sign up for to book appointments online. Haven't tried it yet.

Cool, your surgery sounds cool

bumping for the evening crowd.

Many apologies but the average number of consultations per year for a 0-5 year old is 6 not 24!!!

Communication and mathematical malfunction with DH, confusion over 6 times a year and 6 x the national average of consultations per year per patient which is 4 (6x4=24)!!

Numpty DH has been put in the virtual naughty step for spreading mis-information on MN.

just read the OP so far (wil read the rest in a sec)

At our surgery its a case of phone in the day for an appt BUT there are a few appointments reserved each day for children 5 and under. i think the general thought behind it is that if you need to see a DR immediatly then u need to be at hosp.

Would think you would need a dedicated DR for the clinics. what if you did the clinic from 10:30 til 11:30 but there were lots more ppl that you thought? other appts would run late. Also 10:30 is nap time for some children. My ds2 still naps at that time in the morning and he is 2. Also, if i have to take DS2 and wait without having at least a little idea of how long i would be there for, it would mean i have to arrange someone to collect DS1 from nursery.

That's a good point too squid re pick up time for nursery. Not sure why I didn't think of that too as dd1 is at pre-school until 11.45 every morning.

DH and I have been chatting about this for most of the arvo and thinking an early morning open clinic might work well, with normal appointments with the rest of the doctors. The duty doctor for that day will also see any urgent appointments in the afternoon (but you have to go through an evil receptionist to get those)!

Would the doctor want to differentiate between perceived emergency appointment requests and general non urgent cases to see the doc. Ours will put emergency ones at the end of morning surgery and at the start of afternoon surgery without an appointment and make appointment for surgery time for the non urgent ones.

My comment would not be for in hours seeing a doctor with a child but out of hours. Could the surgey put a message that doesn't necessarily direct to NHS direct and the associated wait. If its a child in the evening it is usually something urgent. I waited 4 hours last week for a doctor to see dd and when she did it was an admission to paed dept for IV antibiotics when I told NHS direct I thought there was a problem 4 hours earlier. If I could have made the appointment direct at the out of hours service it would have speeded up the timescale.

Sack all the receptionists?

Sorry, not v helpful and haven't read the rest of the thread. Good luck with more constructive ideas!

slalomsuki,
what DH is thinking is that it would be better for child, parent and practice efficiency for the parent to triage the urgency of their child's problem (ie attend urgent open clinic or make usual 10 min appointment or request telephone consultation)
rather than get receptionist or triage nurse to decide on the urgeny of the child seeing a doctor.

grumpfrumpy that sounds great (for a big surgery with lots of money) Dh is in a small and currently rather poor practice so employing a nurse practitioner would be difficult but not an impossible option for the future.

I guess your post raises the question do parents with poorly infants (well 0-5 year olds) want their child to see a doctor, or are they happy to be seen by a nurse and triaged accordingly?

lostinfrance. lol at saintly...should have seen our not so excellent parenting skills this arvo!!

at your crap experience with your dr's. MN has really revealed to me (and then indirectly to DH) the shitty service some parents get when they are really worried about their DC.

DH is trying to think up some new solutions as the current 'system'. He'll certainly be feeding lots of this info back to the other partners at the next practice meeting.

Have just scanned this but think the clinic sounds like a good idea, and earlier in the morning would be best (especially for working parents to find out early in case child turns out to be okay for them to be able to go to work later in the day). But I also like the idea of the triage doctor phoning up. I think lots of the time parents really need reassurance, which I guess can often be given over the phone.

Thank you molly.

From this thread DH is going to suggest an open early morning clinic to the other partners. And then hope people will use it!!

we used to have something like this in a saturday morning at my old doctors. it was very convenient but did mean sometime irritable kids would be hanging around for 2 hours.

i wouldn't like only being able to ring up in the morning. usually at my doctors you can ring up a couple of days before and get an appointement.