Difficulty Getting GP Appointments

SallyUK

As well as all GPs and their staff being under tremendous pressure, I'll tell you some of the reasons why you can't get appointments when you need one.

A - people who claim that they need to be seen that same day as they have an emergency - they say they have breathing problems, can't breath, need to be seen - turns out they have a cold and a snotty nose!

B - they ring up and say they have a pain in their chest - advised to ring ambulance - they refuse saying they want to see the GP. Turns out they don't have pain in their chest, merely used that as an excuse to get an appointment for something trivial like a sick note or a repeat prescription!

C - Why can't you see your usual GP - because of people who insist on seeing him/her, even though any other GP in the practice could deal with the same problem.

D - People ring up saying they've had a cough for months - turns out they've had it for a couple of days and only say that to get an appointment and antibiotics - whether they're warranted or not!

E - Oh and then you get the regulars who insist on an appointment, even though they don't really need to see a GP, but they think it's a good idea to take up an appointment that someone genuine could have had.

I've heard it all - I've seen it all too.

Some people think that as soon as a patient leaves the consulting room, the Dr should call the next patient in right away. They don't realise that the Dr has to log the details of each appointment, they might have to order tests, do some referral letters, ring up colleagues, hospitals etc, to find out more about the patient's appointments. Then after surgery they have to go and do home visits, certify deaths at nursing homes, funeral homes etc. Then they have to sign lots of prescriptions, complete Department of Work and Pension reports so people can get their benefit money, complete DVLA reports, Insurance reports, write letters for people who have requested them and so much more!

I think some patients just think the GP is sat behind his desk and seeing patient after patient, without doing anything else whatsoever!

Our online appointments are available for a month in advance, but the main issue is that people don't want to use them, they'd much rather ring up and complain to the poor receptionists! Or they don't want to see anyone else other than their usual GP. We also have emergency appointmentss available morning and afternoon, or sit and waits are available each day, but that's not good enough for some people.

Remember, if you have an emergency, you will be seen on the day, as long as you are willing to see any GP.

Our phone lines open at 8am each morning and we have four incoming lines. We can't pick and choose what line we answer next. Most people ask to see one GP in particular and unfortunately there's not many appointments available for him. We had a complaint come in the other day. According to the complainant, he had to ring up 15 times, and was on the phone for 40 minutes waiting to get through. Oh and according to him, the phone was taken off the hook. Oh and as we didn't know when a certain member of staff would be returning from long term sick, we were liars. Oh and apparently we didn't even check to see if there were any appointments available, we just kept lying to him. Don't patients realise that we know our appointment system backwards and know exactly what appointments are free!

Remember, if you are feeling really ill, you will be willing to see any GP and get the help you need.

mgdavid

SallyUK wrote: »

As well as all GPs and their staff being under tremendous pressure, I'll tell you some of the reasons why you can't get appointments when you need one.

A - people who claim that they need to be seen that same day as they have an emergency - they say they have breathing problems, can't breath, need to be seen - turns out they have a cold and a snotty nose!

B - they ring up and say they have a pain in their chest - advised to ring ambulance - they refuse saying they want to see the GP. Turns out they don't have pain in their chest, merely used that as an excuse to get an appointment for something trivial like a sick note or a repeat prescription!

C - Why can't you see your usual GP - because of people who insist on seeing him/her, even though any other GP in the practice could deal with the same problem.

D - People ring up saying they've had a cough for months - turns out they've had it for a couple of days and only say that to get an appointment and antibiotics - whether they're warranted or not!

E - Oh and then you get the regulars who insist on an appointment, even though they don't really need to see a GP, but they think it's a good idea to take up an appointment that someone genuine could have had.

I've heard it all - I've seen it all too.

Some people think that as soon as a patient leaves the consulting room, the Dr should call the next patient in right away. They don't realise that the Dr has to log the details of each appointment, they might have to order tests, do some referral letters, ring up colleagues, hospitals etc, to find out more about the patient's appointments. Then after surgery they have to go and do home visits, certify deaths at nursing homes, funeral homes etc. Then they have to sign lots of prescriptions, complete Department of Work and Pension reports so people can get their benefit money, complete DVLA reports, Insurance reports, write letters for people who have requested them and so much more!

I think some patients just think the GP is sat behind his desk and seeing patient after patient, without doing anything else whatsoever!

Our online appointments are available for a month in advance, but the main issue is that people don't want to use them, they'd much rather ring up and complain to the poor receptionists! Or they don't want to see anyone else other than their usual GP. We also have emergency appointmentss available morning and afternoon, or sit and waits are available each day, but that's not good enough for some people.

Remember, if you have an emergency, you will be seen on the day, as long as you are willing to see any GP.

Our phone lines open at 8am each morning and we have four incoming lines. We can't pick and choose what line we answer next. Most people ask to see one GP in particular and unfortunately there's not many appointments available for him. We had a complaint come in the other day. According to the complainant, he had to ring up 15 times, and was on the phone for 40 minutes waiting to get through. Oh and according to him, the phone was taken off the hook. Oh and as we didn't know when a certain member of staff would be returning from long term sick, we were liars. Oh and apparently we didn't even check to see if there were any appointments available, we just kept lying to him. Don't patients realise that we know our appointment system backwards and know exactly what appointments are free!

Remember, if you are feeling really ill, you will be willing to see any GP and get the help you need.

Bravo - agree entirely.
(my wife recently retired from GP Reception).

System

As i mentioned above seeing any GP is difficult for me. Its hard enough to be honest about my MH problems, it takes a long time for me to trust someone (i even held back that id moved house because i didn;t want to change GP that id been seeing for years previous). If i see a different GP everytime none of them get to know me, none of them understand my issues on a personal level. Seeing random GPs just leaves me feeling lost and unable to trust anyone. I get fobbed off because they either haven;t seen me before or they only have a vague summary of notes to go on. Not to mention some GP's ilve seen have been horrible about mental health. One after i'd told him i was suicidal and was actively planning on killing myself wrote me a prescription for sleeping tablets and told me to "sleep on it" ( i didnt and instead overdosed on what he'd given me-no longer allowed sleeping tablets ), if he;d been the first GP i'd seen for my MH i'd have never gone back. My GP who i saw for years even had me on weekly appointments, and she could see my need for a referall to CMHT and personally pushed it though asap. So personally its not that i'm not feeling "really ill" its because i need to have some kind of contnuity in who i'm seeing as it has a negative effect on my MH otherwise.

NeilCr

I live in Kent, too, and have to say my GP is superb

You can get an on the day appointment but it is for five minutes and for only one problem. You can't get one just for a repeat prescription etc and you can't choose which GP you see

My GP herself is lovely. Kind, thoughtful and professional. I have to go regularly and can always get an appointment with her using the online system. With a bit of planning on my part I can get the time I want, too. The reception staff are excellent. Occasionally I have a bit of trouble getting through on the phone but I know they are busy and a bit of patience is needed. Nothing major, though

SallyUK

Don't they give you a number for the Crisis Team, in case you need help out of hours?


Sal
xx

xXMessedUpXx wrote: »

Mine aren't open weekends. I tried to book and appointment the other day, nothing for 2 weeks, and no appointment with my GP for 4 weeks (i have mental health problems and it takes a lot for me to be comfortable talking to someone so i really need to see the same GP otherwise i have to start from scratch everytime i see a new one and they don;t get to know me)I ended up making a same day emrgency appointment. I had no choice. Walk In Centre won;t treat you for ongoing conditions you are under a GP for. I got seen but basically got told if i felt worse to come back asap (meaning another emergency appointment). Its madness. Ad part of the reason i dont see my GP nearly as often as i should. Over the last few years i;d had numerous depressive and hypermanic episodes and i've just had to try and cope on my own.

lincroft1710

xXMessedUpXx wrote: »

If i see a different GP everytime none of them get to know me, none of them understand my issues on a personal level. Seeing random GPs just leaves me feeling lost and unable to trust anyone. So personally its not that i'm not feeling "really ill" its because i need to have some kind of contnuity in who i'm seeing

You would really struggle at my local surgery.

Get used to a particular GP and usually after 2 years they've gone. You can often have a 3 day or longer wait if you wish to see your "usual" GP.

maman

DomRavioli wrote: »

. It is literally our job, the GP is there as a gateway to referrals and acute issues.

SallyUK wrote: »

I've heard it all - I've seen it all too.
Remember, if you have an emergency, you will be seen on the day, as long as you are willing to see any GP.

I've quoted you both as it sounds as if you work in GP practices.


My own surgery is great. It's exactly as you say Sally, I can get an appointment on the day with any available doctor but have to wait a little longer (maybe a week or so unless the specific GP is training or on holiday) for a named GP. We also have practice nurses and nurse practitioners who I've found very helpful. The latter will call in a GP if they want a second opinion.


Just recently my (grown up) DD has been unwell and asked me to phone her surgery for her as she didn't feel up to the hassle. The surgery is only a mile away from mine but seems so very different. They have the 'phone up on the day' system for emergencies but over three weeks before a 'routine' (that's what they called it) bookable appointment was available and that wasn't even with the doctor of her choice (i.e. the one she has confidence in that she saw previously).


I appreciate that there are national issues and I'm not surprised as Mr Hunt seems to do all he can to alienate the profession. It seems increasingly difficult to get any full time GPs these days and most, in my area, seem to be staffed by women who want to work part time (that's not a sexist remark just a factual description).


What I wanted to ask was are there national rules about how surgeries allocate appointments or how many patients they can have on their books relative to the number of doctors? It seems to me that the 'phone up on the day' appointments are very useful and necessary but since this happened the bookable appointment system is deteriorating. Why do doctors say something like try this (medication or whatever) and come back in 2 weeks if they know there won't be an appointment? Is it still allowed to have one doctor you can just turn up and queue/wait for while all the others have booked appointments? This used to work well in my surgery and much easier than trying to get through on the phone.


I think like most things, the public need more information. It may not help the situation but it's best to be properly informed.

Ames

I was in my GP surgery tonight, my appointment was after 5pm and was (as expected) running about 40 minutes late.

Someone else's appointment was running 15 minutes late but she was due to be in next. She gave a load of abuse to the reception staff because it was so important that she see that particular doctor today. Then stormed off (nope, no-one else saw the logic of leaving without seeing anyone at all).

Somehow I doubt the staff are paid enough to deal with the crap that gets thrown at them.

SallyUK

Our surgery operates as follows:

We open the telephone lines at 8am, and we have 4 incoming lines. We have three GPs and two practice nurses working every day. The GPs have 17 available appointments in the morning and 16 available afternoon appointments. Sometimes we have people queueing outside waiting to book an appointment. We can't pick and choose which telephone line we answer first or in any particular order.

Once the appointments are gone, we then have to ascertain whether each call after that warrants an emergency "sit and wait" appointment, in which case, if it did, the person is then asked to come down and sit and wait. We explain that they will be seen by a GP, but we can't guarantee which one it will be. Once the person turns up, we then share them out evenly between the three GPs.

It doesn't take the appointments long to be booked up each morning. We then offer pre-bookable, or ask them to book online, or to ring back the following morning, if it's for something routine.

In between appointments, the Drs have to sign prescriptions, write referral letters, do home visits, do reports, deal with Coroner, deal with district nurses, nursing home staff, and much more.

When we get someone complaining about the GP running late, I always point out to them that it could be because someone has recently been bereaved, or that person may be getting bad news - i.e. being told they have cancer - or be upset about anything else. I've had cases where the patient has been absolutely fine one minute and the next, unconscious on the floor.

All appointments are 10 minutes long. If someone arrives late for their appointment by more than 10 minutes, then they can't normally be seen. There is no way, we can guarantee that each patient will be in and out in 10 minutes, although most are, but you have to be prepared for the unexpected.

We get all sorts of abuse. We get accused of hanging up the phone, of not answering the phone, of leaving it off the hook, we apparently lie about there being no appointments available, or if one particular GP is off, for whatever reason, we're liars.

We don't have a limit as to how many patients we can register, however a surgery is permitted to close it's register, if it gets to the stage where they can't cope or don't have enough staff. There is a massive shortage of GPs at the moment.

If your GP asks you to come back in two weeks, for example, then ask the staff to book the appointment for you, before you leave the surgery. (If they have their rotas planned that far in advance.) We do.

Hope this helps

Sal









We

maman wrote: »

I've quoted you both as it sounds as if you work in GP practices.


My own surgery is great. It's exactly as you say Sally, I can get an appointment on the day with any available doctor but have to wait a little longer (maybe a week or so unless the specific GP is training or on holiday) for a named GP. We also have practice nurses and nurse practitioners who I've found very helpful. The latter will call in a GP if they want a second opinion.


Just recently my (grown up) DD has been unwell and asked me to phone her surgery for her as she didn't feel up to the hassle. The surgery is only a mile away from mine but seems so very different. They have the 'phone up on the day' system for emergencies but over three weeks before a 'routine' (that's what they called it) bookable appointment was available and that wasn't even with the doctor of her choice (i.e. the one she has confidence in that she saw previously).


I appreciate that there are national issues and I'm not surprised as Mr Hunt seems to do all he can to alienate the profession. It seems increasingly difficult to get any full time GPs these days and most, in my area, seem to be staffed by women who want to work part time (that's not a sexist remark just a factual description).


What I wanted to ask was are there national rules about how surgeries allocate appointments or how many patients they can have on their books relative to the number of doctors? It seems to me that the 'phone up on the day' appointments are very useful and necessary but since this happened the bookable appointment system is deteriorating. Why do doctors say something like try this (medication or whatever) and come back in 2 weeks if they know there won't be an appointment? Is it still allowed to have one doctor you can just turn up and queue/wait for while all the others have booked appointments? This used to work well in my surgery and much easier than trying to get through on the phone.


I think like most things, the public need more information. It may not help the situation but it's best to be properly informed.

maman

Thanks for that sal.
Out of interest, do you know if there are national /statutory rules about how to organise appointments or is it down to each practice to do what suits them?

When you have 4 lines, does that mean 4 separate numbers? How many receptionists to answer the 4 lines?

Do you have just 3 GPs in your practice or just 3 working on any given day? I've often wondered why they don't share the workload so that e.g. the one phoning nursing homes or doing home visits isn't the one doing appointments.

I'm very pleased with my own practice. They are very patient friendly. Recently started doing Saturday appointments. Same GPs, they just work different 'shifts'.