[Closed] Doctor's appointments - am I doing it wrong?

Does your surgery offer telephone consultations?

All of the above is similar to ours, however if you can't get a face to face appointment (most of the time) then you can arrange a 5 minute telephone consultation at lunch time when the doctor will decide if you need fast tracking/ referral/ prescription.

Not sure where abouts in the country you are but in Derby we have a Walk-In Centre for anything that isnt serious enough to be seen in A&E but you feel that you need to be seen that day. I dont think we have ever had to wait more than an hour to see a Dr or Nurse Practioner depending on the nature of the issue (I had to go once due to a bad reaction to a bee sting that made my hand swell up) - my wife has had to go for an ear infection as well I think.

It works really well and we are lucky to have the facility.

Same round here. Have a look and see if there is a drop in centre nearby. You might have to wait a while to get seen but if it’s a concern then might be best option.

Do they do online assessment? Ours do. You answer the questions it will give you an outcome, if it needs a phone appointment you’ll get one within a few hours, face to face same or next day. It basically filters out the trash that doesn’t need a GP just a trip to the shop for some paracetamol or basic prescription.

Ha!

Went through this process this morning. Been trying online and calling...

It's proving really difficult, been trying for days for an appointment. No joy again today.

Letchworth surgery

Telephone with a waiting time thing. Can be quite a long time - 30-40 mins. Sometimes quicker....

Get through to reception who (I presume) pre screen you and book you in for a Dr telephone appointment in the next few days (or within a couple of hours if it's a serious thing)

Dr telephone appointment decides whether to bring you in or sort things out virtually (which tbh works pretty well)

When I had booster vaccine related side effects I knocked on the door, had a very annoyed receptionist that I didn't make a phone appointment but she got me seen within minutes, they're obviously trained to triage

Check to see if your practice uses 'engage consult' or some other online service. You have to register, but works great for us.

You can send a medical query straight to your doc (they are triaged), including pics or attachments. I then either get a message back with advice, or a telephone consultancy same day with follow up if needed.

Avoids all the phone calls.

Does your surgery offer telephone consultations?

I don't know, I wasn't offered one on the phone or in the recorded message. I would do an online assessment with photos if I knew how to.

This is Wales btw.

Our walk-in centre is incorporated into the A&E at Heath Hospital. I would go there and wait, to get it sorted, but I didn't know that was suitable for lower grade stuff.

There’s some suggestion I can send in photos, but to whom and how?

Nearly every surgery has it's own website. They normally have a "contact your surgery" type option which you can use to describe symptoms and get advice. It's normally triaged by a nurse or GP. they make ask for photos. They'll send a link to your phone, take a couple of snaps, send them in, normally if they want to see your kid, you'll get an appointment.

This is Wales btw.

Oh.

Besides the obviously crap process (why does it take 5 mins to look for cancellations, surely the system should just show the next available date right on screen?) the system is insane.

TBH there probably is, but the most used GP systems are complicated with LOTS of ways of doing things..so if the receptionist isn't 100% clued in on the quickest way, they may simply bee manually looking thourgh each day's 'diary' to see if any free slots.

It's a pain that primary care gets filled up so quickly..I hear your pain.
One major issue we're all facing (GPs) is that due to secondary care (i.e hospital) being so slow to see people, an issue that would NORMALLY follow this process:
GP-> hospital referral -> see consultant -> fixed
Now goes
Gp -> hospital referral -> GP ->GP -> GP...still needs secondary care -> see consultant -> Fixed

This really does happen. THus GPs are filling up with 'recurrent presentations' of the same issues multiple times over, simply because they aren't getting seen in secondary care.

The whole system is swamped.. Pressure in one areas really does impact the whole system

DrP

Ours has eConsult - takes you through a load of questions, gathers a lot of the info they'd need, then usually get a call same/next day, or appointment booked if it needs in-person examination.

Massively better IMO than the "keep redialling at 8am" system.

Molgrips the other option is to try CAV out of hours. 0300 10 20 247

They normally have a “contact your surgery” type option which you can use to describe symptoms and get advice.

I'm going to have to ring them and ask, because the website is shocking. If you click on 'online services' it gives you a page with a link to 'online services'.

Unless I am missing something?

https://www.pontprennaumc.wales.nhs.uk/index.aspx

The one for our local surgery (Rhoose) isn't great either. If you fill in the forms it basically gives you an option for you to call in, which is when the receptionist tells you to go online, or that you're about to die from spontaneous typing syndrome and to call the A&E department

Unless I am missing something?

Seems to put you in an infinite loop.

Been that way at my doctors for years. Apparently there's some kind of online appointment booking system, but in order to be added to it, the GP must do it in person. Which requires an unobtainable appointment 🤣

I just go to the local walk-in centre and wait to be seen, way less painful overall.

My wife is a GP, her rants about seeing her own GP are similar to the OP but ramped up to 11.

The whole system is in a mess, it was already on the edge but then Hunt picked a fight with junior doctors & Brexit made us less appealing, my wife's surgery seem to have an open advert out as they cannot recruit for love nor money & that's basically the same everywhere not just them.

As for the booking & IT side of things, there seems to be a lot of custom & bodged software around that really does not work very well. At the risk of the wrath of many on here, I've never met anyone who can sort an IT problem without it getting messier.

At the risk of the wrath of many on here, I’ve never met anyone who can sort an IT problem without it getting messier.

There are reasons for that I won't go into here 🙂

Its all **** as said above. People can't see their GP so call an Ambulance or walk into AE. People can't get into hospital so keep seeing there GP with long term conditions. Fit people block beds in hospital due to lack of social care.

All this in my opinion is by design of the government in order to bring in private services. (sorry to get political)

Anyway is there not an online solution for booking. A lot of surgeries now have this and it seems to work ok'ish.

I don’t know, I wasn’t offered one on the phone or in the recorded message.

Have you checked the website? Our surgery has links to the online stuff on it and I think they assume that if you are calling the surgery you don't want online as they never refer you back to it if you do call.

And in defence of the 'system' - my wife called our GP last week at 8am as she wanted a face-to-face appointment for something that was concerning us both. She described the symptoms to the receptionist and was given an appointment for 9.40am. By 11am she was in Same Day Emergency (not A&E, but a level up) at our local hospital, had an initial doctor assessment and bloods, a follow-up ophthalmic assessment the next day and is now in the system for a neurology assessment within the next two weeks as they don't think it is something needing to be urgently escalated. Not great news for us, but the 'system' worked quite seamlessly (ironically just last week we had been discussing getting private healthcare but hadn't done anything about it).

"Ask a Pharmacist" seems to be a favourite recommendation on my GP's website, have you tried that?

@molgrips If you look under Prescriptions on the banner menu, it links to MyHealthOnline, which also has functionality to book appointments. It would be worth downloading the form and giving it a try - I don't think you need an appointment to take the form in with ID to register it.

It also mentions a call-back function, not to be used with a mobile; it doesn't explain but I think that means that rather than keep phoning, you should be able ring them from a landline, press a button on the phone and their system will call you back when you're approaching the end of the queue.

molgrips
There are reasons for that I won’t go into here 🙂

I'm sure there's a large element of "we've no idea what we want and no budget".

All this in my opinion is by design of the government in order to bring in private services. 

Agreed. Since the whole country is currently set up to reward the rich and connected, and shaft the plebs, it shouldn't cone as a surprise to find that's what they're doing with the health service.
Make it so shit that nobody complains when they bring in paid for care.

Can you not turn up in person at the surgery at 8am to arrange an appointment? It used to be the case at ours, (not sure if it still is, not been for years) that the 8am phone calls got mostly ignored while the receptionists dealt with the people stood in front of them.

Can you not turn up in person at the surgery at 8am to arrange an appointment?

Well, we won't let you into our surgery if you turn up without an appointment, and most surgeries are like us, and are asking patients to stay away.

I'd suggest trying the 111 number, and explain that you've tried , unsuccessfully, numerous times at your gp.

I no longer bother with my GP, i simply wait until i am sick enough to warrant a visit to A&E.

Before Covid my GP surgery always had the same people in the waiting room.

Now they sit and dial.....

I've no idea how the Welsh on line system works, but one of my GPs thinks you'll have better luck if you sign up to the My Health Online service.

Before Covid my GP surgery always had the same people in the waiting room.

Unless you worked there (or had an unhealthy interest in such things) then you were one of the 'same people' 😉

At least yours gives the option of an appointment in 14 days. Ours is phone at 0800, to sit on hold and find out all the phone call backs have gone for the day already. No phone call back, no appointment. Only option is to call again tomorrow.

It manages demand though - frankly I'd have to be dying to call my GP (and would probably then drive the 40 minutes to the nearest A&E instead....)

Well, we won’t let you into our surgery if you turn up without an appointment, and most surgeries are like us, and are asking patients to stay away.

Fair point!

https://www.patientaccess.com/

Many GP's are registered on this NHS app and you can book slots direct

Rang my GP a couple of weeks ago. Appointment booked for a phone appointment a week later, blood test that was needed booked the day after I called.

Phone appointment confirmed blood tests were clear but face to face appointment made two after that.

Fairly pleased with that to be honest

I work in A&E and see the fall out of the collapsing system. However, A&E can’t provide the sort of services that GPs do in chronic illness/cancer worries/ loads of other things. We can’t order specialist imaging or bloods, can’t follow up patients with results or for review, and frankly don’t have the amazing expertise that GPs have in primary care. This will be true of many walk in centres too- good for minor illness/ injury but not so much for the worrying lump/ persistent headaches/ odd rash etc. Pleas be aware of this if you choose urgent/emergency care as a route to avoid the phone appointment system nightmare…..

https://www.patientaccess.com/

Many GP’s are registered on this NHS app and you can book slots direct

I think it depends on the Practice. Mine uses the app but you can't book appointments on it. You can see upcoming appointments should you be fortunate enough to have secured one, you can see what meds you've had and you can order repeat prescriptions but that's about it. Your medical record is another menu option that goes nowhere.

Do they do online assessment?

I know that it is not the recommended route but 111 can do this and if they assess that you need to see your GP the next day they themselves can access the surgery's appointment system and make the appointment for you.

Like many many practices we stopped people being being able to book direct on our website or through 111. The reason we stopped doing that is because mostly we like to be able to speak with or triage what we see, and direct people who don't need to see a GP to services more able to help them more quickly. Like dentists, opticians, pharmacists, physiotherapy etc. We also found that the same people (the frequent flyers) were using the system in the same way they use the phones, and so eventually you still cant get through.

It's generally hard to get through to the GP because it's a limited resource. Like motorways, you can build more lanes (on line,111 etc) but eventually those will get filled as well. We just need more GPs, and people happy to go somewhere else to get medical advice.

So, things to remember: If you've got an acute issue, try to get help from alternate source before just picking the phone up to speak with a GP. Try the Pharmacist for instance, many of them will be able to both identify that nasty little rash, and give you general advice. Try to remember that GPs are not an urgent care service. If you make a appointment and you can't come, then cancel it. Use online text services/phone appts if they're available to you.

We just need more GPs, and people happy to go somewhere else to get medical advice.

This is especially true - we're currently dealing with a complaint where the issue is a patient was directed towards the new pharmacy service (i.e actively booking people in with a ppharmacist).
He didn't like that - wanted a GP (and wrote a complaint).
He saw me. My advice. Simple self care AKA the advice pharmacist would also have given...

Sigh

DrP

Mine has a number of way to book appointments, all of which are seriously annoying.
1. The 8am call. Call at 8am for an appointment that day. Expect to be on hold for 30 mins and there's probably a 30% chance they'll have a spot free. Since Covid this is for telephone appointments only. If no spots are free you can't book one tomorrow, or indeed anytime sooner than 14 days.
2. 9am scramble. at 9am they open the doors and there's a small number of slots for people to book in to, but people are generally in the queue from 8:15am, often on the phone trying option 1 at the same time.
3. Patient Access. Now this should be the answer, an app that you can book an appointment on. And it is, sort of, but you can only book one 14 days in advance, nothing closer to today, so you have to plan when you're going to be ill in advance.

Now, this is all for telephone appointments only, so everyone is screened over the phone (yes, even those who've turned up a the surgery). If you need a face-to-face the doctor can't book it off the back of the call, you have to call the reception again, who will question if you really do need a face-to-face appointment before, begrudgingly, offering an appointment in a weeks time at best.

Its all **** as said above. People can’t see their GP so call an Ambulance or walk into AE. People can’t get into hospital so keep seeing there GP with long term conditions. Fit people block beds in hospital due to lack of social care.

All this in my opinion is by design of the government in order to bring in private services. (sorry to get political)

Also Mrs a11y's opinion too as an A&E consultant who's in a constant battle with hospital management about insufficient/unsafe staffing levels. Everything backs into A&E from both ends, so to speak.

Going by posts here I count myself lucky that our GP practice seems above average. Generally takes 50-100 redials to get through, but almost always get a telephone appointment on the same or next day.

Patient Access. Now this should be the answer, an app that you can book an appointment on. And it is, sort of, but you can only book one 14 days in advance, nothing closer to today, so you have to plan when you’re going to be ill in advance.

You do realise a fair few number of primary care contacts aren't acutely ill..hence why if I wanted to speak about getting a vasectomy, or have an HRT check, or just chat about my latest blood pressure readings, I'd be perfectly happy to have a booked appointment in 2-3 weeks time...

Just because a function of a system may not suit you, it doesn't mean it doesn't suit all...

DrP

OP - yep, ours are like this. I think the "business model" is, you're either well enough to wait, therefore you don't really need to see a doctor, certainly not today, come back in a week or two for some tablets, or aren't well enough to wait, so you should go to A&E. They do telephone apps which have been very useful however. And the locums when you get to see a Doc are great. I don't think i have seen an actual Doc of the practice in about 5 years.

almost always get a telephone appointment on the same or next day.

Hope you realise just how privilidged you are with that sort of service!!

My consultant wrote to my GP setting out the meds that he wants me to be prescibed. The GP then prescribes something different and adds a note to say that they'll review it with me on Sunday (when none of the GPs at that service are working). The consultant is on a fortnights holiday and it'll take me a fortnight to get a phone appointment with the GP to sort things out, meanwhile my condition deteriorates............. The system really is f****d up!!

 so you have to plan when you’re going to be ill in advance.

Many of our chronically ill folks have issues that need regular monitoring. We'll contact them to remind them to pop in for a check up or bloods or whatever, or they can book in to see a nurse via the text we send them. This system works very well for them.

You do realise a fair few number of primary care contacts aren’t acutely ill..hence why if I wanted to speak about getting a vasectomy, or have an HRT check, or just chat about my latest blood pressure readings, I’d be perfectly happy to have a booked appointment in 2-3 weeks time…

Just because a function of a system may not suit you, it doesn’t mean it doesn’t suit all…

DrP

Absolutely, and there have been plenty of instances where the ability to book in advance is very useful.
What I'm saying is that having the option to book the next day doesn't stop another person booking in 14 days time. However, having the only option being 14 days does stop the person who needs a more urgent booking from doing so.
If the app let you book both urgent/next day appointments and also appointments further in advance then that would seem to work better. Particularly if you also kept an agreed percentage for those who prefer to call on the day.

I feel like i'm just popping up to defend primary care!!

My consultant wrote to my GP setting out the meds that he wants me to be prescibed. The GP then prescribes something different and adds a note to say that they’ll review it with me on Sunday (when none of the GPs at that service are working). The consultant is on a fortnights holiday and it’ll take me a fortnight to get a phone appointment with the GP to sort things out, meanwhile my condition deteriorates…………. The system really is f****d up!!

ooh, now this may be interesting..
Obviously the situation here isn't 100% transparrent, but..
It may well be the consultant has asked the GP to innapropriately prescribe a drug that is either 'red listed' (which means it's consultant prescription only), or is 'blacklisted' (not to prescribe at all).. or maybe the consultant has asked for a drug that isn't part of the local CCG health economy formulary...?
(or, your GP may just be daft and have made an error, of course..)

GPs are forever getting innapropriate requests from secondary care to 'do this, do that', prescribe this'. And in many cases the only option is to say NO (and write back telling them to do their OWN job!) or to prescribe an alternative..

Genuinely, sometimes the cost of Drug B is SIGNIFICANTLY more than Drug A... yes the patient hasn't tried drug A yet..
If a consultant jumps straight to Drug B, you'll find most GPs will suggest and prescribe drug A.
Honestly - if YOU were paying for the drug, i'm sure you'd prefer the option of having a more cost effective optin.

Think...local indy garage vs main dealer and OE kit...;-)

DrP

My GP - phone in the morning by 9. No issues getting thru. You will have a telephone appt AND a face to face if needed that day. I have never not been seen on the day if needed. they also holdback some emergency appointments every day so even if you phone up after 9 and its a situation where you need to see a GP urgently you will

Emailing in symptoms and pictures and things - a huge NO from a confidentiality point of view.

the problem with the variability of service ( apart from the staffing pressures) is the status of GPs as independent contractors so some are just better organised than others.

I’d be perfectly happy to have a booked appointment in 2-3 weeks time…

Just to be clear, they aren't offering apppointments in excess of 2 weeks. On any given day you have TWO options - either that day, or 14 days' time. Both fill up almost immediately, so you're back on the phones the next day. They don't offer you an appointment in 15 days time or later.

The reason we stopped doing that is because mostly we like to be able to speak with or triage what we see

I would have loved to talk to a nurse or anyone. I wasn't offered that.

Do I just have a bad surgery? Can I change to one less busy?

I suspect a disorganized and overworked surgery

Have you tried phoning again in the afternoon and explaining the situation?

Have you tried phoning again in the afternoon and explaining the situation?

I got through, and explained it, she just told me to call back tomorrow. It's just such an inefficient system - there are dozens of us spending hour after hour on the phone every day doing this and the receptionist is just fielding it every day. Must be soul crushing for them.

Makes me want to go and write them a better system just so that they can then book me in. No payment required just a ****ing appointment!

What if you are calling about a suspicious lump or mole and by the time you get an appointment you're already too far gone? This must be happening, surely?

If it makes you feel better the patients who've left a google review all say the same thing; Doctors are great, appointment system a shambles.

What if you are calling about a suspicious lump or mole and by the time you get an appointment you’re already too far gone? This must be happening, surely?

I would assume / hope that the receptionist will triage and, as was the case for my wife last Thursday (as mentioned earlier in this thread), you will get seen more quickly. My wife called the GP at 8am, was seen in person at 9.40am and was at the hospital Same Day Emergency department at 11am.

I told her there was a skin problem on my daughter's head and she just said 'oh you'll need to see the GP and there are no appointments'. Didn't really fill me with confidence. I'd have hoped with that sort of thing she'd have asked a few scripted questions to rule out types of skin cancer. She didn't ask anything about it.

receptionists do not and should not do triage - they are not medical professionals and its well beyond their skill set and would have no liability cover I would have thought

Doctors are great, appointment system a shambles.

No need for the appointment system to be a shambles. thats a management issue and can and should be sorted

Thanks to that covid obsessed and business killing doom goblin Drakeford and his band of minions, the Welsh NHS is a total mess. Many many issues here.

Sounds like the OP uses my local doctors from what has been described. You have to fight to get a same day appointment, even for children. Regardless of anything. Receptionists are generally self appointed doctors, many with deep seated attitude problems who forget who they are. Someone mentioned they are trained to triage, are they hell. Just looking for the first excuse so they can tell you you cannot see a doctor today.

Adding to an already busy if not overrun A&E and doctors surgeries is the fact that they binned the out of hours doctors, so you now have to call the NHS 'helpline' wait hours and hours to get through (if you don't get cut off) which then puts you through to someone who inevitably sends you to A&E - if you're calling about a child they will 100% send you to A&E regardless as they won't take any risks. So don't bother calling about a child - its futile and mere time wasting.

receptionists do not and should not do triage

At a very basic level I expect my reception team to ask some very straight forward questions about why pats are phoning and what they want. I'd expect my team to be able to make a decision about which sort of clinician the patient should be seeing (one of the nursing team, an ANP, HCA GP etc), and I'd expect them to be able to recognise pts that could benefit from speaking with one of our Care Navigators if it's problem that could be best dealt with more quickly and appropriately outside the practice.

Emailing in symptoms and pictures and things – a huge NO from a confidentiality point of view.

No GP will ask you to email anything in. We have a patient records system that enables GPs to send MSM links to your phone and deposits the pictures that you send back via your phone straight into your records. I'd expect my GPs to be deleting sensitive pictures that don't need keeping (acute rash on babies privates, for instance)

If it's any consolation Molly, children get seen generally same day or following morning here by GPs

I would liked to have spoken to a nurse, or even sent pictures in. Apparently they do do this but it wasn't offered. I'm sure the service is there, I've just got no idea how to access it. If I don't get an appointment tomorrow I'll have to press them.

I honestly don't know how the Welsh system works, but I think you can access it by signing up to My Health Online I think.

Good luck, hope you get it sorted.

Can’t book appointments with our GP either . If you finally get through they just tell you to go to A and E if it’s serious enough. I haven’t bothered trying again since getting that message a few weeks ago. They are just doing a patient pass the parcel.

It's reassuring that Jeremy Hunt is working with the BMA to 'rebuild general practice'. You couldn't make it up.

They are just doing a patient pass the parcel.

It works both ways...
999 went out to see a 95 year old man (about 40 min ago) who fell a few weeks ago and hit his head, and now has poor mobility, wife can't cope with him, slurred speach, and a terrible headache...
Their answer... refer back to GP..

So i'm now urgently trying to arrange hospital admission for a man who should have been taken straight to A+E for an urgent CT brain scan.

FFS

DrP

IME rural practices are much better.
I've only been to mine once since I've lived here, six years, but that involved ringing up one afternoon, being told rather apologetically that they didn't have any appointments left that day and that the earliest they could do was 10am tomorrow? Yep, fine by me. That was 2019 though, so before plague if that makes any difference.
Others have reported similar around here.

Thanks to that covid obsessed and business killing doom goblin Drakeford and his band of minions, the Welsh NHS is a total mess.

I was bitten by a dog on Sunday, messaged my surgery via askmygp yesterday, had a call from the surgery about 30 minutes later trying to get me down for a Tetanus jab about 45 minutes later again. I've often had terrible experiences with the NHS, but this week has been a good one. I think that the issue may be more than 'because Drakeford'. (And a lot of it is obviously poor management, something that my GP seems to have sorted.)