[Closed] GP appointments....GRRRRRRR!

Yup, surely you knew 2 weeks ago that you were going to be ill.

C'mon now, you must plan ahead Young Padawan. 😆

Erm....that service is better than many get, what do you expect?

I'd have just gone to the walk in centre. You can see why people use a&e when it's not life or death though.

Seriously you are moaning because they couldn't see you the same day you called?

"Is this an emergency sir?"

What do you expect?

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in demand could be smoothed out.

I think I might call the book something like a Bookings Diary and sell the concept for millions

[edit] just found out that diaries have been available for centuries and the system I describe has been working very efficiently in other areas of life for decades too. Maybe someone should explain the concept to doctors.

go down to the Drs if it's not too far away for when it opens and ask for an appointment asap when it opens. With a bit of luck you'll have a sick note in your pocket and be off cycling for the day by 8.30am.

Its the inevitable result of a tick box culture. The fact that is doesn't function properly is neither here nor there. What matters is that the correct boxes are ticked so the statistics can then be published to say that its brilliant, and can't be improved on.

I decided recently, after nackering my shoulder, to not bother with trying to get a GP's appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn't give me the prescription for it, as I'd have to see my GP for that.

Nice bit of joined up thinking going on there. Why waste some peoples time, when you can waste everyones time instead. Bonkers

Wait until 6.30, ring 111 get a local ooh appointmet tonight. The system works, people just aren't told to use it properly.

Just don't suggest that GP's are in the wrong. They don't like being told that as they are never wrong. Ever. Why would you even form that opinion, you are most likely poorly educated and not a GP yourself.

All of that aside, I think your whinging is a bit premature. Call them tomorrow and see you you get an appointment. If you do, stop whinging, if you don't come back and we will offer sympathy.

You should have told them that you were getting chest pains......that always works. 😳

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in demand could be smoothed out.

Except when this was done lots of people felt a bit better over the intervening days between calling for an appointment and the actual date, and didn't bother going.

Nor did they bother calling to cancel.

Hence people who did wake up that morning feeling unwell couldn't see a GP as they were booked up for days on end with a significant percentage who would not turn up.

If you do get an appointment the following week 9 times out of ten there will be a problem with it and I can guarantee it will be changed.

They could free up a lot of appointments, and do the nations finances a favour at the same time, by refusing to see old people. Cluttering up the bloody waiting rooms, smelling of wee

I decided recently, after nackering my shoulder, to not bother with trying to get a GP's appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn't give me the prescription for it, as I'd have to see my GP for that.

Ah, but if they could give you prescriptions then people would just head to the walk in centre instead of bothering to book an appointment with their GP! 🙂

Except when this was done lots of people felt a bit better over the intervening days between calling for an appointment and the actual date, and didn't bother going.
Nor did they bother calling to cancel.
Hence people who did wake up that morning feeling unwell couldn't see a GP as they were booked up for days on end with a significant percentage who would not turn up.

Ah, well, IIRC, back in the day the old solution was to run an open clinic where you could just turn up and take your chances - which wasn't normally a problem because the GP always had some empty slots where people didn't turn up to their booked appointment 😉

Yeah it's pretty annoying, although hard to see how it could really be improved. At my GP if you phone during the day for an appointment it's usually 7-10 days until you can get one, the other option is queue outside the surgery from about 7:45am (with lots of other people, many coughing and sneezing...) and hope to get an on-the-day appointment when they open the doors at 8am, or wait until 8:30am and phone them (if you wanted to be reminded what an engaged tone sounded like).
The only solution I see is more GPs so the waiting time is only a day or two for any appointment but that's not going to happen.

When I call my local surgery I am given a choice between (a) booking an appointment in c.2 weeks' time or (b) calling back the following day in the morning. If I do that, a doctor then calls me and asks me whether I need an urgent appointment. If I claim I do he then fits me in that day or the next couple.

This is fine, until you get the combination of stiff upper lip and optimism, or gathering depression, that says it isn't really urgent, but there's no point making an appointment in 2 weeks as I'll be better by then and won't remember to cancel the appointment, which is wasteful. Therefore I eventually go to see a GP privately and straight away when I'm properly unwell, and get charged £70 for the privilege.

I suspect if I was better at putting on a sickie voice and pretending my ailments were urgent I'd get pretty prompt appointments, so it's my own silly fault.

🙂

I decided recently, after nackering my shoulder, to not bother with trying to get a GP's appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn't give me the prescription for it, as I'd have to see my GP for that.

and because the NHS seems completely unable to have any sort of IT systems that can share patient records, the drop in centre probably could not see your medical history or share their diagnosis with your GP

I must be lucky then, when the OH rings the docs is very unusual if they cant fit her in that afternoon or worst case first thing the next day. Often they will call back offering a cancellation if one crops up.

by refusing to see old people. Cluttering up the bloody waiting rooms

My old doc(Shipman) tried a variation on solving that but it didnt work out too well for him or them.

To the OP , I thought you were talking about my local surgery at first as they operate exactly the same, I have taken to dragging my poorly arse down there first thing in the morning til it opens, as its the only way to get a same day appointment.

Plus I never seem the same doc twice and have self diagnosed more successfully than them before now only reason for going is comfirmation and to get the necessary treatment whether its medicinal or physio.

I normally just go to the walk in centre these days if I want to be seen quickly but it is clearly not an A&E issue. My Dr also does this ring back thing where they will call you during the day and discuss the best course of action.

3 week wait here. The web is open 24 hours a day, much better service.

But what is the alternative?

The real solution would be to better fund GPs so they aren't running at or over capacity with no room to flex their appointments to meet demand.

But since we don't do that then there is no magic way to allocate time that doesn't exist. Give appointments out in advance then they get booked up by non urgent things, give them on the day and you have this situation. Get rid of appointments all togther and people complain they have to sit waiting for hours.

You can of course reserve some capacity for urgent issues and allow some to be slots to be booked in advance (which most GPs do AFAIK) but you still have to decide the cut off when you release the urgent appointments at some point.

[i]Ummm... Is there a idea there for demand planning/slot optomisation software for GPs so that they could allocate appointments based on predeicted demand[/i]

I have to leave for work before 8am so have the choice of taking the day off work and hoping to see the doctor or booking an appointment to tell him i was really unwell last month but managed to get some antibiotics/pain killer/antiinflamatories, special itch cream from this guy down the pub without a prescription. The guy down the pub is a vet but illness is much of a muchness isn't it.

I have taken to dragging my poorly arse down there first thing in the morning til it opens

Our GPs have "fixed" this flaw in their system by not allowing you to make appointments in person, only by phone. Can usually get a same day appointment to see a nurse though, but if you need a doc it can be three to five days, and you have to see the nurse whether that's useful or not.

Sorry, I wasn't having a go about not getting in today. Though I would have thought that they would keep a couple of slots free in the afternoon for such events.

I'm more annoyed by the pantomime that will be the 8am stampede for appointments which I still may not succeed at getting, and the casual referral to a centre 9 miles away, or the suggestion to abuse the A&E and 999 systems.

Somewhere the system has gone wrong, fundamentally wrong.

Somewhere the system has gone wrong, fundamentally wrong

Funding - Not enough of it. Simple realy.

Our new surgery's telephone triage system diagnosed me over the phone as having a virus. Three days later I was in intensive care with septic shock. Great system.

Is it just funding though? Or is the funding in the wrong place? Our local walk in centre was closed as the local GPs had capacity, but you struggle to get in at the GP, so they suggest you try a more distant walk in centre.

Some sort of phone triage may help seperate the appointments more effectively?

then when you do go for an appointment you have to wait for 45 minutes to an hour.

Some sort of phone triage may help seperate the appointments more effectively?

Yep - But then we get threads of people whinging they had to tell their problems to a receptionist or complaining the automated triage system got it wrong (see above).

The holy grail is probably some sort of alogorithum based automated appointment allocation based on triage assesesed need and predicted demand. With some clever manipulation of supply using locums by GPs the patient could be mostly unaware they have been rationed.

But for this to work people have to be a) willing to tell someone their symptoms over the phone and b)accepting of not being given the next available appointment regardless of their problem.

At present people aren't willing to do/accpet this.

Primary care gets (currently) about 9% of the NHS budget, but deals with 90% of the NHS workload.
Despite the criticisms above (which I acknowledge are a challenge), if you look at it from the 'global perspective' rather than the 'personal one', your GP isn't doing too badly with what they've got...

DrP

EDIT:
RE

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in [u][b]demand[/b] [/u]could be smoothed out.

You should have told them that you were getting chest pains......that always works.

Had killing toothache a few years ago rang NHS direct, spoke to a new girl (obviously), after giving out more info than you do on a first date, she asked if i had any other pain, all i wanted was a number for an emergency on call dentist, i said yes my chest hurt when i hit the tree and bashed my mouth, she put it down as chest pain, and in the background could hear her on the other line asking for an ambulance, luckily she came back to me and i told her again a i just wanted an emergency dentist, but you have chest pains she kept saying.

3 teeth out that night.

and O/P you coulsd also see your local chemist bloke,Pharmasist or someone with a similar speelling

What do you expect from private sector provision of care. With all GP's being private sector they only provide the appointments they think is necessary, not what their patients need.

Primary care gets (currently) about 9% of the NHS budget, but deals with 90% of the NHS workload.

Er... not quite.

Primary care deals with 90% of patient contact, which is a different thing. Still underfunded when the NHS is looked at as a whole, but then again, GPs do earn a jolly good wage...

A good wage within a defined contract. Good wage does not result in there being more hours in the day. And I pretty sure there is nothing in the gp contract that rewards their business for reducing waiting times for GP appointments. I know that doesn't really read that well but that is the reality, they are a private business operating under contract. The more money the business's makes, the greater the profit share of the partners. The weakness is the contract.

GPs do earn a jolly good wage...

When compared with other highly skilled and specialised jobs that put the job holder under high levels of presure, including life and death decision making they don't earn very much at all.

Not every GP gets the headline wages trumpeted by the Dail Mail in its race to the bottom crusade.

When compared with other highly skilled and specialised jobs that put the job holder under high levels of presure, including life and death decision making they don't earn very much at all

Could you tell me about those other jobs that have high pressure and life and death decision making, and tell me the salaries involved?

...and tell me about the nights and the weekends?

GPs get paid well.

Crike is right -I meant patient contact, as opposed to workload.
However, in task terms that is still likely to reflect a high percentage of the workload...

DrP

At my surgery, if you want an appointment sooner than 3 weeks away, you have to appear in person at 8am sharp to join the queue at reception when they dole out the apointments. No use ringing at 8 am as you never get through.

I'm not out to bash GPs, but the current cry for more of them would see workloads fall and presumably each GP earning less?

Oh....

More GP's could mean more anticipatory care planning and potentially less demand on secondary health care. It would also mean they could keep pace with demographic growth. the older person population growth is a crisis on our doorstep, GP's are critical to managing this in the community

Move to Cardiff. An hour or so every morning is open surgery - turn up in that time and you are guaranteed to be seen. Never takes more than about 90 mins in our place.

Not sure if this is a Welsh thing or not.

As mentioned on other page, call 111. Short telephone assessment and if it's needed to be looked at within a few hours then they'll book you an appt. at an OOH GP Service (can only do this after 18:30 and at weekends)

West Meon Surgery is Brill! The receptionist appolagizes if there is not an appointment when you ring...."Will this evening do"?

Molgrips - I run open surgery in my practice every afternoon... If you're willing to wait up to 90 minutes you'll get seen the same day... It does mean I get beasted every afternoon, but the view from up here on my high horse is amazing...!

DrP

got to say my gp has it nailed.. open surgery all morning from 08.30 til 11.30 turn up be seen you ll wait but you ll be seen appointments all afternoon even open late nights twice a week but as he says no ones poorly enough to come when corries on..

Shocking, isn't it. Last time I called for an appointment I had to wait a couple of hours to see a GP and then had to back again - the same afternoon - to get an X-ray.

Me: What if I can't get to Derby?

Receptionist: You can dial 999

For ****s sake no wonder we never stop and doing 14hrs+ shifts.

Wait until 6.30, ring 111 get a local ooh appointmet tonight. The system works, people just aren't told to use it properly.

Really? In the sense is saves you dialling 999 as they do it for you maybe.

I phoned my Dr. I'd like an appoinment please. When for? Soon as possible really. You cant have one. Eh. You have to phone back at 8am in the morning. Do you not find people cant get through at that tie. Its our policy. Its shit I cant walk or drive I need a sick note and I need an appointment so I can arrange to be driven to you. You have to phone tomorrow for an appointment tomorrow. But thats no good as i wont be able to get to you unless i can sort it out in advance. You have to phone at 8 am. How about you **** off.
I never did get a sick note until.a week later when I had my second hospital appointment.

I run open surgery in my practice every afternoon

Good stuff. Although the morning thing is very convenient - seems to be when we need it most.

My wife rang for an appointment for one of our girls today.

She rang at 8.00am. She was in the doctors (seeing our preferred Doc) for an 8.50am appointment.

Had the same problem recently with my GP. Needed to see a GP, didn't want to take time out from work so tried to make an appointment for an evening surgery the following day. "Sorry you'll need to phone tomorrow morning to make an appointment for then. Call us at 8.30 as it's when we open". Result is 30 minutes trying to get through, only to be told they're full once you get anything other than an engaged tone. Helpfully they could fit me in sometime next week. Rang 111, who listened to what my problem was, and told me to ring the GP back and insist I needed an appointment within 24 hours.

Finally get my ultrasound scan on Wednesday to finally get to the bottom of it, a mere 6 weeks later. So much for certain things needing to be checked urgently!

DrP - I agree it is mostly an issue of demand outstripping supply but what our surgery has implemented a system designed to better serve them rather than better serve the patient.

A normal appointment will be available in 10-15 days. Great for long standing conditions and planned events.
An emergency appointment can only be booked by ringing on the day at 8am and again at 8:01am and again at 8:02am...

What about something in between?

I have been running a temperature since Saturday of just over 100. Sometime it drops and I feel okay for a couple of hours and then it comes back and I am sweating and aching. I missed the 8am lottery this morning and will need to stay home again tomorrow to try my luck.

What I would like is to be able to ask for an appointment and get one allocated in the next few days instead of being gold to rest over the weekend and ring again on Monday morning when I would be told to try again on Tuesday.

We speak to everyone first, guarantee to see everyone who needs seeing on the day they call. Seems to work pretty well apart from the fact we're running at flat out, especially if someone's off work.

Each week 9.2% of our patients call to request an appointment.
Each week we see (face to face) 4% of our patients.
(This doesn't include nurse appointments.)

That equates to me phoning 40-75 patients each day, seeing 15-30 of them and visiting 1 or 2 plus prescription requests and letters, blood results, etc. We're at the high end of demand as a practice. Just know that we don't deliberately make it difficult for patients to see us (we spend time and money trying to make it easy)- sometimes I wonder why we bother!

GP's are ace in my opinion! You get seen quickly, and at a given time! You get the drugs you need etc.. If this doesn't happen at 'your' surgery, move to another where it does!

Wait till you end up in hospital... You can spend weeks waiting for a simple test, like an xray! Dr's come when it suits them, not when needed to make desicion on care 👿 Pills that should be given at regular intervals turn up at random times etc etc

I could go on, but I won't.

My GP is usually pretty good- sure you sometimes want to see them faster, but they're obviously up against it resource wise. And a big part of it's got to be the "customer", they ask if it's urgent, I generally say no but you can guarantee there's people taking up the emergency appointments for ****-all.

What does annoy me is hospital appointments. Need an appointment? We'll post it to you. Can't make that time? Phone up and cancel. We'll send you another one. Then, get furious letter because you "missed your appointment"- even though you rescheduled. Then every time you go there there's posters everywhere, "don't miss appointments". Though, one time an outpatient's clinic was rammed and massively delayed, they admitted it was because everyone had turned up- they didn't have enough seats never mind doctors, they plan for DNAs even though they complain about them, turns out they rely on them.

Can usually get a appointment with any of the four gp's the next day. If not Wednesday morning you can get there at 0800 and get seen.

If I can't then ringing 111 and you can get an appointment at the primary care centre.

I have read through this thread and decided that what we need is a nationwide initiative to raise standards which can be driven through at short notice spand lowest cost by a mass reorganisation and a new computer system code eloped by Atos and Cognizent.

Everyone agree???

😉

Move to Cardiff. An hour or so every morning is open surgery - turn up in that time and you are guaranteed to be seen. Never takes more than about 90 mins in our place.

Not sure if this is a Welsh thing or not

My surgery in Cardiff is exactly the same, though the most I've ever had to wait was an hour - which doesn't bother me in the slightest. We probably go to the same surgery (Whitchurch?) 🙂

Contrary to many experiences here my GP surgery is excellent.

Morning and evening appointments reserved for urgent issues and one GP starts each day at 0700 for people who need to go before work.
Nurses are first come first served in the morning and appointments in the afternoon.

Receptionists are helpful and polite with prescription renewals carried out very efficiently

About time people were charged for missing appointments by just not showing up, not even courteous enough to make a phone call to say they can't make it

Do any GPs run a sort of priority booking system based on how infrequently they see you?
I.e if you only ask for an appointment every 10 years or so, it's probable that it may be important, rather than say the worried well booking?

Did the OP get his appointment?

ok, I'm sorry to all the GPs I've offended.

Started ringing at 8.00, 15 redials and 6 minutes later I got through. Appointment at 10.20. Happy with that. 😳

I will add "cranky and short tempered" to my list of symptoms. Though if the doc checks my posting history on here he may decide it's an on going condition.

At least I'll get to ask him if he prefers his R8 to his old 911 😉

priority booking system based on how infrequently they see you

This is a superb idea. 🙂

IanMunro - Member

Do any GPs run a sort of priority booking system based on how infrequently they see you?

I should bloomin hope not, sure some frequent flyers will just be coming in for things others wouldn't, and some of that could be considered timewasting or nonurgent but some people just need more doctor's time than others.

We probably go to the same surgery (Whitchurch?)

Nope, Pontprennau.

He prefers the R8 btw, and made sure I got an eyeful of his shiny Rolex when he took my pulse.

Doesn't actually know what the matter is, suspects I'm a bit stressed and run down. Never knew you could go all dizzy and woozy with stress but apparently you can.

I resisted the urge to say "Stressed? STRESSED? Have you ever tried phoning for an appointment at 8am? I'll show you stress!" 😆

Started ringing at 8.00, 15 redials and 6 minutes later

My doc is pretty good and getting a that day appointment often works.
What pisses me off is that I can't book ahead. If its not urgent I want to plan around work. I call to be told that they can't book ahead and I have to call first thing in the morning.

My doc is pretty good and getting a that day appointment often works.
What pisses me off is that I can't book ahead. If its not urgent I want to plan around work. I call to be told that they can't book ahead and I have to call first thing in the morning.

The problem is that there aren't enough appointments to go around!

At one end of the spectrum you can book ahead but have to tolerate long waits (1st appointment with Dr Popular is in 3 weeks) plus the 8am phone scrum for emergency/on the day appointments. At the other end you have all appointments on the day only with a guarantee that everyone who calls any particular day and wants to be seen will be (but most are dealt with by phone). There's then all sorts of hybrid systems but none is perfect. Part of the problem is that GP practices serve different populations with very different priorities, from the chronic sick who are normally old/ not in work to the young, normally fit and well who need access around work. Keeping everyone happy is nigh on impossible. Perhaps we need to separate practices into those that cater for the normally fit and well and those that cater for those with long-term problems- walk in clinics and suchlike work a bit like this already.

As an aside, I reckon 10 minute appointments are unsafe for many patients...