[Closed] Reasons you can't see your GP when you want...#32

Doesn't it mean you can just put your feet on the desk and start some new threads?

Perhaps they kicked the bucket through the night.

Perhaps they're scared of you ?

Did they phone up to apologise? I can't understand why anyone would not turn up without phoning up to let you know. Bizarre. When they do eventually come in, misdiagnose them with something acutely embarrassing.

To be fair, it is early.

Or possibly they're overwhelmed with the cute factor of a kitten licking its own nose?

http://www.bbc.co.uk/news/uk-england-london-23261505

Waiting rooms make you ill because they are full of ill people. Maybe they did not want to get sick.

Charge them, not sure why the government haven't jumped on this revenue band-wagon already.

Would be interested to know how many is 66% though...

Hmm this always frustrates me now I love the NHS but I need to see my GP and can't get to see him until the end of this month.

I was offered a nurse appointment but that would be with the guy who misdiagnosed the issue in the first place so declined.

The best I can do is go there and be awkward and demanding to be seen.

I do not see GP often. Twice a year would be a lot for me but I think its the 80-20 rule where 20% of the patients use 80% of the resources and clog up the systems.

They've probably been waiting so long for an appointment that they are now well.....or dead. Isn't that how it's supposed to work?

When you say 66%

That's literally just 2 out of 3 people this morning isn't it ?

Just one of those days .... chill 😀

so two out of your first 3 patients haven't shown up?
your percentage is wrong, pffft they'll make anyone a doctor these daya

Probably rang 111 after having the symptoms for weeks and stopped taking the meds prescribed to them by you after 3 days as they weren't working but since then have got worse. 111 would then request an 8 minutre response by ambulance were they'd take them to A&E, they would sit for 5 hours as they aren't a priority before getting home at 4am this morning and now are too tired to come and see you. So they will ring 111 in 3 weeks time saying they feel worse and no one has helped them.

[i]your percentage is wrong, pffft they'll make anyone a doctor these daya [/i]

perhaps one of those that didn't turn up has a limb missing and therefore doesn't count as '1' for these purposes?

Do you operate an 'open surgery' system, btw?

Still, more time to decide which one of your Range Rovers you are going to drive to the golf course after lunch 🙂

Well its fair enough. My local GP surgery has a tv telling the waiting room the % of 'no shows' there were in the last month.

Yet as I sat there, yet again waiting 20 mins after my appointment time for (?10min? appointment) - and it was only 10am, I wondered why that TV didnt give a balanced picture by telling patients this % of late appointments too?

Maybe they're too ill to get in and because it's virtually impossible to get a home visit now they've had to go to A&E? 😉

What are the first 31 reasons? Are they because the Dr's aren't in, won't do home visits, playing golf, riding their bike, etc?

[sorry Dr P]

Two thirds of patients don't turn up, and I still have to wait an hour when I have a 9:30am appointment. Never did quite understand that. At 5pm, sure, delays happen, but at that time of the morning?

After waiting weeks to see my GP and booking a double appointment, he put me on a timer saying you've got a minute get to the point : (

Are you actually on 5 Live now?!

GP appointment system is properly broken here. Who has the patience/time/inclination to jam the switchboard at 8:30am when they're, you know, ill? I'd hazard a guess that the worried-well figure quite highly. I don't have the answer, and you docs have my sympathy, but it aint working as it is.

After waiting weeks to see my GP and booking a double appointment, he put me on a timer saying you've got a minute get to the point : (

That's mad!

Still, more time to decide which one of your Range Rovers you are going to drive to the golf course after lunch

DrP

(Anyway, they're all trickling in now..... on of the DNAs turned up late anyway...)

I think some people aren't pushy enough, in an environment where a lot are too pushy.

I rang up and asked for an appointment and was a little non-plussed when offered a day my grandchildren might just live to see, so the receptionista asked if it was important. I said I didn't know, I had a sort of lump on my abdomen and wondered if it was a hernia. She almost shrieked and demanded I come in immediately.

(That got me in the door so I could show the doc my sore toenail and talk about getting signed off for my nerves. 😉 )

Could you not just get everyone to come in at the same time, then settle who gets the first appointment by recreating the competitive nature of a 70's kids game show?

[img] [/img]

You could offer everyone a free physical exam?

is there a certain psychometric test for GP receptionists?
If they are borderline sociopaths do they get hired on the spot,
or is that just the way they do it in Yorkshire?

Probably rang 111 after having the symptoms for weeks and stopped taking the meds prescribed to them by you after 3 days as they weren't working but since then have got worse. 111 would then request an 8 minutre response by ambulance were they'd take them to A&E, they would sit for 5 hours as they aren't a priority before getting home at 4am this morning and now are too tired to come and see you. So they will ring 111 in 3 weeks time saying they feel worse and no one has helped them.

That would be funny if it wasn't true 😆

What's your receptionist like? Middle aged Rottweilers all of them. They demand to know exactly what's wrong with you before using their self determined medical superiority to deny you an appointment. If you do get through the telephone interrogation and razor wire that they all place out front shortly after the docs arrive, then its a ritualistic torture period of having to stand and stare at their backs whilst they finish their chit chat with colleagues before pointing a flabby finger at the touch screen that you are supposed to use, without so much as a greeting. Of course you can't use this as you'd have to wait behind the 90 year blind woman that's feeling along the wall to find it as the receptionist has already shouted at her to do.

Btw if a doc put me on a timer, he'd be tick tocking all the way home that night...

That would be funny if it wasn't true

It's not true such things would never happen and it was meant in fun. Honest.

My old surgery use to post up how many patients missed their appointments the previous week, the number was shocking sometimes.

My local GP surgery has an incredible amount of DNAs. After a year of living here I noticed this and now whenever I need to see the GP I just go in and ask if they have any "cancellations" and get seen within 10 minutes.

he put me on a timer saying you've got a minute get to the point : (

😆

Also, if you have a receptionist that says 'Doctor will see you now' rather than 'The Doctor will see you now', that would put me off. I'd probably book phantom appointments just to wind her up.

God doesn't need a pronoun for his title, everyone else does.

DrP - Member
So far today, 66% of my expected patients have not turned up....

Why bother the GP, when you can just post up symptoms on here and get an instant diagnosis,
also its sunny so why drive to the GP, when you can sit in the garden and make a recovery, only to be ill tonight

the surgery i use is militant about being on time for appointments (probably justified judging by the number of missed appointments) however if you're literally 1 minute late to see the doc when you got stuck in traffic and are obviously struggling to walk, a bit of compassion would be nice from the receptionist...

my doctor is brilliant though so you take the rough with the smooth sometimes

[i]my doctor is brilliant though[/i]

It's good cop/bad cop isn't it.

GP's choose a fierce receptionist so that a small amount of compassion from them feels like they've wrapped you in cotton wool and sung you lullabies 😉

..also its sunny so why drive to the GP, when you can sit in the garden and make a recovery, only to be ill tonight..

Not far from the truth!
When the sun's out, often the balance between "I'm bored and not 100%, where shall I go..beach or A+E" shifts towards the Beach!!
Well, at least it was last saturday! A+E was oddly quiet!

DrP - being cynical today!

Reasons you can't see your GP when you want...

because they're impossible to contact?

1)phone up at 9.30am - hear a recorded message saying "the surgery is now closed, please call back during our surgery hours; 8:30am to 5:30pm

2)phone up at 10:45am - hear a recorded message saying "we are now closed for lunch, please call back after 12:30"

3)phone up at 1:45pm - hear a recorded message saying "we are now closed for lunch, please call back after 12:30"

4) phone up at 3:15 - hear a recorded message saying "the surgery is now closed, please call back during our surgery hours; 8:30am to 5:30pm

yes, The Crookes Practise, Sheffield, i'm talking about you.

You're very quick to send out the 'you haven't had an asthma check-up for 2 whole weeks, we cannot process your repeat prescription request until you seen the asthma nurse, please call to make an appointment' - but you never answer the sodding phone.

^^^
You need to raise this with the practice manager - this sounds like a phone line fault (auto switching error) and is actually a significant critical incident for the practice. They may not be aware of it....

DrP

I know! But to be fair, I could get to my point in a few seconds - 'had me blood taken, I have a haemoglobin count of 4 I feel crap' I was out of the door in less than a minute. Completely dismissed me on the basis I rode me bike in and riding on a regular basis. Thank **** for A&E.

it's been like that for 6 years.

yes, i've complained.

^^
I'd Change practice!

DrP

[i]I'd Change practice![/i]

this, GP's are private businesses run for profit, if they don't deliver, go elsewhere.

I Booked an appointment the closest i could get was in 7 days time.

That 7 days finally came up, I arrived 15 mins early as I like to be on time (this is the norm for me in any situation) I then proceeded to wait till 10 past 10 (my appointment time)then 10 past 11, then i asked the receptionist what was going on. I then waited another 45 mins for my appointment.

so i was an hour 45 mins late in to my appointment, no apologies. about 2 mins later i left my appointment.

Now if i was an hour 45 mins late to any GP surgery I'd loose my appointment, what makes the GP's think this is acceptable.

Completely dismissed me on the basis I rode me bike in and riding on a regular basis.

I had an irregular heart rhythm a few years back and was on a 24hr recorder. Although they did tell me not to have sex that night as it "messes up the recordings", they didn't tell me I couldn't ride my bike. So I rode in to the hospital to have it removed the next day and got thoroughly scolded by the nurse 😳 Still don't really understand what the problem was - don't they want a representative sample of what I usually do?

You need to raise this with the practice manager - this sounds like a phone line fault (auto switching error) and is actually a significant critical incident for the practice. They may not be aware of it....

DrP

Obviously you live on a different planet to your patients Doc. As you may have noticed there is little sympathy for your no show predicament. Most peoples experience of a GP's surgery nowadays is pretty damn negative.

Appointment system: Phone after 8:30 to make an appointment fot that day. Really ****ing helpful if you happen to have the discourtesy to work some where else and start before 8:30. My experience is once I actually get through, which on average takes no less than 18 minutes of constant calling, the answer is invariably I can get you in in 15 minutes can you get here then? When I say I'm actually at work and it will take me at least half an hour thats answered with a sigh and well thats all we've got available. So the obvious next step being can I make an appointment for another day. Answer No! Phone tomorrow at 8:30. When pressed, they will give an appointment. The soonest I've been offered to date was in 24 days time!!
So I wrote to the practice manager. I got a reply full of patronising platitudes back. Basically saying how I as a mere mortal couldn't possily understand the complexity of the demands on Doctors and more still their support staff.

To me its blatantly obvious that if there is a 24 day wait for a pre booked appointment, there will obviously be no shows, (they've probably snuffed it while waiting to be seen) and more so there aren't enough prebooked appointments available. I am not alone in working away, about 95% of the working age population of my village are in the same boat.

Every morning there is a queue outside the surgery trying to beat the jammed phone lines that can't cope. In fatct when I asked about that the half wit practice manager did admit that it was an issue for them, becuase all the demand comes at once..... (no shit sherlock!) Unfortunately, he couldn't see the connection between the idiotic appointments system, no shows, and jammed lines. Let alone the increase in stress related problems with the reception staff who have to deal with irate patients.

Do you know, I couldn't even get a timely appointment for my wife who is in recovery from breast cancer???

If anyone ever asks me again "is it an emergency?" I'll ****ing scream "no you halfwit, if it were I would have dialled 999 and have been half way to A & E by the time you answered this ****ing phone.

The system is bust. Don't come on here and moan about it. Fix it.

PS: My wife who also works, normally takes the first appointment of the day at the lcoal cancer unit. The earliest she has been seen is 25 minutes late. One time ti was 2 1/2 hours!! I'm sure there is a logical explanation somewhere, but it probably invovles the phrase "couldn't organise a cluster**** in a brothel"

...... and yes I am pished off with it.

I can phone up now and probably get an appointment for today but certainly get one tomorrow, so Berm Bandit what is it you want DrP to fix?

[i]it's been like that for 6 years.[/i]

Has the rash cleared up by itself or do you still need treatment? 😉

and yes I am pished off with it.

so as stated several times, change doctors.

our is pretty good. rarely go for myself but they've been really good with my son.

Are you a real doctor posting things anonymously on the internet? Tut tut 😉

One of my patients came in yesterday to say they didn't want me to treat them. Luckily I had my bike with me so was able to go for a ride for an hour 🙂

so as stated several times, change doctors.

Have you ever tried to do that in a rural setting??

The next nearest practice is the same outfit, as is the one after that. So basically if I could I would, unfortunately the concept of choice is not one that the NHS is that familar with generally.

what is it you want DrP to fix?

I would have thought that was blindingly obvious, but as apparently its not, if his system is not working, rather than come on here moaning about his patients how about having a little think about why its happening and what active steps could be taken to prevent it. I suspect my experience is not that different from most, certainly that is the case anecdotaly if not measured scientifically

I would have thought that was blindingly obvious, but as apparently its not, if his system is not working, rather than come on here moaning about his patients

Well no it wasn't as you were complaining about having to wait a whole 24hours for a Dr's appointment which is pretty good I'd say. I can't see how people not turning up for an appointment is DrP's fault. Maybe if by some chance your practice is DrP's then just maybe if people didn't waste appointments you could get one the same day.

I think he said 24 day wait which seems unlikely.

I'm looking forward to suggestions for DrP to make sure his patients attend.

maybe they went online and got their tablets cheaper and delivered next day free of charge.

there is no place for the modern GP surgery these days, I do all my own analysis online and dont have the time to wait in a doctors surgery to be told what I already know from talking to intelligent multi talented like minded people on forums like www.fevertrackworld.com

in fact I havent seen a doctor or dentist for years as I can now do all my own minor surgery after seeing it on youtube. and following the steps.

The LGPS needs to change how it deals with the public if it wants my business, like opening when I'm walking past, or organising group surgeries, and lending me their equipment if I pop in with some jaffa cakes

😉

Berm-Bandit - you are clearly frustrated, and I'm actually willing to be your punchbag for the remainder of this thread, but yo should also understand the difficulties faced by the other side (i.e. the practice's side).
Yes, the system IS in trouble, but in part that's due to a multitude of factors:
[b]Patient expectation[/b] - everyone can google their symptoms and come up with something terrible, so they MUST be seen ASAP. However, the fact is the vast majority of conditions seen in primary care are self limiting - they usually get better by themselves, though you'll feel a bit 'iffy' whilst it heals. The demand to be seen ASAP for simple conditions really fills up lots of slots... "I can see your well child does have a temperature, but they've only had it for 6 hours, haven't had any calpol, and are running around like a wild thing. I don't know what's wrong, but chances are it isn't serious, but it's too soon to tell" may as well be tattooed on my forehead....

[b]Ageing population[/b]- if everyone died by the time they hit 60, we'd have a lot less chronic disease management requirements. Chronic diseases are time consuming and tough.
I'm not saying everyone should be culled at 60, I'm just saying how it is...

[b]Appointments systems are flawed[/b] and I'm not sure what the answer is TBH.
In response to your comment:

If anyone ever asks me again "is it an emergency?" I'll * scream "no you halfwit, if it were I would have dialled 999 and have been half way to A & E by the time you answered this * phone.

Then it comes to the concept of "waiting" - and I agree that's an issue I can't put my finger on....
Most 'pre-bookable' appointments fill up very early, so when I wanted to see my GP about migraines I felt daft taking an appointment [/b]that day[b], but there was no other option. I could have waited 7 days. I could have waited 10 days. As long as I knew I was due to see them, that would have been fine. But I couldn't, so went that day. Daft.
This then makes every appointment 'same day', and of course then it returns back to the 'first come first served' principle, which again is flawed - as you demonstrate in yor difficulty getting an appointment.

So...
In summary, to fix the system, we need:
-plenty of same day appointments for those needing to be seen that day.
-Those who have booked same day appointments (see the OP) to turn up.
-Plenty of pre bookable appointments, that only become 'open' after 10am, 2 weeks in advance. This means you don't even need to ring in at 0830, as if you're happy being seen in 2 weeks, ring in later in the day.
-Those who book pre-bookable appointments must also turn up.

Not that hard, but you try getting patients and staff to respect the idea, and acknowledge that they must hold some responsibility for looking after themselves, checking their meds aren't 'urgent' because they let them run out, and make sure they aren't talking on their phone when they go through checkouts.....

DrP

last time i went to the drs [ specialist]about 6 of us had the 9 30 appointment and i got seen at dinner time- my degenerative eye condition had not improved [ surprising eh] so I was still entitled to NHS treatment; so it was not a complete waste of time 🙄

Neither side of this equation seem very good with appointment times IME

On monday I waited with my 3 year old lad to have his fracture clinic appointment for his 1050 appointment time, we were seen at 1400.

I didn't get special treatment or nuffin', even when I paraded around with my stefiscope around my neck...

DrP

(though I did see a celebrity in the waiting room)

Have you ever tried to do that in a rural setting??

This is a real issue, all surgeries near me are the same lot. Though its possible the receptionist at one of the other surgeries may let me make an appointment without pre-diagnosing my condition. Oddly she wants to know my ailments before giving me appointment (she's leakier than a sieve and the best way of spreading information round the town), but the online system tells me to see a GP, when the asthma nurse will do. Sorry that turned into a rant.

But serious question, is it a cunning trick that asthma nurse tells you different and sometimes contradictory information each time you get dragged to go and see them? And is it possible to get out of going to see them every year? I can put a peak flow off the scale, have been using an inhaler for 25 yrs and am not about to forget how it works and start putting up my arse or anything, and if my asthma got bad, I promise, I would go to the doctor, myself, spontaneously.

(though I did see a celebrity in the waiting room

surely you can tell us who as you were there in your non profession Joe Pleb capacity.

DrP, stop wasting your time on this thread with a bunch of whingers who probably won't even turn up for the rest of the thread, and get back to my thread where you belong and diagnose my back problem. Sheesh - you just can't get the attention of a real doctor moonlighting on a bike internet forum any more - what's the system coming to...

I think he said 24 day wait which seems unlikely.

😳

"I can see your well child does have a temperature, but they've only had it for 6 hours, haven't had any calpol, and are running around like a wild thing. I don't know what's wrong, but chances are it isn't serious, but it's too soon to tell" may as well be tattooed on my forehead....

Oooh maybe if I get one done too they'll do discount.

Our GP (AFAIK) only does same-day appointments, aside from referrals from other places. You've to ring at 8:30 on the dot and wardial until night services switches off, at which point the recorded message changes from "we're closed" to "you're position 18 in the queue, please hold." That said, once your call finally gets answered there's rarely any difficulty in actually getting an appointment.

The receptionist asks what it's for, but is quite happy to take "I'd rather not say here" as an acceptable answer. Presumably it's either to help with selection of doctor (eg, to ask if you want a female doctor if you're ringing with ladybits plumbing issues) or to gauge whether a double appointment slot might be necessary.

Waiting time is hit and miss. We've just got back from there now and we were seen today within about a minute of arriving; sometimes there's horrendous backlogs but generally they're pretty good.

Hospital appointment waiting times are exponentially worse IME. I touched on this before but we've been to 9:30am consultancy appointments and been sat waiting for an hour or considerably longer, and that's far from an isolated incident. I really do fail to see how there can be such a long delay so early in the day, when there's just not time to build up a backlog and they're not the sort of consultants I'd expect to be called in to attend emergencies. What's really wee-boiling though is there's no feedback; no apology, no word from the receptionists as to how long you're likely to be sitting there quietly growing a beard, and if you dare to ask how long it's likely to be you're treated like Oliver Twist asking for more. Then when you do see the consultant it's like you've been granted an audience with the queen as they swan around (slowly) with their noses in the air.

So yeah, my GP's practice walks on rainbows compared to our hospital appointment system.

I think he said 24 day wait which seems unlikely.

That is precisely what I said, and precisely what was offered. Bascially everytime you call its a battle with the receptionist as described. Ridiculous

Patient expectation - everyone can google their symptoms and come up with something terrible,

I'm sure what they really mean is "do you need to be see urgently".

Regarding missed appointments: My dentist sends an invoice for the time wasted for a missed appointment. Amazing how memory improves when that happens.

Out of interest what I was trying to make an appointment about was shortness of breath over a period of time i.e. as in weeks. I was not asking for an immediate appointment, quite the reverse in fact.

Given that one of the more serious of problems especially amongst men is a reticence to go to the GP even when obviosuly necessary, run it past me again as to why making it such a massive problem to so is a good idea?

A shrug of the shoulders and a statement like this:- Appointments systems are flawed and I'm not sure what the answer is TBH, is the entire reason for my original ranty post. Especially in respect of such an obviously and fundamentally failing system. In my line of work thats enough to close you down.

The self evident answer is that to repeat something that isn't working expecting a different outcome is indicative of madness. So the answer very simply is try something else, and keep trying something else until you find something that works.

Berm Bandit your bad experiences with French GP's may not relate to here in the UK.

Merci.

My old GP used to be ace. The past two just take what they see in front of them and shoe my away. Oh your riding bikes you must be ok. Ignoring the fact that I'm weak as a kitten barely able to stay awake & often failing asleep in the waiting room & in their surgery.

Yet when I had a mole on me arse I'd had an appointment in two days and it was removed within 4 days : )

What really irritates me is my outpatient's clinic... The care is really good, but you can't make an appointment in person or on the phone. You have to tell them "I want an appointment in about 6 months", and they post you one. Which you can't attend, so you phone them about 20 times, and they never answer, so you email them and leave it at that and it turns out they don't read their appointments emails. Or you never receive the letter, so the first thing you know about is the rude "You missed an appointment, you ****" letter. So the sign in that particular clinic about the no-shows really annoys me, because I've been a no-show twice for that clinic and it's entirely their fault.

My GP reckons there's a direct correlation between the rate of no-shows and the average waiting time to an appointment. But there's all sorts of reasons that could be. I reckon a big part has to be that if people are unhappy with the response when they call- come back in a week, or call back at exactly 7.03 on an even numbered date- and so they think "Well if they don't treat me right, why should I treat them right" when it comes to cancelling or not.

Regarding missed appointments: My dentist sends an invoice for the time wasted for a missed appointment. Amazing how memory improves when that happens.

Ah yes. That's a proper can of worms when it comes to medical care. Who administers that? Who collects the money? Where does the money go? What happens if you don't pay? Are you then barred from further treatment? Then what?, etc, etc.

Any more ideas?

That's a proper can of worms when it comes to medical care. Who administers that? Who collects the money? Where does the money go? What happens if you don't pay? Are you then barred from further treatment? Then what?, etc, etc.

Any more ideas?

Pretty straight forward actually. The intention is not to be in a position whereby banning/charging people etc is necessary. In fact it is quite possible for GP's to ban people, and they do use that power. The idea is the precise reverse, which is to generate a situation whereby the desired outcome is achieved. i.e. show up or cancel in a timely fashion. IT IS NOT TO ACTUALLY INVOICE PEOPLE. There is a well trodden path that is summarised by the saying easy come easy go. Which basically means people don't value that which does not cost them much to obtain. So the reverse of that coin is give it a value and people then treat it better. For example putting a price on catalogues is a well know tactic to stop them going in the bin.

So advertise the fact that missed appointments will be charged, and indeed send out invoices. It won't take long to get around, and I guarantee that the outcomes will improve.

I do similar with debt collecting in my business. Sending out a County Court application made out in their name and address normally extracts an outcome within 20 minutes or so of it being emailed/faxed. I rarely ever actually get past filling out the from. Same principle.

The waiting times for appointments with consultants at clinics does seem to take the wee wee in many places - like when you have an 8:40 appointment time for a consultant who doesn't start work until 09:30. I mean, seriously, what the blooming heck is that about? I can understand running late as the day goes on, but this was deliberate. And, to be clear, we were told the consultant started at 09:30 when we turned up (for our 08:40 appointment), so it wasn't that they were running late that day or something. [/breathe]

my GP ( who rides an Orange and has bike mags in reception) has it fully dialled in..

turn up on spec before 11.30am and you ll be seen by a gp there and then.. make an appointment 3pm - 6.30pm and you ll be seen roughly on time.. i usually snap up the last one of the day .. we have a good chat as he has loads of time because no one wants to come at tea time..

Trouble with charging for missed appts is that some people may not pay. I understand what you're saying and I appreciate it works in business and I also get that it's not an aim to be sending out invoices but if you do and people don't pay, then what? Some people actually don't have any money and these may be the same people who miss appts because their lives are chaotic, or they're drunk, or drugged up somewhere, etc, etc. I appreciate that the majority of patients are not like that but there may be a significant number of those who don't attend on a sunny day who are. I'm speculating here but there may be some evidence for this. So what happens then? Are they barred from that practice and blacklisted elsewhere? Do they then turn up at A+E and clog that service unnecessarily?

I don't have any answers either. It may be that the lack of perceived value is the problem, along with a lack of concern about the consequences of your actions generally and failure to consider other people. If we live in a society that cares then these are problems that we need to care about and the answer is not always financial, either as punishment or reward.

I don't have any answers either.

You probably didn't read it, but what I actually said was:-

The self evident answer is that to repeat something that isn't working expecting a different outcome is indicative of madness. So the answer very simply is try something else, and keep trying something else until you find something that works.

I merely pointed out that my dentist uses an invoice for a missed appointment to good effect as an example of thing that can be done. Apparently in Singletrackworld a dentist doing so is not a problem, but a doctor doing the same is apparently an insurmountable issue.

But people generally pay for dental work ANYWAY on the NHS, and those who don't pay (free entitlement) are unlikely to be able to pay for not showing up.
This means the 'concept' of paying a dentist is much more acceptable whether you do or don't turn up.

As no-one (bar private patients) pays at the point of service for a GP, it will be a complete outrage if they were to be asked for money for missed appointments. people simply do not expect to hand over money in a GP practice.

There are plenty of efforts to incentivise the idea of keeping appointments - most of these are along the lines of 'advertising that month's missed appointments' in order to highlight the issue to the wider patient group.

I also agree with your statement alluding to 'ownership of a service you've paid for' (which is one reason why people paying for chiopractor/osteopath services have "great outcomes" - the financial investment made skews their perception of the actual outcome). However, as raised, the idea of charging at the point of service for GP is a very muddy one. I'd like to see a better system, but I'm not sure it involves charging for appointments....

DrP

I think it depends where you live. Ours in Preston isn't that great. Last couple of times I've had to see the nurse instead. Who then had to have a quick word with the doctor. At least i got some decent pain relief (sciatica). Daughter is at uni in leeds and the service over there is superb. eg. she's at home at moment and her doc planned apointments for physio etc at another practise after he'd seen her so we could do it all in one journey 'cause theirs was holiday.

DrP beat me to it. Dentists and doctors are remunerated differently and as well as people being used to paying the dental practice already has systems in place to send out invoices, etc. My point is not that this is an insurmountable problem to do this in a medical practice but that there will be people who do not pay a fine and then how do you sanction them? People don't commonly go to dentists with life threatening problems (although they can) so barring them may not have the serious consequences that barring them from medical services might have.

You probably didn't read it but what I actually said was:-

I read something about patronising platitudes somewhere . . .

You suggested the answer is to try something else. I'm just explaining to you why the only 'something else' you've suggested isn't such a good idea IMO. It's the question 'what else?' that I don't have any answers to. And neither, apparently, does anyone else.

I do sympathise with your problem and agree the system you seem to have to operate in is bad. I've a feeling this may be a system that was introduced relatively recently (I mean in terms of the age of the NHS) and clearly it isn't working. On the face of it more staff are required, to answer phones, see patients, etc but that has implications for the profit of a medical practice (business and care don't always mix well) and the OPs OP suggests that he is only 33% occupied anyway. Pretty inefficient use of an expensive resource.

I'm sure what they really mean is "do you need to be see urgently".
If it's to discuss sexual dysfunction/pill check/8 months of niggling headaches - that can wait can't it.
If it's because you've been vomiting blood, or have severe ear pain, then that should be seen that day.

The trouble is, that's applying a yes/no criteria to something which isn't yes/no. Quite often when I go to see my GP (which isn't to imply I see my GP often - I'm one of these men who tends to put off going longer than I should, and have been told that I should have come in earlier) the problem isn't life threatening, but neither is it something I want to wait over a week to see somebody for, which is the typical earliest I can get an appointment if I book one. Also, exactly how urgent is depression which is sufficiently bad to drag somebody reluctant to see a medical professional in? OK, so maybe I will actually be better in a week's time without seeing anybody - until the next time that is...

To some extent our practice is better than others being mentioned as I don't have to deal with reception staff at all - they have an online booking system. However that doesn't get around the basic issue that there never seems to be an online appointment available the same week, and if there is it's invariably with a female doctor I don't want to see. Oh, and when I asked to make an appointment with the gateway worker, I was told he wasn't available and given some convoluted process to see somebody, the sort of thing I can't cope with when I'm depressed - all those who speak of the benefits of going to see your GP with depression presumably don't go to my surgery, I feel like I've slipped through the cracks.

I must be with the wrong GP practice,I've just gone on line and booked an appointment hor 11:00 this morning,as the pain from my #clavicle appears not to understand OTC pain relief.I had the accident 2 days ago,walked into Barnsley A&E at 16:00,left at 17:30 having been seen by triage nurse,junior medic,had Xray,seen again by junior medic,quick review by registrar,sling fitted,treatment plan explained,and given a fracture clinic appointment for yesterday.Yesterday 's appointment was for 15:55,rocked up at 15:45,nurse explained there might be a slight delay due to numder of recent cases,actually seen by consultant at 16:00,left at 16:15,having had reviewwith him treatment plan explained by him,and follow up fracture clinic appointment given.It can work,and is bloody marvellous when it does.
P.S. I refused the extra pain control offered in A&E as the adrenaline was running and I thought I could cope.

I think what we all agree on here is:
-experience varies from practice to practice
-there is no ideal answer, as Aracer pointed out (I completely agree with you - illness isn't so black and white)

Soo.......

From this point onwards let's all agree to only post proposed, workable solutions, rather than complaints (complaints have all been duly noted....)
I'm sure the thread will slow down now.....

DrP

From the jist of this and the other thread.. it appears you have trouble tying your own shoe laces without needing a large group of people stood behind you coaxing you on.

If all GPs started as early as you? 😀