OT: Doctors

[R D S]

The GP practice we are with used to be great (the very few times we've used it!), you'd go in, sit down and be seen in turn. It's close to work so you could peep through the window and decide whether to wait or try your hand later. #### knows whats gone on* but nowadays (and this is pre-c19) the phone is constantly engaged and currently no-one is answering if you do manage to get a ringtone, i've been at it all morning. I ordered a repeat prescription with them online last Wednesday and as yet i've nothing to pick up and not had the normal text message to say they're on it (but did get confirmation of my request). Blood pressure tablets, irony? I had blood tests booked, they called me and bumped them into the future. Said i'd be referred to ENT for a persistent sinus infection ages ago, that plainly hasn't happened. Sadly, from what I hear ours is one of the better ones in the area, is it this shit everywhere or do I need to move somewhere less godforsaken?

*Thanks not entirely true, there's an elephant in the room...

[Roland Perry]

In message <t2ej0e$ci1$ [e-mail], at 11:58:20 on Mon, 4 Apr 2022, R D S [e-mail]> remarked:

All the GPs I have experienced (and it's several) went to appointment only (no walk-in) 10-15yrs ago. It was all part of a pushback on targets they'd been set.

How long it takes to book an appointment is presumably not a target!

Few will book for more than a month ahead (perhaps on the basis that many patients will have recovered by then anyway) despite 3-4 wks often being the first non-emergency appointments available.

If you want to see a *specific* doctor at a mid-to-large practice, it's sometimes impossible.

[alan_m]

The local facebook group often has similar complaints about the GP surgery (seven doctors and five trainee GPs*) that I'm registered with. In many cases the complaints are justified but the rot set in a year or so before Covid when the surgery took on (or was "persuaded" to take on) many more patients.

*The practice is designated as a training practice. It also has 4 Nurse Practitioners and 7 Nurses plus a few more medial staff.

Since Covid, and still continuing, the first appointment will be a phone appointment and only a follow-up physical appointment if the doctor deems it necessary.

In the last year they have improved on-line facilities - for non urgent enquiries they will respond to electronic communication (web form questions) within a couple of working days. I asked about flu and Covid jabs this way and was texted an appointment time the next day.

On phoning up in a morning there is the press 1 for... press 2 for etc. but they do warn the wait for a phone call to be answered could be lengthy. They advise phoning after 3pm - and when I did so a few weeks back I got through within 5 minutes.

The surgery employs a full time pharmacist to deal with the work related to prescription reviews as well as their point of reference for diagnosed high blood pressure problems. He will request that a patient take tests and check the results etc. The results for my tests can usually be found on line a few days later with the accompanying notes from the surgery - which may just be "no further action needed at this time"

Routine blood tests are not booked by the surgery. They will advise getting a test and provide the forms (and/or provide form and bottle for urine tests) but it is up to me to book an appointment with the local hospital trust blood testing department. The booking is on-line and usually a slot is available within a week. There are only a few blood test locations.

5/6 years ago I would have rated the practice 10 out of 10 for the service and speed of service they provided but today 6 out of 10.

[Dave Plowman (News]

I really can't remember when last you simply turned up at a GP surgery rather than book it first. Except in a true emergency.

I don't get a SMS confirmation of a repeat prescription. Just book it online a couple of days before needed, and collect from my designated chemist. I expect they would contact me if a problem.

Blood tests here are farmed out to a practice that specialises. You take a note from your GP and get it done there (you get a choice of venue)

Phone is answered pretty quickly - but I've never tried early in the morning when most might be using it.

[Peter Johnson]

The NHS app is good for ordering repeat prescriptions I find. (Except that it didn't occur to them to tell me they wouldn't issue a repeat prescription for something I hadn't used for a while until I had spoken to the in-house pharmacist, who phoned me after I had asked how long it would take to issue the prescription.)

[Steve Walker]

Yes. My eldest son suffers from hay-fever and can't buy off-the shelf anti-histamines due to them triggering his epilepsy. Every summer, as exams come around, he starts to suffer from the pollen in the air and every year, they have taken his medication off repeat, because he hasn't requested any for 6 months. Totally stupid, as many people will not need any anti-histamines for more than 6 months of the year, but will need them every year.

[Harry Bloomfield Esq]

It happens that R D S formulated :

Those days are long gone... Now it's all appointments.

Our surgery uses an online system to book doctors appointments, or you can ring and book them, which is the only way to get nurse appointments. Appointments can be made for the following two weeks only.

They do hold appointments back, for emergency same day appointments, if you can convince them it is necessary. They release a batch of appointments each morning, for the following two weeks, so you have to either go on line or ring quickly when the batch is released.

Generally it works reasonably well, but yesterday they sent a text to say they were suffering reception staff shortages, so wait times on the phone might be a little longer.

I use online as much as possible, it allows me to check my medical records, book regular repeat prescriptions and make special requests for prescriptions. I never use it for appointments, because it is almost without fail a nurse appointment I need. I also sometimes email them for things which cannot be done online, like BP logs and they respond.

[R D S]

Yes, I do usually message them through their website but I have signed up for Patient Access so that should make things easier in future.

[Roland Perry]

In message [e-mail]>, at 15:45:07 on Mon, 4 Apr

2022, "Dave Plowman (News)" [e-mail]> remarked:

When I lived in a village 30yrs ago, the practice was just two GPs. While there was no guarantee of being seen, there was certain the possibility of turning up towards the end of the published surgery hours and asking "is he free".

My current, and previous two, GP surgeries perform blood tests, by one of the nursing team. If the test has been requested by a hospital you need to take their "script" with you. Or the hospitals have walk-in testing facilities.

Current and previous surgeries operate "telephone triage" where you have to phone in even for an emergency appointment (although if you self-declare an emergency you get bumped to the top of the queue). One of the GPs then calls back. Sometime the triage call will result in a rapid conclusion (eg 'Go to A&E', 'take some Paracetamol' etc), sometimes they'll [Covid permitting] arrange an in-person consultation.

Phoning more than about ten minutes after the lines open in the morning is not to be advised (until much later in the day).

[NY]

When we moved to a new area, I went to the two practices in town and talked to the receptionists about their appointment systems. The first one I tried seemed good, but I tried the other one just for comparison. That second practice told me that if I needed an appointment I should phone, when I would be offered an appointment either for that day or for exactly 7 or 14 days later. I said "what if I want an appointment for some time in the next few days - as soon as there is a free slot?" In all seriousness I was told that if there wasn't a slot on the day, I should phone on the following day, and if there wasn't space I should try the next day, and so on indefinitely. They seemed to think that this was acceptable.

I chose the first practice, and their service has been fine. I did contact the practice manager for the second practice and explain the reasons why I would not be registering with them - because what I wanted was to make *one* phone call and be offered an appointment for whenever they were free - ideally for the same day, but failing that the following day or the day after - and that having to phone every day on the off-chance that I may be lucky in the draw for that day's appointments was not acceptable.

[Steve Walker]

Yes. Pre-Covid, at our GPs', you could only book on the day (08:30 for a morning appointment, 11:30 for an afternoon one and if you failed to get one, you had to wait for the next half-day), with appointments only bookable further ahead if the GP had told you to book (such as for results or more tests). That was an absolute pain for anything that was relatively minor, but did need an appointment, as I could only phone

*after* I'd arrived at work or had to take the morning (and sometimes the whole day) off, unpaid, to try and get an appointment!

[Dave Plowman (News]

I use Patient Access. Promoted by my GP. But I'd not expect to get a repeat prescription for a drug I didn't take all the time. (like BP meds)

[Chris J Dixon]

My surgery is much the same, and uses Systmonline. Really annoying that a nurse appointment needs a phone call, especially because there are long recorded messages before there is any chance of them picking up. :-(

Chris

[Harry Bloomfield Esq]

R D S explained on 05/04/2022 :

I don't message them via the website, usually I use direct email. I send them BP logs most often.

The only way to message via the web site, well systmonline patient access, is when a special request is put in for a prescription - that I am aware of.

[Harry Bloomfield Esq]

Chris J Dixon has brought this to us :

Same here and the message got even longer since the covid. I would expect it to be the other way around, nurse appointments online, phone for a doctors appointment, but I don't know the ratio of one to the other, only that my appointments with the nurse far exceed doctor appointments.

[Harry Bloomfield Esq]

NY has brought this to us :

+1

[Andrew]

It's the same here in Sussex. Both local surgeries used to operate that 'turn up and be seen' arrangement. In 2007 they combined and moved into a massive new building (that they pay a LOT of rent for) and now we have to make appointments, which are impossible to get in the future 4 to 5 weeks. One of the reasons is that almost all the GP's are now *female*, *part time* and according their CV on the website, have nearly all come to, or are returning to this surgery for 'Work life balance'. So that means that swan in for 1 or 2 days a week when it suits them.

Their website proudly states that they are treating X thousands of local patients for 'cancer', but there are only 4,000 living in the immediate village. Quite where all these mythical patients live is a moot point.

[Andrew]

Flipping Heck, most places won't have appointment slots for *weeks* ahead.

[Andy Burns]

other practices run different booking schemes e.g. you have to phone on the day you want the appointment for.

[Roland Perry]

In message <t2hdod$aeb$ [e-mail], at 13:47:08 on Tue, 5 Apr 2022, Steve Walker [e-mail]> remarked:

That was the scheme at my GP where I lived 10yrs ago (although it wasn't split into half-days).

I too though this somewhat unreasonable for most patients, because at the very least you'd have to take the morning off, to chance the possibility of getting an appointment that day (unless you worked

*really* close by *and* had a job you could 'GP leave' at a moment's notice *and* a job where you could turn up in the afternoon only. Not much good for a bus driver, for example.