How does your local Doctors appointment system work?

I work in a medical centre and it is crazy in the morning. Up until about 9:30ish, it is non-stop calls. We now have online appointments, which makes things better, but the volume of patients we have for the number of doctors we have is increasing. 3 of our GPs are retiring but no one is replacing them. 14000 patients with 7 GPs...

Normally the best time to get through is about 12 till 2 when the morning surgery has stopped.
 
^a lot of people who do use GP's are the constant moaners who go back when they've just clipped a toenail too short or whatever, that's the real reason waiting times are a joke as well as GP's don't seem to give half a toss anymore (generalisation there, don't take it to heart).

Haggisman said:
I did find the auto-redial function on my phone rather useful this morning :p
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Same! Just keep bashing the button until someone finally picks up! Even the receptionists seem droll as anything too...


Reason I seemingly resent going to the doctors is due to what happened on an appointment about 1 year ago, this month actually; because of my severe skin problem (again, causes lack of sleep, would consider myself depressed too now because of it, as well as other stresses) I asked to be referred to a dermatologist, to which the GP flat lined me with a stern "No." ... speaks volumes really - 16 months down the line to when my problem actually began and I'm only just being referred, of which a specialist wants to see me after an initial consultation with a dermatologist. At least I'm on the mend xD
 
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DR_Pingu said:
^a lot of people who do use GP's are the constant moaners who go back when they've just clipped a toenail too short or whatever, that's the real reason waiting times are a joke as well as GP's don't seem to give half a toss anymore (generalisation there, don't take it to heart).
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I agree with that though. The motivation of our GPs has reduced to the point where we can actually see it. They come in late, after staying up till 3am doing their filing from home. I often see them staying behind after the cleaners have gone home. We are doing more now to take the burden off them, but it's not enough.
 
heeeed said:
out of interest how do people perceive an appointment service should run? remember that if you are designing it you need to allow for all patient demographics and you have a limited number of doctors and nurses time. There is no point stating that you want to be able to ring up and have an appointment always that day or whenever you feel is convenient without doing something about the lack of GPs and nurses nationally and the lack of resources in primary care to pay for them even if there were enough anyway

The practice I run has a certain proportion of appointments that can be booked on the day (I think it is 6 per doctor, with 8 for the on call doctor) we also have about the same amount that can be booked online in advance, but they are often booked up well in advance by our silver surfers, or if someone rings then they can be used for a phone up booking instead (ie they arent solely for online booking), or people can ring to book appointments in advance also. We offer 8 telephone appointments per doctor daily split into 3 periods through the day, some of which will be booked by the doctor themselves for followups, but the majority are urgent appointments booked on the day or day after. We are always extremely busy and it is quite unusual for us not to end up adding extra slots at some point in the day (this can then mean we are running later and has a significant impact on our day). There is a limit to the amount of people that can be seen in a day and unfortunately it is completely impossible to design a system that is suitable for all people so ours is designed to reflect the majority of our patient list. I currently see 32 patients face to face daily, 8 telephone appointments, an average of 2-3 home visits, and if I'm the on call doctor for the day it can be more than that. I also have to deal with the reams of admin that seeing those patients makes. We also open 8-12 alternate Saturdays and

My day starts at 8am, and I generally leave around 7.45pm when our caretaker start to make grumpy noises that he never gets to see his family in the evening.

I think we offer a very good service as far as we can and we still get complaints that people want to be seen quicker. I am at a loss to see what significantly people feel is achievable without more resources given to us, so I would genuinely love to hear peoples ideas
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This

Rather than 5 pages of moaning do people actually have any suggestions?

It's no wonder GP recruitment is an all time low
 
Here you phone at 1nS past 2pm. If you get in then you can get a 48 hour appt. If you are late then you spend an eternity on hold until you get an appointment in a week or so.
 
I phone in the morning just after 8am, I get an appointment for that day, and turn up at designated time.

I also live in a busy part of London, so no rural favours here, like on Neighbours.

simples.
 
Just tried the doc again, see if they've had any cancellations.

Turns out they've had 3 did not attends today already. That boils my tinkle.
 
They have a doctors surgery mon, wed, thur in morning and afternoon and a morning session tue and fri. I get in my car, drive to the doctors and with 15 minutes I see a doctor. One of the advantages of living in the countryside I guess.
 
I call up and ask for an appointment and they say can you make 2pm today and I say yes or no. Simples.

I also live in the countryside:)
 
Greg0986 said:
I agree with that though. The motivation of our GPs has reduced to the point where we can actually see it. They come in late, after staying up till 3am doing their filing from home. I often see them staying behind after the cleaners have gone home. We are doing more now to take the burden off them, but it's not enough.
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In addition to what heeeeed said really, I understand the waiting times are partly due to a lack of resources, but it is severely hindered by the people who treat GP's as a hospital, and even then it's with a minor injury - in which case the morons should just go to a MINOR INJURIES UNIT! But no, we live in a day and age where common sense is a rarity, with some probably stupid enough to believe you can buy it on eBay or Gumtree.

I can't imagine the amounts of admin the staff face, but I can somewhat imagine it in some sense, especially with being effectively short-staffed (plenty of experiences of that in my previous job as a lifeguard I can tell you!) but it still does wind me up a bit that the waiting times are so far off what you're told to come to; a bit like A&E waiting times really - saw a guy with a broken jaw, couldn't speak, nurse/receptionist got ****ed off with him because he was led down on the bench, had probably been waiting at least 2 hours. All the while mind, a woman with a "burnt" hand was waiting about the same amount of time (I was there with a broken hand from being tripped in 5 a side, to clarify), when she finally got seen by the doctor she was walking out no more than 10 seconds later and I can imagine the doctor said something like "**** off" to her for wasting so many people's time, including her poor husbands. Meh!
 
lowrider007 said:
Recently our local Doctors surgery has changed it's appointment system so that the only way you can see a Doctor now is you have to ring up first and tell them what the problem is, then the Nurse will tell you a Doctor will ring you back within so many hours (not a specific time) for a telephone assessment, and then he/she during that assessment will decide if it's worth coming in or it.

****ing pathetic.

Since when has seeing a doctor become a 'near' emergency only process?

Is this becoming the norn now?
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Unless mine changed in the last few years then I can either phone for an appointment or book on on the website (if I had bothered to ask them for a key so I can register)


They also do walk in periods first come first served late at night I guess it's primarily aimed at people who can't take time from work



Telephone interview to see a GP is ridiculous, sometimes the secretaries ask what my appointment is for, I just say non of your business and it's fine.
 
Haggisman said:
Something like:

*Ring up*

Me: "Hi, I'd like to make an appointment please, it's not urgent, but needs to be after 5.30pm (my surgery is open till 6, so this isn't unreasonable)"

Them: "The earliest we have available is Tuesday the Xth (in 3 weeks time)"

Me: "That's fine, please can I book that one"

Them: "That's done for you"

Me: "Thanks"

*hang up*

It's 2015, we have computers with electronic diaries that can log, and even remind you of events which are going to occur in the future, there is absolutely no excuse for limiting advance appointments to only 2 weeks ahead.
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It has absolutely nothing to do with electronic diaries. I would be amazed if any practice doesn't do all their appointments electronically. In my practice it is possible to book appointments up to 8 weeks in advance and currently to see the doctor of your choice you may wait a full week (possibly less), but the upshot is the longer you are able to book in advance the less appointments you have available for urgent appointments so it is a fine balance that will never suit everyone which is the whole problem.

The reason it is hard to get an appointment in any practice is an overwhelming workload and any triage system falls down at this point. Short surges of needs can be managed by just fitting people in as extras after a short triage, but in doing so our day gets longer and this becomes impossible to continue in medium to longer term. As I said earlier, I generally work approx 12 hour days. How many more hours per day do you think it is reasonable to work to improve access for all? and when you answer that question how many hours extra is safe for me to work without either making mistakes or becoming burnt out like a huge percentage of the GP workforce is becoming?
 
I can't remember the last time I went to a doctors but I think it was like...

call up.

Ask if methadone addict has died.

Take their spot
 
randal said:
How are you finding life off the smack?
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Jonesing every day man. Honestly though, the place is smack city. It's either people for the drug prescription or people with the clap. I should probably change doctors but it's a family friend so always gone there
 
heeeed said:
the longer you are able to book in advance the less appointments you have available for urgent appointments
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How so? Allocate X number of appointments per day to same day emergency appointments, doesn't matter if you can book 2 weeks or 2 months in advance, there will still be the same number available, but means that the people who don't need an urgent appointment actually have a chance to get one
 
My GP introduced a "phone interview" system, where it would be decided whether you needed an appointment. The first time I tried it I got a call from a hidden number while I was in a meeting. I patiently waited and had no call by the following afternoon. "Oh yes, we attempt to ring you once, but if you don't pick up we don't try again". I ended up having a massive go at them on the phone, pointing out that this was their system and that people at work are often actually doing work, so can't answer calls every minute of every day (what would happen if you work in a shop for example?). As it happens they abandoned the system a few months later.

I do feel sorry for GPs though. Back in my youth I went through medical school (subsequently left the profession) and the GP rotations were a real eye opener. When I do have appointments with my GP we chat about it quite a bit and he tells me how awful it is now. When you have a constant stream of moronic patients all day every day the odd half intelligent one is a real treat for them.


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