How does your local Doctors appointment system work?
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I know it sounds counter intuitive, but the reality is that is what happens. I've audited it over several years and having had 3 different appointment systems in the same population over 5 years. some of this is due to an increased DNA rate on those that book far in advance, despite text reminders etc. whether this is people who book for self limiting conditions and then they fail to cancel or simply forget as its too far in advance for them to remember is anyones guess.
When you get a good chunk booked too far in advance you start to get to the stage that it gets hard to book in the 2-3 week category which is when most people have a cut off that longer than that and they deem too long and demand a same day appointment, and then the whole system falls apart. Most people prefer either to be seen instantly if they deem important enough or they like it to be in a week or so time, to allow them to make arrangements to attend
As I say we currently allow booking as far as 8 weeks in advance, but this is largely booking followup appointments and the reality is very few get booked other than followups in the 3-8 week period as people just dont want them. Our current system appears to work fairly well and we no longer have to have a weekly planning meeting to decide about altering routine/urgent appointment numbers to adjust to the demands, but that is certainly not the case during the winter pressures period when I may see/telephone >50 patients in a day. The big problem always remains that demand sadly always outstrips supply and the only solution to that is more GPs and nurses which dont exist.
I assure you it is not a simple task to make a system that suits all the people and nobody has as much of a vested interest in having the least worst system than the GP themselves or indeed the poor receptionists who have to try and make it work and get an awful lot of the flak for it.
When you get a good chunk booked too far in advance you start to get to the stage that it gets hard to book in the 2-3 week category which is when most people have a cut off that longer than that and they deem too long and demand a same day appointment, and then the whole system falls apart. Most people prefer either to be seen instantly if they deem important enough or they like it to be in a week or so time, to allow them to make arrangements to attend
As I say we currently allow booking as far as 8 weeks in advance, but this is largely booking followup appointments and the reality is very few get booked other than followups in the 3-8 week period as people just dont want them. Our current system appears to work fairly well and we no longer have to have a weekly planning meeting to decide about altering routine/urgent appointment numbers to adjust to the demands, but that is certainly not the case during the winter pressures period when I may see/telephone >50 patients in a day. The big problem always remains that demand sadly always outstrips supply and the only solution to that is more GPs and nurses which dont exist.
I assure you it is not a simple task to make a system that suits all the people and nobody has as much of a vested interest in having the least worst system than the GP themselves or indeed the poor receptionists who have to try and make it work and get an awful lot of the flak for it.
Ring up and get an appointment within a week (ie while you're still ill...) rather than being told to ring back tomorrow or see us in 3 weeks....mind you the doctors would actually need to be at the surgery, the amount of time my lot have off is stupid, you'll more often get seen by the nurses.
Ideally it would be even less for 'non regular' patients, people like me who only go to the doctors when it's needed not for every little thing.
Allowances would be made for patients that actually have illnesses which may require quick appointments too (my mum can get a quicker appointment for flu due to her asthma for example)
Why should people who don't regularly use the service get priority? That's absurd. People who regularly use it are on average the more unwell ie frail elderly with multiple illnesses. The idea of being seen "within a week" "while you're still ill" is also daft. If the illness has settled in a week without seeing a doctor then you didn't need to see one anyway. The problem is everyone who feels ill enough to need to see a doctor feels they need priority and will never be happy with any waits. The whole system is not resourced that way and it's simply not possible to offer that all of the time. I expect even those who have posted good experiences will find some people at their practice who are unhappy about waits or convenience of booking
One of the reasons I moved to my current doctor is that it was possible to make an appointment. I rarely see a doctor because I rarely have any reason to, but it was good to know I could. Some years passed.
Recently my knee became enough of a problem for me to go to the walk-in centre (which is also my doctor) and wait to get it looked at. All working as it had before - wait not bad, see a doctor. The doc said I needed physio but the standard procedure was a month on anti-inflammatory drugs to begin with and apparently you can't argue with procedure even though he thought the drugs wouldn't really help because the problem wasn't a temporary one. So I'd have to take then drugs for a month and come back to be referred to physio. OK, if that's how it works, that how it works. I can wait another month - I'm used to the pain and it's OK most days except on stairs.
A month passes...and I find out that I just happened to get lucky with a locum. There isn't usually a doctor doing the walk-in clinic and the doctor side now runs a daily appointment lottery, which is useless to anyone who works shifts and borderline useless to anyone who works. So if I want the physio I need, I'll have to pay to see a doctor privately just for them to refer me to physio. Or play the appointment lottery every day when I'm on holiday and hope that I win it within a week.
So that's how my local doctor's appointment system works - very badly. My guess is that they've taken on far more patients than they can handle.
Recently my knee became enough of a problem for me to go to the walk-in centre (which is also my doctor) and wait to get it looked at. All working as it had before - wait not bad, see a doctor. The doc said I needed physio but the standard procedure was a month on anti-inflammatory drugs to begin with and apparently you can't argue with procedure even though he thought the drugs wouldn't really help because the problem wasn't a temporary one. So I'd have to take then drugs for a month and come back to be referred to physio. OK, if that's how it works, that how it works. I can wait another month - I'm used to the pain and it's OK most days except on stairs.
A month passes...and I find out that I just happened to get lucky with a locum. There isn't usually a doctor doing the walk-in clinic and the doctor side now runs a daily appointment lottery, which is useless to anyone who works shifts and borderline useless to anyone who works. So if I want the physio I need, I'll have to pay to see a doctor privately just for them to refer me to physio. Or play the appointment lottery every day when I'm on holiday and hope that I win it within a week.
So that's how my local doctor's appointment system works - very badly. My guess is that they've taken on far more patients than they can handle.
I think you need to throw that one at the last few governments rather than the GPs tbh.
A practice has to apply to NHSE to close their lists to new patients and they are always told no. There was a recent case covered in GP press of a practice who tried to informally close their list and simply refuse to register new patients as NHSE had refused their request for list closure. They were contacted within days with a breach of contract order. No GP wants to be snowed under with too many patients. A practice doesn't even get extra funding for new patients until the increase has gone up by 5%. Currently I provide cover for around 320 patients who I don't get any money for and until our list has grown a full 5% from when they last counted it. Maybe this will grow and it will be funded as we grow an extra 1% or maybe I will be expected to provide this free forever more.
Woohoo! I managed to get through just after they opened at 8.30!
"Sorry, we're closing early today"
ME: *RAGEFACE!!*
Maybe they should make it easier for people to buy medicines without having to hassle their doctor?
That way, the people who know what they need can get what they need and buy it without having to make an appointment (leaving GP resources for those who need to see the GP), with maybe a review appointment every 6 months.
Those who think they know what they need can buy the wrong thing and poison themselves to death, thus a secondary reduction in the workload of GPs (this paragraph may not be entirely serious
)
"Sorry, we're closing early today"
ME: *RAGEFACE!!*
Maybe they should make it easier for people to buy medicines without having to hassle their doctor?
That way, the people who know what they need can get what they need and buy it without having to make an appointment (leaving GP resources for those who need to see the GP), with maybe a review appointment every 6 months.
Those who think they know what they need can buy the wrong thing and poison themselves to death, thus a secondary reduction in the workload of GPs (this paragraph may not be entirely serious
)Not at my GP, they really don't give a toss. They spend more time chatting to each other whilst you're waiting to check in (because you know, human interaction is nicer than using the 1 touchpad thing that every other diseased human has touched that day, or so I thought anyway).
Speaking of waits, also relating back to the receptionists:
I actually missed my appointment because I'm not rude enough to interrupt people who are in conversation - as in the 15 minute window - which was for a blood test; partly due to having to leave work later than I was going to, because I still went to work that day but anyway, there was 1 SINGLE PERSON in the waiting room and the doctor refused to see me to take my blood, and it was the same **** doctor who refused to refer me to a dermatologist even though I was, and still am 12 months later, having severe skin problems. GP wise I've only ever dealth with 3 at my local, 1 of which was when I was a child - he was always enthusiastic, I guess times have caught up because the most recent time I saw him (~8 months ago) you could tell him just wanted to get you out of his office ASAP, and tbh I feel quite bad for him because he's a nice bloke. The other non-**** one was always a pleasure to deal with too, haven't seen him since I was a teenager though, but yeah of the 3, 2 of them were decent although Doc1 seems to have dipped in his ability to care as much - probably due to the same factors you face heeeeed in that he's overwhelmed with patients, which I can respect.
I feel sorry for most GP's in general too tbh, as I know - bar the elderly - they have to deal with constant time wasters which, as I've said previously, could easily be resolved through a walk-in minor injuries or so. As well as other factors as to why I feel sorry for them. I'm just glad I rarely "have" to go to the docs, honestly, even with my current problems and asthma which I was born with (which is well under control due to keeping myself rather fit).
That's actually a great shout if they could design and implement a system which functions in that way, or at least similarly.
That way, the people who know what they need can get what they need and buy it without having to make an appointment (leaving GP resources for those who need to see the GP), with maybe a review appointment every 6 months.
Those who think they know what they need can buy the wrong thing and poison themselves to death, thus a secondary reduction in the workload of GPs (this paragraph may not be entirely serious
Great methods for reduction too, but... you call THAT a paragraph?!
Great methods for reduction too, but... you call THAT a paragraph?!
It was a paragraph in the edit screen... but yes, it's merely a lowly line
My doctors has changed from a system that used to be quite convenient to one that I immensely frustrating.
You cannot book appointments in advance unless the doctor has requested to see you in 2 weeks etc - so that means there are plenty of appointments available on the day, this is a good thing.
It used to be the case that they would open the phonelines / building at 8.30am. If you phoned up they would book you in for slots after lunch, if you turned up on the door you could get a morning appointment. As such if I needed to see the doctor then I could warn work I'm going to be late, and then wait outside the surgery from 8am, be seen nice and promptly and then get to work. They decided this system wasn't fair, and now the only way you can get an appointment on the day is by telephone. The phone line opens at 8.30am, they have one line, no queuing system. What follows is 30 minutes of listening to engaged tones while you frantically redial, only to be told when you get through that all appointments are now gone, or the only slot they have is 2pm or something equally awkward.
I start work at 9am, my commute is roughly 90 minutes to work. I have to stay home on the off chance they give me an early appointment, then I end up getting one at lunchtime so I can't even go into work as by the time I got there I'd have to turn around and head back to the make appointment. I also get the interrogation from the receptionist and nurse every time I call, its a frustrating system.
You cannot book appointments in advance unless the doctor has requested to see you in 2 weeks etc - so that means there are plenty of appointments available on the day, this is a good thing.
It used to be the case that they would open the phonelines / building at 8.30am. If you phoned up they would book you in for slots after lunch, if you turned up on the door you could get a morning appointment. As such if I needed to see the doctor then I could warn work I'm going to be late, and then wait outside the surgery from 8am, be seen nice and promptly and then get to work. They decided this system wasn't fair, and now the only way you can get an appointment on the day is by telephone. The phone line opens at 8.30am, they have one line, no queuing system. What follows is 30 minutes of listening to engaged tones while you frantically redial, only to be told when you get through that all appointments are now gone, or the only slot they have is 2pm or something equally awkward.
I start work at 9am, my commute is roughly 90 minutes to work. I have to stay home on the off chance they give me an early appointment, then I end up getting one at lunchtime so I can't even go into work as by the time I got there I'd have to turn around and head back to the make appointment. I also get the interrogation from the receptionist and nurse every time I call, its a frustrating system.
So you say going into see a doctor EVERY time you get a sniffle, and I'm not on about the old and people with existing conditions (I did say this already...), is a good use of the already limited doctors service... yeah sounds about right for someone who works in a doctors surgery, you sound very much like my local doctors receptionists who aren't exactly bothered about the patients, they'd rather 'hide' out back talking than dealing with reception
. Seriously the doctors were designed to treat ill people when you couldn't deal with it with off the counter medicine, not be the first port of call for a sniffle which a lot of people seem to use our doctors for. If the illness can go away in a week then you don't need to go see a doctor, you can likely get off the shelf medicine which will deal with it in most cases, some chemists now have a 'doctor' in store
Example - I get bad hayfever, off the counter stuff from tesco's etc doesn't work, so saw the local chemist and he gave me something stronger... didn't need to see the doctor yet many will go see a doctor for this, it actually costs less than a prescription too. I literally only bother with the doctor when I need something like amoxycillin (usually what I get given) to shift an infection (very very rare, can go years between visits), because you can't get this off the shelf.
The three weeks to get an appointment put people off going to a doctor for things which might be important to get seen to, how often do you read about people who could have had cancer (for example) being caught earlier if they'd have gone to see the doctor earlier.
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