GP Surgeries

[Sylar]

I'm curious as to the setup of your GP surgeries, as I'm on the verge of making a formal complaint to our regional health board about ours (I don't expect that action will change what I'm complaining about per se, but I'd like my concerns on record).

Our GP has gone to a triage and 'on the day only' appointment system. I cannot phone up my GP on a Monday and try and get an appointment for 2 or 3 weeks away for a non-urgent thing. I have to take a day off of work, call my surgery between the hours of 8am-10am, hold (potentially for up to 1 hour +) and see what they can offer me on that day - sometimes it'll just be "advice" if they don't deem it worthy of an appointment based on what you tell them over the phone.

It used to be that there were 2 triage time-slots - you could phone in the morning and then again in the afternoon, but they've now dropped the afternoon one.

I live in a reasonably sized town, but it's principally a commuter town into larger South/North Lanarkshire places or Glasgow.

I'm not one of those that like to "kick" the NHS - I think their workers do a POWER of excellent work and deserve to be championed for their efforts in the face of constant adversity. But the bureaucratic system they find themselves working in is utterly broken in some places, and our surgery isn't fit for purpose for working people or those of us that can't necessarily just take a day at short notice in the HOPE of getting seen by a GP.

[JeMeSouviens]

I'm curious as to the setup of your GP surgeries, as I'm on the verge of making a formal complaint to our regional health board about ours (I don't expect that action will change what I'm complaining about per se, but I'd like my concerns on record).

Our GP has gone to a triage and 'on the day only' appointment system. I cannot phone up my GP on a Monday and try and get an appointment for 2 or 3 weeks away for a non-urgent thing. I have to take a day off of work, call my surgery between the hours of 8am-10am, hold (potentially for up to 1 hour +) and see what they can offer me on that day - sometimes it'll just be "advice" if they don't deem it worthy of an appointment based on what you tell them over the phone.

It used to be that there were 2 triage time-slots - you could phone in the morning and then again in the afternoon, but they've now dropped the afternoon one.

I live in a reasonably sized town, but it's principally a commuter town into larger South/North Lanarkshire places or Glasgow.

I'm not one of those that like to "kick" the NHS - I think their workers do a POWER of excellent work and deserve to be championed for their efforts in the face of constant adversity. But the bureaucratic system they find themselves working in is utterly broken in some places, and our surgery isn't fit for purpose for working people or those of us that can't necessarily just take a day at short notice in the HOPE of getting seen by a GP.

That sounds daft.

Our surgery has an online booking system now. Looking at it just now, if I wanted to make an appointment with any old doctor, then the first one is Mon 28th. To see my own doctor (generally I don't bother, I just take first available) it would be Weds 30th. They keep back some urgent slots you can phone at 8.30 in the morning or they can arrange for a doctor to phone you if none are free.

[s.a.m]

My surgery used to do something similar: you phoned first thing for a same-day appointment.
I yearn for those days
Now there are no appointments at all. You phone first thing to request a call back from a GP before 12.00. The GP, if they decide you should be seen, then books you in for later the same day. No other option is available.
Even if you have been told, e.g., to come back in 2 weeks time for a repeat visit, you still have to phone at 8.00 for a call back request, wait for a GP to phone so you can tell them they told you to come back in 2 weeks. Then they book you in that afternoon as they should have ******* done the first time.
Last week, I needed a routine prescription for which I knew I had to be seen. Phoned at 8.00, was told the procedure was to come in to see the nurse first thing to have blood pressure taken, after which I would need to request a call back from a GP before I left, then go away and wait for them to call me back, then have the GP book me up that afternoon. So, for a routine prescription review, I had to visit first thing, wait for a phone call, then go back on the same day.
I have flexibility over my time: I don't know how having a GP phone consultation works if you're in a place where you can't take calls, or have privacy, or if you drive for a living etc...

[Danderhall Hibs]

Ours uses the same system. 830 they open - if you phone then you’re in a big queue with a small chance of getting through. A lot of folk are now resorting to queuing at the surgery from 8-815 and booking an “emergency” appointment for that day.

That is likely to be a call from a doctor if they havent successfully referred you to the nurse.

That’s the way they run it - seems crazy when they ask “is it an emergency” and if you say no they tell you to go away and come back when it is.

I assumed this was all down to the stats they have to report to the government?

[Jack]

That used to be my area of expertise before I retired!

Your first point of contact/complaint should be the Practice Manager at the GP practice.

[Pretty Boy]

Same system at my GP. It's mental.

I've used the self referral system a couple of times recently to just cut out the middle man and that works well if used responsibly.

[MartinfaePorty]

I've had a cough for about 6-7 weeks, but. not bothered with doing anything, as it hasn't really affected my health until last weekend. Called the doctor yesterday to be told I was too late and I need to call at 8am the next day for an emergency appointment. My work is fairly flexible so I said I could do anytime this week, but was told there are no appointments until February. I think it's perhaps mild asthma, which I had as a child until about my mid-20s, so nothing urgent, but annoyed I have to call for an appointment which may impact work meetings that I've planned for some time with people who are difficult to pin down. Must surely be a better way?

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[Hibrandenburg]

I didn't realise things were that bad back home. No wonder the ER is overloaded when people have to wait days/weeks to see a GP. Sounds like the whole system badly needs overhauling.

[pollution]

When I phone for an appointment or for any matter in fact I will have the engaged tone for 20 or 30 attempts.

Not just me. The reviews section at this practice shows 99% of complaints are about not getting through. All the time.

I am retired so I can go in even though my gout is killing me. Then I can have an appointment in one hour.

This clinic bought their practice for £7,460,000 and they don't answer their phones. The GP's must earn a fortune.

I do not believe in private health care but I can see how some do.

I don't know why I do not name the clinic. Perhaps I show them respect by not naming them...

[RyeSloan]

When I phone for an appointment or for any matter in fact I will have the engaged tone for 20 or 30 attempts.

Not just me. The reviews section at this practice shows 99% of complaints are about not getting through. All the time.

I am retired so I can go in even though my gout is killing me. Then I can have an appointment in one hour.

This clinic bought their practice for £7,460,000 and they don't answer their phones. The GP's must earn a fortune.

I do not believe in private health care but I can see how some do.

I don't know why I do not name the clinic. Perhaps I show them respect by not naming them...

It’s an odd set up the GP thing is it not? Not entirely sure of the details but they seen to operate as quasi private companies but at the same time in some sort of public funded monopoly?

As it is those practices that don’t allow forward booking seem to be totally at it and I have no idea how even from their perspective such a set up can be in any way efficient or desirable (it’s certainly not from a patients view that’s for sure!)

[MSK]

I'm curious as to the setup of your GP surgeries, as I'm on the verge of making a formal complaint to our regional health board about ours (I don't expect that action will change what I'm complaining about per se, but I'd like my concerns on record).

Our GP has gone to a triage and 'on the day only' appointment system. I cannot phone up my GP on a Monday and try and get an appointment for 2 or 3 weeks away for a non-urgent thing. I have to take a day off of work, call my surgery between the hours of 8am-10am, hold (potentially for up to 1 hour +) and see what they can offer me on that day - sometimes it'll just be "advice" if they don't deem it worthy of an appointment based on what you tell them over the phone.

It used to be that there were 2 triage time-slots - you could phone in the morning and then again in the afternoon, but they've now dropped the afternoon one.

I live in a reasonably sized town, but it's principally a commuter town into larger South/North Lanarkshire places or Glasgow.

I'm not one of those that like to "kick" the NHS - I think their workers do a POWER of excellent work and deserve to be championed for their efforts in the face of constant adversity. But the bureaucratic system they find themselves working in is utterly broken in some places, and our surgery isn't fit for purpose for working people or those of us that can't necessarily just take a day at short notice in the HOPE of getting seen by a GP.My surgery is normally 0800 to get an appointment same day, most often than not I get an appointment, failing that they have a system where you can have a telephone appointment whereas the GP will phone house or mobile phone. I recently had a telephone appointment whilst at work. I assume though those are more likely follow up appointments as opposed to actually sitting in the GPs for bloods/blood pressure or examinations. Mines was for follow ups/results for prostate/bladder and diabetic issues.

Ps- Milton Surgery at Mountcastle

[Mibbes Aye]

It’s an odd set up the GP thing is it not? Not entirely sure of the details but they seen to operate as quasi private companies but at the same time in some sort of public funded monopoly?

As it is those practices that don’t allow forward booking seem to be totally at it and I have no idea how even from their perspective such a set up can be in any way efficient or desirable (it’s certainly not from a patients view that’s for sure!)

Most GPs are independent contractors working in essentially small businesses with colleagues (practice partners). There are some who are directly salaried by NHS and those tend to be practice areas where the NHS board has had to step in itself as the independents won't provide services.

In recent years however there has been a rise in big private organisations running practices - Virgin Care, Care UK etc.

The booking system is reflective of a broader dysfunction IMO. GPs are retiring or cutting their hours, reducing supply. People are more conscious of health issues due to health promotion campaigns and Google, creating demand. A fair proportion of GP appointments would be better dealt with by a pharmacist. And whilst it is evolving, the GP contract has often seen certain aspects of GP work attracting additional income from government, which raises the question as to whether some aspects are more attractive than others with the result that some GPs are incentivised to focus on those areas - to what extent this has a knock on effect on general appointments I wouldn't want to speculate.

[Jack]

In recent years however there has been a rise in big private organisations running practices - Virgin Care, Care UK etc.

I don't think any of these companies are allowed to operate within the NHS in Scotland.

[Mibbes Aye]

I don't think any of these companies are allowed to operate within the NHS in Scotland.

I think that’s right, it was English legislation that opened things up for them. I suspect it will come at some point though.

What does seem to be happening on both sides of the border are so-called Uber surgeries. GPs can sell their services to private patients on a varying scale. It’s meant to be fitted around contracted hours but I suppose it still uses NHS premises and impacts on NHS support staff.

[Fife-Hibee]

Sorry to say, but the situation is only about to get a whole lot worse. Everybody could put a complaint in at the moment and it would be pretty much futile.

[Nixweb]

It's a crazy situation. Getting a gp appt for me involves phoning at 0830 for a slot in 2weeks time. But due to school and work I am driving at that time, so I miss the slots. Over the Christmas break I ended up using Livi app, essentially a doctor on Skype just so I could get some advice regarding my kid. Maybe those sorts of services are the future and can help ease some of the pressure on gp surgeries.

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[James310]

I think that’s right, it was English legislation that opened things up for them. I suspect it will come at some point though.

What does seem to be happening on both sides of the border are so-called Uber surgeries. GPs can sell their services to private patients on a varying scale. It’s meant to be fitted around contracted hours but I suppose it still uses NHS premises and impacts on NHS support staff.

I just read a tweet from Neil Findlay MSP saying Barclay Care are taking over a GP surgery in West Lothian. So suggests its happening here.

[patch1875]

Seems to be big differences between surgeries, we lived in Tranent and it was impossible to get an appointment. Now we live in Murrayfield you can get one fairly easy if you phone morning or afternoon they also offer really early appointments a couple of days a week for before work/school.

[heretoday]

Our surgery has drop-in appointments Wednesday and Friday before 10 am. You just take your chance and appointments are 5 minutes long as opposed to the usual 10.
Other than that it's the typical 8 o'clock telephone scramble for a same day appointment.
You can book a telephone consultation but it can take a week.
The days of having a regular family doctor are long gone.

[overdrive]

Luckily it’s not like that at my GP surgery just now but for a number of months they were so short staffed that they had a list of things that they refused to see you about. My old GP surgery had a great system. You could make a normal appointment or you could show up at a set time and wait your turn. It worked well.

I’m actually in two minds to complain about my GP... the person rather than the surgery. I went with three different issues: two that I thought were linked and one that was definitely not linked. She said the two issues that I thought were linked were definitely not linked. I suggested what I thought it might be and she laughed and said “no chance”. She referred me to the hospital about one of these two things and for the other she prescribed me some pills and I got a blood test. The third issue, having spoken to other people who have suffered the same things, it appears she gave me pretty poor advice.

Anyway, I went to my hospital appointment and had tests which were thankfully clear. However, I had to fill in a questionnaire and as part of that had to list the medication I was on. The consultant was gobsmacked that the GP prescribed the medication she did and referred me to that clinic during the same appointment as that medication was on a list of drugs people with the condition she thought I had should not take under any circumstances.

He then said what he was pretty sure was wrong with me which happens to be the thing I suggested to the GP which she dismissed (I hadn’t told the consultant about that at that point). He was also 99% sure that the two symptoms the GP said were definitely not linked were in fact linked. The pills had no impact but taking the advice the consultant gave has helped.

It caused me a lot of unnecessary worry over the Xmas period.