Been feeling a little run down and flu-ey for a week or so, so been taking it easy. Lunchtime today came over a bit dizzy, so from previous experience a couple of years ago – and a quick look on the NHS website – seems that whatever bug I’ve got has probably gone to my ear and is affecting my balance.

Came home, rang the GP to see if I can get in to be checked out…

Me: Is there any chance of an appointment to see someone today?

Receptionist: No, you will have to ring at 8am tomorrow to see if we can get you in tomorrow. Or you can go to the Walk In centre in Derby. (9 miles away)

Me: Is the walk in centre in Ilkeston closed?

Receptionist: It is. So you can take your chances to get an appointment tomorrow, or try Derby

Me: What if I can’t get to Derby?

Receptionist: You can dial 999

Me: Is that really the best use of 999 and A&E?

Receptionist: You can try here at 8 in the morning….

Grrrrr. So I can have the “first come first served” early morning lottery, listening to the engaged tone for 10 minutes before being told I have missed my chance and I should have tried at 8

Yup, surely you knew 2 weeks ago that you were going to be ill.

C’mon now, you must plan ahead Young Padawan. 😆

Erm….that service is better than many get, what do you expect?

I’d have just gone to the walk in centre. You can see why people use a&e when it’s not life or death though.

Seriously you are moaning because they couldn’t see you the same day you called?

“Is this an emergency sir?”

What do you expect?

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in demand could be smoothed out.

I think I might call the book something like a Bookings Diary and sell the concept for millions

[edit] just found out that diaries have been available for centuries and the system I describe has been working very efficiently in other areas of life for decades too. Maybe someone should explain the concept to doctors.

go down to the Drs if it’s not too far away for when it opens and ask for an appointment asap when it opens. With a bit of luck you’ll have a sick note in your pocket and be off cycling for the day by 8.30am.

Its the inevitable result of a tick box culture. The fact that is doesn’t function properly is neither here nor there. What matters is that the correct boxes are ticked so the statistics can then be published to say that its brilliant, and can’t be improved on.

I decided recently, after nackering my shoulder, to not bother with trying to get a GP’s appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn’t give me the prescription for it, as I’d have to see my GP for that.

Nice bit of joined up thinking going on there. Why waste some peoples time, when you can waste everyones time instead. Bonkers

Wait until 6.30, ring 111 get a local ooh appointmet tonight. The system works, people just aren’t told to use it properly.

Just don’t suggest that GP’s are in the wrong. They don’t like being told that as they are never wrong. Ever. Why would you even form that opinion, you are most likely poorly educated and not a GP yourself.

All of that aside, I think your whinging is a bit premature. Call them tomorrow and see you you get an appointment. If you do, stop whinging, if you don’t come back and we will offer sympathy.

You should have told them that you were getting chest pains……that always works. 😳

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in demand could be smoothed out.

Except when this was done lots of people felt a bit better over the intervening days between calling for an appointment and the actual date, and didn’t bother going.

Nor did they bother calling to cancel.

Hence people who did wake up that morning feeling unwell couldn’t see a GP as they were booked up for days on end with a significant percentage who would not turn up.

If you do get an appointment the following week 9 times out of ten there will be a problem with it and I can guarantee it will be changed.

They could free up a lot of appointments, and do the nations finances a favour at the same time, by refusing to see old people. Cluttering up the bloody waiting rooms, smelling of wee

I decided recently, after nackering my shoulder, to not bother with trying to get a GP’s appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn’t give me the prescription for it, as I’d have to see my GP for that.

Ah, but if they could give you prescriptions then people would just head to the walk in centre instead of bothering to book an appointment with their GP! 🙂

Except when this was done lots of people felt a bit better over the intervening days between calling for an appointment and the actual date, and didn’t bother going.
Nor did they bother calling to cancel.
Hence people who did wake up that morning feeling unwell couldn’t see a GP as they were booked up for days on end with a significant percentage who would not turn up.

Ah, well, IIRC, back in the day the old solution was to run an open clinic where you could just turn up and take your chances – which wasn’t normally a problem because the GP always had some empty slots where people didn’t turn up to their booked appointment 😉

Yeah it’s pretty annoying, although hard to see how it could really be improved. At my GP if you phone during the day for an appointment it’s usually 7-10 days until you can get one, the other option is queue outside the surgery from about 7:45am (with lots of other people, many coughing and sneezing…) and hope to get an on-the-day appointment when they open the doors at 8am, or wait until 8:30am and phone them (if you wanted to be reminded what an engaged tone sounded like).
The only solution I see is more GPs so the waiting time is only a day or two for any appointment but that’s not going to happen.

When I call my local surgery I am given a choice between (a) booking an appointment in c.2 weeks’ time or (b) calling back the following day in the morning. If I do that, a doctor then calls me and asks me whether I need an urgent appointment. If I claim I do he then fits me in that day or the next couple.

This is fine, until you get the combination of stiff upper lip and optimism, or gathering depression, that says it isn’t really urgent, but there’s no point making an appointment in 2 weeks as I’ll be better by then and won’t remember to cancel the appointment, which is wasteful. Therefore I eventually go to see a GP privately and straight away when I’m properly unwell, and get charged £70 for the privilege.

I suspect if I was better at putting on a sickie voice and pretending my ailments were urgent I’d get pretty prompt appointments, so it’s my own silly fault.

🙂

I decided recently, after nackering my shoulder, to not bother with trying to get a GP’s appointment and just head into the walk in centre instead. They checked me out and told me exactly what i needed. Unfortunately they couldn’t give me the prescription for it, as I’d have to see my GP for that.

and because the NHS seems completely unable to have any sort of IT systems that can share patient records, the drop in centre probably could not see your medical history or share their diagnosis with your GP

I must be lucky then, when the OH rings the docs is very unusual if they cant fit her in that afternoon or worst case first thing the next day. Often they will call back offering a cancellation if one crops up.

by refusing to see old people. Cluttering up the bloody waiting rooms

My old doc(Shipman) tried a variation on solving that but it didnt work out too well for him or them.

To the OP , I thought you were talking about my local surgery at first as they operate exactly the same, I have taken to dragging my poorly arse down there first thing in the morning til it opens, as its the only way to get a same day appointment.

Plus I never seem the same doc twice and have self diagnosed more successfully than them before now only reason for going is comfirmation and to get the necessary treatment whether its medicinal or physio.

I normally just go to the walk in centre these days if I want to be seen quickly but it is clearly not an A&E issue. My Dr also does this ring back thing where they will call you during the day and discuss the best course of action.

3 week wait here. The web is open 24 hours a day, much better service.

But what is the alternative?

The real solution would be to better fund GPs so they aren’t running at or over capacity with no room to flex their appointments to meet demand.

But since we don’t do that then there is no magic way to allocate time that doesn’t exist. Give appointments out in advance then they get booked up by non urgent things, give them on the day and you have this situation. Get rid of appointments all togther and people complain they have to sit waiting for hours.

You can of course reserve some capacity for urgent issues and allow some to be slots to be booked in advance (which most GPs do AFAIK) but you still have to decide the cut off when you release the urgent appointments at some point.

Ummm… Is there a idea there for demand planning/slot optomisation software for GPs so that they could allocate appointments based on predeicted demand

I have to leave for work before 8am so have the choice of taking the day off work and hoping to see the doctor or booking an appointment to tell him i was really unwell last month but managed to get some antibiotics/pain killer/antiinflamatories, special itch cream from this guy down the pub without a prescription. The guy down the pub is a vet but illness is much of a muchness isn’t it.

I have taken to dragging my poorly arse down there first thing in the morning til it opens

Our GPs have “fixed” this flaw in their system by not allowing you to make appointments in person, only by phone. Can usually get a same day appointment to see a nurse though, but if you need a doc it can be three to five days, and you have to see the nurse whether that’s useful or not.

Sorry, I wasn’t having a go about not getting in today. Though I would have thought that they would keep a couple of slots free in the afternoon for such events.

I’m more annoyed by the pantomime that will be the 8am stampede for appointments which I still may not succeed at getting, and the casual referral to a centre 9 miles away, or the suggestion to abuse the A&E and 999 systems.

Somewhere the system has gone wrong, fundamentally wrong.

Somewhere the system has gone wrong, fundamentally wrong

Funding – Not enough of it. Simple realy.

Our new surgery’s telephone triage system diagnosed me over the phone as having a virus. Three days later I was in intensive care with septic shock. Great system.

Is it just funding though? Or is the funding in the wrong place? Our local walk in centre was closed as the local GPs had capacity, but you struggle to get in at the GP, so they suggest you try a more distant walk in centre.

Some sort of phone triage may help seperate the appointments more effectively?

then when you do go for an appointment you have to wait for 45 minutes to an hour.

Some sort of phone triage may help seperate the appointments more effectively?

Yep – But then we get threads of people whinging they had to tell their problems to a receptionist or complaining the automated triage system got it wrong (see above).

The holy grail is probably some sort of alogorithum based automated appointment allocation based on triage assesesed need and predicted demand. With some clever manipulation of supply using locums by GPs the patient could be mostly unaware they have been rationed.

But for this to work people have to be a) willing to tell someone their symptoms over the phone and b)accepting of not being given the next available appointment regardless of their problem.

At present people aren’t willing to do/accpet this.

Primary care gets (currently) about 9% of the NHS budget, but deals with 90% of the NHS workload.
Despite the criticisms above (which I acknowledge are a challenge), if you look at it from the ‘global perspective’ rather than the ‘personal one’, your GP isn’t doing too badly with what they’ve got…

DrP

EDIT:
RE

Try this as a concept : you are able to phone in advance to book a time for your appointment. This time could be written into a book with your name against it. There could be a set number of times each day that are left empty to cope with emergency appointments that are added to the book on the day. This way the less urgent appointments could be booked for the less busy days and the peaks and troughs in demand could be smoothed out.

Nick – this IS how the appointment system works! However, I’ve highlighted the key word in your statement there, as presently it’s too high.

You should have told them that you were getting chest pains……that always works.

Had killing toothache a few years ago rang NHS direct, spoke to a new girl (obviously), after giving out more info than you do on a first date, she asked if i had any other pain, all i wanted was a number for an emergency on call dentist, i said yes my chest hurt when i hit the tree and bashed my mouth, she put it down as chest pain, and in the background could hear her on the other line asking for an ambulance, luckily she came back to me and i told her again a i just wanted an emergency dentist, but you have chest pains she kept saying.

3 teeth out that night.

and O/P you coulsd also see your local chemist bloke,Pharmasist or someone with a similar speelling

What do you expect from private sector provision of care. With all GP’s being private sector they only provide the appointments they think is necessary, not what their patients need.

Primary care gets (currently) about 9% of the NHS budget, but deals with 90% of the NHS workload.

Er… not quite.

Primary care deals with 90% of patient contact, which is a different thing. Still underfunded when the NHS is looked at as a whole, but then again, GPs do earn a jolly good wage…

A good wage within a defined contract. Good wage does not result in there being more hours in the day. And I pretty sure there is nothing in the gp contract that rewards their business for reducing waiting times for GP appointments. I know that doesn’t really read that well but that is the reality, they are a private business operating under contract. The more money the business’s makes, the greater the profit share of the partners. The weakness is the contract.

GPs do earn a jolly good wage…

When compared with other highly skilled and specialised jobs that put the job holder under high levels of presure, including life and death decision making they don’t earn very much at all.

Not every GP gets the headline wages trumpeted by the Dail Mail in its race to the bottom crusade.

When compared with other highly skilled and specialised jobs that put the job holder under high levels of presure, including life and death decision making they don’t earn very much at all

Could you tell me about those other jobs that have high pressure and life and death decision making, and tell me the salaries involved?

…and tell me about the nights and the weekends?

GPs get paid well.

Crike is right -I meant patient contact, as opposed to workload.
However, in task terms that is still likely to reflect a high percentage of the workload…

DrP