End to hated '8am scramble' for doctors' appointments after GPs sign new deal

Growstuff, medical receptionists can learn how to work with the sort of algorithm , or fomulaic set of questions that 111 uses.

Medical receptionists can also be trained to respond sympathetically to people who are anxious when they call the surgery.

Medical receptionists can also be taught how to advise callers which sort of help they need, doctor, nurse, and so forth.

None of these areas of expertise involves diagnosis.

Yay, sounds great to me

It won't just be about online requests. This is the key section from the new contract:

7. We want patients to contact their practice, by phone, online or by walking in, and for people to have an equitable experience across these access modes. This will be a key intervention in the government’s ambition to end the 8am scramble. From 1 October 2025 practices will be required to keep their online consultation tool open for the duration of core hours for non-urgent appointment requests, medication queries and admin requests. This will be subject to necessary safeguards in place to avoid urgent clinical requests being erroneously submitted online.

Nuttynanna2

Ok. Whatever!

???

To be honest, if I needed urgent treatment, I wouldn't ring the GP. I'd ring 111 or 999.

ayse I think they will have to have some kind of register too. If most people are using the online system, there should be greater capacity to answer calls from people who need to phone.

Our surgery does this already. They get back to you n 24 hours with either a prescription, a telephone appointment or they call. I’ve had a same day appointment using this system with my nominated doctor. Our surgery uses a nurse practitioner or doctor to triage the patients.

It concerns me that those without access to the online system are missing out. I think each surgery should run a register for those who are unable to use online or at risk of needing urgent treatment.

Calling 101 is also an option. They can make representation to your GP practice on your behalf etc.

We must be fortunate here as the NHS seems to work well.

Caleo I'm not objecting at all to an empowered reception service. Wherever did you get that idea? If you've read threads on GN, you'll see that many people (not me) object to telling the receptionist what's wrong with them.

I have given a number of reasons why I like the e-consult system, the main one being that I don't have to hang on the phone to get an appointment.

Gin I expect it's different in other practices, but I know in my practice, nurse practitioners do the triaging.

My chum is a GP Practice manager. To date they have not had any instructions or money to implement the computer system. They already have one in place. They did get a small uplift but that only covers the extra NI.

When I fill in my online request and list my reasons, who is actually doing the triaging? Is it a doctor, nurse or the receptionist?

Growstuff I recognise your objections to an empowered receptionist service including landline telecommunications.

These objections need to be considered.

The image of the GP receptionist needs to be upgraded by professional image makers on behalf of the NHS. This would help members of the public to trust receptionists to understand and respect confidential information.

If receptionists are not already trained in techniques to elicit key information from patients during the telephone call, then the receptionists should be trained to do so, as are doctors. 111 service does this efficiently and no reason why the doctors' receptionists can't be as efficient and empathetic.

The other point, that patients talk on the phone for too long, is handled by e.g. "Thank you, I have your message now and will tell the doctor directly we finish this phone call".

My surgery used to have on-line booking, but they stopped.it because they said it wasn't fair for those who had no access to a smart phone or computer...... wonder what they'll do now....

Caleo

Growstuff, I expect GPs to communicate intelligibly. An important part of the receptionists' remit is efficient communication. There is no excuse for GPs and their practise managers for any ineffective use of telephones.

The very least of GP services should be easy access to qualified receptionists at the end of the landline.

Qualified in what? The trouble is that most receptionists aren't qualified in diagnosing medical problems and people don't like telling them what's wrong with them.

Elusivebutterfly

I don't understand why they are making an issue about seeing the same GP regularly. In the past this was something to hope for, but now they need to find a way for people to be able to see a GP atall.
My surgery has most appointments by phone with a pharmacist a couple of days later. If you need an urgent appointment, you will usually be told to go to the Urgent Care Centre a few miles away. Routine GP appointments are sometimes available 2 weeks ahead, other times there are none.

All surgeries seem to be different. My (admittedly very limited) experience is that I've made an e-consult request and been directed to the most appropriate person. I've had face-to-face appointments without a phone appointment. The only times a GP has rung me was when tests were slightly unusual and I've been given appropriate advice - I didn't need to see anybody face-to-face. I had a lengthy medicine review with the surgery's clinical pharmacist - again, I didn't need to see her face-to-face and it saved me the hassle of getting to the surgery.

If you really do have a need for an urgent appointment, you're probably better going to an urgent care centre, which is better equipped to deal with urgent cases.

Caleo

Each practice ought employ a receptionist who can make phone appointments to suit each patient's . There are a lot of patients and their carers who lack any knowledge of or access to computers.

Doctors are expensive to hire : receptionists are comparatively cheap to hire.

The trouble with making phone appointments is that people can hang on the phone for ages, which just isn't practical if you're on the way to work or have children running round your feet. An e-consult request takes minutes.

Secondly, lots of people don't like telling the receptionist what's wrong with them (look back at some GN threads on the topic). Personally, I'd father write a couple of sentences than tell an unknown receptionist what's wrong with me.

Thirdly, surgeries will need to make some provision for people who don't have internet access, don't have the capacity to make an online appointment or are blind, etc. Those patients will need coding somehow, so that if somebody rings up and says their name is X, the receptionist can check the records and see that this is somebody who needs to make an appointment by phone. I don't know how they'll do it - maybe you should contact your patient voice group (or whatever it's called) and make the point.

I don't understand why they are making an issue about seeing the same GP regularly. In the past this was something to hope for, but now they need to find a way for people to be able to see a GP atall.
My surgery has most appointments by phone with a pharmacist a couple of days later. If you need an urgent appointment, you will usually be told to go to the Urgent Care Centre a few miles away. Routine GP appointments are sometimes available 2 weeks ahead, other times there are none.

*money

growstuff

One of the things I noticed in the proposed improvements is the re-introduction being able to make an appointment with a specific doctor.

Extra money (again) given to GPs who agree to do this “where there is a need”.

Perhaps they could’ve just taken Monet away from doctors who didn’t sign up to it?

It’s been proven to give better patient outcomes.

Growstuff, I expect GPs to communicate intelligibly. An important part of the receptionists' remit is efficient communication. There is no excuse for GPs and their practise managers for any ineffective use of telephones.

The very least of GP services should be easy access to qualified receptionists at the end of the landline.

each patient's circumstances

Each practice ought employ a receptionist who can make phone appointments to suit each patient's . There are a lot of patients and their carers who lack any knowledge of or access to computers.

Doctors are expensive to hire : receptionists are comparatively cheap to hire.

mae13

Maybe. And then maybe not.

The '8am scramble' will just go online and the Internet will be log-jammed. Same difference really.

This hasn’t happened in our practice, mae13. Both my DH, daughter’s family and myself have used the system and as long as you fill in the form in the morning you seem to get a phone call in the afternoon, either with a doctor, nurse, or receptionist depending on what the request was for, often with an offer of a face to face appointment that day or very soon after. We have been very pleased with the system but our practice has always been quite thorough.

Our Surgery has an online form, which is only available Sun - Thurs 7pm-8pm. But it is for non-urgent medical requests.

Last time I used it, I had a text offering an appointment the following week.

Most people have no idea how much demand there is for GP services. Each full time GP is responsible for around 2000 patients. My DIL is at the doctors pretty much every week - and I’m sure we all know people like this. Do the maths on that and you can understand why practices are struggling so much.

Under the deal doctors would be paid more for identifying patients who would benefit the most from regularly seeing the same GP.

I think that's important. I know I've read reports in the post which have shown that elderly people especially benefit from continuity of care. I would think people with mental health conditions and some disabled would also benefit. I suspect we'll be coded in some way to ensure that happens. (And then people will moan that it's agesist or ablist - can't win really.)