NHS Doctors not helping themselves?

Doodledog

Ours has a good system (sorry, I realise that's not what those with frustrating ones want to hear, but I mention it to show that it can be done). You go online and fill in a form with a brief description of the problem. You are guided through it with questions about how long it has been going on, what you want from the surgery (eg a consultation, a change of meds or whatever) whether it's getting worse and so on, so the triage team have enough information to work with. You can ask questions, too.

The forms are triaged twice a day and you get a call back (sometimes within the hour) to resolve it. You might get a call from a GP or nurse, or the receptionist might call to make an appointment, to tell you that your meds have been changed and will be at the chemist by tomorrow, or to pass on an answer to a question. Sometimes a GP will answer questions by text if they are straightforward. It is all very efficient.

As an example of the efficiency, Mr D had an odd-looking lump on his head, which he couldn't see, but I could. He kept saying it was fine, and put off getting it looked at, as men can be won't to do🙄. I took a photo and uploaded it to the system, said I was concerned and asked for advice, leaving his number so they didn't need to worry about speaking to me about him and breaking confidentiality. Within an hour he got a call asking him to come straight to the surgery, where a nurse practitioner said it was a basal cell carcinoma and prescribed some ointment to zap it. From my message to his applying the first lot of ointment took a couple of hours. You couldn't ask for better service.

It is so much better than the 8.00am scramble, but people still moan. The receptionist will fill in the form over the phone for anyone unable to do it themselves, but that that leads to complaints about having to tell the receptionist the nature of the problem, and people don't want to be triaged - they want to speak to a GP immediately, which is just not efficient and leads to longer queues for everyone else.

There are downsides around having to talk on the phone for patients who don't have privacy. You can't specify a time for a call back, but you can say when you are not available. Now that I am retired I don't need to do that, so can't say how well it works, but I assume they take working hours/commuting time etc into account.

I don't know whose responsibility it is to sort things out. Surgeries are businesses now, so the government can't impose systems (or can they?), but they could employ more GPs and other staff. My home town has nearly doubled in size since we moved here, but the number of GPs has stayed the same, and most of them are part-time. Things have declined over the past 15 years, so it can't be reversed by tomorrow, but I'd like to see a move towards a reasonable cap on the number of patients per GP in any surgery, and that would mean government involvement.

Many GP practices that used this system have to to restrict the hours of availability or, in the case of my GP practice, abandon it completely. People became rather too adept at using it and it generated so much extra work the practice couldn't cope. Having used it l can appreciate why, in order not to miss something crucial the submissions have to be checked regularly and quickly, GP surgeries became swamped. I hope it continues where you are, l thought it was an extremely useful tool but absolutely understood my GPs experience and frustration when it was explained.

Three weeks at our practice would be quick, five to six weeks is more like it. Even then that is usually a phone call, my doctors still won't see patients face to face if they can avoid it. I am baffled why 5 years after Covid when everything else has returned to normal, GPs are still allowed to behave like this.

Doodledog. That sounds like the Accurx triage or very similar. I’ve experienced filling in the online form and getting a callback almost immediately to go to the surgery if it sounds serious.

I suspect one of the problems may be older, isolated folk who don’t use or are not confident with technology. I hear it from people at the twice yearly pop up Covid vaccination facility. They may struggle with phones in general through impaired hearing or the instructions to press this or that for different services, and digital technology (no mobile phone or computer). So they walk in and are upset when the receptionist tries to turn them away as all the time slots are booked.

I’m old enough to remember when one could just walk into a doctors’ surgery and wait (sometimes hours) to be seen but I’m talking about the 1960s when a lot of people still didn’t have a phone in the home and the phone box on the corner was often out of order.

I don’t like that some older people feel marginalised. It will come to all of us eventually that we struggle with some things. I think there is a place in GP practices, certainly larger ones, to allocate say an hour or two a day in the mid afternoon, after the early morning rush, for older people to be able to walk in to see someone. First come, first served.

It's rare that either of us would forget an appointment but DH suddenly realised that he should have gone to see the nurse to give blood the other week. The clinic was still running that afternoon. He rushed there, about three-quarters of an hour late and the receptionist refused to let him go through. I said to him that some patients would have arrived early and so he could have been tagged on at the end instead of having to make another appointment.

Why should people have to potentially work late because your husband forgot his appointment? I’m sure he wasn’t the only one, so should they let everyone rock up late?

This rule will be coming from the GP, not the reception staff, so no point in blaming them.

Older people aren't marginalised though, PaynesGrey. The receptionists will fill in the forms for them, but they have to wait to be triaged like everyone else, and some don't want to. A two-tier system would cause resentment, I think, but we did use to have 'drop in' appointments from 11.00-1.00 for all patients, and it would be great if they could be reinstated. I used them a couple of times for babies with a temperature and similar - when you want quick reassurance and even an appointment the next day is too far off.

Old Frill My surgery doesn't restrict consulting hours AFAIK. You can only send the forms in during surgery hours, and they are collected at something like 10.00am and 2.00pm. A GP, a nurse and an admin person go through them and sort them depending on what action is to be taken. I know this as I was talking to someone who used to work in the surgery and she told me how it worked.

Obviously the number of consulting opportunities are restricted by time and the number of GPs available, but surgery hours are 8-6 on weekdays and 9-12 on Saturday mornings. I hope they don't change the system, as the one where everyone had to ring at 8.00 (when people are on the way to work) and try again tomorrow if they don't get through was atrocious.

Mostly, I have used the system for important problems, so have had very prompt responses, but less important appointments do have to wait. I have only had one experience of having to wait three weeks for an appointment, but it wasn't urgent and I had specified the GP I wanted to see, so knew that I'd probably have to wait, and didn't mind.

Summerlove

*It's rare that either of us would forget an appointment but DH suddenly realised that he should have gone to see the nurse to give blood the other week. The clinic was still running that afternoon. He rushed there, about three-quarters of an hour late and the receptionist refused to let him go through. I said to him that some patients would have arrived early and so he could have been tagged on at the end instead of having to make another appointment.*

Why should people have to potentially work late because your husband forgot his appointment? I’m sure he wasn’t the only one, so should they let everyone rock up late?

This rule will be coming from the GP, not the reception staff, so no point in blaming them.

Why should people have to potentially work late because your husband forgot his appointment? I’m sure he wasn’t the only one, so should they let everyone rock up late?

No need for rudeness.

As I said, the clinic was still running, patients often arrive early (including DH usually) so one of the next patients would have gone in DH's slot. The nurse was still there taking the clinic for another hour or so after he went there. She would not have worked late and, knowing the nurses at our practice, she would have seen him.

It was the receptionist who was intransigent. Also she needed to do was ask the nurse if she could see him - yes or no. He was very upset and apologetic that he missed the time.

I was at a birthday party yesterday afternoon and on our table were locals we know well and the chat got round to our GP practice.

I think we have about 10 partners but two of them now spend a couple of days a week teaching. One of them is our named GP so no wonder we can seldom get an appointment with her.

Allira that is similar to what happened to my friend’s husband. He had a text to say he could get a flu jab and to go to the surgery between 9 and 1 pm. He turned up at 10 to 1 and was told he could not have it. He pointed out there were still 10 minutes left but the receptionist said “we close at 1”.
They told him to come back at 2 but he said it was a 10 mile round trip again but she wouldn’t back down.

Primrose53

Allira that is similar to what happened to my friend’s husband. He had a text to say he could get a flu jab and to go to the surgery between 9 and 1 pm. He turned up at 10 to 1 and was told he could not have it. He pointed out there were still 10 minutes left but the receptionist said “we close at 1”.
They told him to come back at 2 but he said it was a 10 mile round trip again but she wouldn’t back down.

DH said to me that often, if we arrive for an appointment on time, we have to wait for at least half an hour or more to be seen anyway.
If you get called in within five minutes of the appointment time, it can catch you on the hop!

It was the receptionist who was intransigent. Also she needed to do was ask the nurse if she could see him - yes or no. He was very upset and apologetic that he missed the time.

I wasn’t rude, I was asking you a question on why your husband felt that him forgetting his appointment was then the practices problem to solve in that moment.

Him being upset and apologetic doesn’t change the practices rules. I don’t understand why he thinks it should? If the receptionist spent all day asking the medical staff administration questions nothing else would get done.

I genuinely don’t understand the distaste so many have for those who work in an administrative capacity.

Again rude.

Perhaps you don't realise.

We're so lucky with out GP surgery, it's excellent and we've no complaints. I'm usually seen on the day, not always by a doctor or in person but the triaging is very good so I always feel that I've seen someone suitable. My only complaint is the communication between the hospital and the surgery, I've sometimes found my hospital medication prescriptions have not got to the surgery in good time which causes a problem but the GP pharmacy is always really helpful.

The doctors and nurses are fine, as are some of the receptionists but there are a couple of receptionists who are downright obstructive and have been caught out in lies.

Give someone a little power and they then abuse it.

We have a similar system to others e-consult, fill in and online form and await triage, it works well.

Jaxjacky

We have a similar system to others e-consult, fill in and online form and await triage, it works well.

So your receptionists don't triage then?

Ours do.

Allira

Again rude.

Perhaps you don't realise.

Direct and disagreeing with you isn’t rude.

Rude would have been calling him entitled for asking for special treatment.

Maybe you don’t realise.

It would be lovely if my DH could just rock up as you so rudely put it.

It is time the NHS bit the bullet and stopped using privately contracted businesses to run GP surgeries. They should be directly managed by the NHS like hospitals are. The quality of primary care seems to have plummeted since Covid. My DC is a young doctor (in a hospital), but many of his friends have trained and qualified as GPs but cannot get jobs! It is just crazy.

In my surgery, everytme there is a notice 131 did not attend their appointment.The few times I have managed to get an appointment. I point this out to staff. The surgery has been empty.

The hospital is even worse
I am losing my sight and already deaf due to bad service at the hospital and specsavers. This is Southampton

The last time I got to see a real GP in the flesh was in 2018. Since then it's been nurses and a paramedic ( in whom I have no confidence as he misdiagnosed me).

The underlying UK problem is we don't have a bouyant economy generating enough tax to pay for the NHS and no matter how much Streeting talks up minor reorganisations there won't be an improvement to the NHS or any other key public service until the economy improves.

All political parties know this but none of them have a solution.

Louisa1523. Really, not in my area in Herts. If I attempt to make an appointment we have to fill in a 3-page Triage appointment form about an ailment and then it has to be justified by a senior staff member before we are granted an Appt! I find it difficult being elderly as I have multiple conditions and it always takes more than the allotted 10 minutes to discuss, so I dont always mention all of them.

Quercus

It is time the NHS bit the bullet and stopped using privately contracted businesses to run GP surgeries. They should be directly managed by the NHS like hospitals are. The quality of primary care seems to have plummeted since Covid. My DC is a young doctor (in a hospital), but many of his friends have trained and qualified as GPs but cannot get jobs! It is just crazy.

Yes, it's ridiculous.

However, I think there is a lack of training places for newly qualified doctors in other areas too.

Our loss will be other countries's gains, as happened before.

Cannot book appt. at our surgery! Have to phone at 8am,nightmare! If you don't get through immediately by the time you do none left!!! Shocking system

Allira

Again rude.

Perhaps you don't realise.

There honestly is nothing rude about that post and I would also add, that I doubt the nurse saw another patient in the time your husband did not turn up, she probably had a chance to catch up as someone else have said they always run late, so this was her chance to catch up, perhaps even spend a penny. Both you and your husband are being unreasonable in expecting for him to be seen at the end. Sorry but I totally agree with the poster you call rude.

Allira

The doctors and nurses are fine, as are some of the receptionists but there are a couple of receptionists who are downright obstructive and have been caught out in lies.

Give someone a little power and they then abuse it.

Oh you do have a real chip on your shoulder about receptionists, they will know that for sure, which will not help you nor your husband.