“Non siamo rottweilers”: dietro le quinte in una ragazza di GP 8am
https://www.bbc.co.uk/news/articles/c2lzny07jqxo
di Ambitious_Lan
“Non siamo rottweilers”: dietro le quinte in una ragazza di GP 8am
https://www.bbc.co.uk/news/articles/c2lzny07jqxo
di Ambitious_Lan
35 commenti
“Only five minutes after the lines open, more than 30 people are queuing to get through.”
Thirty?
“You are currently number …. ….. …. 46 in the queue” and that’s at 08.02
I feel so sorry for most of these workers. It must be one of the hardest jobs to do in the uk at the moment.
>Anyone who has ever tried to get a GP appointment in England will be familiar with the “8am scramble”, as you phone your local surgery desperately hoping to get through.
Don’t know why they’re limiting this to England. It’s the same bullshit up here in Scotland.
Try that they won’t let you phone and the que starts outside the doctors from 7am and opens at 8am and the assign the appointments
The thing that annoys me about my GP isn’t the 8am rush. Its the fact I HAVE to make an appointment for that day.
I’m quite happy with most things to wait a few days, but nope. Not able to
Our GP surgery recently changed their approach. You can call at any time or use the online website to fill in a form to explain what your medical issue is. The “team” then decide the right course of action. Basically, whether you get an appointment on the same day with a Dr or something else.
I suspect this will make it even more difficult to see a fully qualified GP in person (and we’ll instead be seen by physician associates and nurse practitioners etc). The surgery has been clear this is their solution to less resource and too many patients wanting to see GPs.
I thought that the government’s plan was to improve access to front line healthcare. Instead it’s becoming ever harder to see an actual Dr in person.
Dear I say it but I preferred the 8am scramble to the new alternative offered by my surgery.
Population too big for the amount of surgeries and GPs we have, I doubt my grandparents had this issue and they were born in the 20’s
The key is “I’m old , lonely and a full-time hypochondriac” – boom, hour long in-person chat with your fav GP that very afternoon followed by a shandy at the local and an early night.
The biggest problem with the 8AM rush is that it’s basically a way to fudge the numbers.
There was a government initiative saying all UK citizens should have sameday access to a GP.
So, what did they do? Hire more GPs? Open more surgeries? Of course not.
They created the 8AM rush.
Now, anyone who manages to get through and get seen that day gets logged as a “sameday appointment” and on paper, the metrics look great.
But they don’t seem to care about the hundreds of people who get turned away and told to try again tomorrow because the higher ups in the NHS don’t care about that.
GPs should be measured, within reason, on how many people they turn away each day. Then you’d see appointments roll in because common sense could be used to book an appointment in a weeks time or something.
I think the process is so challenging that it makes people think irrationally. There’s only a finite number of appointments. People need to think of appointments as a resource. Unfortunately the government doesn’t want to invest more into primary care, and we are all suffering for it… It would be great if GPs could start charging a nominal fee for you to book an appointment with the Dr of your choice no matter the surgery, injecting a little competition into the sector thus creating growth.
I used to work as a GP admin and it was so difficult. I hate the system for appointments. HATE IT. It’s really unfair on people and nothing was worse than telling people we had no more appointments. Our Gp would see a max of ten patients a day, then go home, even though he was the only Gp in our surgery and legally, we are meant to have a Gp on site while open.
The abuse we got from people due to the GP refusing to take more patients was insane. We didn’t have headsets in the place I worked so we’d have to cradle the phone between our ear and shoulder while we typed and I genuinely got hearing damage from people screaming at me from it. I got a hearing check and have partial hearing loss in my left ear from using the phone like that.
Are some receptionist absolute assholes? YES. But not all. Myself and many others tried out best to help. I remember when we lost funding for our in house councillor and the GP gave me a list of names and said ‘call them and tell them they’ll have to find somewhere else for counselling.’ And that was it. I was screamed at, insulted, threatened and some people just flat out cried. I had one guy who was so upset I spent half an hour consoling him and helping him fill in an IAPT referral. I felt so awful for him.
A lot of people don’t realise how much is on the admin. The GP’s don’t do as much work as many think. We scan and copy all your documents, we write up all your referrals from a doctors dictation via software, we organise appointments, transport, blood tests, lab results, chasing all of those up, reorganising clinics when a nurse or GP is off sick, put prescriptions through, chase them up, organise ambulances, send emergency info through to hospitals and then some. There is so much to juggle.
Hell I remember our GP tried to get me fired because someone he knew personally, registered at the surgery and saw a surgeon privately for a consultation, and was told they would then go to the top of his NHS treatment waiting list. I shot the GP down and said no, they go to the back of the queue and wait like everyone else. All they do is bypass his consult waiting list. But whatever treatment it is, they wait. It’s utter bullshit behind the scenes. But I promise not all admin are trying to make your life hard.
Like when they ask for symptoms and more info it’s to put you in with the right clinician. If you put people in with the wrong doctor/nurse, most likely that GP/nurse will tell you they won’t see them and the appointment will be cancelled. Then you the patient get called and told you need to make a new appointment because our system literally won’t let us prebook appointments. It’s so dumb. It’s genuinely not to be nosy, we can see your entire record, nothing is hidden to us because we do 90% of the work on them. GP’s don’t send your referrals off. We do. They don’t write your letter. We do. GP’s don’t do the subject access requests, we do. We go through them to ensure they’re correct. GP’s don’t even answer their own damn post most of the time.
It’s legit chaos behind the scenes with so much shit to deal with.
Let me book online then! Why do I need to phone the GP practice to get my monthly prescription. If there’s an issue and the Dr wants to see me email me back!
Even fax would be more efficient than making people phone.
Put in a request for an appointment rating how severe you think it is. They can take a look and assign you an appointment based on current symptoms.
My previous doctor’s you filled out the online form (with the opportunity for pictures!), they’d triage you and text you an appointment time or you’d just get a phone call if it was an emergency. You could also call and fill out the same form by voice leaving a message on their phone number. You could do this at 3am if you wanted so it was ready for them in the morning.
It was an utterly brilliant system, they started triaging early with appointments from 8.30. You could not call and speak directly to a receptionist for appointments, it was an online or voice form then they came back to you promptly.
No rush on the phones, no feeling like I couldn’t communicate what I needed to (as I could put anything I wanted down in the pre-appt form), shorter wait times.
This would probably be politically unfeasible because we’d have people screeching about privatising the NHS, but a £10 charge for a GP’s appointment would resolve 90% of this. It’s just enough money to deter time wasters, but not enough to be a serious blow to someone’s bank balance.
Last time I had to phone the GP was about 10 years ago, I managed to get through eventually and the receptionist said “well if it’s that bad, go to A&E” and hung up on me!
Ours is effectively book 2 weeks in advance, Got to be triaged online then offered slots anytime in the next 3 weeks – never any available less than 2 weeks out though,
Only time I’ve ever got same day was because the GP thought that as a new patient to the practice I’d be a good practice for his medical students at taking a history. Especially as I’m at an age when they want to start prescribing as preventatives.
For everyone critical of the current system, I would love to hear how you would organise it differently
You are a GP manager
You have
1. An increasing population of more elderly, complex patients with more medical diagnoses and prescriptions
2. Increasing costs of business, staffing, buildings, maintenance, and consumables
3. A secondary care system which is failing, so patients wait longer to see specialists, so they expect you to manage their complex problems yourself
4. Insufficient funding increases to cover the rising staffing and business costs
5. Far greater demand for appointments than can be met by current staffing levels
6. Increasing numbers of patients per GP
7. Failing A&E departments meaning patients come to see you about issues they should have gone to A&E for, and refusing to go to A&E when you suggest it
8. More complex frail elderly patients being managed at home rather than in hospital, requiring more home visits than before
So go ahead. Any good suggestions more than welcome
My GP just pushes everyone to an online form that doesn’t get you anywhere. An 8 min phone call two weeks later.
I had a great gp in Fulham and now a shocking one in Leeds. The difference is the triage of appointments by using the patches system. When I filled out the form for fulham they then referred to the level of appointment needed, when I had a bad sprain it was a phone call to see if I could move it and then referred to a specialist, ear infection saw a paramedic. In my 5 years there I only saw a GP once and only needed to see one once. In Leeds they have the patches system but dont use it instead demanding you ring ar 8.01 with the earliest appointment being 2 weeks time and you have to be very lucky to get it. The technology os there to cut out the time wasters and those looking to go as they are bored but certain gp clinics are refusing to utilise them
My medical centre abolished phone bookings for all GP appointments. Now it’s an 8.00am scramble for an online form to report issues/symptoms, that a duty doctor will triage within 24 hrs, and arrange further action, such as a phonecall or physical appointment – in my current case its a 5 week wait to see my named GP for what once would have been a same day appointment..
its a bullshit recent system most of the folks phoning at 8am phoned sometime the day before and where told to phone back the next day, Just book them in a day or 2 in advance. The receptionists 100% try to get rid of you
round here theres surgeries that moved over to using an answering machine for anyone phoning in a repeat prescription
..Then cut the answering machine itself to strict Mon Fri office hours! evidently a bundle of repeat prescription requests to work thru on a monday didnt suit them
Is there a reason you can’t have an open calendar online to book an appointment bit like a restaurant?
My latest engagement with this process:
Ongoing chest infection, started coughing blood about 7pm, didn’t want to clog up A&E if I didn’t need to so I rang 111. They referred me to the out of hours GP, who rang me back at 4am and told me at length to go to my regular GP. 8am rolls round, I ring as near on the dot as I can, first appointment I can get is 4:30pm.
When I get there, the doctor is worried about a pulmonary embolism (in part because I’m sweating and that’s on the list of symptoms for PE, though it’s also pretty diagnostic of it being 28 degrees and their office having no air con) so refers me to A&E because it’s too late in the day for anything else. So after nearly a full day of pissing about I go to A&E and they rule out an embolism, then prescribe me some of the good antibiotics.
Replace GP receptionists with AI immediately.
It cannot possibly be worse.
I can’t speak for every specialty but in ours that would require a large increase in the staff you need-at least 50% more staff. Probably a bit more if you account for leave/sickness/other absences. (Going from two of each grade to three).
Also, who wants to work six days a week?? Staff do have lives outside of work. Admittedly seven days in a stretch is (or at least wasnt) unusual but that’s not all the time.
Some of these receptionists are total arseholes ! They think they are doctors, all you need is an appointment , not to be grilled like a criminal.
Im sorry but those receptionists and basically everyone who isnt a nurse or GP at a surgery are little hitlers. I have never had experiences anywhere like I have had with trying to deal with my surgery. Makes me just not want to even engage
Just a quick reminder what everyone was bitching about with GP appointments in the mid 2000s.
https://www.youtube.com/shorts/Do3Y3ga7dyE
The results you get are the results of two things:
1) Amount of GPs.
2) incentivisation in GP contracts.
For 1), you need to accept that if you want lots of GPs, you train lots of doctors, pay NHS GPs so well they don’t take off for private practice, and that you need what will be recognisably spare capacity in good times.
For 2) you need to look at services as a blanket. If you don’t want it “too big” because of the cost, you either incentivise covering your feet or covering your arms, cos it won’t cover both.
Why not just open slots exactly 24hrs before? Honestly it’s mad to have everyone call at 8am. Stagger it a bit.
They are what their employers have caused them to be
It’s been 5 & 1/2 years since I’ve been face to face with a GP.
My experience with the 8am scramble was poor and when I am in the surgery say for an appointment with a nurse or healthcare assistant (bloods or blood pressure check) I often see the 8am queue of people with colds lining up wanting the few last minute GP appointments available.
My go to now is e-consult via the NHS app, I’ll usually speak direct to a GP the following day on the phone or they’ll put me in connection with the required service I need if it involves a referral.
I’m fortunate my meds are on a recurring because I’d be constantly on the phone. A few years ago I found a lump in my breast and despite telling the receptionist, I still had to wait 2weeks to see my GP. It was all okay in the end but it wasn’t a pleasant experience.
I have no idea what the 8am rush is about, I seem to be able to call up in the middle of the afternoon and get a same day appointment or in a couple of days time
It’s amazing to me that no one is talking about the root cause of this. It’s a fiddle, doctors are paid more for short notice appointments than they are for regular ones.
Each doctor has a rate they charge as standard, and a rate they charge as a locum – short notice same day appointments are charged at a locums rate. As the GP’s run the surgeries, they’ve fiddled the system to make an impractical ugly mess in order to get paid more, even if it results in worse outcomes for patients.
So no, these old ladies aren’t Rottweilers, but they are useful idiots supporting a system that’s harmful for patients and puts undue burden on the NHS. I’d love to see an investigation into this.