End the 8am scramble': Govt plans booking changes. Does your gp offer online requests?

Arthuritis

Excerpt from ITV news:

POLITICS Mon, 08 May 2023

End the 8am scramble': GP booking systems to be overhauled under new plans

Patients will be able to contact their GPs for an appointment more easily under government proposals to improve access to primary care. The Department of Health and Social Care (DHSC) said practices will be handed £240 million this year to introduce online booking tools and upgrade telephone systems, as ministers aim to end the "8am scramble" of patients ringing surgeries for a slot. Follow us on Apple News More receptionists will be trained, with their role expanded so they can asses patients’ needs and speed up the booking process.

— Ours has an email requesting system not particularly sophisticated but it avoids the phone scramble. Does yours offer something similar or better?

stickywicket

I think that'll be good news for many though I don't know if it'll apply to us in Scotland. However, I'm perfectly happy with our practice. You have to ring at 8am, always get through by 8.15am and are then told someone will ring you back. It's usually a nurse but we have very good nurse practitioners and, on the one occasion when I saw one and she was unsure, she just called a doc in straight away. When I had the TIA the doc had an ambulance round within 20 minutes. (Oh, the gorgeous young paramedic Aidan! What a tonic for a sick patient!)

I think it's probably true that much of the difficulty lies with antiquated computer systems so anything to improve them should make big differences.

Trish9556

Hi

I can usually get through at 8 am if I keep redialling until I get in the queue. We then are told a Dr will phone back before 7pm.

The practice only has two permanent drs, the rest are locums. Those two drs have about 13500 patients each. We used to have 8 full time drs. They don't offer bookable appointments unless you can wait about 4 weeks. If a Dr thinks you are ill enough to be seen they will tell you to go in that day. The chances of seeing or speaking to the same Dr twice in a row is zero.

Letters from hospitals take at least 6 weeks to appear on your online record, test results are often not looked at on time and so it goes on.

The rest of the practices in town are just as bad. We have thousands of new builds around here but no new surgeries so everyone goes to an already failing practice.

There is a new large surgery planned about five miles away which people will be referred to but who needs to travel across town in rush hour when they're ill?

I don't have any confidence in anything changing anytime soon.

Love n hugs

Trish xx

Arthuritis

@Trish9556 I hope for success in the recent announcement from government & nhs to allow pharmacies to prescribe medication to handle the myriad of minor ailments that clog up gp time will free up GPs to handle more serious cases. Pharmacists get 6 years of training so should be able to handle a lot of things, including diagnosing & prescribing antibiotics and antivirals within their allowed list.

@stickywicket Indeed. I think the NHS is still the worlds largest fax user, as their systems are so old and every part has its own incompatible system.

Not for lack of money though, as billions on grandiose NHS IT projects have been written off, when they could have been invested in small projects which can be delivered quickly before the requirements changed, and small enough to fully understand the risks and mitigate by buying in proven solutions, trialling and standardising on what works. The NHS has never understood spend efficiency in my view. In Corp Inc & PLC land we called it think global, act local (think of the whole org, but test it out quickly at low risk locally and share the results good or bad).

Trish9556

Hi @Arthuritis

The scenario of pharmacies taking on more duties should be good. However it relies on having a good pharmacy.

I had to change from the one adjacent to my surgery.

Alhough my surgery was releasing my repeat prescriptions the same day I sent them in, it was taking on average 10 working days for them to even look at my prescription let Ali e process them.

When I phoned them their responses varied from we are just doing it, you can pick it up late this afternoon/we haven't done it we will do it tomorrow/we are too busy with flu jabs/health advice/covid jabs/travel jabs etc etc etc or, maybe the most telling one, we are getting 500 prescriptions through a day. Order your scripts earlier (I find this statement makes you cross when you've ordered them at the maximum amount if time possible) and lastly we will text you when it's done...you've run out? Why have you run out? Order them earlier.

Pharmacists on the whole do an excellent job as do drs but when new infrastructure isn't put into place at the same rate of new housing then we are fighting a losing battle and putting extra work onto pharmacist's before it's been thought out isn't the answer.

My new pharmacy is brilliant but I can't walk there. As it's the same one my son uses he picks my prescription up and drives it to my house.

I don't believe that my local problems are isolated to me but I'd like o think they weren't

Love n hugs

Trish xx

jamieA

There are 11 doctors listed on my GP surgery website yet it's still a 3 week wait for a face to face appointment and (last time I booked one) 10 days for a telephone consultation. When I attend my 3 monthly blood test - booked 4 weeks in advance - the surgery waiting room is normally almost empty.

There is no published means to send an email or book online. I managed to get the email address of the surgery manager in the early days of my illness and sent an email to complain about their lack of service and urgency and over two years later I'm still waiting a reply.

Surgeries here now work on postcodes so if you're outwith their postcode area - though we weren't when we first joined 15 years ago - they will refuse a home visit. In 2021 my wife was asked to take my pulse whilst on the phone to the GP when I was ill with atrial fibrillation and tachycardia as the GP wouldn't make a house call. The GP said for her to call NHS24 who in turn told her to call the GP. She eventually called 999 and I was blue lighted to hospital. There are only two surgeries now covering my postcode and one has even longer wait times with only 3 GPs and the other has a really poor reputation.

I've documented some of the issues I've had with hospital rheumatology and cardiology services elsewhere on this forum when they have been no better.

I cannot believe in 2023 communication between hospital and GP is still by paper letter. The consultant dictates a letter, the secretary types it up, prints it and leaves it for the consultant to sign it. The consultant signs it and the secretary posts it. The GP surgery gets it, the GP reads it and then there is a discussion with the patient. I've had a medication change for both cardiology and rheumatology in the last 6 months and it's taken more than 6 weeks in each case between the consultant telling me and the GP implementing it to my pharmacy. In both cases my medication had to be reverted and in each case it took another 6 weeks to go back. I've just received a letter regarding a cardiology scan I had 2 months ago.

I think the quicker we and our politicians realise we don't have a 'world beating' health service the better.

Trish9556

Hi @jamieA

One thing our local health authority does well is send all letters electronically. Problem s they take about 8 weeks to type up then another 8 weeks from an electronic attachment to be added to your patient access or NHS app.

Head and brick wall springs to mind!

Trish

frogmorton

Ours is diabolical @Arthuritis 🙄

THE most stupid system out there definitely an 8am scramble.

The phone system does not even queue you so it means each time you dial you are just hoping to get through at the right millisecond 😠and rarely do.

However if there is something really urgent lumps in breasts, trouble swallowing, passing out etc they will always find you an apt.

It's not right that the idea seems to be do dump us on already pushed pharmacies either.

To quote @jamieA '....I think the quicker we and our politicians realise we don't have a 'world beating' health service the better.'

ah well....

Toni x

veryaraf

Hi, I can email my gp direct and he answers same day. x

Arthuritis

@jamieA @frogmorton I think part of the issue is that our politicians think that WE think the NHS is a sacred cow that can do no wrong, and certainly the vast majority of the public who do not get a regular taste of the shambles think it’s wonderful. The medical lobby is powerful and has scared the public into gaining support to fund a very inefficient service where a few work very hard and those at the top of the gravy train enjoy junkets. Politicians are scared of getting voted out by the public if they attempt any reform, so you keep hearing more money for the “cash strapped NHS”.

They truly believe the money spent is a great investment, but what if they had a roofer come to their house, quote them £10,000 for a new roof because you are desperate, but the work done is actually worth only £1000, with the rest squandered in the shambles. Other than those who have been frequent fliers or work in the system no one else realises this. But it’s scary not having a roof over your head so we keep paying.

But for more pragmatic solutions you can change your surgery to a more technologically astute one, and those that are, comply with the law that allows you to choose your surgery and hospital, this was changed 10 years ago. I’ve been at surgeries closer to my work place and later home. Bad pharmacies will get squeezed out by online services, Amazon has entered the pharmacy business, and if your gp can place a prescription to Amazon pharmacy then you get your stuff delivered! I am lucky in that my current surgery service can send a prescription to a tiny family run pharmacy just opposite my home and they are open till 11PM! Better still, a few pharmacies have started offering automatic secure lockers to collect your prescription 24/7, a bit like those Amazon lockers.

@Trish9556 Agree the electronic letter thing is great. My hospital uses an an American system https://www.mychart.org/ and it’s used by many hospitals round the world including Oxford Addenbrooks NHS. Unfortunately each hosp trust makes its own decision as does each surgery and they don’t talk to each other or engage in collective bargaining with suppliers happy to fleece them.

The best we can do is make use of what little leeway the govt has made in allowing us to choose which surgery/hosp/pharmacy as an indirect way of rewarding the good & squeezing the bad.

Then write to your MP to with well thought through arguments about improving the NHS service not by glibly demanding more money, but demonstrating spend efficiency and and avoiding grandiose projects and instead focus on replicating the success of the high performing hospitals and surgeries where patient feedback has been positive. MPs keeping their jobs must depend on them wisely using the power we vest in them.

The NHS should Stop re-inventing the wheel.

One hosp uses the ready made proven mychart system, another decided to commission its own at great cost, because they thought they were “special”. Or at least the consultant in charge thought so. It was terrible and inadequate yet they thought it was a great achievement!

If addenbrooks has a great working system why are others wasting money creating and reinventing?

I’ll try out Amazon pharmacy and post here if it’s of interest to anyone.

Arthuritis

@frogmorton BTW I signed up for BABYLON video telemedicine a few years ago under the NHS programme and it was quite good, you deregister from your local surgery and go online, always got an appointment at my convenience and in person visits could also be booked. Of course this was before Covid so quite ahead of its time, but I found that video medicine worked just fine. In fact in 2021 my in person hospital consultant told me after prodding me a bit, that I had no signs of RA, and should carry on, this was when I just had painful feet that no shoes would alleviate. However when I described my symptoms to the telemedicine doc over a webcam she said she strongly suspected these were symptoms of RA, although what caused it was not known but I should get tested and she immediately booked my blood tests which came out high positive. Then the hosp accepted and redid the tests. I switched hospitals soon after.

Since Babylon I have moved to a workplace gp online service which works in the same way but offers free annual checkups and flu jabs for about 2 years now. What I like about both is booking an appointment is all online, including the date & time slot!