As part of the current contract between GP's and the Primary Care Trusts, practices are required to operate a form of "Advanced Access" booking for surgery appointments.

With this system the emphasis is on availability of same day appointments, so that people are not faced with having to wait to see a Doctor about an immediate problem or with having to "negotiate" with a receptionist as to why they should be fitted in to an already full surgery. The principle is that when the surgery opens each day, there are enough vacant appointment slots to provide same day appointments for as many people who are likely to require one on that day.

 

Unfortunately this has two obvious problems.

1) For most practices the number of appointments needed for same-day appointments is almost as many as the total number of appointments on that day.

This results in there being very few appointments that can be used for advanced booking for next week or "come and see me in four weeks".

 

2) There is an inevitable pile up of phone calls when the surgery lines are opened at 8:30 as everybody all try to phone at the same time to grab the available appointments, with many people having difficulty in getting through on the phone.

 

We have done our best to get around this by increasing the number of appointments as far as we can, and by keeping a reasonable number of appointments back for advanced booking. We are also introducing on-line appointment booking to help with the problem of so many people trying to ring for appointments all at the same time, as soon as the surgery opens at 8:30 in the morning.

However there is a limited number of appointments that can be squeezed out of any practice. Doctors have other things to do as well as holding longer and longer surgeries. Home visits have to be done, repeat prescriptions signed, letters to be read and written etc.etc. This all takes time.

We try to accommodate everybody but needless to say this can not always be done. Whilst true emergencies allways take precedence over other appointments, for less life threatening situations, there must be a point where a surgery is simply full, and more people can not be fitted in, however much fuss they make.

It is unfortunate that so many people will insist that their problem must be treated as an emergency, only for them to present some relatively minor and certainly not urgent problem when they do see the Doctor. This person will have used up one of the very few spaces that can be slotted in between other patients in an already full surgery. This ends up as a bad deal for everybody. The "emergency" can be given little time, and what time they do get is at the expence of the other patients in that surgery. If more people are pushed in, usually the Doctor can not just run the surgery later. Frequently the next Doctor or Nurse or Physio is waiting to get into the room,

so extra patients have to take someone elses time. We do our best, and try to be flexible and respond to true need. If this works both ways then we can provide you with a good service. The sort of cases that end up being fitted into an already full surgery tend not to be those with the more serious or alarming symptoms. They tend to be those who make the biggest fuss, demanding that they MUST see a Doctor immediatly, when in fact they could have waited until the following day with no detrimental effect. On many occasions the demand for immediate attention is based not on the patient believing that he has a serious problem that can not wait. Rather it is simply less convenient for them to come to the surgery the following way.

With surgeries being as full as they normally are, we do not have the luxury of being able to fit more and more people in, just because it is more convenient.

What would happen to the people who really are ill if we did that ?