There was a recent article in The Times by Doctor Mark Porter which seemed to make some useful points, so here is our local take on it.
At the Alderley Edge practice we are proud to be GPs but are saddened by the relentless bad press doctors have been receiving over the last few months. GPs are seemingly responsible for NHS crises from struggling A & E departments to growing antibiotic resistance and we are also allegedly overpaid and lazy. No wonder patients get fed up when they can’t get in to see us!
In fact, all the GPs in our practice are working harder than ever and we have taken on an extra doctor in the last 2 years. Our average working day has increased by about 3 hours over the last few years – we come in earlier and stay later. I’m sure some of you can testify to phone calls received from us at 7.45 in the morning or 8 or later in the evening. There has been no increase in our pay over this period.
In the UK as a whole, 90% of patient contacts are in general practice which receives just 9% of the health care budget. GP surgeries in England alone offer about 300 million appointments a year, up from just over 200 million in 1993. In our practice in Alderley Edge we now offer more appointments in an average week than we did a few years ago, even though our practice size has not increased.
Over the last 10 years we have taken on 146 nursing home patients and 3 of our doctors spend about 12 hours a week just looking after these patients. The proportion of patients over the age of 65 is higher for our practice than the national average and this has inevitable workload implications.
Compared with 5 years ago, we have a greater percentage of patients taking long lists of medications which require regular blood tests and monitoring. We now have to take staff out of reception to deal with repeat prescriptions for about 3 hours every day and each doctor spends about an hour a day signing these, a process which involves safety checks through patients’ notes, not just scribbling an illegible signature! We also deal with many phone calls from the local chemists every day with queries about repeat prescriptions.
So what can you do to help?
Think before you dial. Is your problem something that will get better on its own given a bit of time and patience, or could you talk to your pharmacist about it?
Avoid busy times, particularly Monday mornings. If your problem isn’t pressing, try not to call before 10.30am any day. However, if you require a home visit, do call early. It is much easier to allocate visits if they are known about by mid-morning. Late requests for visits can cause disruption if the duty doctor has to go out and this can cause delays in the running of the afternoon surgeries.
Only request a visit if you, or the person you are concerned about is housebound. A doctor can see 4 or 5 patients in the surgery for the time it takes to do 1 house call. There is nothing more frustrating than to arrive on a patient’s doorstep only to find nobody at home and to find out subsequently that they have gone to a hospital appointment/hairdresser/shopping. It does happen!
Think ahead. People expect to book their dentist or hairdresser at least 3-4 weeks ahead and GP surgeries should be no different for routine matters such as immunisations, smears, blood tests, blood pressure checks etc.
Be honest and sensible when requesting an urgent appointment. We have slots available every day for genuinely urgent conditions but these are not always appropriately used. Sometimes we see a patient in an ordinary appointment slot who has been struggling with a serious condition for days and we really would have liked to see them sooner but they were too self-effacing to ask for an urgent slot. Alternatively, and more commonly we see the “urgent” fungal nail infection which has to be sorted before the holiday to Dubai in 2 days time! The fact that you have an opening in your busy schedule to fit in a doctor’s appointment today does not justify the demand for an urgent appointment – a scenario which is not uncommon in our practice.
Try to distinguish between “urgent” and “important” – are you actually poorly today or is it something that can wait for a doctor to tackle calmly in a non-emergency surgery.
When you do get to see the doctor, be succinct. Your appointment is only for 10 minutes and really both doctor and patient have to be working efficiently to get through all that is necessary in that time. Please do not bring a list of several problems to 1 appointment – the doctor will feel under time pressure and may not be able to give adequate and safe attention to each problem. If all the patients in front of you take even 15 minutes for their consultation, then you may be an hour late going in to see the doctor and will probably feel pretty annoyed about this. And please wear something sensible that will allow speedy access if you need to be examined!
If you do think your problem will take a long time or would like to discuss 2 separate matters, then please book a double appointment. Do mention the most serious or most worrying symptom first; don’t waste your 10 minutes on something trivial then bring up something serious just when the doctor thinks the consultation is coming to an end.
And what can we do for you?
We regularly discuss the service we offer and agonise about how to offer the best spread of routine and urgent appointments. It is not a subject we are in any way complacent about. We have recently decided to take on an extra doctor to do a 2 hour surgery one evening a week and hope this will help with access.
We constantly look at ways of reducing any patient inconvenience and are currently looking into the use of a text messaging service for blood results and more online booking access. We are also looking into a major overhaul of our repeat prescribing system by employing a pharmacist to streamline the service and improve convenience and safety.
So, in short: in spite of what you may read, your GPs haven’t suddenly “gone to the dark side”. Just as we always have done, we still want to give the best care to you and your family. But please understand that we are also fallible humans; we also have families, and like you we often have to juggle many different demands in our lives. We are doing our best and will continue to do so and we are confident that if we work with you in partnership we can continue to offer a good service to the people of Alderley Edge.
Thank you for reading this.