We hear a lot of complaints about difficulty getting access to doctors, so let’s try to put them in some perspective.
Much of what follows is applicable to every GP practice in the country; Barnabas is in no way special.
This is a factual statement of the way things are working, and why, to help everyone understand. We may not agree with it, but this is the way things are, an for good reasons.
- First of all, keep in mind that yes, the Practice is under a lot of pressure. They were before, and the pandemic has just made everything worse. They are working flat out.
- All doctors will give you a face-to-face appointment if you need one (and always have done). But they will triage you first over the phone and treat you that way if they consider they safely can. A large percentage of cases can be treated quite successfully with a phone call and maybe a couple of photos. (I know all this from my, and my wife’s, experience.)
- GPs have a legal duty to provide safe working conditions for both themselves and their staff – as well as their patients.
- Restricting the number of patients in the surgery is a protection for everyone. If staff at the surgery get Covid and spread it around then it is likely the whole surgery is closed down for the duration, which means patients (us!) are potentially left without care.
- Covid is not over. We currently have infection rates around 3 (or more) times higher than a year ago, and the rate is rising very quickly locally. That’s how infectious the Delta variant is, and how much we’ve relaxed. (And that is despite the high level of protection being provided by the vaccination.)
- So doctors are (still) having to be especially cautious. From talking to our Practice Manager, it is clear they want to open up but currently it is too risky for them, their staff and their patients.
- One knock-on effect of all this caution is that they also do not want a street party of patients queueing at the door wanting to make appointments (or anything else). It puts the receptionist who (inevitably) has to open the door at risk, and it puts all those patients at risk, the more so in the cold and wet.
- Phoning the Practice can be a fraught experience because of long holds. This is well understood by the Practice. It is due partly to a change in the way the new phone system works; everyone now gets automatically answered and put in the call queue. Before you just got an engaged signal when there were a very small number (like one or two) already in the queue (and we complained about that too!).
- In March 2021 the Practice was handling 10,000 calls a week (up from 4-5000 before the pandemic). On average each phone call takes 6-7 minutes of a receptionist’s time. By comparison, handling/redirecting an email/eConsult/prescription request to the right clinician takes a couple of minutes. There is a balance that has to be struck between how many receptionists to employ, the level of calls/requests and the NHS funding available.
- If you must call the Practice, pick your time. You will get stuck in the queue longer first thing in the morning (especially on a Monday). Try to call later in the day. But yes, if you call late in the afternoon there may be no free slots for you that day (just as would be true for your dentist or the garage). Yes, I know, you my not have a lot of choice over when you’re ill!
- If you have the Practice’s admin email address then yes, you can email. Unfortunately the email seems not to be on the website. (I personally think it should be, but the practice appear to have made a deliberate decision otherwise.)
- Your best alternative is to use the eConsult facility, accessible through the Practice website. I know it’s a bit long-winded – that is to ensure that any emergency problems are caught and if necessary redirected to 999, and also to give the medics as much information up-front as possible. My experience of using eConsult is that you get a call back usually within 2-3 hours.
- Having had a call, if you need to be seen face-to-face you will be asked to go in. Your desire/opinion should be taken into account.
- In order to help with the level of requests, the Practice has this year recruited two additional receptionists; plus a phlebotomist/HCA, a Pharmacy Technician and an extra salaried GP.
- Yes, the Practice is under a lot of pressure. They were before, and the pandemic has just made everything worse. But believe me, they are working flat out. On top of the normal load they are currently working to give flu jabs to all those who are eligible as fast as possible. I don’t know the exact numbers but I would guess that out of our almost 10,000 patients around 7,000 are probably eligible for flu jabs. That’s a lot of work even at 5 minutes/patient.
Yes, this is not the ideal service, and I’m not here to defend everything the Practice does. Nor am I trying to defend general NHS practice and funding. My role is to be a critical friend to the Practice, reflecting your views, and also to help patients understand how/why things work the way they do. It would help everyone if we all keep the current difficult position in perspective.
Keith Marshall, 14 October 2021