"Used to be such a good practice, gone downhill"

Dear Mrs Allum

Thank you for making us aware of your concerns, and I am sorry that you are unhappy with the service from the surgery.

The subject of GP appointment systems is unfortunately a circular discussion.

There clearly is no best solution otherwise we’d all be using it. The way we work suits some of our patients and doesn’t suit others, and is the same scenario for those who decide to have a pre-bookable system.

Unfortunately we experience queuing because there is always an 8am rush to call the GP. Not so long ago our telephone system couldn't cope with the volume, so we upgraded which enables more people to access the surgery but means they queue. We installed a "queue buster" to help patients who want to retain their place in the queue but not hold on. The queue represents the demand we face and in essence is very similar to that we experienced when we offered pre-bookable appointments.

The fundamental issue is that the demand across the health service exceeds the supply of appointments. There is a national shortage of some 6,500 GPs and no sign of this number being eaten into. The BMA advise:

“Despite there being 1,565 fewer fully qualified FTE GPs today than there were in 2015, each practice has on average 2,222 more patients than in 2015.

There are now just 0.45 fully qualified GPs per 1,000 patients in England – down from 0.52 in 2015. For the GPs that remain, this means increasing numbers of patients to take care of. The average number of patients each GP is responsible for has increased by around 300 – or 16% - since 2015.”

The result of this is there are more people chasing fewer GP appointments, and therefore like all surgeries we are trying ways to manage the workload, and as I said our method works for some and not for others. If we were to change that would equally be so.

However we feel the mix of telephone and eConsult does enable those patients who don’t need to be seen immediately to raise an eConsult and receive back either a next step contact or a pre-bookable appointment. This is achievable because a GP triages the eConsults every day and makes a clinical decision of what needs to happen next. This is a quick process that enables us to optimise the use of pre-bookable appointments. Previously we saw many patients where a telephone call would have been appropriate.

We do appreciate that we cannot always meet patients expectations but in situations where demand exceeds supply the outcomes are either the price goes up or people wait. In the NHS there can be no price adjustment, therefore we are all faced with queuing.

Having said that the Partners will be, as we regularly do, reviewing the appointment system and I will ensure they are aware of your opinion.

I trust the foregoing answers your concerns and thank you again for bringing them to my attention, and thank you for the positive feedback about the quality of clinical care you've received.

Kind regards

Paul Butterworth

Practice Manager