"Appointments system is a mess"

It's very difficult to book an appointment within a month, and generally you are lucky to get one within 6 weeks.

So you have to ring up and say that you're "urgent" for any unplanned care at all (i.e. if you're actually unwell).

The reception staff are then excellent at making sure children are seen quickly. The doctors are always very very good.

For adults, if you get to see a doctor, I am always very impressed by the care I and my family receive. But there is often in practice no care available at all, because you just can't get to see a doctor.

Out of hours care is just as problematic: the 111 service is excellent, but my most recent experience was that the doctor calling back afterwards from the out-of-hours GP service:

- did not ask all relevant questions;

- did not correctly triage or diagnose the problem;

- passed on incomplete information to the surgery, and

- had hung up before he could even be prompted to give advice on interim care.

The referral that I got was for an ECG, and had I taken this up it would have been nearly a week before I was actually seen by a GP. Having gone instead to Whipps' Urgent Care Centre, we were seen quickly by a GP who diagnosed a stomach ulcer, something that would never have been picked up by the ECG.

Unfortunately, with the quality of primary care currently available from this practice, local A&E/Urgent Care Centres will continue to be under severe, unnecessary pressure. Patients that "follow the rules" will tend to be diagnosed late and could end up presenting with more serious symptoms.