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The waiting game

Prominent MP criticises ‘frustrating and ineffective’ GP appointment systems

A former challenger for Labour leader has publicly criticised GP practices' systems of allocating appointments to patients, calling them ‘frustrating and ineffective’.

In a series of posts, MP Owen Smith - who unsuccessfully challenged Jeremy Corbyn for the Labour Party leadership in 2016 - highlighted his own difficulties in securing a GP appointment through what he called the 'telephone at 8.30am and try your luck' system.

While this way of managing appointments may be effective for GPs, it does not work for patients, he argued.  

But GPs were quick to point out the issue stems from a lack of Government funding for general practice and 'cuts elsewhere in society', and argued it is up to the Government to fix the problem, not GPs.

Writing on social media last week, Mr Smith said: 'We have to get our GPs to change the systems they use to allocate appointments. It’s almost impossible to get an appointment with mine (they’d all sold out by 8.35am today) and I know that’s a situation experienced by millions in Britain. No wonder A&E fills up.'

In another post he said: 'To all doctors on my timeline, in light of my pointing out how hard it is to get a GP appointment, I agree (a) nine years of cuts are part of the problem, (b) there aren’t enough GPs and (c) demand is spiralling.

'But not all surgeries employ this “telephone at 8.30am and try your luck-style” of appointments system – but lots do in my patch. And though it may manage demand effectively for the GPs, it is both frustrating and ineffective for patients.'

In response, Nick Steele, a GP partner in Stockton-on-Tees, said that there is ‘no magic bullet’ to fix this longstanding issue.

He said: ‘Many GPs use different systems to allocate appointments and in my experience, as with many other people, whatever system we employ gets filled up because ultimately we don’t have an unlimited number of GPs. 

‘It’s classic politicians making capital out of GP appointments when we’re under resourced. Increase in funding tends to go to secondary care first [while] primary care is neglected.’

Earlier this month, health and social care secretary Matt Hancock told Pulse some of the extra £4.5bn funding for primary and community care will be used to relieve pressure on GPs, however details on this are still lacking.

Tower Hamlets LMC chair Dr Jackie Applebee agreed it can be frustrating for patients who struggle to get a GP appointment, but argued it is not up to GPs to change this.

She said: ‘It’s not for us to rearrange the way we do it. It’s [up to] the Government to funds us properly [to ensure] we’ve got enough GPs to offer enough appointments to meet demand. 

'In my opinion, there’s nothing wrong with the traditional model of general practice. If we change our system, it has to be because of clinical effectiveness and not because of financial pressures.'

'Of course we should be trying to educate patients on certain things they don’t need to come for but when there are cuts elsewhere in society, such as advice centres, then we’ve got people coming with housing issues. People come to us as a first port of call because we’re easily accessible and we’re there,' she added.

A Pulse survey in May found one in six GPs have resorted to stopping routine bookings and limiting appointments to ‘emergency’ patients only, due to increasing pressure.

Readers' comments (29)

  • National Hopeless Service

    Dear (not actually) prominent PM and dear Anonymous ex-GP (leaving didnt help GP numbers),If i go to Tescos are there are 25 tills open I get served very quickly, if there are only two tills open I get served slowly and briskly. Its simple bloody maths you idiots.

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  • This morning I am a bit pi**ed at 'frustrating and ineffective ' politicians.Ah well such is life.

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    ok i don't know the ins and outs of MP Owen Smith..
    but as a GP.. i must say
    in a lot of areas
    this appointment system is just awfull

    I guess you only realise when you are a patient yourself or when a family member is unwell

    lets say you need to contact the practice
    as an agency or as a locum
    lets say if you are stuck in traffic
    forget about it the main line is engaged
    you are in a cue
    are you happy to hold

    Yes Agree
    Best job is to physically walk in as soon as they open and book

    its really frustrating as a GP
    when you could quite easily deal with your families simple medical problem
    or prescribe for them
    but under GMC guidelines are unable to do so

    Many places are running e consults and phone triage
    The profession and royal colleges must do something
    and enforce it under CQC
    Otherwise really do not winge when babylon takes up the slack

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  • This MP in his wisdom should understand that I have 3900 patients and get paid for 3380 only - for full service including home visits at 89.50 per year which is £77.50 per patient per year.
    The local OOH Provider charges Practices around £128 pounds per home visit if a GP is not able to do one during my core hours !!
    What does he expect for £77.50 per year !
    There are morons and morons - and this kind of GP basher is the worst as does not realize how immoral and discouraging it is for overworked professionals already pushed to limits.

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  • 20% of our workload results form other providers - get them to their bit - esp as they have had all the funding - let patients self refer for certain things and stop needing a GP referral or signature for everything!

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  • Problem is not managing peaks and troughs it is a lack of total capacity due to the natural well demonstrate effects of communist economic models.
    A plastic bag is cheaper at the point of use than GP time in the UK.

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  • Spot on Unscepted. You get what you pay for.

    80-110 £ / pt / year including LES/ QOF depending where you are in country is less than people pay for their dog and cat's insurance.
    Unfortunately this is what will people get in free for all NHS. If politician really want to improve things let them fund the system properly. Why don't GPC/BMA make publish it in national media?
    How they fund the NHS it is not our problem. It's theirs.
    We will provide service depending upon what it pays for. If government wants to increase funding to double what it is now i am sure we will be able to attract more doctors and provide better system. If government wants people to pay part of the cost, let them say it public . Its not my Job.
    I am doctor not a politician

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  • There is no doubt the current system isn't helpful. But why?

    1) We cannot do unlimited work with limited resources. If we remove either one of them i.e. define how much work or change to payment by activity, you'll see an immediate improvement (and NHS will collapse overnight)

    2) Evidence suggests 20-40% of GP work does not need health care at all. Our residents are creating their own problem by using state resource. How many times have we seen "cough for a day, wanted to be check before going on holiday"?

    3) 40% of GP work is now paperwork due to government policy - may be cut this down and we can see more patients?

    4) under resourced = less admin, less clinicians to provide quicker convenient service. May be Mr Smith needs to think about this?

    5) With the workload, most GPs don't have the space/time/resource for "innovation" to improve their practice. Do you blame them? I called home at 18:30 yesterday to say I'm coming home and I got the reply "oh, you are leaving early today"

    6) And with yearly changing contract and evershifting government policy, who would want to invest in their practice to make improvement? Only those who are willing to capitalise from their patients will invest as state money is too poor to have any return

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  • let him run open surgeries from 0800 to 1830 5 days a week and find ?why can"t we get anybody to be a MP anymore?

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  • little MP got cross because he didn't have priority access for his "needs"
    no thought for the funding crisis and the dying profession - just himself ( but uses "millions" of others to back his cause)
    under the Labour government in 2003, £90 million was pumped into improving winter access to urgent community care- £88 million vanished into the hospital sector without any effect

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