Can’t see the GP? What can you do?
Getting a face-to-face appointment with a doctor at the local surgery seems to have become almost impossible in many areas of the UK. There has been a great deal of anger focused on GP practices from people struggling to get the appointments they want.
Yet according to GP leaders, more than half of all appointments during the pandemic have been face-to-face. And surgeries are reporting that telephone appointments are proving more efficient, as doctors can talk to more patients than they would be able to do in person.
What’s up doc?
What has happened, and what can you do when you or a parent needs medical advice?
The Covid-19 pandemic is a clear factor in the backlog. GP practices have been taking stringent precautions to protect staff and patients from the spread of the virus. Fewer people have been allowed into the surgery, and telephone consultations have replaced in-person meetings. While GPs have worked from home in many cases, practices have still been affected by staff being ill or self-isolating.
Many patients have delayed visiting their GP while the virus has been prevalent, but that means a growing demand now to catch up with regular appointments as well as urgent needs.
GPs themselves are worried about being able to deliver safe care, as the number of doctors falls and demand surges.
Staffing is an issue across the surgery, with many reporting that they are finding it difficult to recruit receptionist and administrative staff, and to retain them when some patient relationships have deteriorated.
There’s quite a bit of discussion going on about whether part of the problem is the lack of GPs. The UK Government had promised to increase the number of doctors in general practice, and the BBC has carried out a reality check on the counter-claims made about how many GPs there are now, and how many are in training. The answer seems to be that it depends how you interpret the figures. There are trainee GPs in the system, but it will be some years before they’re ready to work. Meanwhile many older GPs have retired and those in practice have moved to ‘part-time’ working, so it’s hard to assess the number of GP hours actually being worked.
Contacting the surgery
It seems that most GP surgeries have their own guidelines for making appointments. And those guidelines change regularly as practices search for effective ways of responding to their patients. You may find that if you want an in-person or telephone appointment, your only option is to call early and wait in hope and in a queue.
That said, you may not need a GP appointment. Nurses, paramedics and other medically trained staff are being hired by practices to deliver care that doesn’t require the services of a doctor.
Online GP consultations
At When They Get Older we’re lucky to be able to access LIVI, one of the online health consultation services staffed by GPs and available in some parts of the country. Provided you can get an appointment, it’s a good way of getting queries answered that don’t need personal examination. For example, I’ve been reassured about when and how to take a new medicine. And a GP would be able to assess whether, from your reading your history, listening to your story and seeing you on screen, you need an urgent face-to-face consultation.
Calling 111 and visting 111 online
The NHS 111 service is available by phone and on the web.
If you call, you’ll be asked a series of questions by a ‘fully trained adviser’, who will then explain where you need to go for further help. You may be connected to a healthcare professional, such as a nurse, emergency dentist, pharmacist or GP. Theoretically you may even be given a GP appointment. You’ll also be advised on how to get medication, and given self-care advice.
Alternatively you can visit the online service at 111.nhs.uk, which is intended to point you in the right direction for help with symptoms.
Walk-in centres and minor injury units
Urgent treatment centres are intended to help with non-life-threatening but urgent health problems, such as suspected broken limbs, or minor scalds and burn, cuts and grazes, and infections.
The NHS describes hospital casualty departments as the service that deals with ‘genuine life-threatening emergencies’. This might include chest pain and breathing difficulties, as well as severe bleeding, burns and allergic reactions.
The advice is to call 111 first, as the service can book appointments at A&E, saving you some time when you get there. Waiting times can be long, first to see a triage nurse and then to talk to a doctor if needed. Not only are A&E departments dealing with emergencies, but they also see many less urgent cases where patients have been unable or unwilling to find help elsewhere.
Calling an ambulance
The most serious medical emergencies require urgent help, and that usually means calling an ambulance. Call 999 if you suspect someone is having a heart attack or a stroke, as time is of the essence.
If your parent is on regular medication, then managing their prescriptions shouldn’t need to involve in-person contact with the surgery, unless a review is due and then the practice will contact them to make an appointment.
You can set up repeat prescriptions online using services such as Patient Access. The surgery should notify patients if these services are available them. Patients can nominate the pharmacy from which they would like to collect their medications. Once a request for repeat medication reaches the surgery, a GP will sign it off and send the prescription electronically to the pharmacy. If your parent is active, they may like to visit the pharmacy themselves. If they’re housebound, there are a number of companies that will deliver medications to homes – some free of charge and some for a small-ish fee.
It’s worth noting that many surgeries have in-house pharmacists now, who can answer queries about medication and possibly carry out health checks – without having to see the GP.
If your relative does run out of medication and needs a repeat prescription urgently, they may be able to get emergency help from a local community pharmacy. They will need to show evidence of being prescribed the medication and their own identity and address – and it’s unlikely to be a free service.
The online 111.nhs.uk service is also intended to advise on where to get emergency supplies of prescribed medicines.
With the NHS under pressure, a growing number of people are turning to private GP services. This means they can see a doctor more quickly and enjoy longer appointment times.
You can search for private doctors on the web. You may be able to get virtual or face-to-face appointments, with an example 15-minute online consultation costing around £50. Prices do vary, and any tests, such as blood tests, are likely to be an added cost. It’s worth checking whether the service is available out of hours.
What happens now?
The future of face-to-face NHS GP appointments is not looking good. According to industry leaders, the problem goes further than the backlog caused by Covid-19. They say there is a chronic shortage of GPs, and would like to see more team members recruited, as well as a reduction in bureaucracy.
Evidence suggests that the rising number of patients per doctor is currently being further exacerbated by the number of GPs taking early retirement and not enough new doctors entering the system. GPs may be falling through the cracks when the crisis in the health service is being considered.
There’s debate about just how ‘back to normal’ life is, and whether it is possible to increase consultations right now when infection rates are still volatile, or whether healthcare professionals need to continue to be cautious for their sakes and the sakes of their patients.
It may be that the ‘new normal’ means fewer face-to-face appointments and more use of phone and video technology – however much it’s unsettling for patients. The UK government seems keen to drive more technology into healthcare, and this may be just one outcome of that desire.
Photo by Pavel Danilyuk from Pexels