Getting access to a GP is becoming a national scandal
There is no surer way of getting a conversation flowing with UK residents than by bringing up that thorniest of current British issues: booking a GP appointment.
"Postcode lottery" has become one of these phrases overused to the point of losing its impact, but one of the issues that is undoubtedly a case of postcode lottery is how one accesses one's GP. Every day we hear anecdote after anecdote about impossible booking regimes, impenetrable phone systems and appointments, when you can get one, at inconvenient times.
GP provision is barely out of the headlines at the moment, with the most recent major story being the first in-person conference of GPs since the pandemic. "We risk sleepwalking into the death of general practice," Dr Andrew Buist, chair of BMA's Scottish GP Committee (SGPC).
Much is blamed on the pandemic and whilst the pandemic has certainly given renewed vigour to discussions about the future of the NHS, the truth is that methods of accessing GP services have been ineffective and unsuitable for an extremely long time. The BMA committee is calling for a national conversation around what patients want from a GP service and that conversation is certainly overdue with the service taken to breaking point to prompt an appetite for change.
As a nation, we continue to idealise the NHS and whilst we're lucky to have the system, in discussing the future of the NHS, there is always an underlying tension between the sense of gratitude and the need to be able to speak freely about what doesn't work. An honest conversation is still to be had about how to make the NHS working well for everyone in the 21st century.
Accessing appointments has become an Olympic-style hurdle. It's stressful, upsetting and time wasting at best and exacerbates patients' physical and mental health problems at worst. One GP practice, for a time, switched the phones off at 11am. You could ring from 8.30am till 11am but once all the appointments were allocated that was that. No one would pick up. You could leave a voicemail to ask for a repeat prescription but for anything else, it was a case of trying again the next day. One person revealed recently that they got through to their GP reception on the 103rd try on day four of phoning. Another tweeted recently that she'd had to call more than 100 times before getting through to her GP surgery and plenty of people in the replies had the same experience.
At many GP practices, standard practice is that patients call in the morning to ask for an appointment and are told a doctor will call back between 2pm and 6pm. If you miss each other, tough luck. The whole arduous process begins again.
This, and similar set ups at other practices, aren't designed with the patient in mind but, unavoidably, with the allocation of the scant resource in mind. Basically, the GPs are doing the best with what they have but it creates an unwieldy service that's only manageable for people who work out with regular 9-5 hours. If you don’t fall into that category, then it's extremely difficult trying to see a doctor in good time. Making yourself available for four hours to be glued to a phone is impossible for anyone without a desk bound job, an office with private space and a sympathetic boss.
It's also clear that with vast numbers of doctors leaving general practice, they're also overwhelmed and struggling. Reception staff report being abused and intimidated by frustrated patients. We know there aren't enough GPs, retention of current GPs is a problem, the system doesn't have enough money. In having a public conversation about the future of general practice, we must be very careful to distinguish between the system and the people in it. Criticising the system is not criticising the GPs working in it. Ultimately, it should be the most straightforward thing in the world to call a surgery and speak to a doctor. For millions of people in the UK in 2023, this is simply not the case.
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