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People Struggling to Get a GP Appointment Think ‘They’re All Out Playing Golf’

Published on: 5 Mar, 2022
Updated on: 8 Mar, 2022

By Julie Armstrong

local democracy reporter

Surrey’s GPs have been criticised by a councillor who says they are “designing a failing system” where “it’s impossible to see a GP” and people think they are “are out there playing golf”.

Patients’ struggles to access their doctor have been heard, Surrey County Council’s adults and health select committee was told this week (March 3), and the system is continuing to evolve as research shows it is not working well a lot of the time.

A Surrey GP told councillors they are “working all day, trying to serve as many patients as possible.”

A new cloud telephone system will be delivered across the whole Surrey Heartlands area, which includes most of Guildford Borough, though this will take at least a year.

Cllr Ernest Mallett (Residents’ Association and Independent, West Molesey) said: “The simple fact is that you are running a system at the moment where none of us can see a GP.

“If I waved your report in front of any of my residents they would just say that’s a load of nonsense and they’d be infuriated.

“You’re talking about doing cloud services, well you’re all in the cloud that’s the trouble, where are you, where are the GPs today?

“The common view is that the GPs are out there playing golf, because none of us can see them.”

Under a new digital system accelerated by the pandemic, consultations by phone or video are considered by a practice to be a better alternative than face-to-face in some cases.

Many patients “feel confused and out of control re[garding] accessing their GP”. Typically they “struggle to make contact with the surgery and then either fail to get an appointment or have to wait too long”.

Clare Burgess, chief executive of Surrey Coalition of Disabled People, told how John (not his real name) from northwest Surrey, who has an ear infection and is completely blind, “hadn’t been able to get hold of his GP so over the weekend he crossed three main roads to deliver a handwritten note”.

She said: “He hadn’t had a response so got in touch with me. I jumped online and the GP practice said because we’ve given out all our appointments today, you can’t even send us a message.”

Dr Charlotte Canniff, a Sunbury GP and clinical chair of Surrey Heartlands clinical commissioning group, said: “I cannot defend the experience that John just went through, it’s not acceptable and it’s not what I’d want any patient in Surrey to have to go through.

“We’re just about aware of the capacity that hits our front door. I think that’s the tip of an iceberg and what we’re not aware of is the capacity that never even gets to our front door.

“I would like to really stress there is no practice in Surrey that is playing golf, that is not working all day, trying to serve as many patients as possible.”

She later joked she had a “tee-off time” before clarifying she was due in surgery.

Councillors were told more than three million of the over 6.5 million Surrey Heartlands patient consultations in a year were conducted face-to-face.

In January 2022, 237,522 appointments (61.4 per cent) were delivered in person and 149,144 (38.6 per cent) were virtual.

Dr Canniff added: “It’s changed in some ways for the better, it’s opened up additional channels. Many people like not having to leave work, sort out childcare or a taxi.

“We’ve also been told loud and clear, and agree loud and clear, that there are some conditions and some patients with certain preferences that are better dealt with face-to-face.

“As we design the offer going forward we are very mindful that we need to be flexible around the types of access.”

‘There is a lot of pressure on the system’

Director of primary care Nikki Mallender said: “Surrey Heartlands is the first integrated care system as I understand it, certainly in the region if not nationally, to start re-engaging with our community about the co-design of our services, so we are trying to respond – it’s just that there is a lot of pressure in the system.

See also: Updated Letter: Why Weren’t Patients Consulted Directly on Proposed GP Surgery Closure

“Alongside of that delivery we’ve had a very intensive delivery of the vaccine service, of which general practice I think delivered 80 per cent – if you think about 1.1 million population and the three doses it took to deliver, the GPs certainly haven’t been sitting on their laurels, there’s been a lot of work going on.”

Dr Canniff said they were “still battling with a lack of availability of appointments” and had “had significant issues recruiting for at least the last five years and it’s getting progressively worse”.

Surrey Heartlands has 530 full-time equivalent GPs, each offering eight half-days of consultations a week and each serving around 2,500 people.

She said: “Most practices would actually love to be able to recruit more GPs, but they don’t exist.

“Most GPs, due to the complexity of our workload, have chosen to… become locums and do ad hoc work.”

The Government made a 2019 manifesto pledge to recruit 6,000 additional FTE GPs by 2025, but said last year it was not on track to meet this.

Dr Pramit Patel, Surrey Heartlands primary care network lead, said that to have a net gain of GPs “when we’ve got quite a few of our working GPs in the final years of their working career – we are going to have a sort of fall off the cliff position.”

Select committee chair Councillor Bernie Muir (Con, Epsom West) asked: “What is an acceptable length of time for someone to be hanging on the phone before they are answered… having to listen to the interminable music?”

She was told Surrey Heartlands had just received enough money from NHS England to upgrade to a cloud telephone system in every one of their 104 practices. This would take at least a year.

How did the online consultation system come about?

Changes to the traditional face-to-face access model were in progress even before the pandemic arrived.

Surrey Heartlands bought a platform to enable online access for patients at the end of 2019, which was scheduled to get underway over the next year.

But when the pandemic hit, it was rolled out more rapidly than had been expected.

Many practices now encourage patients to submit written requests online under the total digital triage operating model.

If a patient chooses to phone the practice, admin staff will complete an online form on their behalf.

In either case, the practice will then decide what they think is the most appropriate channel – consultation by phone, video or in-person or an online message – a great source of frustration for people who would prefer to see their doctor in person.

And in October 2020, practices started to switch off access to online forms when they were already dealing with as many requests as they could safely manage.

An online consulting audit conducted in October 2021 highlighted that only just over a quarter of practices had forms available 24/7.

How has this been working according to research commissioned by Surrey Heartlands?

The key finding from research done by Barnham and Raynor reported this January was that “access to primary care is not working well for many Surrey residents a lot of the time”.

Many patients “feel confused and out of control re[garding] accessing their GP”. Typically they “struggle to make contact with the surgery and then either fail to get an appointment or have to wait too long”.

The sensory impaired are “left bewildered by persistent text messages” asking them to ‘call the surgery’ when they have profound deafness or blindness.

Several practices only make appointments on a day-by-day basis, forcing all to be treated as emergencies even though a future appointment would be fine.

A small number of participants were extremely satisfied, but experience was highly variable.

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Responses to People Struggling to Get a GP Appointment Think ‘They’re All Out Playing Golf’

  1. Ricky Sonn Reply

    March 5, 2022 at 3:50 pm

    Dapdune Surgery has been very good with our toddler during the pandemic but things have changed the past two times we have called.

    The first time we had a call back which we missed, so were sent a text. We couldn’t reply to this to correct misunderstandings and when we called Dapdune they claimed to have no idea who this doctor was or how we could contact them.

    The second time we were offered an appointment at other surgeries in the middle of nowhere. Not much use as we don’t have a car and the rural bus services as so poor.

    As someone who works for a software company, I am all for using technology to improve services but this seems to be having the opposite approach.

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