Patients rally against ‘ridiculous’ GP appointments system as doctors face growing pressures
PUBLISHED: 06:30 25 September 2019 | UPDATED: 10:13 25 September 2019
An attack victim suffering mental ill health claims to have missed out on medication due to the dread she faces booking GP appointments.
The woman, who asked to remain anonymous, said the system at Orchard Medical Practice in Ipswich often reduced her to tears, making her illness worse.
Her criticism comes amid changes to many GP appointment systems in Suffolk and north Essex where practices are facing unprecedented patient demand. To cope, some GPs are trying to reduce unnecessary face-to-face appointments by assessing on the phone whether or not people need to visit in person.
The woman, aged in her 30s, has been diagnosed with post traumatic stress disorder, depression and anorexia following an attack 10 years ago, in which she feared for her life.
After a recent setback left her severely underweight and confined to her room, she was persuaded to seek help from her GP, who prescribed medication.
But despite claiming to need follow-up visits to check on her prescription every four weeks, the woman said she struggled to book in advance as she was told to call back on the day - by which time appointments were often unavailable.
"The moment I think about phoning up to book an appointment, I start to dread it," she said. "I'm so tired of fighting for this - I just feel completely defeated by it all."
Her father, Colin Randall, 66, has to leave work to take her to appointments and says he cannot afford days off on the chance the booking will be successful. "It's a ridiculous system and every time it drags her right back down again," he said.
Mr Randall claims the problems meant his daughter went weeks without an appointment and ran out of medication.
Despite the claims, the GP surgery has received good patient reviews. Its practice manager said a limited number of appointments were available in advance. She said she was surprised by the complaint, claiming the patient had "always been able to book at a time of her choosing".
Frustrated by the system, Mr Randall contacted Ipswich MP Sandy Martin, who wrote to the practice requesting special arrangements for vulnerable patients.
Speaking to this newspaper, Mr Martin said: "I'm not convinced we have all the GP surgeries we need in Ipswich and I'm not convinced they are all as helpful as they could be when it comes to booking appointments."
Many Suffolk practices have changed their booking systems - but often face backlash.
Constable Country Medical Practice in East Bergholt and Capel St Mary came under fire over changes requiring people to call-up, explain their symptoms and await a call-back to decide whether a face to face visit would be needed.
Patients commenting on Facebook said the new system was a "shambles" a "waste of time" and needed a "rethink".
Practice manager Pete Keeble said the system had been adopted by many practices to reduce unnecessary face to face appointments - around two thirds of which he said could be better dealt with by phone.
With growing numbers of older patients and difficulties recruiting GPs in Suffolk, Mr Keeble said it was important to "manage the precious resources we have as efficiently as possible".
However, Mr Keeble also said the practice would respond to feedback. "Any system takes time to settle in so if it's not working right, we're always happy to listen and change things," he added.
NHS Digital figures show almost 30,000 more patients have been registered in Suffolk since 2014 - and more than a quarter were now aged over 60.
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But despite the big rise, the number of full-time equivalent GPs working across Ipswich and East Suffolk and West Suffolk CCGs fell in the past year. With parts of Suffolk having one of the oldest workforces in the country - some 28.6% of doctors in Ipswiuch and East Suffolk (IESCCG) are now aged 55 or older - the challenges are expected to worsen.
Appointment data also shows patients have less contact with doctors than in other parts of the country. Of the 204,518 appointments recorded in IESCC in July fewer than half were carried out by GPs and around a fifth were conducted by phone.
IESCC chairman Mark Shenton said a 'Five-Year General Practice Forward Plan' included measures to help doctors cope with workloads amid increasing patient lists, people living longer with multiple conditions and recruitment challenges.
"Telephone consultations to reduce the need for unnecessary face-to-appointments are one suggested way of managing demand, as are the use of other healthcare professionals with different skill sets to lessen the reliance on GPs," he added.
Practice says appointments system works for most patients
The Orchard Medical Practice's manager said its on the day appointment system "works very well for us and our patients".
While she said most patients preferred to call on the day, a number of appointments were also released up to ten days in advance.
"However, we have found that when people book up too far in advance the failure to attend rate is increased and appointments are wasted, so we have to manage these appointments," she added.
"Sometimes we also have the situation where a patient likes to see a particular doctor and that might not always be possible especially if they happen to be off work sick or on holiday. We aim to provide a system which meets a wide range of needs and in general from patient feedback we feel we do very well.
"If there is a specific issue with a specific patient I am always happy to speak with the patient directly to try to address their concerns and put a plan in place to resolve any issues."
Calls for improved understanding and empathy
Health consumer champions said there was a "lack of consistency" in how people booked GP appointments for mental health concerns.
Healthwatch Suffolk's CEO Andy Yacoub said while patient experiences were good at many practices, its recent report on mental health found "too much variation" in appointment systems.
He said problems were compounded by a lack of access to mental health provision and increasing patient demand. However he said new mental health strategies for Suffolk could address concerns by integrating primary care with mental health.
"We feel there is a need, within some practices, for an improved understanding and empathy from staff when dealing with mental health patients," he added. "This includes taking on board that people who feel vulnerable may struggle to communicate their wishes when trying to access services. Staff should then work to improve communication about the alternatives available to patients such as GP+ or social prescribing, which are not always proactively offered by practices."
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