Lincolnshire Talks: Why can’t I get a doctor’s appointment?

Ever been caught in the 8am GP appointment stampede? Lincolnshire residents have described totting up over 100 attempts to call their GP surgery before getting through to receptionists, only to find slots are filled. So what’s being done to improve access to services in the county?

GP access is an annually monitored issue, with many factors affecting the ability of surgeries to meet the growing patient demand, including a widespread staffing shortage – which is currently below the recommendation of one GP to every 1,750 patients of the county’s 730,000 population.

There is currently a shortage or around 80 GPs against the target of 415 for Lincolnshire.

The Lincolnshire Local Medical Committee, the statutory board which offers advice and support to GPs in the county, has noted what it describes as an “increasing crisis” in general practice.

Only six out of 30 vacant GP places were filled on the Lincolnshire GP Vocational Training Scheme in the year 2015/16.

According to aggregated NHS England data from Jul-Sept and Jan-March 2016, 14% of people in the Lincolnshire East Clinical Commissioning Group (CCG) area said they were unable to make an appointment to see or speak to a medical professional. Some 10% of patients had the same problem in the Lincolnshire West CCG area.

Almost half of those people couldn’t get an appointment for the day they needed one. In Lincolnshire East, 9% of the people who could not see their doctor resorted to a trip to A&E. Some 2% of people in the west of the county went to A&E.

What patients said:

When asked on social media whether they’d had difficulties booking a doctor’s appointment in Lincolnshire, residents had mixed responses.

While some said they’d rarely experienced issues, others were highly critical of the current standards, providing screenshots of mornings spent listening to their GP’s ‘busy’ tone, before being told appointments had been booked up.

Lincoln resident Hayley Jayne said: “I’ve spend 90 minutes attempting to get an appointment this afternoon in Lincoln.

“The system at my practice is as follows: For morning appointments, phone at 8am, and for afternoon appointments, phone at 1pm.

“I’ve been phoning since 12.45pm to get an appointment, hoping to get in early. No. Someone eventually answered the phone at 1.17pm for them to tell me that afternoon appointments are now 2pm.

“Waste of time. It’s an awful system, takes far too long to get an appointment.”

Phillip Marshall said: “My wife phoned our surgery in Gainsborough  and was told the next appointment would be November 28. The IT system isn’t working properly. It’s a joke.”

Lizzie Russell said: “You have to ring at 8am for an on-the-day appointment. You try and ring and get through at 8.15am to be told there aren’t any left.

“Some of us have work and can’t afford to spend 20 minutes trying to get through to be told no appointments left!”

Cherrie Roberts however had nothing but good feedback for her local practice: “I’ve never had any problem getting an appointment at my surgery in Lincoln. Yes I have to ring at 8am but always get in that morning to see the doctors. Can’t fault them.”

The solution?

Dr Sunil Hindocha, chief clinical officer at NHS Lincolnshire West, said: “As has been widely documented, there remains an issue with GP recruitment – and other types of frontline medical staff.

“It is not just a shortage across Lincolnshire – it is all over the country.

“We are now in the process of an international GP recruitment drive with the Lincolnshire Medical Committee. This means a number of GPs will be arriving in Lincolnshire in the coming months and we hope this makes a difference.

“With so many thousands of people wanting to see GPs in Lincolnshire’s primary care sector every single day, it is of course extremely difficult to get everyone seen at the exact time they want to be seen.

“There is also the issue with DNAs (Did Not Attends). For every person who doesn’t attend an appointment, someone else could have been seen.

“In some practices, DNA rates are at 4%. That equates to around 1,800 appointments every year at just that one practice.

“We are now involving our Patient Participation Groups in working on different ways of doing this. It is already more flexible in that people can ring up in the morning, or over the phone for a later date appointment and also online.

“The NHS in general is hugely stretched and primary care is no different. But we remain committed to ensuring patients can to access good quality, local, GP-led health services.”

According to the Lincolnshire Learning Medical Committee the solution to the issue lies with greater NHS investment and recruitment incentives.

The committee said in its report in June: “An increasing workload with fewer clinicians to perform the work cannot be safe.

“Eventually patients will suffer as the time for them to see their GP gets longer and diagnoses become delayed.

“Tired and overworked clinicians are more likely to make mistakes. GPs who are tired and overworked are also more likely to leave the profession, exacerbating the problem.

“As access to GPs becomes more difficult patients will attend urgent care settings more frequently. One attendance at A&E costs the NHS £1248, whereas GP practices are funded £140 to care for a patient for a whole year. Costly hospital admissions will also increase when there is reduced access to GPs.”