Booking an appointment with the doctor

Until almost 2 years ago, it was difficult to get a doctor's appointment at the surgery we attend in less than 2-3 days. However if I wanted to book an appointment a week in advance, there was no problem at all. Then the government introduced a target of of no patient having to wait longer than 48 hours for an appointment.

This should have been a Good Thing.

But many practices, including ours, chose to implement this by refusing to give appointments more than 48 hours in advance. Our surgery didn't even write to inform us of this change in policy - I discovered it when I phoned to make an appointment for the following week for something that was not medically urgent, and was told that I would have to phone the day before I wanted the appointment. They also insist that they will only deal with arranging appointments between 9am and 10:30am. The result of that is of course that from 1 second past 9 o'clock in the morning, the surgery phone is engaged, and it can take ages to get through. Not exactly convenient if you have a busy schedule, and want to organise non-urgent medical appointments around other commitments.

Since then, Chris and I have struggled to arrange doctor's appointments. Just a couple of months ago, I phoned on Tuesday morning to ask for an appointment on Friday, as I had client meetings on the Wednesday and Thursday mornings - the surgery staff refused, insisting that they couldn't book appointments more than 48 hours ahead. I did not have time to phone the surgery on the Wednesday or Thursday, so it was Friday before I was able to phone again, with the result that it was the following Tuesday before I was able to visit the doctor. And that makes me angry, because their official records will show that as being within the 48 hour target, since the surgery isn't open on Saturday or Sunday, despite the fact that, for me, it was actually a week from when I first phoned them to when I saw the doctor.

So I started looking around online to see what I could find out.

You may remember Prime Minister Tony Blair's surprise and concern, in the run-up to the general election, at hearing that this was how this particular target was being implemented. It certainly wasn't what they had envisaged. I had hoped, at that point, that we might see a change in policy filter down to the surgery level, but clearly that hadn't happened in our surgery, whatever was going on elsewhere.

Just a week or so after that frustrating episode trying to arrange an appointment to see the doctor, a set of figures were published, indicating that around 33% of patients were still being subjected to these restrictions on how far in advance they could book an appointment. I then found a Press Release on the Department of Health website indicating that additional measures were being put in place to "encourage" GP surgeries to implement more flexible booking systems. I started to feel hopeful.

In the same Press Release, a reference was made to a question about appointment booking practices, which had been included since late in 2004 in the monthly survey carried out around all Primary Care Trusts. I hunted around some more, but could find no further information about this.

What I did notice, however, were references to the Freedom of Information act, and information about how to request information from the Department of Health under this legislation. So I sent them an email asking for the exact wording of the question and the responses to this question that had been submitted by the Primary Care Trust which covers this area, since the question was introduced into the monthly survey.

About 10 days later, I received a reply, containing the information I had requested. And guess what? Our local Primary Care Trust has been reporting for the last FOUR MONTHS that NONE of the GP surgeries in this area operates a booking system that prevents patients from booking an appointment more than 48 hours ahead. Oh yes?

I had an opportunity to speak the the Practice Manager a week ago, and in the course of our conversation, I asked when they would be introducing more a more flexible booking system, in the light of the recent communication from the Department of Health, and she said that all you have to do when booking an appointment is inform the receptionist that you work, and need to fit the appointment in around other commitments, and they will book an appointment up to a week in advance. I pointed out that I had tried that on several occasions, the most recent just a few weeks ago, and that the receptionists had nonetheless always refused to book an appointment more than 48 hours ahead. She agreed to speak to the staff and remind them that they should be more flexible when requested.

I'll see what happens next time I need to make an appointment to see the doctor - should be in a month or so. But if they still refuse to book an appointment more than 48 hours in advance what do I do? I don't want to get on a GP blacklist for complaining, and how do you complain about something that the Practice Manager and the official figures say isn't happening in the first place?!

Technorati subject tags: NHS, Health Services, Doctors, Healthcare

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