Changes to prescribing Over The Counter medicines

In-line with NHS England recommendations, NHS Dorset has asked GP teams to stop prescribing medicine and treatment for 35 minor conditions listed on this page. This allows GPs to focus on caring for people who have more complex needs. NHS Dorset wants people to have the confidence to look after themselves where they can. This

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Why can’t I just book an appointment to see my GP?

Why can’t I just book an appointment to see my GP?

This and its related question, “Why can’t I see a GP”, are clearly at the forefront of all of our minds at present and are often in the Press.

We’d like to help address these valid questions by sharing some information and insights into the everyday pressures and demands we are continually facing in our surgeries. With the hope that our patient population will support us with patience and understanding during these exceptionally busy times.

Every month in our practice we have just over 2000 GP appointments per week available. 2079, in fact. This assumes that no-one is off sick, on annual leave, or on study leave, which basically never happens. A more “real life” figure is having 1839 GP appointments available per week as this figure takes an average of the various types of leave. This adds up to 7356 GP appointments per month across our 5 sites. Everyone knows this is not enough.

It is important however to put this in the context of the ever-rising pressures for our services. Two years ago we started using a new system called Klinik to support us in managing increasing demand.

In April, we received 10341 Klinik enquiries, 8197 were asking for an appointment. Compare that to the 7356 GP appointments available and you have the answer to the question at the top of this article.

This is why you can’t book directly with a GP and why you will sometimes see an allied health professional such as an Advanced Nurse Practitioner (ANP), a Paramedic, a Clinical Pharmacist, or a First Contact Physiotherapist. We trust our colleagues to help us to provide high quality care for our patients. We quite literally could not manage without them and we are grateful for all their hard work and support.

8197 Klinik enquiries in the context of 7356 GP appointments is why you will sometimes have to wait several weeks to see a GP and is why we are all working harder than any of us can remember.

If you add into this the 14808 prescriptions that were signed off, the majority of which were signed off by GPs, you can get an idea of our workload outside of seeing patients.

It is therefore unbelievably frustrating to know that in April, the same month where 8197 Klinik enquiries were submitted, 603 appointments were booked in but not attended by the patients involved. That equates to £18,090 worth of wasted NHS money but more importantly, 603 of those 8197 Klinik enquiries missed out on the opportunity to see a clinician with their problem because of the wasted appointments. All those patients would have received at least one text reminder. And the same Klinik system that is used to ask for an appointment also has a “cancel/rebook” button so that people can do that without having to phone the Practice. We often find that patients cancel appointments at the last minute, meaning we are unable to re-book these with other patients.

Which brings me nicely on to phoning the Practice which is a very frustrating situation for all concerned. In April, the Practice received 9618 phone calls. This equates to 437 phone calls per day or around 50 calls per hour.  I am sure we can agree that this is not a manageable number for our hard-working Patient Services Clerks. We understand and share people’s frustration when they can’t get through on the phone, but it is certainly not the fault of our staff.

We are trying everything we can think of to try to improve this. This is why we ask you to use Klinik if you can. If you order on Amazon, or do an online supermarket order, you can use Klinik. You don’t have to be a computer whizz and no-one is marking your work. We want Klinik to be used to free up the phonelines for those who do not have access to a computer or who can’t use one independently. Or for those who are very unwell and have been asked to contact the Practice.

“Employ more staff” is an obvious statement to offer as a solution.

Funding for General Practice has been cut repeatedly. Any “increased funding” that has been announced does not keep up with inflation. We experience the cost of living crisis as a Practice just like everyone else; we see our utility bills going up and our income from central Government going down.

Primary Care receives less than 10% of the overall NHS budget in funding. In 2022/2023 the funding for Primary Care services was 9.5% of the overall NHS budget (data from The King’s Fund). And Primary Care is defined as General Practice, Dental practices, Optometrists and Pharmacies so not all of that 9.5% is in General Practice.

It is difficult to quantify workload in such a complex organisation as the NHS. The King’s Fund data for 2022 suggest that there were approximately 329 million appointments in primary care and 140 million “patient interactions” in hospital. Remember Primary Care receives less than 10% of the overall NHS budget.

It takes 5 years of medical school, 2 years of Foundation training, and 3 years of specialist training to become a GP. More GPs are needed but according to the British Medical Association there has been an overall drop in number of GPs since 2015.

We are trying our very best to continue to offer high quality patient care across the whole of The Adam Practice. We have regular meetings to brainstorm ways to try to improve access and think innovatively about how we provide patient care to try to free up our GPs to deal with more complex problems. So if you see something that isn’t how it used to be there is a very good reason behind the changes you may see.

We certainly do not want to discourage any of our patients from contacting the surgery but ask that they are mindful of when it is appropriate to seek GP care, so that we can ensure patient care is given at the right time by the right person.

We thank you for your support and understanding in these challenging times for the NHS.

Best Wishes,

The Partnership at The Adam Practice

Upton, Lytchett, Poole, Hamworthy & Lifeboat Quay