Dulwich Medical Centre - Late patient policy

[mexicanMike]

So I had an appointment last Friday at 6:50pm. Due to a crap tube I was running late, I ended up arriving at 6:52pm.

"Sorry, we have a policy, if you are even one minute late for an appointment, you can't be seen and have to rebook."

ONE MINUTE!

I can understand that there has to be a cut off point for being late, but one minute! I can only imagine that the GPs who run this operation have introduced such a policy to avoid having to stay any longer at the surgery than they have to. Well very nice for them.

"Salaried GPs employed directly by PCTs earnbetween ?53249 to 80354, ..." According to the NHS careers website.

(http://www.nhscareers.nhs.uk/details/Default.aspx?Id=553)

Well if you can't be bothered to stay an extra ten minutes or so at work to help ill people when you are paid that much, shame on you!

What a downright mean, nasty and oppressive policy this is.

ps to those reading this thread, I am indeed sack donger, the same guy who posted this issue last week. Some of you may remember the outrage caused by my choice of words. I admit that my original choice of language towards DMC was inappropriate and apologise for any offence caused. In mitigation I was absolutely furious, and of course highly ill!

I have re-posted the same topic again as I feel that this is a very important community issue, for which DMC need to be brought to account. I promise not to use foul language again, so please don't try to provoke me!

Let the debate begin once again!

[Nero]

MM, all very well reigniting the debate, if there is one (to me it seems there isn't - DMC was being inflexible and should have seen you, no question) - but you would do much better in writing a letter to the DMC, copying it to Tessa Jowell and the relevant NHS department that deals with GP complaints. Banging on about on here really won't do anything.

[felt-tip]

why dont you just change surgery

[OutOfFocus]

Do we really need another thread on this. In what way does Dulwich Medical Centre (Post removed) not meet your needs?

[Fuschia]

I posted quite a gew times to the other thread saying that in recent years I had always found the reception staff to be incredibly helpful and they have allowed me to book my children in late for appointments on occasion. But I don't really feel like rehashing the debate again.

Yes, a one minute late in the evening policy is draconion, if true. As originally you said you were 20 mins late, I am not sure of the truth of it. Certainly, if you were as rude in person as you were in te original thread, yoy probably wouldn't have won any friends amongst the reception staff (and by 6.50pm with no one waiting for that last appt, maybe the dr had left?)

[hellosailor]

I like DMC and generally find them helpful and efficient, but I have also had a similar prob there. I once rushed to get there for an end of day appt and fearing I'd be late, I actually ran the last couple of roads so I got there, panting, with 2 minutes to spare. The receptionist informed me that I would not be seen as I was 1 minute late. I assured her that I was not as the clock on my phone is set (anal I admit) by the speaking clock to ensure I'm not late for appointments and trains etc!

In the end I phoned the speaking clock to show her that it was (by now only about 20 seconds!) before my appointment, but she just kept nodding at the surgey clock and telling me I was 1 minute late. After a few minutes of us quibbling about this I asked for her to get a senior colleague and then she said 'well your appointment should have started 4 minutes ago so you're definitely too late now' as if it was my fault she had kept me arguing in reception! I was not best pleased. Having said that, I think the service there is generally good, but when being 'late' comes down to the difference between your watch and the receptionist's clock, (which was running 2 mins fast) there should perhaps be a better rule. Or the surgey clock needs to definitely be set to the speaking clock! :)

[Smiler]

Mexican Mike, are you the person who posted the original thread? If so, assume you have changed your forum name!

Admin was going to resurrect the thread, sanitised etc. Don't see any point in further debate.

[mothernature]

I was at the DMC yesterday and mentioned this post.There is no one minute rule.The subject will be up for discussion at the next Practice Meeting.

DMC has helped me through some very difficult times.They deserve support not childish unsupported rants.

MN

[toomuchchocolate]

It's a shame you missed the appointment due to a crap tube and that someone said there was a one minute rule - this seems strange, since i have heard them tell people if you are more than 15 minutes late your appointment is lost. This is fair enough.

Your argument that just because doctors earn ?x amount they should be expected to wait around after hours isn't particularly balanced. Why should the doctor hang around after hours just in case a late appointment shows up - not fair on the medical staff who may have a family to get home to or a life to lead outside of work.

If you miss an appointment and must see a doctor then there is always the out of hours surgery run through SELDOC or alternatively A&E is a bus ride away

[Fuschia]

Mexican Mike has been deleted. I guess the previous poster might have been banned and Mexican Mike was an attempt to get round it?

Interesting what you say, mothernature. Maube it was one over zealous receptionist.. or maybe Mexican Mike or whoever he was, was just rude to them!

[SteveT]

Being in the front of the general public as a full time job is a personality changing experience.

People coming at you all the time makes one rather short tempered, and the general public are very demanding and in some cases obnoxious and aggressive.

Even in countries where they have a delightful countenance like Thailand, the taxi drivers are the most surly of all the Thai's I met, and mainly because they are constantly trying to earn a living by negotiating or rather arguing, several times per hour over the cost of the fare.

DMC reception is no different, the people employed there are not going to retire early on what they earn, so are there for the long haul,

and whenever I have been in there, even though something has gone wrong and an hour or so of my time has been wasted I have always maintained my civility.

Nothing can change what's already happened, so I try to be a patient patient.

[merylou]

Last time I booked a late appointment I was told (rather sharply) at the time of booking that I wouldn't be seen if I was late. I've not been told this for appointments in 'normal' working hours, so presume it only applies to out of hours appointment, which is fair enough... just a shame that appointments still run late even with the rule!

[citizenED]

I think most people would agree that a GP practice has the right to have a rule about appointment times. They have to have a cut-off point somewhere. If they choose it to be one-minute late then so be it. Next time you make an appointment aim to get there 10 minutes before the appointment. Take a good book.

[ito1]

18 months ago I had numerous infuriating encounters with DMC ranging from ineptitude, poor management to peculiar policies. Thoroughly annoying at the time but I have now moved surgeries and, fortunately, haven't had to find out if my new surgery is equally bad. It really doesn't surprise me at all to hear that the DMC has failed to meet simple standards again.

EDITED to amend rubbish grammar

[njc97]

I'm not a patient at DMC but at my surgery the "charter" I had to sign before being taken on as a patient included agreeing to turn up 10 minutes before my appointment time to ensure I was there on time. And I'd consider turning up at 6.50 for a 6.50 appointment to be late - there's no way you'll be ready to be seen on time.

[kristymac1]

DMC is one of the better GP surgeries I've encountered, I find their reception staff (mostly) very efficient and polite and the doctors (mostly!) are very good - there are one or two that I am able to avoid, all of the others I have seen have been excellent. As for late policies, just before Christmas I had 9am appointment and ended up being 30 minutes late, I explained the situation - a lady had gone into labour literally on me in the street and I took her into a house and waited until the ambulance arrived - there was no question about me not being seen by the doctor (even though the situation seemed fairly far-fetched). I am very happy with the service they provide and can imagine they deal with a number of a**holes on a daily basis.......

[craigy]

I too find DMC to be an excellent GP surgery....

[Sue]

So do I.

[Jessie]

Me too. They've gone beyond the call of duty with me and my son in the past.

[Penguin68]

In the thread which was taken down I had noted that a policy of punishing late arrivals is consistent with, and similar too, the policy that airlines have of over-booking - many GP and Dentist practices rely on no-shows (and lates) to allow them to over-book practitioner time - that way the doctors, and dentists, are working all the time. Of course, on the days when everybody actually turns up it is necessary to be strict about 'punishing' late arrivals so that the work-load is manageable - of course that is also the reason why so many of us have to wait so long after our booked appointment time to see anyone - we are suffering from fewer people than anticipated missing appointments or being punishably late.

If, as patients, we become more reliable then the over-booking will have to be cut-back - that I think is what we are not seeing at the moment - practices are still booking in (probably) 5 minute slots when the average time is probably 6-7 minutes - it all mounts up when everyone turns up, and on time. At the end of the day, or at the end of a morning session I suppose, punishing any latecomer, even when only fractionally late and that by a surgery clock out of synch with other time sources will be the only way that the staff can get home at all at a reasonable hour - they can't actually handle the numbers of people they book in for a particular surgery session, nor do they plan to.

As a patient it is of course annoying that we are punished for lateness, but we can be required to wait (sometimes) inordinate amounts and often without apology or explanation.

I am not a DMC patient by the way, and have no experience of the way they treat their patients - I am picking up from the experiences I have of my own surgery (which operates a 10 minute rule, to my knowledge).

[tulip]

As far as I am aware - knowing many practices well - that nobody over books like an airline. In fact most surgeries underbook and add catch-up slots in for their GPs to help them run to time. Missed appointments are not a relief because they mean the surgery runs better, they are a waste of time and a frustration to the practice who could have offered the appointment to someone else. Many practices put a lot of work into reducing missed appointments and have spent money on texting patients to reduce this.

The fact is that the line for late arrivals has to be drawn somewhere and at 10minutes the patient has missed the entire appointment. If a GP practice were to allow everyone to come in very late they would run further and further behind. GP practices devote an enormous amount of time trying to arrange their appointments to suit local needs, their patients work patterns, children's school hours and holidays, fluctating demand over the week, seasonal changes etc to accomodate patients. If you call them to warn them you are running late for a good reason they are generally understanding. The average consulatation time in real terms is more like 12 minutes. If you want to be seen on time for sure I suggest you simply ask to book an appointment at the beginning of the surgery.

It is very easy to say patients should be allowed to run late because GPs run late, but GPs do not run late by choice. They run late as patients and people do not fit neatly into 10 minutes slots and never will, because emergencies crop up or because some patients just need that little extra time in with the doctor. Those who complain about being late in are quite often happy to overstay their 10 minutes when they see the GP and appreciate the time spent with them. Sometimes I think it is forgotten GPs want to go home at the end of the day too or perhaps have a school run to get to themselves!

[citizenED]

And with those two comprehensive posts we should be the end of that. However, my guess is that someone will come on bleating about missing a appointment because they were a couple of minutes late.

[Penguin68]

If it is true that the average time per patient is 12 minutes (I assume that this includes 'write-up' time for notes), then doctors should be aiming to see 5 patients an hour - but I think they book normally in 10 minute slots (based on the times I have been given for appointments) i.e 6 patients an hour - so leaving unbooked catch-up time is effectively admitting that they are otherwise over-booking. Over a 4 hour surgery (without slack time built in) that means that they would be booking-in almost a full extra hour of patients.

Over-booking is normal to ensure full utilisation of scarce resources - making run-rate assumptions about no-shows - which we know to be an issue for the NHS. That is also why airlines over-book - and are occasionally caught-out when everyone does turn up for a flight. Airlines want to fly full planes, doctor don't want to be sitting around twiddling their thumbs because there are no patients waiting (and we, as tax payers funding them, wouldn't want that either)

And of course GP medical staff need to work to predictable hours - that is often why they have chosen to be GPs rather than work in hospitals - so they can organise their personal lives better.

[Gimme]

What is DMC policy on them seeing people at appointment time.

Last 3 appointments - 1 hour wait, 30 minute wait, 45 minute wait.

Any organisation that is so totally impunctual cannot but be flexible with people turning up a minute or so late.

My surprise wasn't that they didn't tell him he was 29 minutes early...

Has anyone ever been seen on time at DMC? I'm yet to meet the person.

And to those people who say "don't bang on about it here" etc, you obviously haven't been on this forum before because that is exactly the purpose of this section of the forum (see 13 odd pages on Nasty Nigel etc). Who are you to tell anyone what they can and cant debate?

[Sue]

So next time you're ill, you'd like the GP to turn you out of their room bang on the time of the next person's appointment, regardless of whether the examination/investigation of your symptoms has finished?

Yes?