Having turn up and swim isn't efficient. Either they're too packed and everyone loses, or there are vacancies which people aren't aware of because there's no booking system.
Or have both special sessions and turn-up-and-swim sessions (with the emphasis on the latter, because that’s the most accessible and historically and socially acceptable way of doing things, which was only jettisoned because of the effects of a pandemic.
They used to fine people for not turning up, but I think the reception staff were overwhelmed by mistakes/people trying to appeal their fine. I think instead they should just temporarily reduce the booking window for people who don't turn up as a deterrent.
I'd recommend this guy in Fulham (or a digital consultation). I've used him recently and was very impressed with his knowledge and manner, fairly pricey I think but was worth it for an initial chat in my case. https://www.drdropin.uk/dermatologist/dr-james-denny-dermatologist
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