Forest Hill Road Practice - in Meltdown ?

[George Orwell]

Many aspects of the Forest Hill Road Doctors' Surgery have gone downhill over the last year or two and I think it's nearing meltdown.

Unfortunately two of us in this household each have several repeat prescription items and between us need to see a doctor maybe every couple of months so we do have some long term experience.

Firstly the renewed repeat prescriptions started to be often handed to us unsigned and needed to be sent back for a signature. Then we found we couldn't get a doctor's appointment in the same week as requesting it. Gradually over the last 12 ? 18 months the time lag from call to getting an appointment extended to two weeks, then three weeks and a month.

Finally, on Thursday last week I was told that no appointments were available at all and I should call again on Friday when some would be ?released?. On Friday they said try Monday. On Monday I was told none were available but they should have some released for booking on one day later on this week. Today (Tuesday) I popped in to collect a repeat prescription and was told again that no appointments were available at all but if I phoned at 8am any day I stood a chance of getting one, but certainly not before January.

A couple of months back my ears needed syringing but no nurse was available either ? I couldn't wait, it certainly wasn't an A&E matter, I had no choice and so I paid ?60 privately elsewhere. Before that they "lost" a prescription of mine and it turned up 4 weeks later together with a newer one.

It won't be long before a simple review or a modification of a drugs dose will require an emergency appointment.

Today I was also told that a new Appointments Manager was joining the practice on Monday next week when thing are sure to improve.

Unless this new manager can influence the space-time continuum, finds a Tardis or starts seeing patients him/herself I really cannot see how any meaningful changes can take place.

They have lost several doctors from the Practice in recent times, and many of those remaining work part-time only.

It looks to me that the situation can only improve if they employ more GPs, get the part-timers to put in a few more hours or they reduce the size of the patient list. None of this seems imminent.

Sorry for going on, but having already complained to the Practice Manager a while back about a ?forgotten? hospital referral and having being ignored by her I am at my wit's end. I can only suggest don't be ill.

Was there any feedback from the recent Patient Forum ?

[NewWave]

I think this is Par for the course these days I'm afraid.

I'm with a practise in Sydenham (no one else would have us..even though ours isn't the nearest or the one most my neighbours are at) and I can't get through on the phone, sometimes it takes 31 calls and two days calling only to finally get through and be told there are no appointments for at least two weeks etc,

My repeat perscription (which I can't be without and can't stop suddenly) is always not being sent on time to Boots so they end up giving me emergency meds.

Its a joke I can't afford private but I have no faith in my GP whatsover.

[dbboy]

I walked into FHR practice a couple of weeks ago having had a letter from the CCG saying I was due a health check, Receptionist turned around and said, can't make an appointment till all the flu injections had been done, On asking if the health check was with a doctor, the receptionist told me a nurse does them. Shan't bother.

Seems like they run the practice with no regard for patients.

[Sue]

This sort of thing is happening in GP surgeries everywhere. The NHS is in crisis.

This suits the present government, as if the NHS runs down even further (and I can't see how it won't) they will have the excuse to privatise it, or at least large parts of it.

Forgive my cynicism, but they seem to be able to find large amounts of money for bombs which will potentially kill and maim innocent people in Syria, but somehow can't find the money to help ill people (or prevent illness in well people) in the UK.

Go figure.

ETA: And yes, I know that's simplistic.

[HOMum]

As a contrast, my husband called in at 8am this morning with a sty which we expected had turned in to a pretty nasty eye infection - he was offered an appointment at 2pm today, was given some strong antibiotics and is off to the eye hospital tomorrow for another check up. Pretty good service we think.

The NHS is struggling because so many people go to the doctors when they could go to the chemist/go to the hospital when they could go to the doctors etc.

I wouldn't say it's in meltdown, but what you have experienced isn't good enough, I agree.

[dbboy]

Don't get me wrong, it is NOT the doctors, but rather the managers and receptionists who have no regard for patients. if they were sorted things may then run much smoother.

[uncleglen]

People go to the doctors in preference to the chemist because they are on free prescriptions for whatever reason, or they have a season ticket for another complaint and therefore will be covered for the prescription. If you go to the pharmacist- (sorry to be a cynic(not really..I appear to have contracted Forumitis.)) they will SELL you something whether you need it or not.....I tried this out....

[intexasatthe moment]

NewWave - I don't know which branch of Boots you use but the pharmacy bit in Peckham is indescribably bad . And not just with Boots ,many times I've been piggy in the middle with the pharmacy blaming the surgery and vice versa .

I now use Krystals in Nunhead .Fantastic service and carries lots of stock .

and I'm with Sue on this one .

[LondonMix]

This place is awful. They don't follow NICE procedures for newly pregnant women (i.e. the refer first time mothers for their booking appointment which itself is usually once they are 8-10 weeks pregnant) without giving them any advice on what they can or can't eat or to take pre-natal vitamins. For some first time mothers, this is a massive disservice that sets them and their children up for poorer health outcomes. This is national policy and they simply don't do it.

I got a letter from them saying it was time for a routine exam (that must be carried out periodically). When I called up they said they had no appointments for the rest of December and won't be releasing any more appointment dates until Friday and I should ring up early to get a spot. What sense does that make? The exam I need is a required medical exam that needs to take place within a specific period of time. Surely it shouldn't be a lottery of who can ring up first on the day! As a system it makes no sense so I'm glad they are getting someone in to help.

I have private insurance but like others have said, there are numerous thing for which your NHS GP is still responsible. This place is truly becoming terrible.

[slarti b]

Their on-line system is showing NO appointments available for booking at all so yes, are in meltdown.

I checked ordinary (ie F2F) appointments on 23 November and , at that time, they had only 17 slots free for the following 4 weeks. It is hardly surprising that a fortnight later then is nothing left till next year. From my experience this has been going on for at least several months and has not been resolved.

According to their web site they have 4 partners and 3 Associate doctors (presumably salaried?) Does anyone know if these are all full time? Out of interest, was the delay to making appointments discussed at the Patient Group meeting on 5 November. They haven't posted any minutes yet and the links to the old minutes don't work!

I chatted about this with work colleagues. None of them have delays we have been experiencing with Forest Hill Group. Their waits for GP appointment ranged from 2 days ( county town in Surrey) to 10 days ( 3-4 doctor practise in Putney.

Which organisation is responsible for monitoring performance of GP Practises? They should be alerted.

[LondonMix]

I agree with all of that. These kinds of waits are not standard, not even for NHS in its current state.

[poppet27]

Don't even get me started on this place. Even if one sympathizes with the enormous pressures on the NHS, there are basic, micro level failings at this practice that needn?t be blamed on an economic issue.

The doctors are great but the reception team seem like they?re from the reject bin. They?re slow, they?re unhelpful, they sound cross all the time, they don?t make eye contact even when you?ve been in the queue 10 mins, they ask for personal symptoms, they don?t answer the phone, you?re on hold for 35 mins.

The really sad thing is that each time I?ve written to the practice manager, she has replied with a petulant, unhelpful, excuses-ridden letter implying that I should be grateful for a country that has a national health service at all.

[bobbsy]

Agree with the above - when I have needed to see a doc and have actually managed to get an appointment (perhaps once per year), the doctors have been great. Last time I tried the wait was about 1 month, which I find completely unacceptable.

[Growlybear]

I think I must be going to a different Forest Hill Road Group Practice to some people. My most recent experience was two weeks ago, when I phoned very late in the day to ask about some blood test results. There was a problem with one of the results, which meant I had to speak to a doctor. The receptionist understandably couldn't tell me what the problem was, but was able to reassure me enough so that I didn't jump too much to conclusions that it could indicate a recurrence of my recent serious illness. There were no telephone consultations available that week, so I was told to ring the next morning and I would be able to book an on the day telephone appointment to speak to a doctor. I rang shortly after the surgery opened the following day, explained why I needed to speak to a doctor, and a delightful new doctor rang me back less than two hours later. Both of the receptionists I spoke to were as helpful and polite as the reception staff always are at the surgery. I made two visits to the surgery after the telephone consultation to collect prescriptions and to clarify something the doctor had told me, and on both occasions was helped by Anne, who is unfailingly cheerful and pleasant, and always goes out of her way to be helpful. Whenever I wait in the Reception queue, I'm always struck by the way in which some patients speak to the reception staff, and yet they still manage to be polite in response.

I joined this practice in 1975, and have seen in grow from strength to strength. After 40 years, I have still never had cause for complaint, and have had some truly superb treatment, particularly over the last four years. I accept that it can take a while to get an appointment with some doctors, but if I need to be seen urgently, I'm just grateful to see whoever is available. I have never yet been unable to see or speak to a doctor the same day if it's been necessary, but I do think people need to have realistic expectations about whether they need a same day appointment. I've often heard people demanding urgent appointments for trivial ailments, which they could easily discuss with a pharmacist. If you're entitled to free prescriptions, then many medications are now available under the Pharmacy First scheme free of charge from the chemist, so there is no benefit in seeing a doctor for something really routine. I really do feel fortunate to have such an excellent practice on my doorstep.

I agree with the poster above about Krystal pharmacy - they provide a brilliant service, and are the only pharmacy I've ever found who have been prepared to order in a specific brand of medicine for me; I was having difficulty in finding the brand that I take and was doing a tour of pharmacists in the area; the lovely pharmacist at Krystal offered to order in a huge supply of my medication for me, which is waiting for me each time I get a repeat prescription. There is a huge contrast between Krystal and Day Lewis opposite the Practice, and the staff at Krystal are lovely, unlike one of the women in Day Lewis. It is also quicker for me to drive to Nunhead to collect prescriptions from Krystal, which are dispensed at lightning speed, than queue up in Day Lewis for ages.

[dbboy]

I have nothing but absolute praise for Krystal's in Numhead, for four years they supplied all the medicines for my elderly relative that I collected every month, nothing was too much trouble, they always ordered things so had everything in stock, are always polite, kind, helpful and go the extra mile and some.

If only other pharmacies could be like Krystal, one of our local bright stars, unlike the unhelpful, miserable, begrudging Day Lewis Pharmacy across the road were everything is an issue, or Morrisons or Boots in Rye Lane.

[Penguin68]

I suspect that one of the problems with the practice is their method of allocating appointment slots. From what I have gathered (in part listening to conversations in the queue) only some of a GPs available slots are ?released? by the office manager at any one time to be booked. This, I imagine, was to avoid the possibility of people booking all the time slots ahead, and then no-showing. So only a few are trickle fed into the system at a time. This makes availability look sparse, although my family (4 adults) has never had a problem getting an appointment quickly when actually in the throes of illness. So if you want to see a doctor ?in three weeks time? there are probably very few slots available at any one time.

The practice manager is almost certainly not monitoring the situation in real time (he/ she should be) in order to release more slots if they are all taken. The appointment staff cannot offer slots they cannot access.

Hence both the reported problems and those countering by saying they aren?t having a problem. It depends, in part, I am guessing, whether you are asking for an appointment when the practice manager has just realised more slots, or not.

There are algorithms which would make this work better.

[Siduhe]

I think the repeat prescription issues mentioned above may also be a contributing factor. I went for a nurse's appointment recently and four of the six people in front of me in the queue at FHGP appeared to have run out of medicine and needed an urgent appointment with someone to get a new prescription - all of them were given appointments for later in the day and a doctor came out to see one lady who got pretty vocal and upset about having to come back in 5 hours time for an urgent appointment. I don't know if this is down to failings in the ordering of prescriptions, people not thinking ahead, or if it was just a particularly bad morning, but if this sort of thing could be sorted out without needing urgent appointments it would seem to potentially free up a lot of time.

I have to say the service I got from the nurse was great and I'm generally very happy with the practice but I can understand the frustrations of people who want appointments more quickly than four weeks time if they need regular care from a doctor.

[Growlybear]

I think it is a real abuse of the system if people are demanding urgent appointments because they have run out of medication. It isn't exactly difficult to keep track of the amount of medication you take and submit a repeat prescription request in time so that you don't run out! Most long term medications have to be reviewed from time to time, but my repeat prescription forms have always been very clear when a review is needed, and now that the surgery has its own pharmacist, she is able to carry out prescription reviews over the phone. There really shouldn't be any need for people to run out of their medicine!

[Fjgb]

I really wanted to disagree with this but I called today and was told I couldn't book an appt because there weren't any and new slots weren't opening up till Friday. That seems ridiculous to me. Surely if there is literally not one appointment available they need to open up more slots right away rather than waiting 3 more days.

[muppet19]

I have to agree with all this - receptionists with no idea how to assess the risk of something your child has got, offering an appointment in 3 weeks for a five-year-old's head injury but once you get past that the doctors themselves are great.

[loobylou]

I tried booking an appointment today, for sometime in the future not urgent but necessary, (admittedly with a particular doctor), as I'd had to cancel one last week due to staffing shortages (I also work for the NHS), and was told to ring back in the New Year! Not impressed...

[Azalea]

Do the receptionists ask what you want to see the doctor about? They do at Melbourne Grove, and I don't think they should. How is it any of their business?

[Penguin68]

How is it any of their business?

How can they then triage if they don't? If you want e.g. to discuss your medication or side effects, then a telephone consult might be sufficient, or a chat with the pharmacist. If you are worried about a lump then there may be a greater urgency than if you are seeking a regular review. They want sufficient information to determine the urgency and nature of your needs. It may be that the practice nurse or pharmacist is actually your better first port of call than a GP, and may be more readily available. GPs having face-to-face appointments with patients who don't need to see them face-to-face, or who could be as effectively seen by another type of practitioner is one of the reasons why there is a shortage of appointments. Nurses and pharmacists are very good at handing on to a GP if there is something outside their competency.

[LondonMix]

They have released more appointments today (many slots available as next week). My guess is this thread has had some impact on releasing sufficient spaces.

[ruffers]

As I write I am in the phone queue, having called between 2 and 4 as advised as it would be less busy. Initially I was told I was number 4 in the queue and thought "Ah, not bad, should get through fairly quickly." That was 18 minutes ago, and I am now number 2 in the queue.

Do people just rung up for a chat or something? How long can a call to make an appointment take?