Forest Hill Road Practice - in Meltdown ?

[slarti b]

@inTexas.. Ok, I understand you point. But maybe Gerrit found that comment somewhere else on web site?

I had issues last year trying to get an appointment (I think was a telephone one?) and was told that they would only do this at the time I needed for children and elderly. That is not on web site!

@unclegen

My colleagues at work have GPs in Stockwell, Clapham Putney and Guildford. Max wait for them is 2 weeks, and often much shorter. So FHR can't blame a general meltdown.

I came across reviews by patients on the NHS web site and many of them confirm the problems raised here. http://www.nhs.uk/Services/GP/Overview/DefaultView.aspx?id=43499 It seems astonishing that the NHS isn't investigating.

Anyway, I think I will write to Practise Manager and see what she says.

As I have said before once you do get to see a doctor (or Practise Nurse) the treatment is normally fine. It is a shame it is so difficult to get to see one!

[dbboy]

The receptionists act as "Gate Keepers" once penetrated it is easier to get what you want. I went in December last year and was told no appointments with the nurse till all the Flu jabs had been dispensed. This is a totally ridiculous way to be running a practice. The purpose of the practice is to service the health needs of the community. Clearly they are failing in their duty to meet this overarching requirement of providing a health service to patients that is funded via the NHS contract they hold.

Perhaps the contract needs to be withdrawn and new management installed to run the practice as a going concern.

[Growlybear]

Well once again, I had superb service from the practice last week. After spending a week in bed with flu, I realised that my chest didn't feel right, and I was a bit breathless. I rang the surgery at about 8.30 a.m., got through to a receptionist within two minutes. There were no routine appointments available as you would expect, and the 'on the day' appointments had all been allocated by that time. However, the receptionist put me on the list for a telephone call by the duty doctor. The doctor rang me within 10 minutes, and arranged for me to be seen by one of the doctors later the same morning who confirmed that I had a chest infection.

I have always maintained that if you NEED to be seen urgently by the practice, they will always fit you in. In the 40 years I've been with the practice, I've never had difficulty getting through on the phone, and have never felt that I've had an unreasonably long wait for an appointment. If I want to see a particular doctor for a routine matter, then I'm happy to book an appointment three or four weeks ahead, but if I need to be seen more quickly, then the receptionists always do their very best to fit me in. I have always felt privileged to be a patient at Forest Hill Road.

[steveo]

Like

[Penguin68]

I too have had no real issues with the practice - in general urgent problems are dealt with, routine appointments are (eventually) available. I think their current method of 'releasing' appointments in a dribble isn't working - but the alternative (make everything available at once) would almost certainly lead to multiple slots being booked and then not taken-up by a small minority of patients.

If their booking system was more open, it would be possible for doctors to book-in follow-up appointments during a consultation themselves in 'their own' calendars - which would offer a better continuity of care for a particular medical problem. That way you wouldn't reach the impasse of the doctor telling you to come back in x weeks, but such a visit actually being un-bookable at reception. It would also stop doctors setting impossible return times based on an ideal rather than a practical timetable. No point in saying 'come and see me in three weeks' if you have no 'routine' slots available for a month and a half.

[gerritsmith]

Phoned last week to make an appointment. I was told that they are not making any appointments because they are changing the system and the system would start on 1st of April, so have to phone in April to make an appointment. I suggested you only need a diary and a pen and is not complicated to make a list of appointments. I insisted that I needed to see a doctor. The receptionist then asks me what my symptoms were? receptionist started to play doctor's role.

[singalto]

gerritsmith I tried to make an appointment on Tuesday and got that answer too! I then asked to be put on the duty doctor 's list. When asked if it was an emergency I told the 'patient services officer' that I wouldn't know until I had spoken to a doctor!

[dbboy]

Patient Services Officer, really!!!!!!!!!!!!!!!!!!! So we have Officers as receptionists. I wonder who came up with that daft job title, perhaps that's why it's so difficult getting through the "gatekeepers" to see a GP at this practice.

[Alan Medic]

Phoned this morning to be told they are having a meeting today to try and resolve the problems. I was told what a nightmare it is to organise 9 doctors who work different hours. I suggested it can't be that difficult and was invited to spend a day with the lady who answered the phone.

No appointment available and not even a suggestion as to when it would be worth phoning to make one. I had phoned last week and was told to phone this week. Now there is nothing available until 2nd week in April but you can't yet book anything for then. I can only guess the surgery is over subscribed with patients.

[Cora]

Phone the complaints line on NHS choices to try and get something done...

[intexasatthe moment]

No appointments for 5 weeks because they have doctors working different hours and it makes it difficult to organise ????

[LondonMix]

I wondered the same. Surely surgeries stop taking on new patients when they've reached capacity. Much of GPs funding is tied to the patient roster so taking on more patients that you can adequately service would be pure greed.

I hope instead that they are trying to support a GP who needs temporary flexible working for personal reasons or something and that's causing the extended chaos. I wouldn't expect them to confirm this but I would be sympathetic to that situation.

Alan Medic Wrote:

-------------------------------------------------------

> Phoned this morning to be told they are having a

> meeting today to try and resolve the problems. I

> was told what a nightmare it is to organise 9

> doctors who work different hours. I suggested it

> can't be that difficult and was invited to spend a

> day with the lady who answered the phone.

>

> No appointment available and not even a suggestion

> as to when it would be worth phoning to make one.

> I had phoned last week and was told to phone this

> week. Now there is nothing available until 2nd

> week in April but you can't yet book anything for

> then. I can only guess the surgery is over

> subscribed with patients.

[intexasatthe moment]

I tend to agree that being short staffed and overwhelmed with work is the most likely scenario.

[dbboy]

Why can they not take on more doctors to see patients or extend the surgery opening hours? This would allow more patients to be seen and hence reduce the delay in obtaining an appointment.

[Lynne]

OK. I am very old and can remember when receptionists had a book or diary where they could see empty slots and would book you in accordingly. This didn't seem a very difficult process, and worked, as far as I can tell, far better than it does now

[LondonMix]

I have no insight what's happening at this surgery. I am only speculating based on experiences at my own place of employment. During moments of personal crisis for employees, we have temporarily been understaffed as we've given the person time off / flexible working to deal with whatever is going on. If its unclear how much time they'll need (family illness etc) then it can be hard to bring in temporary staff. In the end, everyone works a bit more to cover for the person but less gets done overall. Its a tough situation but often the humane thing to do.

I'm really playing devil's advocate because while the level of the service recently has been exceptionally poor, it seemed to change radically over a very short span of time. The doctors also seem fairly caring.

With that said, if this situation is caused by them simply taking on more patients without increasing hiring, that would be totally unacceptable. That's greed at the expense of patient care.

I suppose complaints should be made either way so the situation can be investigated.

[intexasatthe moment]

I'm a patient at FH, haven't used them recently but my experience of them is very variable .

My own experience is not that this is a sudden change in circumstances ,rather that problems with getting appointments is an ongoing issue which peaks every now and then .

It would be really encouraging if the surgery could explain what steps they'll be taking to try and improve the situation.

[Penguin68]

Why can they not take on more doctors to see patients or extend the surgery opening hours?

Cost?

GP practices are private business or partnerships - they are paid on their NHS contract for the number of patients they have and for undertaking specific health care procedures (such as vaccinations and inoculations, certain types of health check etc.) This money arrives regardless of their costs - more doctors or longer hours open mean that the surgery operating costs go up, but their revenues are fixed (or at least, not associated with their costs). All practice staff are contracted to the practice (not the NHS - although some types of primary care NHS staff may work out of doctors' surgeries - such as Health Visitors and Psychotherapists in the IAPT programme).

[LondonMix]

That would be the greed argument. If its down to that an investigation should be launched as its simply not on to take on huge amounts of additional patients without increasing staffing levels. Also the receptionists are poorly trained and they don't follow certain NICE guidelines for first time mothers. I've had phone appointments booked, the doctor has failed to call on time and then refused to call back after follow up.

Honestly, there is a lot that needs sorting out there. I would say before 2015, I never had any issues with the practice. To me its been a sudden change in quality as I've been signed up to them since 2007.

Penguin68 Wrote:

-------------------------------------------------------

> Why can they not take on more doctors to see

> patients or extend the surgery opening hours?

>

> Cost?

>

> GP practices are private business or partnerships

> - they are paid on their NHS contract for the

> number of patients they have and for undertaking

> specific health care procedures (such as

> vaccinations and inoculations, certain types of

> health check etc.) This money arrives regardless

> of their costs - more doctors or longer hours open

> mean that the surgery operating costs go up, but

> their revenues are fixed (or at least, not

> associated with their costs). All practice staff

> are contracted to the practice (not the NHS -

> although some types of primary care NHS staff may

> work out of doctors' surgeries - such as Health

> Visitors and Psychotherapists in the IAPT

> programme).

[vic.ham]

I had cause to ring the surgery this morning and made sure I was ready to start dialling at 8am, I was 19th in the queue and my call was taken at approx. 8.25, is that an excessive amount of time to wait? (I thought it was)I don't remember waiting that long last time I called, although that was last year sometime.

[intexasatthe moment]

Greed or the being humane to an employee - it's all speculation .No doubt the causes will ne many and complex .

Only the surgery can know the full picture from their side ( less aware I suspect of the picture from the patients side ) .

[ED - NAGAIUTB]

I was there @ 7:30am for an appointment (booked 6 weeks ago) and needed to book a follow up in 4 weeks time. I queued with 10 other people only to be told that even at the desk they couldn't making a booking and to call (!) after Wednesday.

Pure greed on behalf of the Partners is my diagnosis.

[TJ]

I called yesterday to make a fairly important appointment, and furnished the receptionist with quite a bit of info, to be told there was nothing at all, no appts were being released and to call back for an emergency duty doctors call in the morning.

My wife called today, spoke to a different receptionist, explained the same as me, got an appointment tomorrow.

It's just bloody frustrating and a waste of 30 minutes of my life sitting on hold. Her lack of manners and grace is quite something to behold too.

[alice]

It's clear that something is messed up at fhr. its absolutely nothing to do with the front of house staff. How could it be?

[Jacqui5254]

Well said Alice.