GP Wait Times - your experience please….

Big Bag of Chips

https://www.boards.ie/discussion/comment/122389631#Comment_122389631

I'm not a GP receptionist but I do work in admin in the health service. The consultant I work for trusts me to get a sense of how urgent a person needs to be seen. We have different clinics and as the point of contact for the clinics I am the first (and only) person the patient gets to speak to when arranging an appointment so I am the one deciding when to schedule someone, and into which clinic. I do not bring every phone call to the consultant and ask them when to book the patient.

If I think someone is very urgent I will tell them to go to their GP or ED. If I think someone needs to be seen but isn't an ED case I will schedule them for the next available appointment. My consultant has one general clinic a week so the next available appointment could be in 3-4 weeks. If I think someone needs to talk to the doctor but doesn't need to be physically seen I will schedule them for a phone call appointment in the coming weeks.

You might not like it Ezeoul but that is the truth of it.

Deeec

10 days to 2 weeks to see GP here. I have been registered with the same practice since birth. When I was a child there were 4 GPs in the practice - we could always get an appointment when needed and had a trusting relationship with the GP who knew our history. About 10 years ago the practice moved to a bigger premises, hired lots of new GPs and called itself a 'Medical centre'. Since then the service has nosedived rapidly. GPs seems to change often so you never get to form a relationship with them. They have to sometimes hire GPS with poor English which leads to communication issues. Even if you have an urgent issue you haven't a hope of getting an appointment soon. Reception staff just keep saying the unhelpful advice of go to And E if the complaint is urgent - so some people could end up clogging up a and e with minor complaints that could easily be dealt with by a GP. I joke that you have to plan ahead to be sick in order to see a GP here when you need to. Getting to speak to a receptionist by phone could be an hour's wait to be told no appointments. They are trying to get people to move to their online appointment system which is poor and some elderly can't use so I fear some some people don't bother even trying to get an appointment and this leads to sicker people or worse death. It's a brutal service. Thankfully we don't need to see a doctor that often but when we do we wait until after 6 and ring out of hours doc or use the service provided by our health insurance provider. I have found both services good but obviously you can't build a relationship with a GP which worries me as I get older. There are no other practices in my area taking on new patients so we are stuck with a bad service that's probably going to only get worse. I envy people who have a GP who knows them, their history and offers a good service.

Medical attention in Ireland in 2024 is brutal from start to finish be it GP practice or hospital. It's hard to believe but we had a better service years and years ago

Ezeoul

Thanks for confirming that consultants are allowing admin staff to make judgement calls on patient urgency with no medical training.

I think that's disgraceful, much as you may not like it.

@Big Bag of Chips

https://www.boards.ie/discussion/comment/122390507#Comment_122390507

Good Lord, are you purposely being obtuse?

The “calls” @Big Bag of Chips makes are set by the GP/consultant, the receptionists act based on instruction. The receptionist doesn’t get to walk into a clinic and decide how they perform the tasks assigned. Once policies are established, the GPs/Consultants then trust the Receptionists to carry out their instructions.

One of the attributes absolutely necessary in a good Receptionist, is the ability to deal with, and tolerance for, dealing with people who find it difficult to understand.

Ezeoul

I cancelled an appointment with a consultant clinic last week as it clashed with another in the same hospital on the same date. I asked about a new date and was advised my notes would go back to the Consultant at the end of the clinic and they would decide when to reschedule me. Not the admin staff.

So no, not being obtuse. The thought that an admin person is making these decisions on patient priority is actually scary.

Are consultants even reading referrals, or is this confirmation that it left up to an Admin?

But probably explains a lot of the delays patients are experiencing.

https://www.boards.ie/discussion/comment/122390596#Comment_122390596

Your new appointment will be assigned based on the Consultant’s policy, and related to you by the Receptionist, either verbally by phone, or written via letter. This also applies when you phone to make an appointment, the Receptionist assigns you an appointment, not based on their medical opinion, but rather on how the Consultant has dictated appointments be booked and entrusts the Receptionist to carry out that instruction.

This really shouldn’t be difficult to understand, it certainly explains the challenges faced by Clinic staff.

banie01

I'm in Limerick city, I've been at the same GP practice since birth, over 45yrs ago. The only time I've ever needed to wait more than a couple of days for an appt is when my usual GP is off. More often than not l, I get an appt next day.

My GP practice has one of the largest GMS lists outside Dublin and I am astonished that so many other practices are struggling to see patients in a timely manner. I don't know what is being done different in my practice (nor do I believe there is).

GP's are the gate-keeper to the broader health system. Efficient & timely GP services keep people healthier for longer, keep people out of hospitals and A+Es and manage resources and patients better than in-patient services the majority of the time.

We've had years of being told that Slaintécare is coming, that an integrated primary care system will improve service and outcomes for patients. Yet, to do that? We must increase GP numbers and place further services and facilities at their disposal. To see that years into proposed implementation that wait times are growing is incredibly frustrating.

Big Bag of Chips

https://www.boards.ie/discussion/comment/122390507#Comment_122390507

One of the judgement calls I made this week:

A GP letter, new referral, had come in for a patient. Consultant triaged it (as they do with all new referrals). Consultant decided patient would be brought to the general clinic in 8-12 weeks.

The patient contacted me to enquire how long they'd be waiting. After speaking with the patient, and getting some further information I made a judgement call and contacted the consultant to tell them the patient would end up coming to a specialist clinic following the general clinic and as such it would be better to just bring them straight to that specialist clinic rather than waiting for the general clinic only to be then given a return appointment to the specialist clinic. The consultant agreed and the patient will now be seen in the next 4 weeks in the specialist clinic rather than 8-12 in the general and then another 4 week wait for the specialist clinic.

So if you consider me making that judgement call and getting the patient seen quicker and in a more appropriate setting as "disgraceful" then there is nothing anyone will ever say to convince you otherwise.

I am not a medical professional. I will not give any sort of medical advice to any patient. But I have an excellent grasp of my job and I know the timeline certain things will need to be seen and dealt with. I know if a person needs to be physically seen in clinic. I know if a phone call is sufficient. I know if a patient just needs to have a chat and reassurance and I know if they need to speak to the consultant rather than a junior doctor. I make those judgement calls every single day based on my years of experience in the role and advice and guidance from the consultant over the years. And patients get a very good service due to that. Anything I am unsure of will be checked with the consultant.

Ezeoul

Stop with the insults on my intelligence Dav010.

I understand perfectly, I just do not agree with how it is done.

By the way, aren't you a dentist, not a doctor?

Big Bag of Chips

https://www.boards.ie/discussion/comment/122390596#Comment_122390596

Just on this point. If a patient cancels an appointment I will often try put them into the next clinic I have available. However, if the consultant looks at the chart they often write 6/12 (6 months) on it.

So often the secretary will try bring you back sooner than the consultant will.

I also would have tried to arrange that you could have attended both on the same day. Unless one involved you being knocked out for a procedure. But just a simple outpatient clinic in the same hospital at the same time? I'd have arranged for you to attend both.

Ezeoul

Off to the vet with my cat now.

Got an appointment within 24 hours.

Animals get better healthcare in this country than humans do.

https://www.boards.ie/discussion/comment/122390681#Comment_122390681

Both, but a practicing Dentist.

Ezeoul

https://www.boards.ie/discussion/comment/122390804#Comment_122390804

To be honest, this thread is not about hospital or consultants, it's about GP's, but has gotten sidetracked.

You asserted in your first post "if you are sick you'll be seen in a day or two" when experience has shown this is untrue.

Certainly in my surgery where the stock response is "we've nothing this week" even before they ask why an appt is needed, and even if you ring first thing Monday morning.

End of.

Jim_Hodge

We can sometimes get same day appointments but it can be the next day, depending on when we phone in. It's a large practice in a large town, with three doctors and three nurses. If you were in urgent need they'll usually fit you in within a few hours.

Big Bag of Chips

https://www.boards.ie/discussion/comment/122390910#Comment_122390910

In your GP surgery maybe. With my GP I have never waited longer than 24 hours for an appointment unless it was something routine. Often even being seen on the same day.

You asserted in your first post "if you are sick you'll be seen in a day or two" when experience has shown this is untrue.

I'm surprised you can speak with such authority on my experience with my GP practice!!

tohaltuwi

https://www.boards.ie/discussion/comment/122390596#Comment_122390596

Re a private women’s health clinic, last autumn I had a complex and very unusual situation, and approached the clinic, describing my situation in a detailed email. It was triaged by a gynae nurse specialist who got me quickly to see the consultant best suited to my predicament, and my goodness was he insightful and quickly told me the bad experience I had in a public hospital was due to their failure to perform an ultrasound ahead of a hysteroscopy, and he was able to see I had suffered a uterine perforation. I had just been discharged after an episode of peritonitis following hysteroscopy, the cause of which they had not explained to me. This is a very good example of a situation where a person with expert medical knowledge triaged me. I now attend this excellent, lovely, and very pro-patient consultant.

https://www.boards.ie/discussion/comment/122390674#Comment_122390674

Slaintecare is currently in the process of being rolled out, the new EHR system with a Medical record app coming online this year,

It includes development of a national patient app, the conclusion of a community health-based record system for the Enhanced Community Care Programme as well as concluding procurement of a National Shared Care Record.

The national e prescribing services became available where I am recently (according to a text I received from my gp practice not too long ago) which means if you have a prescription you no longer have to attend your GP to get a repeat and can do it via the hub/app on your phone.

https://www.rte.ie/news/politics/2024/0521/1450297-ireland-politics/

With all the sh'tty news in the world this stuff kind of went under the radar, but it really should benefit everyone from patient to medical staff.

Ezeoul

Only when you made that assertion, you didn't specifiy "in my GP practice".

So right back at you in regards to speaking with authority on any practice except your own, and there are plenty of posters here who are also experiencing long delays in accessing their GPs.

This thread went sideways, being pedantic is attacking the poster, I am still reviewing the rest of the thread

Grem

Big Bag of Chips

The title of the thread is 'your experience please'.

I posted based on my experience.

I'm not disregarding anyone else's experience. I work in the health service. I speak to people every day who can't get a GP appointment. I also speak to people who can't even find a GP to register with.

Ezeoul

https://www.boards.ie/discussion/comment/122391150#Comment_122391150

And I posted mine, which you somehow felt you were qualified to contradict.

https://www.boards.ie/discussion/comment/122391141#Comment_122391141

I think there should be some clarification here, both BBOC and Dav10 are sharing from their respective places of work, one is a dentist and the other admin in a hospital setting. They are very different set up to a gp practice. I'd go so far as to say that even within a hospital setting the disparity between disciplines varies greatly.

For example, a dental clinic is generally going to be dealing with routine procedures, the majority of which are probably not life threatening. Cleaning, extractions, fillings and maintenance at a guess would be the primary gist of appointments being made and could with great ease be determined on a case by need basis by a practice receptionist.

An admin in a hospital setting may be working with acute conditions and the need for discrepancy would be of a higher tolerance. The requirements from department to department would be dependant on the specific area, oncology clinics leave little wiggle room compared to orthopedics schedules for example. For the most part all of these conditions have been 'triaged' in a sense as there is a general diagnosis that's being referred for.

A GP practice is pretty much a point of referral, where the range of issues can be a slight as a head cold or congestion that is causing someone to miss work, to genuine health concerns that need to be assessed for further diagnosis. The scale of which could not be determined by a receptionist over a phone call. A set of parameters are most likely set out by the relevant practice in order to maintain a surgery schedule and nothing more. Hopefully the roll out of the new healthcare apps will help ease the congestion in GP surgery's for basic things like work certs or repeat prescription and the new EHR system will make transitions between care services easier and swifter.

@Big Bag of Chips

https://www.boards.ie/discussion/comment/122391170#Comment_122391170

Considering @Big Bag of Chips has first hand experience in booking appointments for patients, she is well qualified to contradict your nonsense.

Ezeoul

https://www.boards.ie/discussion/comment/122391263#Comment_122391263

@Big Bag of Chips has no experience of my GP surgery, so you can stop your nonsense.

The defensiveness is off the scale.

https://www.boards.ie/discussion/comment/122391293#Comment_122391293

You expanded your viewpoint to a generalisation about the competency, and acceptability of Receptionists dealing with appointments. It isn’t defensiveness to point out that you are misinformed.

tohaltuwi

https://www.boards.ie/discussion/comment/122391064#Comment_122391064

I email my GP when I need new prescription every 6 months, he sends to chemist. Usually works out well. For certain controlled meds repeat prescriptions are not possible, one must attend doctor.

Ezeoul

Not misinformed at all. There have been plenty of accounts and more than one thread on the subject over the last few years.

In relation to my own GP surgery, their online reviews say it all, and the two most repeated comments are waiting times, and issues "getting past" the receptionists, to actually see a doctor.

I've been actively looking for a new GP for coming up to three years now. However, everywhere is full. Hopefully I won't fall seriously ill in the meantime. I wouldn't trust my GP's receptionist to think it serious enough to let me see a doctor.

https://www.boards.ie/discussion/comment/122391336#Comment_122391336

No receptionist is qualified to make a judgment call on anyone's health, I suspect that those that do have led to many cases of untimely death or undiagnosed illness. You're a dentist, not a GP.

tohaltuwi

This morning I requested a GP appointment within a week or so, specified it was non urgent, getting meds for travel & a few things like that. I was offered next Tuesday, perfect.

I email my GP when I need new prescription every 6 months, he sends to chemist. Usually works out well. For certain controlled meds repeat prescriptions are not possible, one must attend doctor.

not sure how it works, afaik it used to be a case of every 6 months would require a check up either way but instead of using email to your chemist you can now order it via Pippo? Web based GP app.

(like I've said, I've been out of the healthcare system for almost a decade so this might be the norm)

banie01

https://www.boards.ie/discussion/comment/122390674#Comment_122390674

In a weird coincidence my GP practice rang me this morning shortly after posting the above, regarding BP readings I had collated & submitted. The nurse rang back and said the diastolic was a tad high and I needed a 24hr monitor.

I was in with her at 12 and am now strapped for the next 24hrs, so I know many are struggling with accessing GP services and with wait times but, I can't fault my practice.

tohaltuwi

https://www.boards.ie/discussion/comment/122391141#Comment_122391141

It would be interesting to see a broad survey across the country as to how long people have to wait on GP appointments, but it seems to vary quite widely from practice to practice. Being seen same day is pretty rare from what I hear. When one cannot see a GP for a week, with a nasty infection that could be got under quick control with an antibiotic, well that is going to drive people to a hospital emergency department and unecessarily fill those places.

Ezeoul

https://www.boards.ie/discussion/comment/122391460#Comment_122391460

Had similar at my last long term lllness checkup with the practice nurse, in June.

Given a date for 24 hour BPM monitor in mid August. 🤷

https://www.boards.ie/discussion/comment/122391443#Comment_122391443

Again, practicing Dentist, I also have a medical degree.

Rather like Ezeoul, you appear to think the Receptionist makes the judgement call of their own volition, don’t fall for the nonsense she is posting. The call is made by the GP/Consultant, the Receptionist merely puts it into practise.

Just because there are a few threads with disaffected patients complaining about how GPs schedule appointments based on urgency, which requires information being provided, doesn’t mean they are correct. Receptionists have to deal everyday with the Ezeoul’s and Strumms of this world, it takes patience and tolerance, but remember this, someone who asks nicely rather than being a prat, will likely be looked on favourably for non urgent appointments.

Ezeoul

https://www.boards.ie/discussion/comment/122391480#Comment_122391480

Agreed. I also know from comments made at my last visit to TLC-Doc, that they are aware of the number of patients from my GP practice seeking appointments with them.

Twice since Christmas I have had to go to them for antibiotics for chest infections, when my surgery would not give me an appointment in less than ten days.

My brother had to go to A&E last week after being told it would be at least ten days before he would be seen, it turned out he had some kind of blood clot forming in his leg. (eta) to clarify, he took the appointment offered, but after two days, went to the hospital due to worsening pain.

I am seriously just fed up with them at this stage and have no confidence in them. I'm not that old yet, (mid-50s) but do have some health conditions, (inluding respiratory) and the thought of getting older with the standards of care at my current surgery worries me greatly.

Deeec

https://www.boards.ie/discussion/comment/122391538#Comment_122391538

With respect to you I dont think you fully understand what is happening. For example last month I had to call our GP for our 84 year old mother who had an ear infection. She is prone to ear infections and if left untreated it can lead to other issues and has in the past led to hospital admission - so when she gets it she needs an antibiotic quick. I explained the situation to the receptionist and said she was in alot of pain but no she wouldnt give her an appointment or indeed let me chat with a GP to get a prescription. This was 9am and my mum felt she couldnt wait to see out of hours GP after 6pm so we had no choice but to head off to A & E ( thats a whole seperate thread on what happens there). Unfortunately this is not the first time we have had to do this. So this receptionist 100% made the decision soley that my mum did not need to see a GP urgently despite her age and having an infection that was causing severe pain. If I had been allowed to speak to a GP or indeed she had spoke to a GP I would feel that at least they would have wrote a prescription and we wouldnt have had to go tthough the trauma of an A & E visit to just get a prescription for an antibiotic. Your telling me that this procedure is fair - well its not at all. This receptionists response is just a blanket NO to everyone and her advice is always go to A and E. In fairness the other girls that work there a bit more helpful but sadly this wan seems to be on receptionist duties alot.

Deeec

https://www.boards.ie/discussion/comment/122391460#Comment_122391460

Im envious of you. That sounds like a GP service that really cares about their patients. You are so lucky.

banie01

https://www.boards.ie/discussion/comment/122391752#Comment_122391752

It really is a very patient orientated practice IME. I have always felt well looked after with them. I find that very reassuring and supporting. I am sorry that others seem to have such poor experiences with other practices.

balanced24

Same for myself. 8 days, two days later in A&E on verge of heart episode. They didn’t use phrase heart attack I can’t remember but it was very serious and I’m on tablets now for life. Scary experience that could have been avoided. Doctors seem to have forgotten referred pain and Sally the receptionist doesn’t want to hear about my dingly dangly bits swollen to the size of a warermelon * just for illustrative purposes 😂

_Whimsical_

I have to say I've been really disappointed by the level of access to my own GP. My mum also goes there too. She was extremely ill a few weeks ago, in so much pain she couldn't take a proper breath. Rang the GP at 9 in the morning, no appointments, receptionist unconcerned by the gravity of the symptoms offered to have her ring back next morning at 9 to hopefully get in quicker and nab an emergency appointment, even though it clearly couldn't wait. I rang around a few surgeries to see if anyone had anything free, eventually 1 receptionist said she just tells all emergency patients to go to a new walk in clinic the other side of town so we went there and were dealt with efficiently. This seems to be the future of acute medicine like infection etc - go to one of these one-off clinics, let GPs deal with chronic non-acute stuff that can wait a week.

While this is a good option in cities it really isn't great for people on medical cards and low income. We met a Ukranian lady there stunned that I was taking my mum out in this state and not calling a Dr to the house. Said she'd never experienced this kind of poor healthcare in Ukraine. She was there on very minimal income though having to pay for her son to see someone and it felt very wrong.

Ezeoul

https://www.boards.ie/discussion/comment/122391538#Comment_122391538

Appointments shouldn't be "granted" based on how nicely you ask for them. FFS.

I am well used to dealing with the public in my own job, both over email, the phone and face-to-face, so would never treat a receptionist rudely. Unfortunately, that does not mean I always receive the same courtesy in return.

I've sat in the GP's waiting room, 10 feet away from them and overheard them discussing patients, heard them being really rude and nasty to callers on the phone, and also outright lying to them about appointment availability (one caller told here was no appointments and ring back next week, and another told they could come in on such and such a date). There is one in particular who is definitely on a power trip.

I did raise this with the doctor when I got in to see them, and they said they'd have a word, but apparently nothing has changed. In hindsight, the GP probaby just told them to lower their voices when discussing patients.

_Whimsical_

An unpopular opinion here but based on experience of friends who are Drs and professionals I have dealt with.

I know 3 girls who are GPs who see patients 3 half days a week, 2 run facial filler and botox clinics in salons in town and in other counties 2 other days. One does an online skincare clinic prescribing anti-aging prescription treatments for a UK service for a 4th days work. They are home to pick their kids up from school and have a nice lifestyle. It is a different life than the old school GPs who did a 9-5 ,5 days and arguably did have very little home work balance as a result. In my GP clinic all GPs work 3 days and have other interests other days - one runs private menopause clinic in another area 2 days for example. The issue of GP availability is bigger than clinics being over-run. It does happen, but we also need to address the fact that some GPs need to be available for GP work a greater amount of time than they currently are.

https://www.boards.ie/discussion/comment/122391920#Comment_122391920

They aren’t granted based on how nicely you ask, but if you are a dick, you get the first available appointment, show some respect to the Receptionist, and the job they do, they may well help you out with a sooner appointment if one becomes available.

I really feel you would benefit from joining a Practice with an online booking system, that way you just stand inline so to speak, with everyone else.

Ezeoul

https://www.boards.ie/discussion/comment/122392036#Comment_122392036

It was you who said being nice to the receptionists will win you their favour.

Because you're assuming I am the dick here, right? That I must be giving the poor receptionist staff a hard time? Well, you're wrong. I've never been anything but respectful and polite when dealing with them, even when I have felt like ripping into them. Because I know what I'm dealing with. And you've just unwittingly confirmed that not all appointments are given out fairly.

So yes, I'd much prefer an online booking system. 100%. Then I would only need to have minimal interaction with the particular nasty power-tripping wans at my current GP surgery. And that is what they are, no matter how you choose to defend them without even knowing them or having dealt with them. I've seen it an overheard it with my own ears.

Hopefully, when I do find a new GP (🤞) they will have an online booking system.

tohaltuwi

https://www.boards.ie/discussion/comment/122391515#Comment_122391515

the one halter BP monitor that the practice has probably had to go around tons of patients. Maybe Banie’s practice has several of them 🤔

tohaltuwi

https://www.boards.ie/discussion/comment/122391920#Comment_122391920

I was in waiting room about two years ago, speakerphone in reception was on and they were playing back voice messages, some very intimate details being relayed to all and sundry, name, date of birth, address and full details of complaint and likely cause. Distracted myself not to hear it all, but everyone else could loud and clear.

Ezeoul

https://www.boards.ie/discussion/comment/122392203#Comment_122392203

If so, maybe they should invest in more equipment.

tohaltuwi

https://www.boards.ie/discussion/comment/122392113#Comment_122392113

We should hopefully not judge our “real life” behaviour based on here, otherwise I’d be terrified of going near the dentist for fear of having my mouth de-dentified by Dav 🤣.

tohaltuwi

does anybody know if this standardised online system has a way of “triaging” eg, if you have a fever and coughing blood (my go-to example because I personally familiar with aspiration pneumonia which can be managed at home with prompt antibiotic) or are you advised to contact reception for for that kind of urgent appointment?

https://www.boards.ie/discussion/comment/122392264#Comment_122392264

I havent downloaded it yet but might do that in a bit so I'll let you know, for safety's sake however I'd say a direct call might be most appropriate action.

Hippodrome Song Owl

https://www.boards.ie/discussion/comment/122390805#Comment_122390805

I have said many times, I could only dream of the level of health care my pets get! Same day appointments with blood test results in an hour, and immediate xrays and ultrasound scans. Surgery within a day if necessary. All in a local clinic.