By Neal Adolphus
It used to be so easy, didn’t it? You just popped into the surgery or rang up and there you were, soon sitting in front of the friendly doctor. ‘Your’ doctor of course. A bit of a chat then down to the medical stuff. Why isn’t it as simple nowadays? What went wrong? Well there are more of us wanting appoint-ments, for one thing. Some local practices were designed for much lower numbers, Shepperton now has about 13,000 patients. We are also getting older (Shepperton has the highest number of elderly people in the Bor-ough) and, consequently, we have more needs. This isn’t taken into account in fund-ing. Before the pandemic, doctors knew that things had to change as it was impossible to keep up with the demand; the number of days we had to wait stretched ever longer (particularly if many patients wanted to see the same GP).
When the pandemic struck we accepted that everything was going to be difficult, and clapped the heroic doctors, nurses and other key workers. As we come out of lockdown, and go back to the pub if we wish, it would be great to think that the doctors’ surgeries would settle back as they used to be – but they won’t. The way it was wasn’t working anyway. Doctors knew that. Waiting times for appointments were ever increasing.
Although infection rates are continuing to drop – we can even go back to the pub if we like – practices are still under great pressure because:
– Not enough doctors – there is a general shortage (which will increase as some leave the profession through exhaustion etc.), they tend to work fewer shifts (currently going afterwards to help with vaccinations etc.) and of course the budget is limited – our doctors have actually taken a voluntary pay cut in order to increase the number available;
– Fatigue and stress affects all types of staff, many of whom have been helping with vaccinations after work and this leads to absence and perhaps losing the member of staff completely;
– Many more people telephone the practice – lines have been increased as well as staff to answer them, but there is a limit to what can be afforded and places to put people. A lot of the calls are about vac-cinations, which they generally can’t help with;
– People who didn’t come forward with health concerns during the worst of the pandemic are doing so now (particularly following NHS advertisements on televi-sion);
– Some additional tasks are set from above, NHS etc, over which the practice has no control. Similarly, website design and triage systems are decided regionally. Of course the practice needs to respond to complaints about long waits on the phone etc, but ironically that gives them less time to actually take the calls!
What can be done? The Patient Participation Group for Shepperton Medical Practice repre-sents patients and assists in communication between them and staff. We are always open to hearing about your concerns and will pass them on – in general terms, we can’t go into individual cases as there are complaints pro-cedures for that when necessary. We have come to the conclusion that helping patients to understand the situation and how to access services is now the most useful work we can do.
If you have a health problem that is urgent, contact NHS online (http://www.111.nhs.uk/) or dial 111 (or 999 for life-threatening emer-gencies). For Covid related issues you can use 119.
If it is something else, you can:
1.Consider whether a local pharmacist could help, or a video consultation with a doctor (https://www.livi.co.uk ).
2.Go on the SMP website, click on Consulting Room, then click on the red ‘get help for any health problem’ box. You will be asked if you have any emergency need, if not click on ‘I have none of these’. You will be taken to an online form to be completed. As appointment times were stretching further head, TO KEEP PATIENTS SAFE, THE PRACTICE WILL NOW ONLY MAKE APPOINTMENTS ON THE DAY. When that day’s routine appointments have been filled, the online form for doctor’s appointments will be switched off. The form can still be used for nurses, health questionnaires etc.
3. If you can’t use the form, phone 01932 229524. You may have to wait, typically 15 minutes (as we often do when contact-ing companies). Calls are in a queue, so putting the phone down and trying again will add to the waiting time.
4.If you don’t have a phone, call in at the surgery. Because of Covid, only a very few people can be inside queuing, so be prepared for whatever the weather may be!
5.Whether you use the internet, telephone or visit, the form will probably have to be completed.
6.You may be directed to someone other than a doctor, a paramedic or pharmacist for example if their help is more appropriate;
7.Your appointment may be by telephone or video link rather than face-to-face. This isn’t just to minimise infection, it takes less of the doctor’s time and so enables them to care for more patients;
8.An assessment of clinical need drives all these decisions, i.e. who ‘sees’ you, wheth-er or not it is a face-to-face consultation, when you have your appointment. This has to be better than just ‘first come, first served’.
The more we can support the practice in this way, the more they will be able to help us.
Neal Adolphus, chair of Shepperton Medical Practice Patient Participation Group (neal.adolphus@yahoo.co.uk)