Issues with phone access and booking appointments

Updated 19.10.21

We continue to receive more incoming calls than our hardworking call handling team have capacity to answer. We’re currently providing large numbers of both telephone and face-to-face appointments and these are fully booked every day, despite increases in our clinical team this year. Our team are dedicated, 100% focused on patient care, and are working at the limit of their capacity.

Our data and patient feedback tells us that there are more people requesting an appointment, than the appointments we and other local health services can provide. This was the case before the pandemic, and the pandemic has exacerbated the situation. We expect it will continue to do so for as long as isolation requirements impact our staffing levels.

We know that some people are being left without the expert support from their GP that we want to offer. We recognise the depth of feeling in the community about this – we share everyone’s concerns and are committed to fighting for better, for you and our team. We are on the same side here.

At an individual Practice level we’re doing everything we can to try and improve the situation, including:

Working to maintain our staffing levels:

  • five new GPs have joined the Practice this year – Dr Maeve Chestnutt, Dr Michael Slowey, Dr Anne Money, Dr Hannah Astle and Dr Lucy Milner. One GP (Dr Kate Magee) returned from maternity leave in October 2021, with another to follow later in the year.
  • We’re still recruiting for a further GP to work two days a week. There are not enough GPs in Scotland, so recruitment is challenging – in this environment, it’s great to see that so many GPs have chosen to join us this year. We must keep them here in Musselburgh – and patients have a role to play in that.
  • If we successfully recruit for these remaining GP sessions we will be fully staffed in terms of our clinical team – we cannot recruit more with the resource available to us.
  • The BMA recommendation is for 1 full-time GP to 1,600 patients, which is what we have in place at Riverside when fully staffed.
  • Three triage nurse practitioners also joined us in 2021, along with a specialist paramedic in 2020.
  • We’ve also recently recruited three more people to our call handling team, to replace two team members who have moved on to other roles and give us some extra capacity over the busy winter period – again, once these call handlers are in place our Reception team will be fully staffed and we cannot recruit more with the resource available to us.
  • The number of clinical sessions our doctors, nurses and other health professionals provide has been stable for the last three years and is broadly comparable to other Practices, proportionate to the number of patients we have.

Improvements to our phone system:

  • Following feedback from patients, we’ve already updated our on-hold messaging to include information about our emergency assessment service and other local health services, and changed our on-hold music.
  • Our triage team are developing a new care navigation/triage system so we can better assess the concerns people have over the phone, and book them in for an appointment with the most appropriate health professional, at the most appropriate time.
  • We want to move to this system, rather than returning to our old ‘same-day or pre-booked’ system. The old system often saw waits of up to four weeks for a routine appointment and a much smaller number of same-day appointments available for urgent health concerns, which is also not ideal for patients.
  • We continue our community education efforts, so people better understand when they should call us and at what time of the day – and when they should contact different health services.
  • We’re investigating an online booking system for nurse appointments and blood tests, to bring convenience for patients who are online and freeing up the phoneline for those who need it.
  • We’re looking at other ways we can reduce call volumes, for example by offering the option to cancel some appointments by text and sending text messages to confirm registration.
  • We’re continually trying to maximise the number of calls we can answer, with the team we have in place – we can’t increase the number of appointments we offer though.

We must be clear about a number of things:

  • There’s a limit to what we can do to improve access issues, as an individual Practice – wider change is needed in the local health system.
  • The current access issues are not due to the way the Practice is run: small improvements can always be made and we’re committed to making them – but broadly speaking demand is simply greater than our ability to meet it, and that is not something we can fix.

The way forward

The Practice met with Colin Beattie MSP in March and June 2021, along with the East Lothian Health & Social Care Partnership, local Councillors, Community Councils and our Patient Participation Group, all of whom expressed their willingness to work with us to bring change.

We’ve been clear about what we believe needs to happen if people in Musselburgh are to have their primary care need met – namely, putting in place the changes outlined in the 2018 GMS contract.

These changes include the movement of urgent same-day care needs, pharmacotherapy (prescriptions), vaccinations and community nursing away from General Practices, to be provided instead by local health & social care partnerships. This will allow GPs to provide the expert, scheduled medical care we know patients want – the care we want to provide.

It’s ever more important that these changes take place, as more people move to Musselburgh.

We’re committed to working with all the above parties to bring about these much-needed changes, and call for our patients to lend their support too.

Advice for patients

At this time when we’re extremely busy:

  • Please consider whether you need to speak to a GP before you call, or whether you should be seeking care from more appropriate health professional. These might include your pharmacist (prescriptions can be often be provided free of charge via the Pharmacy First or Minor Ailments schemes), a minor injuries unit, the CWIC mental health team, CWIC physio team or CTAC community nursing team.
  • If you do need to speak to a GP, please read our appointments page for advice on the best time to call to book, and how to make sure your phone appointment runs as smoothly as possible.
  • Please use our online services as much as possible, including our online prescription service and online registration. Please check the expected timelines on our prescription page first, before calling us. Our test results page has information about the process for these: please read it before calling us if you’re unsure.
  • Call 999: in a life-threatening emergency
  • Call 111:
    • If the Practice is closed and you have a medical concern which you feel needs immediate attention
    • Before going to A&E, if you feel able to
    • To access a Minor Injuries Unit