Current issues with phone access and booking appointments

We’re currently experiencing a large and unexpected surge in call attempts, which is making it really hard for our patients to get through to us on the phone and to book an appointment.

After a period where the number and pattern of call attempts we got each month were returning to something closer to pre-Covid levels, in March we’ve seen an extremely large increase.

We’re looking at all of the data we get via our phone system as quickly as possible, so we can understand the full extent of the situation that we and the local community in Musselburgh are facing. We’re also trying to better quantify all the different reasons people call.

But one thing is apparent: demand is completely outstripping the health system’s capacity to meet that need, and there are more people needing an appointment, than each appointment we have available. This has been the case for some time.

This means that some people are being left without the expert support from their GP that we desperately want to offer, and we recognise the depth of feeling in the community about this.

We’re doing absolutely everything we can to try and improve the situation, including:

Increasing the number of clinical and non-clinical staff we have:

  • a new GP has recently joined us, with a further GP due to join us this summer and two GPs due to return after maternity leave. We’ve had locum cover while they’ve been away.
  • Two Nurse Practitioners have also joined us in 2021, along with a specialist paramedic in 2020.
  • We’re currently recruiting for a one more full-time GP, one part-time GP and three more call handlers. There are not enough GPs in Scotland to fulfil Primary Care needs nationally, so recruitment is challenging.
  • If we’re able to recruit these additional GPs appointment numbers will increase, but will not increase further after that without further investment into the Practice or the changes described below taking place.

The number of clinical sessions our doctors, nurses and other health professionals provide has been stable for the last three years and – we think – is broadly comparable to other Practices, proportionate to the number of patients we have.

We’re also doing a lot of work to improve our phone system and the way we manage the calls we receive, including:

  • Led by our new Clinical Manager, our new Nurse Practitioner and experienced Reception team are building a ‘triage hub’ 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.
  • Improving our phone system, so that people are told how long a wait to expect, and fewer people get asked to call back because our lines are too busy.
  • Increasing our community education efforts, so people better understand when they should call us and when they should contact different health services that are best suited to their needs on that day.
  • We think we can increase the number of calls we can answer, but that doesn’t mean there will be more appointments available.

We want to be clear about a number of things:

  • All of these changes will take time and will not improve the situation overnight.
  • Once all of the recruitment mentioned above is completed, we will be at the limit of people we can employ at the Practice: the number of appointments we then have available will not substantially increase, without wider health system change.
  • Our team here are dedicated, 100% focused on patient care, and already working at the limit of their capacity.
  • The situation we and the people of Musselburgh find ourselves in currently is not a result of the way the Practice is run: improvements can always be made and we’re committed to making them, but demand is simply far greater than our ability to meet it.

The way forward

The Practice has met with Colin Beattie MSP this week, along with the East Lothian Health & Social Care Partnership, Community Councils and our Patient Participation Group, all of whom have expressed their willingness to work collaboratively with us to bring change.

We’ve made clear to all the pressure we’re experiencing and the impact this has for people in Musselburgh, and for our staff.

We’ve also made clear the changes that need to happen if people in Musselburgh are to have their health needs met – namely, a rapid move to put in place the changes the Scottish Government has already agreed must happen right across Scotland, to relieve what’s been recognised as an unsustainable workload in General Practice. This was identified several years ago.

These changes include the movement of urgent care, pharmacotherapy (prescriptions), vaccinations and community nursing away from General Practices, to come instead under the control of local health & social care partnerships. This will allow GPs to focus on their role as expert medical generalists, working to improve the long-term health of both individuals and the wider community they serve.

More people will be moving to Musselburgh in the coming years, so it’s ever more urgent that we ask those overseeing the planning of these developments, how the healthcare needs of these new residents are going to be met.

We are absolutely committed to working with our colleagues at NHS Lothian, our elected representatives and local community groups to bring 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, 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