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Issues with phone access and booking appointments

Updated 14.2.22

Our data tells us that there are more people requesting an appointment, than the amount of appointments we and other local health services can provide each day. While our data shows that getting through on the phone was less of an issue before the pandemic, the mismatch between demand and the number of appointments each day still existed – albeit to lesser extent than currently. The pandemic has exacerbated this mismatch, and also brought challenges getting through on the phone.

We are sadly not alone in this, with a BMA Scotland survey showing that over 80% of General Practices in Scotland felt that demand ‘substantially exceeded’ capacity in their local area in November 2021.

We know that some people are at times being left without expert support from their GP. We want to offer the same timely, high quality care to all of our patients and 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. Our team are on the same side as you in this respect and we hope our patients recognise this.

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

Maintaining our staffing levels, in a challenging jobs market:

  • four new GPs joined the Practice in 2021, with a further four joining us in early 2022. It’s great to see that so many GPs have chosen to join Riverside recently: we must keep them here in Musselburgh – and patients have a role to play in that. Our GP staffing levels are in line with observed averages at other GP Practices and in line with BMA recommendations for the number of GPs per 1,000 patients.
  • Three triage nurse practitioners joined us in 2021, along with a specialist paramedic in 2020. Some of this specialist team are currently doing prescribing qualifications, which will bring benefits for patients.
  • Our Reception team is now 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.

Being the best we can be:

  • We’ve updated our phone messaging.
  • Our triage team have developed 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 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 currently looking at other ways we can reduce call volumes, through increased use of new digital tools for certain requests.

We must be clear that:

  • Some improvements and efficiencies can always be made and we’re committed to making them – but broadly speaking demand for appointments is simply greater than our ability to meet it, and that is not something we can fix alone.
  • We will always try to answer as many calls as we can, but we believe that phone access issues will likely remain to some extent, for as long as demand continues to exceed capacity.
  • Our clinical team is fully staffed and already providing as many appointments as they safely can, and these are always fully booked each day.
  • We’re aware that our same-day phone system creates challenges – and for some groups of patients more than others. However at this time when demand for appointments exceeds capacity and Covid isolation rules are still impacting our staffing levels, we cannot return to a pre-booking system. Pre-booking would – at this time – lead to excessive and potentially unsafe waits for pre-booked appointments and our needing to cancel appointments at short notice, if clinicians were unable to work due to Covid isolation rules or for other reasons.

The way forward

We believe that if all local health providers (GPs and local health boards alike) are being clear that they are already working at capacity yet there is still unmet need, then all parties need to sit down around a table to discuss a way forward. We have met regularly with stakeholders including local MSPs, East Lothian councillors, Community Councils, the East Lothian Health & Social Care Partnership and patient groups to share our view of the situation. We’re committed to working with all the above parties to bring change for patients, and ask patients to lend their voice to this call too.

Advice for patients

At this time when we’re extremely busy:

  • We receive a large number of calls each day that could have more appropriately have been dealt with by someone else. 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.
  • Remember our test results guidance ‘from ten after ten’: please call for your results after 10am, ten days after you had the test – if you haven’t heard from us by then.
  • 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.
  • 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