Different kinds of GP appointments

Surgeries may work slightly differently and offer different kinds of appointments, including some or all of the ones below.

Urgent appointments
Some practices (surgeries or health centres) keep a number of slots for patients who need to be seen urgently (urgent appointments). There is usually less choice of doctor and patients may have to see whoever is free.

Aphra felt very tired and hadn’t slept properly in weeks. Her neighbour noticed something was wrong and made Aphra an emergency appointment. The GP signed her off work.

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Did you ever need to phone in and say it was an emergency appointment or?

I didn’t need to phone in the first year and a half or something like that. But then when things went really badly with the job I was having Iactually my neighbour was the first one to make me an emergency appointment because she realised the state I was in. And she just said, “There’s something really wrong, you need to go to the GP.”

And they saw me within an hour and a half; it was literally a case of, “Come down, we’ll get you in.” And I got signed off for a week then because my job had been quite abusive, and I don’t think at the time I’d realised I was suffering from depression.

I think it was one of those things where I just felt tired all the time. I’d had insomnia for two weeks before, maybe even three. I couldn’t really remember the last time I’d slept properly. And so I just felt a bit worn out. So they said, “We’ll give you a week off and then come back the next week if you need to.”

Well I hadn’t bothered to make an appointment for the next week, but again on that day I called up and said, “I need an emergency appointment, I can’t go back.” And so they signed me off for a bit longer then, and then they gave me sleeping tablets. And then I got into the pattern more of booking a regular appointment, but if I need my medicine changing then I’ll get an emergency appointment.

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Caitlin is living with a long-term illness and has little movement below her neck. If she needs to see the GP, her mum makes an appointment and the doctor visits Caitlin at home later that day.

Caitlin’s a special case. The GP usually visits her in the afternoons if she’s got an appointment. Her mum also has the GP’s email address in case of emergencies.

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Can you remember how long he’s been your GP?

Caitlin: Has he been my GP since -? Well I don’t know about personally, like yeah he’s been a GP since we were up here.

Caitlin’s mother: Probably since nine I would say.

Caitlin: Probably.

Caitlin’s mother: Since you’ve got the CIDP he’s been involved.

Caitlin: Yeah.

And when you need to see him at that point were you going into the surgery, but now would he visit you more at home?

Caitlin: Yeah, he comes here. Every time.

Caitlin’s mother: On the day that – there’s no – they’re very good, we can get a home visit within a day, so…

Oh right that’s good. So when you were younger, can you remember going into the surgery itself to see the GP, the local health centre?

Caitlin: Yeah, yeah, yeah.

And when he comes to the home, he’ll come on the day, do you get a time that he’s going to come or you only know he’s coming on the day?

Caitlin: Well sort of. But we know it’s…

Caitlin’s mother: We know it’s early afternoon, so it’s when they do their home visits. But we, you know don’t know a precise time.

Caitlin: Which is alright I suppose.

Has that always been alright or would you have liked more of a precise time or how do you feel about that?

Caitlin: I don’t know, I think it’s… the only…

Caitlin’s mother: In a perfect world it would be nice to have a time [laughs].

And the care from the GP, how would you say?

Caitlin’s mother: They’re very supportive. I think it is different, you sometimes

Caitlin: It’s been more reasonable.

Caitlin’s mother: Yeah, probably the last couple of years because we’ve been at home. But they will, like I had a call just as I came about my other daughter actually. But they will happily ring you back, they ring you back within the day. Or they’ll visit within the day, and they don’t – I’ve even got the email of the doctor sort of thing, so it’s…I think it’s…but I think we are an individual case.

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Arrive and wait appointments
Aphra’s surgery also offered ‘arrive and wait’ appointments. These appointments guarantee that patients will be seen on the day, but the waiting time can be long depending on the number of people waiting to be seen. Monday mornings and Friday afternoons are usually the busiest times for practices.

Patients at Aphra’s surgery always get seen by the GP if they come in and wait. The surgery often closes as late as 8pm.

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If you rang up and you said it was an emergency appointment, they would give you sit and wait appointments either in the morning or in the afternoon. But my doctor’s surgery is regularly not closing till maybe half seven/eight o’clock. Because if someone says they need to be seen that day, they take it as they need to be seen that day.

And it might be that they tell they’ll give you a card and you have to do it as quickly as you can, but sometimes, you know, if it needs to be a longer appointment, they’ll give you that longer appointment. It’s about rushing through those who are quick fixes, and taking the time on those who needed a bit longer.

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John recalled that his university surgery had ‘open hours’ – students could walk in and wait to see a GP. Sarah’s university surgery had something similar – drop-in sessions three times a week where students could see a GP without making an appointment beforehand.

Advance appointments
It’s important to book an advance appointment if someone needs to review a repeat prescription for medication they take regularly, whether that’s for an illness or contraception. Sarah now makes sure she books an appointment for repeat prescriptions straight after a consultation because she once ran out of the contraceptive pill. Aphra had to make an emergency appointment when she ran out of antidepressants and Siobhan – who knew she’d need a repeat prescription for antidepressants – intended to book an appointment before she went on holiday. Most practices allow patients to book an appointment from a few days to several weeks in advance.

Sarah advises booking an appointment in advance to avoid running out of the pill and messing up your cycles. If you do run out, it’s good to use other methods.

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I’ve had to wait like, for the pill I’ve had problems when it’s been like, in [place name]. I think I immediately thought you could get a doctor’s appointment within two to three weeks and you can’t. You have to like book an appointment when you need to see a doctor every three months, you have to book the appointment when you’re coming out of that appointment.

Oh for the pill.

For the pill.

Because you’re going in routinely to get more?

Yeah, yeah. So the first time that happened, I think I thought, Oh I can get one within two weeks. And then was thinking, I’m gonna run out. And I did run out. But that’s not the end of the world, like that was alright. That wasn’t serious medication. And if it had been serious medication, something else would have been an option. But no I’ve never been to A&E. I’ve only been to A&E for like, I broke my ankle once, but yeah.

So when you ran out of the pill?

Yeah.

If someone was in the similar situation

Yeah.

what would you advise them?

Use other methods of protection.

Till you get them?

Till you get the appointment. And keep it within rhythm with your cycles. So, if you ran out of the pill and have your period, and then wait until you’d normally start, like wait a cycle and then start again cos it stops everything getting a bit mucked up. And take other forms of protection.

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Same day booking
This system involves patients calling the practice at specific times when appointments are ‘released’. Some surgeries have a special telephone queuing system, so people can listen to the recorded message and follow the instructions. It can help to know which days a preferred GP works, and to keep calling or to visit the surgery in person to get an appointment. It can be a longer wait if someone wants to see a particular GP, especially if that doctor is very popular. This mattered more to some people than others, partly depending on the reason for the appointment. Simon, who has two long-term conditions, preferred to see the same GP whenever possible but Louis, who rarely saw a doctor, was less worried about this.

Louis would rather get an appointment with any GP than wait a week to see his own doctor. Booking an appointment involves making lots of phone calls in the morning.

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Who do you usually go with when you go?

It depends who you can get an appointment with in the morning cos they always leave some free in the morning, but it depends who’s free. I don’t usually try to get a [particular] GP cos I don’t really see the point of waiting maybe an extra week or a few days just to see it, one person, so I don’t really mind who it is. So, usually just the person who’s free on that day.

So it could be any of the GPs?

Yeah, anyone there, yeah.

So youto get an appointment that day, you have to phone in the morning, or even that week?

Yeah, they always leave some free for each day, but when you rang up in the morning it’s usually like engaged, so there’s not usually a chance to get through to anyone. But you have to keep calling, calling, calling. But yeah, if you want to book an appointment for the week, you usually get one for the week with the doctor you want. But if you want one on the day, you’ll just have to go with anyone, yeah.

So who usually phones and makes the appointment?

It’s usually my mum, yeah.

So she usually makes the appointment; does she usually go with you as well?

Yeah usually, or my dad depending whoever’s home, yeah.

And when do you usually try to have the appointment because normally Monday to Friday you would be at school?

Usually try for before school; I kind of come in a bit late with a note or after school so like, like six to seven, something like that.

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Hannah phoned the surgery again and again in the morning but the line was busy. By the time she got through, all the appointments had been taken. It was easier to get an appointment in person:

Hannah went to the surgery at 7.30am to book an appointment. She wishes someone had told her before that it was easier at her practice to make appointments in person.

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I remember calling a few times asking for an emergency appointment. They, we have always known and always been told that if you ring at 8 o’ clock in the morning, then you’ll be able to get an appointment, emergency appointment, or that’s when you should ring.

And then, you know, you could be on hold or there’s no answer and it’s 8:03, cos I’m ringing constantly from 8:00 to 8:03. And the phone will be answered and there’s no appointments left. And I say well, I’ve been on the phone since two or three minutes to 8 o’ clock and how is that possible?’ And they say that people have been waiting outside since 7:30. I was never told, nor is it advertised anywhere, that if you come to the surgery at 7:30 that it’s more likely that you’re going to get an appointment.

And I think my mum also probably said that to the receptionist at some point as well because I was never to know. If that was the case, then I would have done that sooner, gone down to the surgery at 7:30. And I had to do that that time recently so it was really frustrating for a while that we didn’t know why there was no appointments left, but it was because you had to go down in the morning, yeah.

And when you did go down in the morning, then you did get the appointment?

Yeah, I did. I’ve only had to do that once but, yeah, I did get an appointment that day.

And at that time it was because you had cystitis?

Yeah.

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Telephone consultations
This is when patients phone in for a telephone appointment with the GP. It usually involves speaking to the receptionist first and giving a brief description of the problem. This information is then passed to the caller’s preferred GP, who will call the patient back, often within a couple of hours.