Improving access to GPs: young people’s views

Several things can be important to people when they register with a GP and make appointments to see the doctor. This includes whether the surgery is easy to get to and if they can get an appointment when they need one. Here, people talk about their views on improving access to GPs.

Surgery opening times

Emma’s local surgery was open from 8.30am-6pm, which she thought was ‘decent’, even if it was sometimes hard to take time off work to see a GP. She felt that GP surgeries being open ’24 hours a day’ was unrealistic, though wondered why some didn’t offer appointments over lunchtime, which would be helpful for people who are working. Other people, like Paula, felt that it can be hard attending appointments for people who are still at school. She didn’t like missing lessons and would like it if GPs could have clinics after school hours. Ish often found it hard to get an appointment that fitted in around his job and felt that it would be helpful if surgeries could employ more doctors and stay open longer:

It’s hard to switch shifts with people at work because of a doctor’s appointment. It would be easier if surgeries stayed open until 7 or 8pm.

Gender Male

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If I would have to go and see a GP, I would have to look at my own schedule first to see when I’m off or when I have time because when I’m at work, most of the time I work from eight till five or six. So that’s totally out of their range most of the times. I have to see when I’m off. Then I have to call them to see if they have a free time slot. If they don’t, then I have to basically just go into my office and just like try to find a time slot where I can switch with someone.

I might not be able to switch, just cos of these things cos they have their own personal life too. So they might not want to switch. So it’s just like you’re sacrificing a lot of your own time also and you’re, if you’re going to be doing this every two weeks at your work, they’re not really going to look at it as like, Oh, you’re really reliable. Like, you can’t even go to the doctor or something like that.

It’s just like, I don’t know it seems a little bit awkward every time something’s wrong you have to go in and just like move everything around. It just gets frustrating.

Mm. Yeah. So what are the opening hours like at your local GP?

I think it’s from eight till five, yeah. It’s eight till five.

And what do you think about those opening hours?

Well to be honest, like I don’t think a lot of people are going to go in. So they should have more doctors covering so they can stay open later a little bit.

Not a lot of people are going to go in. Most of the people that are going to go in during like twelve o’clock, probably going to be little kids and moms. So they should seriously think about just moving the time slot a little bit, to like, seven or eight o’clock. You know, that’s a little bit more flexible for everyone I think.

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The local surgery that Simon goes to closes at 6pm and he gets home from work at 8pm. If he has a doctor’s appointment, he often has to take time off work. He felt that longer opening hours and weekend opening would be really helpful. Louis also wondered if GP surgeries could open at weekends, and have more late openings in the evenings, perhaps until 8.30pm. He felt that young people were more likely to go at later times instead of during school. Extended opening would also be useful for people who were working and at college.

Even if GP surgeries opened until 9pm on just 1 or 2 days of the week, that would really help people who are working. It might help the economy too.

Gender Male

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In an ideal world, would you prefer it if the GP surgeries were open longer or ?

Definitely. So my GP surgery closes at six o’clock. So, I work in [place name], so I don’t get home until eight o’clock at night. So when I have an appointment I work from home, I’ll take the day off, or have the day off, which is an inconvenience to the company. It doesn’t add to the economy at all really. So having them longer hours and, you know, weekend hours as well would be really helpful for the patients who are working and trying to contribute to society. To help them just to fit it into their lives really.

Yeah. So, ideally now they close about six, six thirty how late would you like them to stay open?

Even if it’s perhaps not every night of the week but perhaps, you know, nine o’clock really would be ideal. You know, even if it was two to three nights a week perhaps. Just so, you know, there’s one day when they’re open late and you can try and book an appointment on that day really.

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Ambeya felt that more young people could access GPs if surgeries were open 24 hours, and there’d be less need to go to A&E if they needed medical advice. John liked the idea of surgeries that opened seven days a week, too, rather than everyone ‘bundled in on a Monday morning’. Lara, though, felt that ‘they should just be open when shops open. Cos they’re not really, you can’t really expect them to be open, because that’s what hospitals are there for as well, cos they’re open all night….I think they should just be open when shops open, but maybe close a little bit later.’ When people can’t get an appointment with a doctor, they can phone their usual GP surgery for out-of-hours services, or go to an NHS walk-in centre if there is one locally, where minor illnesses can be treated without an appointment.

It would be good if GPs could work shifts, like doctors in A&E do, and stay open 24 hours.

Gender Female

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What would be the ideal opening times for a GP’s surgery do you think?

It should be likeit should be twenty four hours if it could, because you never know something could randomly happen in the night when you’re sleeping, and you have access to nothing other than A&E. So, if it was twenty four hours, that would be the most perfect. But obviously that’s not possible because no GP would be able to stay in the GPs for twenty four hours. But twenty four hours would be most ideal.

Ideal. So if they could have shift systems?

Yeah.

Then you think that they should be there all night as well, and then during the day another GP?

Yeah, because that’s how A&E works right, it’s twenty four hours. So if a GP was twenty four hours, that would be good.

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Siobhan often found it hard to make an appointment at her local surgery because appointments were released early in the mornings when she was going to school and in the afternoons when she was still at school. She felt that it would be helpful if surgeries stayed open until later, offered weekend appointments, and more appointments that could be booked online.

Siobhan usually books appointments online when she’s at school. Extended opening would allow her to finish her homework after school and then see the GP.

Gender Female

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It opens at 8 o’clock and appointments are released at half 8. I have to be in school for 9. And then the appointments in the afternoon are released at 3 o’clock. And I don’t get home till 4.

So what could be done to improve that? How would it be better hours- wise?

Yeah.

Open later?

Yeah, I think if like, staying open a bit later or having weekend appointments. But they’ve got like an online booking thing. But there’s only like a few appointments released on that at any time. So I think maybe having more appointments available on the online bit. Cos that’s what I’ve been using to book my appointments rather than going in. Cos I can book them in school then.

Oh right.

Get —

So you can just get on the computer?

Yeah, and book it. So that’s a lot easier to book it. So I think there needs to be like more appointments available through that system.

More choice, more choice of times?

Yeah. Like when I’ve looked, it’s always been 10 o’clock on a Wednesday. I can’t do that obviously.

And does it say which doctor you will see? Or just the appointment and then you would see which doctor’s there?

Sometimes it says which doctor. But often it’s just one particular doctor that has online appointments. Like you don’t always have the same one every time. And if you want a certain doctor, it can take ages to get it on the online appointments thing.

So really it would, if they were open say till 8 o’clock or something like that, would that —

Yeah.

— be much better? Because you’re not missing any sixth form —

Yeah.

— lessons and —

If like, cos I sometimes revise or do my homework as soon as I get home so I can relax for the rest of the evening. That gives me time to finish off whatever I need to do. Go there, and then I can just go and sit in bed and watch TV.

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Peter was unsure what hours his local surgery opened and thought it was open at weekends too. He felt improving access for young people would include making it easier to get appointments, shorter waiting time in the waiting room, and more GPs as most surgeries are usually busy. Overall, though, he felt that his local surgery was good.

For Sophie it was important that patients were seen quickly. She sometimes felt that, when people couldn’t get an appointment for three weeks, they’d go to A&E instead. She thought that weekend opening could be helpful but that it was more important to improve the quality of care first.

When Sophie had mental health issues, getting an appointment was easier than finding a GP she could open up to. Good care is more important than extended opening.

Gender Female

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If you do need to go and see someone Saturday and Sunday, then it would be good to, but actually when you think about it, if you’reif you’re going to be waiting three weeks anyway, you can wait those extra two days, that kind of thing. But also I think in my case it wasn’t really a case of timing it. It was a case of the quality of it, and so improve the quality first before you extend the opening hours of a GP’s surgery.

That’s a really good point. So improve the quality?

Yeah, because otherwise I think the more you have the GP’s surgery open, if it’s not providing good quality care, then it’s just going to stretch it even more and make it even worse, and so there’s…that’s just a really kind of daft way to go about it, so make sureyou know, speak to the patients and speak to people who have been through the experience, and speak to how they feel. Do they want a seven day a week open GPs surgery. For me that’s definitely not my priority when it comes to improving GP’s surgeries.

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More medical staff

Auberon, like a few other people, would like to see more doctors and nurses at his local surgery so that people could get appointments when they need them and wouldn’t have to wait so long in the waiting room for their appointment. His local health centre operates as a GP surgery as well as a walk-in centre but is often very busy. Jal‚àö¬© felt that more walk-in centres would also be helpful and could take the pressure off GPs in surgeries. She often found it hard to get an appointment and sometimes had to wait for about three or four weeks. Rowan felt that it would be helpful when booking appointments if people could explain what was wrong and be selected a GP with expertise in that area. When he had ongoing stomach pains, he saw around ten different GPs, none of whom came up with the same diagnosis.

Auberon once waited 8 hours to be seen as a walk-in patient. The nurse speaks to every patient first and decides if they need to see a doctor.

Gender Male

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I think they could have slightly more nurses working in terms of a walk-in centre, because every time I go there, there was all the chairsit was like fifty chairs and they always used to be packed and people standing around, and it was always packed. So I think there could be less waitingfor most I had to wait for a walk-in centre was something like eight hours; eight hours.

Eight hours?

So, yeah, so I think there could be more nursing staff or to minimise the waiting time.

So some of the people could actually see a nurse instead of the GP?

Yeah, because it’s run my GP’s run by a it’s a nurse led clinic, so it’s run by nurses. So every walk-in centre, you get you would see a nurse first. And then if the nurse thought it was necessary, they would ask you to see a GP.

But on, at weekends, it used to be within the area if you’re within the age range. But, however, if you are a registered patient there you can go and see anyone you like really, depends on your appointments. But if you are just a walk-in patient who’s from a different surgery, then you need to go and see a nurse first, and then they will tell you what to do next.

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Rowan rarely sees his named GP. He’d like to be able to see a doctor who has expertise in the problem he wants an appointment for.

Gender Male

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And you mentioned that what you would like is, if you were phoning to have to make an appointment, to explain what the problem is, so that a doctor in the practice who’s more specialised in that particular problem couldyou could then see that…

Yeah, because I know lots of theand in fact I think it’s now on the practice website now lots of the doctors have extra qualifications in certain areas. Or have a particular interest in certain areas, or they provide additional services, or do minor surgery in certain areas. I think that would be really helpful.

Yeah. So you would prefer to see a particular doctor who’s more specialised in what’s wrong, instead of the same one every time, or how would you think?

I think that would be logical because I know you have a family doctor, you have your named GP but it’svery few are the times when I’ve actually seen my named GP.

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Private face to face appointments with GPs and private telephone and online GP services can also be used, though none of the people we spoke to had used these.

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