GP Articles

Arranging an appointment at your GP surgery can feel challenging! You may find that you have to wait for the phone to be answered or take time to send an online consultation form, only to discover that the Care Navigators aren’t able to offer you the appointment that you want, and the next available appointment slot may seem like an awfully long time away. When you arrive in the waiting room, you may see a sign telling you that you should only discuss one thing with the doctor and make another appointment if you have multiple problems and you only have a minute slot to tell your story.

 

Many patients feel hurried by this short time frame, and it can be tough for the doctor too; in this short time they have to engage with the current problem, which may be complex, deal with ongoing conditions like diabetes, offer interventions such as how to stop smoking and listen out for a hidden agenda – the reason you might have come, but haven’t felt able to raise. So, it is no surprise that in the last year many practices have increased the appointment time to fifteen minutes; this means seeing fewer people per session but allows a bit more time to deal with problems properly. A current standard day now allows for 26 appointments, which is recognised as a safer workload than previously. Having said that, our duty team will often manage more than 120 patients to ensure that those who need to be seen urgently are able to do so. Across England there were almost 39 million appointments delivered in general practice in October 2024, with an average of 1.68 million appointments being delivered per working day. This is a significant increase from the previous month when there were 1.3 million appointments per working day. 38% were booked to take place on the same day and 70% were delivered face to face. In Tavyside, we had 6,463 appointments and 5,902 answered calls. Sadly, the increase in workload has not been matched by a transfer in the proportion of funding or staff.

 

 

Explain to the Care Navigator why you have phoned. This may include a bit of information about the condition you would like to discuss with the doctor. They are experienced and able to priorities your request as appropriate, particularly if your symptoms are serious. GPs are always able to see patients on the day should that be necessary. However, it may be that another member of staff is better able to deal with your needs: our mental health workers are here three days a week and have an hour to see each new patient to really give time to sort out difficulties. Likewise, the physiotherapists have 25-minute appointments to do a thorough assessment of newly presenting musculoskeletal conditions. Sometimes no appointment is required at all, and a quick administrative request can be easily sorted out by sending a message. It is important to remember that receptionists work within the parameters set out by the doctors, so it is not always possible for them to be able to give you exactly what you would like but will do their best to facilitate your appointment.

 

When you see a GP, they will start with an open question such as ‘what brings you here today?’ This is an invitation to tell your story. Evidence suggests that if you are allowed to talk uninterrupted for 90 seconds, you will be able to share the key details which will allow your doctor to make a diagnosis. This may be backed up with a few specific questions, an examination and some basic tests. Doctors are trained to listen out for ‘red flags’ that may indicate that you have a serious underlying problem, for example; if you say you’ve had unexplained weight loss or a new breast lump, expect further detailed questioning and urgent referral for investigations and a specialist opinion. Other diagnoses are made by recognising a pattern of typical symptoms that suggest a particular cause and then confirming the diagnosis with examination and tests. Don’t feel you need to be to be too clever. Some people will Google their symptoms, find a diagnosis and then mould their story to fit it but the ‘best historians’ just tell their symptoms as they are. However, if there is something specific that you are worried about then it’s fine to ask; ‘I’ve had tingling in my right hand and pain in my neck for the past week since I got back from a cycling holiday’, this may say a trapped nerve to the GP but if you are worried you may have multiple sclerosis, you should say, so this worry can be specifically dealt with. And don’t leave the most important thing until last as it will almost certainly be worthy of more than the minute of time that might be left at the end of the consultation!

 

When it comes to the examination, you need to be prepared to show the body part that you are concerned about. Nail varnish makes it impossible to examine for a possible fungal infection. It is time consuming to remove skinny jeans and high boots in order to have a rash on your calf checked out. It’s understandable for teenage girls with facial acne to wear makeup, however this needs to be wiped off before the appointment if severity of the condition is to be assessed appropriately. If you would like a chaperone for your examination then that can easily be accommodated. All GP surgeries offer chaperones, so if you would like someone with you for an intimate examination, you can just ask. Don’t feel you need to apologise; you may feel embarrassed, but your GP won’t. The most important thing is to be clear and open about your concerns so they can assess appropriately. If you prefer to bring someone with you for support or another pair of ears that is fine too. But don’t let them talk over you or interrupt. It is your story.

 

Bringing additional observations with you can also be helpful. You may have a blood pressure machine at home which have been using on a weekly basis and a record of these results is really useful. Likewise peak flow measurements, weight changes, blood sugars, the date of your last period or a list of allergies can also add valuable information if they relate to the problem you want to discuss. If you think you might have a urine infection, bringing a sample in a sample pot means it can be tested on the spot and a diagnosis and treatment plan offered straight away, with time left over for a medication review and a relaxed chat about your family. You’ll be in and out within fifteen minutes – sometimes that’s all it takes!

 

One final thing; please be understanding if your doctor is running late. Almost certainly this will be due to something beyond their control; there might have been a medical emergency, or an earlier patient may have been recently bereaved, or been told they have cancer. On those occasions it is important that a bit more time is spent helping them through a life changing moment.