What are they queuing for?

Queue outside Sunbury GP

That queue at a Sunbury GP

Newspapers know how to build a story around a picture.  At times irresponsibly, sometimes showing what we need to understand.

The one of the queue outside the GP has done the rounds, and does show the reality outside many practices at 8am.  Even if few are standing outside the door, many more are trying to get through on the phone.  Inside, a battered team of receptionists is handling as many as they can, and failing to keep up.  We’ve seen call abandon rates of 40% and even 80% in a morning.

So what are those patients queuing for?  We might hope that politicians would try to understand, because a queue means desperation, and that must mean votes.  Let’s look at recent policy initiatives and manifesto pledges and see how they match up.

  1. Are they queuing to come in at weekends?  No, everyone we’ve asked has had to coax people to come on Saturdays, still more on Sundays, leaving GPs underused and wasting resources.
  2. Are they queuing to come at 8pmNo, the problem is 8am.  Evening surgeries are often underused, or “the usual suspects” turn up because it was the only time available.
  3. Are they queuing to come in the next 48 hours?  No, given a choice over 90% of them want to be seen today.  48 hours is too late.
  4. Are they queuing because it’s an emergency?  No, only 1 in 200 calls to a GP is a medical emergency.  Patients may talk it up to get in, or it may become urgent, but that’s not why they started out.
  5. Are they queuing because they are under 75 and fear being sent to the back?  Not yet, but there’s no general clinical rule that the over 75s are always more urgent than the rest.
  6. Are they queuing to be able to book online?  No, they can book online already, but it doesn’t work, there’s nothing available when you want it.
  7. Are they queuing to see their records?  No, it’s a good thing but they need encouragement, not holding back.
  8. Are they queuing to order repeat prescriptions?  No, another good thing but take up is slow.
  9. Are they queuing because they want a Skype call?  No, the only study I’ve seen shows take up of 3%, and saves no time for the GP.  Secure video may have a place, but it’s still synchronous and harder to organise than a telephone call.

Well intentioned as they are, the policies miss the problem.  They champion the idea of a named GP, and a good thing too, but they have no idea how and the drive for longer hours makes it harder.  (See “Continuity, the myths and maths.“)

So what are the people queuing for?

They want to see their GP, today, now.

It’s a testament to the success of NHS primary care, the registered list, local, highly qualified, highly trusted GPs, universal and free to patients.

It’s also a testament to systemic failure to understand demand.

No politician has understood the system problem and how to tackle it.

I have a dream, where patients are able to access their GP, by name if they wish, and get help whenever they need it.  The GPs and practice teams love their work, feel in control and have time to think and to care.  We are making this a reality – do join.

Harry Longman

Founder, Chief Executive
GP Access Ltd

PS  Running the London Marathon tomorrow, number 27471, charity MSF, wave!


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