GP Appointments

Try dealing with this as someone with Chronic health conditions including cancer, CPTSD and undiagnosed autism. It takes all my human strength to avoid exploding with anger & frustration at the way I am spoken to and treated by medical staff and professionals. A lifetime of not feeling heard and then having to be an advocate for your own healthcare is utter torture. The toxic worship and culture of the NHS in the UK is incredibly unhelpful and unhealthy. 

That's exactly what I'm going to need to do.

I need to send a letter to the practice manager and drop the terms "Equality Act" and "Public Sector Equality Duty".

When I received my ASC diagnosis documents I went straight to my gp surgery and asked to speak to the practice manager about reasonable adjustments. She happily met me f2f that morning and agreed to my request to communicate in ways which work for me as an autistic person, plus some other matters around admin. So …

I no longer have to participate in the ridiculous 8am telephone circus, they allow me to correspond by email, I can request appointments this way and repeat prescriptions, I can discuss administrative matters but occasionally clinical too. She put an alert flag on my records so that all staff, admin and clinical, are aware of my needs. I can book appointments in advance at any point of the day either at reception or by email, (I’m not aware of others at my practice allowed to do this), I can get same day appointments without entering the competition with other patients on the phone and I can chose who I see. I have developed an excellent working relationship with the senior nurse practitioner so am getting continuity of care, she on average gives me 20 minute appointments but they flex as per my needs, the latest one was 35 minutes. She can do everything a gp can do, she prescribes serious medication without the approval of a dr and refers on to any clinic or specialist I need  

The benefits are huge and I’m getting treatment for conditions Id been unable to get help for for years. 

So my advice is take your diagnosis documents to your practice and request the reasonable adjustments which work for you. They are required by law to help us as autism is a protected characteristic. 

Good luck xxx

I am pretty sure that my GP’s phone based system is designed to prevent people getting face to face appointments. I spoke to one of the practice’s own nurses last year and she was scathing about the GP’s, saying they don’t pull their weight and don’t want to see patients.

That sounds like the system ours use but but only part of it. A lot of time is still wasted with phone calls. Hopefully more surgeries will use it as efficiently as that one day.

I like what my current GP is doing. They've got rid of making appointments by phone so no more 07.30am rush. Instead they have an online form where you log in via NHS ID and then write some short text of what the issue is and how you would like to be contacted.

They generally get back to you within a few hours. Sometimes a GP might ask follow up questions and you can respond by following a link in a text message. Sometimes a receptionist might advise that you need to see a GP, and they'll give you a link in the text which lets you select a time and a doctor over the next couple of weeks.

It's worked very well for me. I used to find it completely impossible to see a doctor, the phoning up was so hard, and they had a 5-6 week backlog and I generally just thought what's the point and didn't bother.

Now I have been seen quickly if it was urgent or been able to book a routine appointment without having to use the phone. I think it's allowing them to filter things out more without holding up phone lines, because lots of people can put in the requests at the same time and then the receptionists can go through them or have multiple people going through them.

With everyone phoning up it has to operate in serial rather than in parallel, so one request at a time and first come first serve.

Also not being time limited makes a massive difference. Instead of only being able to get an appointment if you call in the first 5 minutes, now you can use the text/website based approach at any time of the day, so I can just request the night before and then I'll receive a text response the next day.

This seems to be a problem for every one at the moment.  But what is an enormous irritation to most non-autistic people can be very traumatising to us.  Many of us find the phone too difficult to deal with and like you not being able to predict any closer than 10 hours is also a huge deal.  I do much the same; find myself unable to do anything other than sit there fretting about the call and scripting out what to say.

Yes, indeed you most certainly can ask for "reasonable adjustments" to the procedure in view of your autism.  Legally, the practice must make them.  Autism effects us all differently, of course and often practices do not just magically know which adjustments you personally need.  I would have a good think about which aspects of accessing your health care are causing you a problem in view of your autism and then write them a letter setting them out.

I would have thought it quite reasonable for you to e-mail the day before describing your symptoms and requesting an appointment for the next day with a time slot narrower than 10 hours.

The 8am scrum for a GP appointment is ridiculous and stressful. There has to be a better way. The current set-up, which appears to be national, only increases people's anxiety and makes them more ill. And then, even when you get through, there is a chance you will end up speaking with an abrupt receptionist who will make you feel worse for having the audacity to be ill and interrupt their day (I appreciate that this is not universal, and there are great & supportive receptionists in the world).

That sounds a very challenging experience. It seems all surgeries change their systems to try to improve things but they don't have enough appointments available.

Yes that waiting for a call is awful because you don't want to miss it. I thought the patient access was good because I could send a message, but had to wait 10 hours on a working day only to realize my callback fell on the second day of the possible callback time. Then when I had to book a follow up appointment they release appointments one day a week for the following week, then when that didn't work because they ran out it changed to same system but one week two weeks appointments and next none. If only we could book online, our surgery doesn't support that. I agree not at all autism friendly.

My GP surgery used to be the same. One had to phone up at 8am, to then be placed in a queue. Unless one was lucky enough to be first in the queue (rare), by the time one got to speak to the receptionist, all the appointments for that day would have already been snapped up.

When Covid came along, my surgery introduced an online triage system for patients able to access the internet. Via my surgery's website, the patient provides details of their symptoms. If it's decided the patient requires an appointment or treatment (i.e. a course of antibiotics), the receptionist will then e-mail the patient within 48 hours.

Patients unable to access the internet have no alternative other than to phone at 8am.

It has to be said that the receptionists at my surgery aren't always the most helpful. Previously, I have resorted to sending letters in the post to my "named" GP, as a way of bypassing the receptionists.

My one has a website on which you can cancel an appointment online.

Can't make one of course. But you are able to cancel one.

Stoopid.

Could not agree with you more. It’s no good for anyone but it’s like it was designed to torture autistic people.

And if that’s not bad enough, my local health centre hosts three different GP practices, and the other two allow people to book appointments using the Patient Access website.