Struggling to see your GP?

Jane is a GP, a breast cancer survivor, and we're lucky to have her on our trustee board. Here she's sharing some advice on how to get medical help when you're struggling to make contact:

Long waits for GP appointments have been hitting the headlines for months now, with many patients understandably frustrated and angry by the situation. 

As a GP, I know we are trying our best to keep up, but it’s becoming increasingly difficult. (For more on the context of this - see below.) 

I also sit on the other side of the fence, having gone through cancer treatment myself. I know the slightest symptoms can cause anxiety, whether that’s at the start of the journey or years after remission. When we are being encouraged to report a cough or blood in our wee, it’s tough to be met with brick walls. That’s why I want to share my tips for navigating the system.

What can you do? 

• First: Persevere: Don’t feel that there is no point in reporting symptoms - these are still potentially serious symptoms and do need to be reviewed and possibly investigated.
• Triage - Don’t be put off if you are told that you’re being put on a triage list for a nurse or doctor to call you back. Triage is a way to make sure people are getting the correct response to their problems. Because of the way surgeries are structured, it may be more appropriate to speak to the clinical pharmacist or practice physio in certain situations. This can even speed up the process of getting seen and sorted.
• Convey urgency to receptionist - If you feel the problem is urgent, for example, you are in a lot of pain or passing a lot of blood, make sure you convey this to the receptionist. A lot of surgeries will have coded the notes of patients who have cancer so that a ‘pop up’ will prompt the reception team to expedite help. This doesn’t contain any confidential information, but it lets them know that the patient may need urgent contact with a medical professional. 
• E-Consult Applications - Some surgeries now require patients to complete e-consult applications to make appointments. I have used this from the patient’s side and I know there are quite a few questions to click through. If you find this difficult then ring the surgery, but otherwise these e-consults can provide a quick response - and get prescriptions sorted out quickly.
• Duty Doctor - If you feel the appointment offered to you is too far away, ask if you can be seen by another doctor sooner. It may be that there are certain doctors in the practice who are part time and so the wait to see them is greater. 
• Your own doctor who you might have seen for years won’t be offended if you’ve opted to see someone else at that time. You can ask to speak to the duty doctor, who has appointments available sooner.
• Contact your hospital team - If you are in the middle of cancer treatment and need help, make sure you have the numbers of your specialist’s secretary, specialist, nurse, or your chemotherapy suite. It may be that they can answer your question more quickly and they are used to all sorts of things that happen during treatment. If they can’t help you, they will often contact your surgery on your behalf to leave a message for the doctor to get in touch with you.
• Community pharmacists can be invaluable - if you are worried about the medication you are on or potential side effects then speak to your pharmacist. They have a wealth of knowledge and they too can get hold of someone at the surgery if you need further help.
• People want to help - Remember that although services are under pressure, people do want to help. Know it’s totally OK to share your worries and share exactly what’s on your mind. You won’t be judged!
• 111 - If you really cannot get an appointment, and for those who feel defeated by the whole system, it may be worth calling 111. It might not always prove useful, but the 111 team can get in touch with your GP if they feel necessary.
• Changing GPs - In some areas, you can change your GP practice to others close by. Some practices, particularly in London, take on new patients even if they don’t live close by.  If you feel communication has really broken down, you could take a look at what other GPs are available. 

And here’s some tips from our Community:

• Building Relationships - Start as you mean to go on with admin staff, doctors and nurses. Set out to build really positive, supportive relationships. Doctors’ receptionists, for example, get a really bad reputation, which isn’t always justified. It’s important to stay calm when talking to them, while also sharing your concerns. Try keeping people on side as much as possible. Take deep breaths, try seeing their perspective (many of them are feeling stressed right now), and work with them to find a way forward together. Here’s a post on things you might think about when worried about symptoms and choosing the right GP: www.mission-remission.com/The-Fear/Aches-Pains
• Emails - If you get to know a GP who you feel you have/ could develop a supportive relationship with, do ask for their email. It might feel a bit forward, but loads of people here at Mission Remission have their GP’s emails - it is massively helpful for communication. Note from Jane: Please don't rely on emails as a means to communicate with GPs - we get so many of them that I really worry about the possibility of important information being missed If it's important ALWAYS get in contact with your GP through phone too. 
• Go in Person - If you’re finding it difficult to contact people online or through phone lines, it might be easier to convey the severity of your symptoms if you’re in the surgery. It can make you feel vulnerable asking for help, so try to state as clearly as you can what the issue is and what help you need.
• Family/ Friends Support - It can often feel like you’re ‘making a fuss’ when seeking medical help, particularly if you have to make quite a few calls. Your support network could play a significant role here, taking on the task of liaising with GPs and finding you an appointment. 
• If you have a spare £100 (!) - Last resort, and if you have spare cash (we appreciate how hard times are!), you could book a private GP appointment. There are lots of options available online, but always check the reviews first. Private GPs can also refer in to NHS treatment. 
• Writing a Letter - We’ve heard from quite a few people who write letters to their GP so that admin tasks are followed up, or appointments are made. One lady we heard from was diagnosed with cancer after writing a letter about her symptoms - old fashioned communication still works! 

Why are we in this position? 

Before the pandemic, surgeries across the country were struggling to meet demand, as patient lists grew and the number of full time GPs declined. When covid hit we started doing more regular phone appointments, in an effort to protect vulnerable patients. The vaccine push from December 2020 also put increased pressure on GPs, as we attempted to vaccinate people in the community and take care of our patients. 

Fast forward to 2022, and the impacts are still ongoing. Those people who were understandably afraid to go to the GP when the virus first hit are now presenting to us for the first time, along with patients who have more recent onset of symptoms. In addition, we’re playing catch up on routine tests, many of which were cancelled during the worst of the crisis.

In the past our healthcare services have run on the goodwill of professionals who want to make a difference. But as we emerge from the covid storm, many GPs are feeling burnt out and exhausted, meaning this goodwill is starting to run dry. Instead of staying on a few extra years, many GPs reaching retirement age are leaving, while younger doctors are looking for alternative employment. 

As we continue to move forward from the impacts of lockdown, I’m hopeful the situation will settle down. In the meantime it’s important that you don’t ignore or try to minimise your symptoms, no matter how busy you feel the surgery is. Whether you’re experiencing bodily changes, you’re suffering from cancer or another condition, it’s important that you get the support and treatment you need as soon as possible.