Patients wait up to a month to see their doctor

GPs are struggling to cope with demand. Picture: John Moore/Getty Images
GPs are struggling to cope with demand. Picture: John Moore/Getty Images
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PATIENTS in the Lothians are having to wait up to four weeks for an appointment to see a GP.

An Evening News investigation has revealed a startling variation in waiting times at doctors surgeries across the Capital – ranging from same-day sessions to waits of up to a month.

One cancer patient who called Dalkeith Medical Practice for an appointment last Thursday was told the soonest she could be seen was April 3.

And as the British Medical Association warned that the problem was widespread, calls to several GP practices in the Capital revealed several were unable to offer an appointment for at least a fortnight.

The wide-reaching problem has become so bad, NHS Lothian – responsible for the 127 GP practices in the region – is carrying out a review of demand, capacity and patient access to services.

Scottish Government guidelines mean doctors have a duty of care to see or speak to patients within 48 hours.

Many surgeries offer a number of emergency slots so patients can either telephone first thing that morning or call into an open surgery and wait for the next available doctor. But anyone simply wishing to go in and see a GP for a lesser complaint will face a lengthy wait.

Patient groups have hit out over the “shocking” findings, which they say are putting lives at risk.

And medical professionals warn the situation is only going to get worse – with a shortage of doctors, the rising population and funding cuts being blamed.

Dr Dean Marshall, a partner at the Midlothian practice and former chairman of the British Medical Association’s Scottish GPs committee, said the situation has reached crisis point.

“The long waits are because we are incredibly busy,” he said. “Today, for example, we’ve had 37 people ring up this morning for emergency appointments and 28 house calls – these are in addition to the booked appointments for the day. Of them, ten have been seen and we’re dealing with 27 on the telephone.”

The News investigated how easy it was to get a pre-booked appointment at 25 GP practices in the Edinburgh region, phoning between the hours of 11am and 1pm yesterday.

Three practices were able to offer same-day slots and two within 48 hours. However, there were 12 which would see patients waiting three days or more, five that had no available appointments for a week or longer and three that could not see patients for more than a fortnight.

Most surgeries offered an alternative for anyone desperate to be seen the same day, although two said it would be a matter of calling back up to two days later for an emergency slot.

Margaret Watt, chairwoman of the Scotland Patients Association, warned excessive delays could put patients at risk as they could be put off going to doctors for vital checks.

She said: “It’s a very serious situation. People want treating when they’re ill – not four weeks later. How do they know that whatever the patient is ringing for isn’t serious or worse?

“It’s not the doctors’ fault, they are under a great amount of pressure but the government needs to do something as they’re not getting the mix right. Early diagnosis is crucial for so many illnesses but if people can’t get an appointment, it will put them off and people will fall through the net.”

Lothian MSP Sarah Boyack said the health board must work with the Scottish Government to improve things.

She said: “GPs are the first port of call when people have health concerns and it is totally unacceptable that it is taking up to four weeks to be seen. Many people delay going to see their GP in the first place. In the case of cancer, early treatment is a key factor in survival rates so the length of wait can be crucial.”

The British Medical Association – which represents doctors including GPs – said there was huge pressure on GPs.

In Scotland, there are 16.2 million GP consultations every year, with patients having contact with their GP an average of 4.4 times in a year. A spokeswoman said the average practice list size was 5000 and going up annually with the rising population.

Individual GP practices are responsible for managing their own patient list sizes and ensuring their patient numbers are manageable but this calculation often depends on the make-up of the local community. Those with an older population will often see patients in their home, taking a doctor out of the surgery for a couple of hours rather than the usual ten minutes allotted in a surgery.

Other surgeries will not allow patients to book an appointment at reception – but instead have to wait for a doctor to call them that day and determine if their condition requires that they see a GP. A BMA spokeswoman said: “There’s a lot to be done to try and manage demand but we do need to invest in making the whole range of services better to make sure we can meet the needs of the population.

“Better signposting would help in the first instance, with people referred to a pharmacy for example where appropriate, but not all patients will want to disclose to a receptionist why they want to see a doctor.”

A Scottish Government spokesman said the number of GPs in Scotland has increased by 5.7 per cent since 2006, with more GPs per head of population than in England.

“We have successfully negotiated a general medical services contract for 2014-15 which will substantially reduce targets and bureaucracy for GPs, allowing them more time to focus on their patients, and this includes a review of patient access by each GP practice.”

Professor Alex McMahon, director of strategic planning for NHS Lothian, said all patients were entitled to good access to doctors, despite the growing population.

“Patients should be able to see or speak to a doctor or nurse within two working days and NHS Lothian is committed to ensuring that access remains available, despite recent increases in population, especially in Edinburgh.”

Postcode lottery

Earliest non-emergency appointment offered at GP practices called yesterday.

• Stockbridge Blue Practice: next day.

• Eyre Group Practice: nine days.

• Inverleith Medical Practice: three days.

• Leith Walk Surgery: 12 days.

• Leith Mount Surgery: four days.

• West End Medical Practice: 22 days.

• Restalrig Park Medical Centre: four days.

• Gilmore Medical Practice: five days.

• Meadows Medical Practice: three days.

• Marchmont Medical Practice: same day.

• Muirhouse Medical Group: three days.

• Dalkeith Road Medical Practice: four days.

• Murrayfield Medical Practice: four days.

• Morningside Medical Practice: 14 days.

• Davidson’s Mains Medical Centre: three days.

• Craigmillar Medical Group: three days.

• Inchpark Surgery: 21 days.

• East Craigs & Parkgrove Medical Practice: three days

• Cramond Medical Practice: same day.

• Liberton Medical Group: three days.

• Oxgangs Path Surgery: seven days.

• Colinton Surgery: next day.

• Sighthill Green Medical Practice: same day.

• Inveresk Medical Practice: 11 days.

• Pentlands Medical Practice: next day.

ANALYSIS

By Ian McKee, Former GP in Wester Hailes and former SNP Lothian MSP

It’s true there is increasing demand in the health service and a shortage of GPs, but I was shocked to hear people were being told they would have to wait four weeks for a GP appointment.

If you want to see a specific doctor and she’s part-time or on holiday, I could envisage a situation where you might have to wait four weeks to see a named doctor.

But a practice that made you wait four weeks to see any doctor should be in trouble with the health board because they would not be fulfilling their contract.

Practices have an obligation to deal with emergencies and to see people within a reasonable time.

You try to give people an appointment within 48 hours, although it depends on the request – people might want to see a male doctor or a female doctor, or specifically Dr X or Dr Y, or someone who specialises in this or that.

But making people wait four weeks for an appointment is totally unacceptable.

Any practice doing that should be reported to the health board.

Neil accused of hypocrisy over cash for private care

IAN SWANSON

Political Editor

HEALTH Secretary Alex Neil has been accused of hypocrisy after giving NHS Lothian £540,000 to pay for patients to be treated in private hospitals – just weeks after speaking out against the practice.

Mr Neil said in January that using the private sector to treat NHS patients in a bid to meet waiting time targets should “not be the norm”.

But now it has emerged that a few weeks later NHS Lothian was given the additional £540,000 – to spend within six-and-a-half weeks on increased use of independent hospitals to ensure more patients were treated within the Scottish Government’s treatment time guarantee, which gives a legal right to treatment within 12 weeks for many inpatient procedures.

Correspondence released under Freedom of Information shows NHS Lothian chief executive Tim Davison and chairman Brian Houston welcoming extra cash to “procure additional independent sector support”.

Labour health spokesman Neil Findlay said: “The hypocrisy of Alex Neil beggars belief. He publicly states that NHS boards must reduce the use of private sector healthcare, meanwhile behind closed doors he endorses the use of extra funds for NHS Lothian to utilise the private sector to help meet waiting time targets.

“Health boards wouldn’t be in the position of going cap in hand to the government if their resources hadn’t been cut in the first place.”

A Scottish Government spokeswoman said Mr Neil had made clear that health boards were expected to do all they could to ensure the private sector was only used “in exceptional circumstances”.

But he added: “He has also recognised there will be times where it is not possible for the patient to be treated by the NHS within a reasonable timescale.

“We have provided NHS Lothian with an additional allocation to support it until the end of March while it puts in place additional internal initiatives and gear up towards investment in additional staff and theatres.

“This is a short-term approach designed to help alleviate waiting time pressures at the health board.”