As always when the subject of GPs comes up on the forum, we all seem to quote what happens at the particular surgery we belong to as if that was some sort of "standard" pattern. In my experience, all parts of the NHS work very differently, depending on how local medics prefer to work.It sounds to me that all the practices we belong to are arranged quite differently. As far as I am aware, there's nothing to stop a practice employing more nurse practitioners to alleviate waiting times - except this would come out of existing fees and the "owners" of the practice would each receive less money. At least one local practice is run by nurses and they have more money available for staff as the principals earn less than GPs would. The government sets strict guidelines about how much GPs are paid per patient and how many patients they can have. Regarding Did Not Attend (DNA) problems, I worked with the NHS at a cluster level a few years ago and was amazed at how badly stats were collated for these. For example, about 8 years ago, Ealing Hospital installed a new Patient Admin System and, as a result of teething problems with new PCs, a huge amount of appointments had to be rebooked manually. This was no more than a clerical exercise, however, each person affected was recorded as a no-show and a stroppy letter was issued to each of them as well as their GP. This is not unusual but the NHS had no means to amend the figures, so it looked like our local population had had an unruly year.When I see my dentist, I understand that she will see me as close to my pre-arranged time as possible, and delays will almost always be out of her control. Conversely, when I attend the hospital, a huge amount of people seem to have been given the same time-slot and no one knows when they will be seen. When I have asked consultants why they do this, they say that it maximises the efficient running of their unit and means that whether they are running fast or slow on any particular day, their time is used fully.I believe that people don't attend their appointments because there is consistently so little relationship between the time they arrive and the time they're seen by a medic. The dentist's approach is more customer focused - yes she charges on an individual basis but, more importantly, she is aware that my time is just as valuable to me as hers is to her.We have already paid for this service, I do not wish to pay for it again.
Phil Kay ● 4288d