A couple of months ago the health secretary, Wes Streeting, rolled out his latest master plan to save the NHS. From 1 October, it became compulsory for all GP practices in England to offer the online option for patients to request non-urgent appointments or medical advice throughout core working hours (8am to 6.30pm, Monday to Friday).
The doctors’ union might not have much liked it, but it made sense to regular punters like me. It seemed like a common sense means of avoiding the maddening early morning scramble for the few available appointments, hanging on for an age, only to be told all the slots have gone. Or worse, just have the phone go dead on you.
Who wouldn’t prefer filling out a form in relative serenity? And, of course, it was just an option. The NHS made it clear that those who struggled with literacy or forms, or didn’t have access to the right technology, could still phone. So it seemed like the best of all worlds.
Only Streeting hadn’t bargained for practices misusing the system.
A few days ago, I started getting typical winter flu symptoms. I have a history of flu turning into bacterial pneumonia, and on one occasion sepsis. A course of antibiotics tends to knock it on the head early.
I dutifully filled in the online form because it has always been a nightmare getting through to the GP. I explained my history – chest, pneumonia, sepsis. At the end, I discovered I had been triaged by AI and it had decided not to refer me to the GP. I was told that my request for an appointment would be going no further and I had to talk to the GP directly. It explained that the symptoms I described sounded potentially dangerous. “We can’t safely assess your symptoms through this online request. You need to talk to somebody today instead,” the AI triagist replied in the name of my GP practice.
It seemed to make sense. After all, the form is primarily for non-urgent cases, and it had decided mine could be serious. But I didn’t realise I was trapped in a catch-22 at that point.
I did what I’ve always done before the introduction of the online system. I phoned the practice.
Me: “Hi, could I make an appointment with the doctor please? I think I have a chest infection.”
Receptionist: “You have to fill in an e-form. We are no longer making appointments by phone.”
Even the language was alienating. God knows how I’d cope if I was much older or struggling to make sense of the digital world.
“I have filled in the form. It rejected me, and said it wouldn’t pass on my complaint and I had to speak to the practice directly.”
“Sorry, you need to fill in the e-form to get an appointment,” she repeated.
I explained that meant it was now impossible for me to get an appointment if the online form rejected me as too serious and the practice simply didn’t want to know unless it was via the form. As Kafkaesque vicious circles went, it was up with the best of them. If I’d not felt so bad I might have found it funny. Briefly.
But I was one of the fortunate patients – I knew the form was an option, not a replacement, and I was gobby enough to say so. Disturbingly, the practice website said that urgent calls as well as routine calls had to go through the online system. An FAQ document from NHS England states that the online “consultation tool” was primarily for “non-urgent appointment requests, medication queries and admin requests”.
The NHS acknowledges that sometimes, practices might choose to refer urgent cases through the form, “but patients with urgent needs should still call their GP practice or attend in person”. Dr Amanda Doyle, the national director for primary care and community services at NHS England, said: “This is unacceptable – GP practices must keep their premises, telephone lines and online consultation tools open from 8am until 6.30pm, as part of their contractual requirements.”
I’m sure most GP practices will abide by the founding principle of the online form being a) an option and b) mainly for non-urgent appointments. But for those that don’t, the impact will be deadly. The NHS must clarify its position that the online booking system is an option, an extra choice, and that it is meant for non-urgent appointments. Practices that tell patients it is a replacement system must be penalised.
Share your experience
Have you had a similar experience? If so tell about it in the form below.
Your responses, which can be anonymous, are secure as the form is encrypted and only the Guardian has access to your contributions. We will only use the data you provide us for the purpose of the feature and we will delete any personal data when we no longer require it for this purpose. For alternative ways to get in touch securely please see our tips guide.
If you’ve been asked to only book a GP appointment via an online form, please tell us about it here
Please include as much detail as possible.
If you are happy to, please upload a photo of yourself here Optional
Please note, the maximum file size is 5.7 MB.
Choose file
Can we publish your response?
You can add more information here Optional
If you include other people’s names please ask them first.
By submitting your response, you are agreeing to share your details with us for this feature.
Submit
Show more
In the end, because I was a pain in the arse, I got my face-to-face appointment. The receptionist said she would make an exception for me. Which made me more furious than if they’d simply turned me away. After all, doctors are now contractually obliged now to provide patients with access through three routes – online, via phone and in person.
The doctor looked delighted when I told her that the new system was disastrous. She couldn’t agree more, she said. I told her why it didn’t work for me and how the practice was misusing the system, but before I finished she appeared to have lost interest and was gesturing me to the door. I asked her why she thought it was disastrous. “We’re getting too many referrals,” she said.
Just before this article was published, the surgery got in touch to tell me that it was amending its website to make clear that patients can still make appointments by phone or in person.
