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The problem with GP waiting times is something that is spoken about in the press a great deal, but until someone experiences it first hand, the reality of what this problem is having on those aiming to get appointments is purely statistics. For example, a study published in August 2018 found that one in four patients have to wait over a week to see a GP, while another found that the average wait for a routine appointment is two weeks, with emergency appointments being resorted to instead. Emergency appointments are appointments that are released early in the morning for the same day, which are booked on a first come, first served basis.

This is my experience of the current problem. Having recently joined a new practice, I enquired how long it would take to see a GP for a routine appointment and was told that they had none for the next three weeks. I was told that appointments are released at 8am every weekday for that day only. From this conversation, I took away that if I needed an appointment I would either have to wait three weeks or make sure I was free at 8am to either phone the surgery or go online to book an appointment. I would then get an appointment that same day; as long as no one else got their first, of course.

This has got me thinking – what effect is this having on people who are probably in an emotional state to begin with? I doubt anyone likes going to see a GP, but surely the stress to just get an appointment to see one is one thing that patients could do without? It is causing unnecessary stress in a potentially already very stressful situation.

Problem 1: Stress for the patients


To illustrate this point, take this for an example; if someone has not had good experiences with doctors in the past, it may take all their courage to pick up the phone to make an appointment; to actually admit to themselves that they need to see a doctor. They psych themselves up and replay the conversation they will have with the receptionist over and over in their head until they have thought of their answers to every possible question the receptionist may ask them. They have also thought of every scenario when they see the GP, every part of them is now ready to do this, to take control of the situation and deal with it. They phone the GP surgery and are then told that everything they had thought would happen cannot, because it is going to take a week or two (or maybe even more) to be able to book an appointment. That person then has to go back to square one in their mind, and start the mental process all over again. The adrenaline they had to make the phone call in the first place turns their emotions to feelings of despair. To enable them to obtain an emergency appointment, what if they are at work at 8am on a weekday? What if they are on the school run at that time and can’t be on the phone, in a queue, waiting to get an appointment? What if their internet isn’t working to be able to book an appointment online? Also, what if it does not warrant an emergency appointment, but the waiting would cause undue stress none the less? These are all potential consequences of not being able to do the seemingly straightforward task of booking a GP appointment.

For some people, this whole situation is just something they have to put up with. But to others, I’m sure it causes stress on top of whatever problem they are already having which is the reason why they are trying to see a GP in the first place. Stress could be an unnecessary result of this situation, as one cause of stress is when someone feels like they are not in control of their life. This in itself can cause its own problems as the mental and physical effects of stress include:
  • Constant worrying
  • Difficulty concentrating
  • Racing thoughts
  • Difficulty making decisions
  • Headaches
  • Sleep problems
  • Tiredness
  • Eating too much/little
  • Muscle tension/pain
  • Dizziness
So on top of someone already having a reason to want to see a GP, they also potentially have to cope with the effects resulting from the stress of getting an appointment. But surely there are solutions? Well, yes there are, but not ones that have been put into practice yet. Alongside GP waiting times being spoken about in the media, extended GP waiting times are also spoken about a great deal. In January 2017, Prime Minister Theresa May declared that she would push ahead with the seven-day GP surgeries, but over 18 months later there seems to have been nothing done about this. Extended waiting hours may seem like the perfect solution, but what about the mental health of the GPs? Is this not just moving the problem from the patients onto the GPs?

Problem 2: Stress for the doctors


Doctors work long hours, helping patients in times which can be incredibly emotional and frightening. By putting more pressure on them to work even longer hours to keep up with the demand will only fuel this already stressful job. Back in 2016, 90% of GPs already found their job to be stressful, and last year it was reported that there were rising levels of GPs seeking treatment for substance abuse as a result of trying to keep up with their demanding workloads. So surely the pressures GPs are under will result in them quitting? Well, yes; a survey this year reported that many GPs have expressed plans to leave the profession in the next few years, largely due to the pressures they experience from their increasing workloads. So I ask the very important question of why isn’t anyone doing anything about this? If this was a hospital and all of the doctors were thinking of leaving, there would be uproar. GP surgeries are just as important; if they were not open, then A & E departments would be experiencing even more problems than they already are. This should not be something that we just put up with either. Not when the effects of the problem (waiting times) is affecting both the patients and the GPs. It seems like we are currently stuck between a rock and a hard place.

Is there a solution?


So is there a solution? Well, there are ways of dealing with the symptoms of the situation this leaves society in; there are ways of dealing with the stress it causes:

  • Practice mindfulness to reduce stress and improve your mood
  • Use calming breathing exercises
  • Share your problems with family and/or friends
  • Make sure you get enough sleep
  • Take regular exercise
  • Eat healthily
  • Take a break or a holiday

However, these ways of dealing with stress are only ways of dealing with the problems the situation could cause, it doesn’t actually deal with the root cause of it. In my opinion, GP waiting times are actually contributing to the ill health (both physical and mental) of individuals by creating unnecessary stress; those individuals being the GPs as well as the patients they aim to help. There is also the very real possibility that people will not bother seeing their GP altogether because of it, which is quite frankly an awful consequence of the situation we live in today. Not everyone has the luxury of being able to turn their back on the NHS and use a private provider, but I’m sure it looks like the ideal answer to ease the saturated GP surgeries. And surely this is only going to get worse? Not only are GP waiting times affecting the mental health of those patients trying to see a GP, but it is also affecting the mental health of the very health providers that deal with this problem every day. Something needs to change because this can’t go on like this; the nation-wide task of patients getting an appointment to see a GP is causing more problems than it aims to resolve.

Sarah Keeping MBPsS MSc PgDip GDip BA (Hons)

Follow Sarah on twitter at @SKeeping_Psych

Hyperlinks:


https://www.independent.co.uk/news/uk/politics/theresa-may-seven-day-week-gp-surgeries-jeremy-hunt-nhs-hospitals-accident-and-emergency-a7526951.html

https://www.nhs.uk/conditions/stress-anxiety-depression/understanding-stress/

http://www.pulsetoday.co.uk/news/gp-topics/access/pressures-force-gp-practices-to-halt-routine-appointment-bookings/20036756.article

https://www.telegraph.co.uk/news/2018/08/09/doubling-long-waits-see-gp-record-pressures-ae-revealed/

http://www.pulsetoday.co.uk/news/hot-topics/war-on-workload/stress-leaves-one-in-four-gps-unable-to-cope-once-a-week/20036724.article

https://www.theguardian.com/society/2016/aug/11/nine-in-10-gp-practice-staff-work-life-stressful-poll-mind

https://www.independent.co.uk/news/health/nhs-doctors-substance-abuse-stress-burnout-rising-gps-addiction-health-service-bma-clare-gerada-a7805571.html

https://www.telegraph.co.uk/news/2018/08/08/patients-may-walk-away-nhs-long-gp-waits-britains-leading-family/

https://www.independent.co.uk/news/uk/home-news/gp-shortage-nhs-leave-doctors-pay-hours-a8376266.html