Comment by hanoz | Hacker News Reader

Comment by hanoz | Hacker News Reader

It may be relevant and of interest to readers around the world to learn how we in Britain access the NHS, our envy-of-the-world National Health Service.

The main way is via your allocated General Practitioner (GP). To see a GP you need to telephone the GP's place of work, known as a surgery, and to have any chance of getting a same day appointment you need to call at 8am precisely. Don't call at 7.59 because you won't be connected, and don't leave it until 8.01 because it will be far too late. Call within the first few seconds after 8am and you'll be informed that you're in a queue, behind several dozen earlier callers.

After an hour of waiting you'll get through to a non-medical receptionist who will ask you about your symptoms, and make a judgement about whether or not you or your child is worthy of one of the few remaining appointments for that day. If you're a very pushy mother, or someone who really enjoys talking with GPs' receptionists (which most people don't) then you may have some success in this. If you're just a chilled out guy who doesn't like to fuss, you've got no chance.

You'll then be informed that to make an appointment for a later date you need to try again for a same-day appointment the next day by repeating the process above the following morning. It is not possible to arrange an appointment for any time further in the future no matter how long you are prepared to wait.

The only other means of accessing the NHS is by rocking up at the Accident and Emergency (A&E) department of your nearest large enough hospital. Unsurprisingly given the above, these are rather busy and you may be waiting for a day or so before you get seen. To avoid adding to this delay you should make you own way to A&E because ambulances routinely take several hours to reach you for the most urgent cases (heart attacks, stokes etc) or up to a few days for, say, a fallen elderly person, and on reaching the hospital you wont be able to leave the ambulance and enter the A&E department for up to another day.

However, once you're in the system and being seen by a specialist then by all accounts you do get fairly well looked after, so putting in the hours at A&E or regularly playing the GP telephone lottery may well prove worth your while if you wish to make use of our envy of the world NHS.

For what it's worth this is quite similar to my experience here in Sweden except:

- you speak to a nurse on the phone, not a non-medical receptionist (frankly, that sounds insane)

- the Vårdcentral (equivalent to surgery) prioritizes children in my experience

- your Vårdcentral is not allocated, but you can choose one. Some have better capacity, some have worse.

- there is another layer between Vårdcentral and Akuten in a hospital called Närakuten where you can go to get checked out. The waiting times are anywhere between 30 minutes and a couple of hours.

I would even guess that the British situation is not unique but the medical system is overloaded everywhere in Europe.. Most people I know, including myself pay for private care.

> The main way is via your allocated General Practitioner (GP). To see a GP you need to telephone the GP's place of work, known as a surgery, and to have any chance of getting a same day appointment you need to call at 8am precisely. Don't call at 7.59 because you won't be connected, and don't leave it until 8.01 because it will be far too late. Call within the first few seconds after 8am and you'll be informed that you're in a queue, behind several dozen earlier callers.

1) Genuinely baffling to see people who think their individual sucky experience is universal. What you describe is how your gp works. Change GPs! There are better surgeries around.

I called my GP after 12 midday and explained that I had turned a bit yellow and had pain under my right ribcage, and they booked me in for an appointment a couple of hours later, and after I'd send them they booked me into my local hospital's surgical assessment unit (thus bypassing A&E) where I was hooked up to IV fluids and antibiotics. I got scans that day, I got surgery the day after, I was discharged a few days later when the infection had clear and my numbers were better.

Same day appointments are for emergencies, and if you have an emergency you will get a same day appoint

> The only other means of accessing the NHS is by rocking up at the Accident and Emergency (A&E)

No, this simply isn't true. In this order depending on severity of illness, people can chose to get support from: NHS Website, NHS 111, Pharmacy, GP, Minor Injury and Illness Units, Emergency Departments, or Ambos.

Plenty of services now have self referral - podiatry, physiotherapy, dietetics, eating disorder, mental health crisis, antenatal, etc etc. So you don't have to go via your gp, you just phone them up and make an appointment.

I think this is a common framing because not everyone is aware that GPs are independent private businesses. We always refer to them as "part of the NHS" as if they were (or at least should be) equivalent to each other.

I think you may be suffering from some quite literal survivor bias.

Okay, I may have over-extrapolated for effect, after all some surgeries don't even have telephone queuing, you just keep getting the engaged tone and redialing until your call is finally answered at half past ten, to be told the same thing.

I don't know the exact circumstances of your case but it sounds quite likely you wouldn't have lived to tell the tale if you'd been registered with my GP.

I think you're overestimating the ease with which most people can swap surgeries, and you're definately overstating the extent to which your list of NHS hacks are a realistic prospect for most people, who by and large don't even want to bother thier doctor unless they really have to, and then when they really have to - they can't.

You missed one important entry point: 111 can refer you to an Urgent Care Unit. There are growing numbers of these in town centres and hospitals. It's basically an extra GP resource.

If your GP offers eConsult then you can also fill out a form online and your doctor will typically contact you the same day or the next.

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