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Comment by lucaspiller | Hacker News Reader

> More simply want better customer service than British GPs tend to provide, with their brief consultations and frustrating systems for booking appointments

I can definitely sympathise with this, although it isn't a UK wide problem. My local surgery (in a remote part of the country) consists of a couple of GPs who both know me personally and making an appointment involves a quick phone call (and chat to the receptionist who I also know personally).

When I was living in London it was completely different, getting an appointment involved phoning up the surgery the morning you wanted an appointment and hopping somebody hadn't done so before hand so they had space. There was no way to book an appointment in advance. It was easier to go to an NHS walk in centre, wait for a few hours, see a nurse, and have them refer me to A&E to see a doctor if need be.

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One thing that's quite improved it in Denmark is that a company came out with a whitelabel hosted-health-portal SaaS product (http://www.mithelbred.dk/) that has really caught on. Doctors can sign up with it and reskin it on their clinic's website, and the product handles the backend interaction. You can book appointments, cancel or move them, send/receive notes to the doctor (if you have a question/worry but aren't sure you really need to go in person), check and renew prescriptions, etc. There are even mobile apps! They claim to have >50% of all doctors in the country signed up with them. I think it's caught on to such an extent because from the doctor's perspective it lets them outsource the patient-management / administrative part of their clinic's work for a price that's lower than it'd cost to do in-house, and the fact that patients now get some online convenience is just an added bonus.

Not entirely related, but UK's NHS holds a crown for (probably) biggest IT project failure ever. It took 11 years and £9.8b to reinvent patient record system.

At least they can finally sell the patient history to third parties.

"At least they can finally sell the patient history to third parties"

Not sure your sarcasm is all that clear. To those not aware the UK government is passing this off as a way to improve your care within the NHS via centralised records. They have made it opt-out and have sent out a confusing leaflet that leads the reader to believe their care will suffer if they opt-out of selling patient records.

Records are already centralised within the NHS. What is happening is the government is setting up a free for all with easily de-anonymised records being sold off to third parties (read: private health providers and insurance companies).

Wasted £9.8b must be related to the state of the NHS, and so to the article, too.

GPs in London seem to be at breaking point. I move house every year, staying in the same area, but even though it's only a short walk from my current flat to my old one I no longer fall within the catchment area of my GP. In fact, I am right on the edge of the catchment area of my nearest GP! My local A&E is absolutely swamped with people going straight there instead of even bothering with their GPs. You get told off for doing that but at least you can see someone.

the problem with A&E is that its used as a dumping ground for a lot of problems that would have been handled else where.

I few years a go i got sent as an emergency admission to our A&E and there where kids with sprained ankle that woudl have been seen by the school nurse a few yeas ago - but due to cuts schools dont have their own medical staff at all and just clog up A&E

I agree that A&E is stretched, but:

- A&E is meant to cover accidents and emergencies. Spraining an ankle is (usually) an accident.

- Is there an argument (based on efficiency or something else) for schools to have their own medical staff, over and above some proportion of teachers trained in first aid, and maybe a full-time person to make decisions on next steps for more complicated cases?

No schools in the UK are gaming the system to maximise the outcome, a school nurse doesn't help get a nice but dim kid get a grade C in English and Math. Uk Schools put all their effort in turning D's into C's

So they just dump the cost on the NHS

Very true - this is still the case now. The added an "Urgent Care Centre" to our local hospital to absorb people coming in because their GP was overbooked. They're really good though to the point people just go down there straight away rather than going to their doctor. You can get in and out within an hour with a prescription handed over to you with no prior appointment.

Ultimately, the GP should disappear and more of these centres tied to the hospitals should appear. They are more than walk-in-centres as well at which they are sometimes limited to what they can prescribe. Our local walk-in-centre can't even prescribe antibiotics or provide any help to anyone under the age of 3.

I have to book appointments with my GP a week in advance unless it's urgent.

Last time I visited I was told to get a blood test, I had to book that a week in advance as well.

When I was a child, my GP (in South London) didn't have an appointment system. You just showed up, took a number from the hook, and waited until your number was called. You would always be seen the same day if you showed up before closing time.

When I went to university (in another town) I registered with the GP surgery recommended by the college. When I had occasion to use their services, I was _shocked_ to discover that (i) I had to make an appointment and (ii) I would have to wait a week to get one.

I was recommended to see the college nurse (who, if I recall correctly, was unable to prescribe medication). I ended up going back to my parents' home in London for almost a week. I got better, but it would have been quicker and less disruptive if I could have just seen a doctor and got some medicine soon after I became sick.

At the UCC in our local hospital, we get same-day blood work and imaging done and a call back from a doctor when the results come back in.

Screw the GP's week lead time. It's about time we stopped funding their mismanagement if you ask me.

(Disclaimer: I spent a lot of time in my life working at GP's as well and they are inefficient and incompetent as a rule to say the least).

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