I have written to the Practice Manager of the Over Wyre Medical Centre following concerns over lengthy delays for appointments.

I am grateful to the centre for their swift response below. Please get in touch with me if you have any further concerns. 

Dear Cat,

Thank you for your letter reference the appointment situation at Over Wyre Medical Centre and rest assured this was an issue we were already in the midst of correcting.

I apologise unreservedly that many of our patients had to wait longer than usual for a routine appointment over the last couple of weeks.  You will appreciate that it is important to ensure that there is sufficient capacity across the system to manage the expected surge in demand over the winter period, including Christmas and New Year, and that General Practice is part of the wider system. It is vital that each part of the system plays its specific role in order to minimise undue pressures on any one part of the system, particularly in A&E.

To support the Fylde Coast Winter Plan, Over Wyre Medical Centre has followed the recommended guidance and conducted an urgent appointment baseline assessment.  The outcome of the assessment was that we reserved more appointments for same day urgent slots during the month of December to ensure we had capacity to deal with the increase in demand on the run up to the Christmas and New Year period.  A corollary of this is that it meant there were much less routine appointments available than usual for patients which had the unintended consequence of increasing the wait time for routine patients.

It is accepted that we probably misjudged the balance and reserved too many appointment slots for emergency access to help deal with capacity over the winter period and we have subsequently released a large number of these slots to revert back to routine slots which should help address the situation.

We accept that we must ensure patients have confidence in the availability of primary care services over the Christmas and New Year period. The great news for patients is that the Doctors have subsequently put on more additional appointments which will obviously have the effect of increasing their workload but will hopefully reduce the routine appointment wait time.

Whilst that is great news for patients it is not ideal for the doctors and it is something I will have to monitor.  Increasing demands on general practice over the past five years – not just a heavier workload but the increasing complexity and intensity of work – have led to a challenging work environment.  Having a team of overworked and tired GP’s can lead to drops in concentration levels and reduced outcomes.

Recent King’s Fund research has highlighted GP workload has grown hugely, both in volume and complexity. The research sample showed a 15 per cent overall increase in contacts: a 13 per cent increase in face-to-face contacts and a 63 per cent increase in telephone contacts.  At the same time, more people report difficulty in accessing care and are less satisfied with their experience of using GP services.

Over Wyre Medical Centre has had to learn to be self-sufficient because we are different from other Fylde & Wyre practices due to our remote location.  Whilst other practices are able to benefit from NHS initiatives to help with appointment pressure such as the Same Day Health Centre and Extended Access Service at Fleetwood, we have found they offer little assistance to us as our patients often struggle to travel the distance to Fleetwood.  We consider it to be an inequality that other practices are able to freely access these services which are intended to take some pressure off General Practice and our Patient Group has flagged this up to the Clinical Commissioning Group.

The Clinical Commissioning Group recently commissioned 13 hours per week for the Extended Access Service to be sited in Garstang.  We have made it known that we would have much preferred for this 13 hours to have been shared with Over Wyre Medical Centre as the poor transport links and lack of bus service between the two practices means that this 13 hours of extended access is of little assistance to Over Wyre Medical Centre and does not benefit our patients.

As I say, we are all working extremely hard. In the month of November we dealt with 5,106 booked appointments.  In November we also had 259 DNA’s (Did Not Attend).  This equated to 5.1% of all appointments and whilst this is considered to be an acceptable DNA rate it is very unhelpful at a time when winter pressure is leading to unprecedented demand on our services.

Whilst I apologise wholeheartedly that the wait times for routine appointments reached an unacceptable level you can be rest assured we are working very hard to get the wait time down.  It must be remembered we always provide same day appointments for urgent and emergency matters.

I hope my letter provides a concise overview of our appointment situation. I have written a detailed response because I want you to see that we are engaging at all levels and like yourself, take patient concerns seriously and want improved outcomes for our patient population.  We will continue to work hard to meet the needs of our community.