The fabled unicorn of a face-to-face GP appointment

The lottery of seeing a GP in an underfunded, understaffed Swindon medical system

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Is the needle in a haystack of getting a face-to-face GP appointment becoming harder to find?

We’ve all heard over the past few years from friends, family members and work colleagues that it is harder and harder nowadays to get a face to face GP appointment in Swindon. And according to figures released by our regional NHS organisation this situation is gradually getting worse. Jamie Hill reports on his experiences having been diagnosed with quite a major affliction.

By Jamie Hill

I feel like I’ve been left out in the cold.

Two weeks ago, I was around a friend’s house who had a family member with Type 1 Diabetes and just for a laugh (or more because I’ve been extremely fatigued for the past couple of years) I undertook a fingerprick test for Diabetes.

And my blood sugar level was off the charts according to the friend (22.9 to be exact).

According to my friend I needed to see my GP urgently because of my high levels.

It then took me three days to even get a blood test including the dreaded 8am scramble. Seeing my GP seemed to never be an option.

Three days after, so six days in total, I had my diagnosis. I had Type 2 Diabetes.

That day, including the diagnosis, I had three phone calls. Two from the same practice nurse and one from the diabetes nurse. But not one from the GP.

My mind was fried. I didn’t really know what questions to ask. I did ask about diet but was referred to a website. But I was mainly told what drugs I would need to take and that I would get a fingerprick blood sugar monitoring machine.

It’s now a full week later. I’m still clueless. I have the blood monitoring machine, which I had to set up and work out how it works myself, but I don’t know what the numbers mean. No-one’s explained what they should be and the websites seem vague.

Weirdly I feel abandoned. And clueless.

In my life I have three blindspots where I glaze over and nod along. These are cars, the stock market and anything medical. I trust in the experts in those fields to know what they are doing. And if they have to explain something to me so that I can understand it really does need to be face-to-face.

I know Type 2 Diabetes is common. And in the hierarchy of diseases and ailments it’s pretty minor but when you read about going ‘hypo’ or ‘diabetic comas’, it’s pretty scary stuff.

Sometimes a leaflet or website is just not going to cut it and a nice reassuring chat with a GP is really what is needed to make you understand.

My story is pretty common in Swindon. It’s pretty damn hard nowadays to see a GP. And it’s getting worse.

I do realise my story is only one story in a multitude of stories across the town and across the country.

We’re living through an NHS crisis after years of underfunding and an ever increasing population. Phone consultations or pharmacist referrals are necessary to ensure that things don’t get too overloaded.

I understand the need to triage patients’ needs to take the pressure off.

But I did think a patient being diagnosed with something as serious as Type 2 Diabetes would be worthy of a face-to-face even if it’s just to allay fears and explain what life changes needed to happen.

But it’s hard to lay the problem at the feet of the NHS as they are under so much intense pressure that things that we knew and relied on in the past like ready access to doctors or even doctor house-calls are now out of the question.

This isn’t just a problem in Swindon. This is a nationwide problem. Everything is overstretched.

And the workload of GPs is just increasing.

It’s not just underfunding that’s a problem. There’s actually a shortage of trained GPs.

Fewer fully trained GPs were working in Bath and north east Somerset, Swindon and Wiltshire in November than 12 months earlier, new figures show.

NHS Digital figures show 459 full-time-equivalent fully trained GPs were working at surgeries in the former NHS Bath and North East Somerset, Swindon and Wiltshire CCG area in November – down from 470 the year before.

The figures follow the Government's 2019 manifesto pledge to recruit 6,000 more GPs by 2025, with the number of GPs across England dwindling since 2015.

The British Medical Association trade union has even said the GP workforce is in "crisis".

Dr Julius Parker, deputy chair of the BMA's GP Committee for England, said: "There are no two ways about it, we are in the midst of a GP workforce crisis.

"We are having to do more work with fewer resources and are being stretched to the limit, leaving patients frustrated that they cannot always access the care they need."

Dr Parker said people living longer means more GPs are needed to "…provide the level of care that people deserve and we want to deliver.”

He added: "The Government must prioritise GP recruitment and retention, otherwise the NHS will continue to haemorrhage doctors, putting patient care and safety at risk."

So the problem is only going to get worse.

The Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board is the organisation which heads up our local health system.

Let’s call it BNESSWICB for short. Although that’s also pretty unwieldy. So let’s not.

For those of us living in Swindon that seems a pretty wide area for an organisation that has so much impact on the ground in our town, especially as it includes areas that the majority have little or nothing to do with.

It kind of feels a bit like how BBC Points West seems to be so much more focussed on the more glamorous Bristol and Bath than it does on our quite sizeable town of Swindon.

But I’m sure that’s not the case.

Anyway according to the latest figures released by this care board our region (of which Swindon only seems a small part) face-to-face doctor appointments are decreasing.

Prepare yourself for a bombardment of numbers.

According to the stats released for the year up to the end of November 2023 there were 569,937 appointments at GP surgeries in this region, which works out on average as 2,633 a day. Of those appointments 310,373 were with auxiliary staff members like nurses etc. That’s 54.6% of them.

Of the remaining 45.4%, 240,783 were actual GP appointments, which is 42.4% and the remaining 17,857 were missed appointments which equates to 3.14%.

Out of those GP appointments 143,869 were actually face-to-face (59.75%) and 85,799 (35.6%) were phone consultations. I know those don’t add up to 100% but on the data released we could find no mention of the missing 4.6%. Let’s call them ghost appointments.

This compares to the year before, up to the end of November 2022, of 562,821 appointments in total of which 229,871 were GP appointments. Of these 147,677 were face-to-face and 81,117 were phone consultations.

So that means, and I promise this is the last bit of the number bombardment, in the latest figures up to the end of November 2023 we have seen an increase of 0.9% in the total number of appointments, an increase of 4.74% in GP appointments which means there was a drop of 2.5% in face-to-face appointments and an increase of 5.77% in phone consultations.

So year on year, it is getting harder to see a doctor in person.

Just as a tiny bit of a caveat, this is only a picture of the last two years and as Swindon is such a small area of the vast region these figures cover, it doesn’t really reflect what the situation is here in this town.

I know, eventually I will get my head around my new way of life but I wouldn’t mind a tiny bit more guidance just to make sure I’m doing the right things and don’t do myself serious damage like slipping into a diabetic coma. Mars Bars are bad right?

It’s no wonder that, on Monday, Circle Health Group, who run Ridgeway Hospital in Wroughton, launched a new private GP service offering patients in Swindon and the wider area face-to-face consultations.

A Circle Health Group spokesperson said: “The demands on primary care services in Swindon are at an all-time high with a shortage of GPs being one of the main reasons for delays in getting appointments and access to treatment. Demand for GP services can’t be met. 

“GP services are an essential component in the patient's pathway. Failing to get a proper diagnosis or proper triaging can often leave patients failing important pre-assessments. The result of such failings only delays the patients care further and ultimately makes waiting times worse.

“The private GP service represents a significant addition to what we can offer patients in Swindon, Wiltshire and surrounding areas. It will allow patients to see a GP face to face with easy access to any diagnostic tests, scans under one roof or onward referrals that may be required.”

The new service costs £140 for a half-hour appointment. That’s a lot of money but the private healthcare company know the state of the NHS and therefore know there’s a market for it. A market that shouldn’t ever have existed in the first place.

But when people are ill and need to see a doctor face-to-face they are desperate and £140 might seem like a small price to pay.

There’s been talk of the privatisation of the NHS by stealth for years and now it’s happening right before our eyes.

And it’s starting with our basic services. The GPs. Our first port of call when it comes to our health.

I dread to think of the people who have been put off contacting their GP because of the problems of actually talking to one in the first place. The impact that must be having on preventing health problems must be massive. And the eventual cost of medical care further down the line of something that could have been prevented must also be massive.

This isn’t a piece having a go at GPs or nurses or anyone who works in our health system. They are all heroes.

It’s a piece about the woeful neglect that we’re seeing from the ground up from those in charge.

In 2012 we celebrated the achievements of the NHS as something this country can be most proud of at The London Olympics Opening Ceremony.

And then in 2020 we stood on our doorsteps and clapped for the NHS.

And unless the powers that be start taking this problem seriously and actually giving it the resources that it needs, we’re going to see this slow rot creeping ever forward until the NHS has been completely overwhelmed.

Our GPs and the rest of our local NHS system all need the tools to do their jobs properly and it’s time The Government faced this head on and actually gave them the tools needed.

Face-to-face GP appointments should not be like trying to find gold dust.

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Culture Vulture 

Making a Scene

A Spotlight on... Will Lawton and the Alchemists

By Dave Franklin of Dancing About Architecture

People turn to music for all manner of reasons. Sometimes, they want something upbeat and escapist; at other times, a more cerebral and ornate artist is called for. There are times when songs built on energy and excitement will tick the boxes and when you want music of a more meditative nature to wash over you. Music can be entertainment, and it can be informative. It can make you feel, and it can make you think. Those of us smug enough to say that we are already familiar with the music of Will Lawton and the Alchemists already know that all of the above and more can be found in their music.

Perhaps because the band has always been rooted in friendship and collaboration and has evolved slowly over time, their music is so elegantly and eloquently wrought. Like the music they make, the band seems less concerned with the destination than with enjoying the journey. Something that becomes obvious when you listen to their music, music that is at once unique, adventurous, energetic, seductive, cinematic, wilfully complex, wide-screen and exploratory, often within just the one song.

Whilst most bands claim a broad musical palette on which they mix their musical hues, few can claim the diversity and deftness with which Will Lawton and the Alchemists paint their sonic scenes. Songs that just about push the music/paint metaphor to near breaking point, ranging from the equivalent of delicate watercolour understatements to vibrant and vivacious oil paintings.

And again, whilst many bands claim to be eclectic and adventurous enough to defy generic labels, for most, that is just wishful thinking, especially when compared to a band who can, at a turn, move from classical grace to progressive rock intensity, leave four-four patterns behind whilst they explore all manner of complex jazz-fuelled time signatures, embrace cinematic realms and tribal beats, wander lush folk-scapes and embrace the infectiousness of indie and even pop-aware hooks. (If anyone is unsure of the term "run-on sentence", you've just been forced to wade through one. Sorry.)

And sorry, too, for the more flamboyant than usual style I have adopted when writing about this band and their music. Though it does hopefully help to capture some of the grandeur of what they are about. That's my excuse, so there. (Or for younger readers... sorry, not sorry.) But, the best music makes you write in such verbose language, helping to avoid the usual hyperbolic writing tropes of things being "catchy," "awesome" or "up and coming"… not that I would ever adopt such slovenly ways, bro. After all, describing the music that Will Lawton and The Alchemist make in everyday musical terms is like trying to understand the mastery of the ceiling of The Sistine Chapel by talking about where Michelangelo's trusty assistant bought the paint. That might sound slightly overdramatic, but I think it makes a valid point.

But it is when you experience the band live, especially if you are lucky enough to do so in a good-sized venue or arts centre, you begin to appreciate the magic that swirls around the band. If alchemy was the art of turning base metal into gold, watching this five-piece turn mere music into mellifluous magic is enough to make you believe in those dark, ancient arts.

Music is going through some troubled times, and for a long time now, the backbeat you hear in most mainstream music is that of the cash till ringing or the ping of likes being racked up on social media. All this means that the industry is just looking for more of the same. Well, more of the same doesn't cut it with the discerning music fan of today. 

If ever a fightback was needed, then it begins with bands such as Will Lawton and the Alchemists, bands that are uncategorisable, brilliantly unfashionable (as defined by the paid movers and shakers of the industry...or worse, the self-appointed, gatekeeping influencers of social media,) and ploughing their own sonic furrow across the fallow earth of the current musical landscape. 

Send any review submissions in physical form to:

Dave Franklin, Dancing About Architecture, 21 Portsmouth Street, Swindon, SN1 2LF

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