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Waterloo health centre - stopping morning walk in clinic

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Thursday 21 February 2013 7.12pm
Found this on there website today ..good idea ??

Improving Access at Waterloo Health Centre

At Waterloo Health Centre we have always worked hard to ensure you have rapid access to a high standard of patient centred care. We have achieved this through the commitment of our staff, our walk in service and wide availability of appointments including late nights and early mornings.

We are taking the next step in improving access for our patients. From 18th March 2013 we will be introducing an innovative new system, which has been successfully developed in hundreds of practices across the country.

The new service will:
• Ensure timely access to a GP to discuss your problem across the day – No need to race for walk in services or appointments at 8am
• Allow patients to deal with problems and advice without having to attend the Centre – minimising disruption to your day.
• Reduce waiting times within the practice when you do come.
• Ensure you see the best healthcare professional for your problem.

How will I contact a GP?

From 18th March 2013 simply:
• Contact the centre on 020 7928 4049 Monday to Friday, 8.00 to 18.30 and speak to our reception team.
• Arrange a time for the GP you choose to call you back.
• A GP will contact you and discuss your problem.
• For many problems, the GP can help by phone, however if needed, they can arrange an appropriate appointment for you to be seen at the Centre.
• You are able to book appointments with our Nurse and Healthcare assistants as normal.

This will mean the Walk In and Booked GP Appointments will be unavailable from 15th March 2013 in order to transition over to the new service.

If you require more information, please visit our website, or contact our reception team who will be able to help.
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Friday 22 February 2013 10.30am
I'll be really interested to see how this goes. WHC was my former practice until I moved and they were imo really at the forefront in making improvements to their practice.
Saturday 23 February 2013 4.30pm
Very interesting. I'm certainly not averse to progress ( if that is what it is) and improving the patient experience but I do have some serious concerns:

(1) This system seems to me to rely heavily on self-diagnosis. What about those 'grey areas' where a patient may be uncertain what the cause of their illness is? You can of course argue that the public has experience of phone services ( nhs direct)and that they have worked well. Doctors rely heavily on what is 'presented' to them. If a patient via the phone is suggesting something to them incorrectly where are the safeguards to ensure that if there is ever any doubt, that individual will be given a surgery appointment. A physical appointment for a patient means that sometimes doctors can pick up on what cannot be verbally explained by the patient.

(2) With this system, is it not simply the case.. that doctors will become MORE seperated from their patients... and will eg. understand family circumstances etc etc less and less?

(3) Whilst I understand that there is a considerable strain on resources I have not been at all impressed by the limitations in place at my own surgery on making phone calls in order to facilitate an appointment..what has happened is that there a mad rush on the phones early in the day in order to facilitate an appointment.. and that one effectively has to ring in on a daily basis when subsequent days become available!!!
Saturday 23 February 2013 6.03pm
I wouldn't want a system where I couldn't choose to see a GP if I wanted to. However, I also would like to be able to have a quick chat with a GP sometimes, so it would be nice to have a surgery that offers both.
Monday 25 February 2013 12.04am
I can't really see how this is going to be better for patients. It's just a way of making it more difficult to see a doctor when you need to.

Funnily enough nearly all the appointments I've had at the surgery over the past 15 years have been at their insistence. Either annual reviews or because a specialist at St Thomas had requested or changed the medication I get prescribed through the surgery.

I see a specialist at St Thomas every 3 months. They changed the NHS rules a few years ago, so that the hospital can no longer prescribe most things - it has to be done by the GP. That change just doubled the amount of hassle - instead of just getting everything at the hospital, I now have to go back and forth between the hospital and GP. If that hadn't happened I probably wouldn't have been into the surgery for the past 15 years.

Many of my appointments over the last few years have been because the repeat prescription service had gone wrong somewhere. Strangely, when this happens, the receptionists insist I make an appointment with a doctor, when it's just an admin problem.

If the surgery were to launch a phone advice service staffed my medical professionals, not receptionists, it could be a good idea. Equally, a similar email service would be useful. I'm guessing the logic behind this change is to cut down on unnecessary appointments, but I don't think you should have to justify needing an appointment when you want one.

I also have serious misgivings about phone triage to establish whether you are ill enough to need to need a doctor. Lots of things can be missed over the phone. Doctors need to be able to see the whole situation, not just what people might say over the phone.

To make this point I should say what happened to me 15 years ago. The particular doctors are no longer at the surgery and I wouldn't name them anyway. I became ill, kind of fever thing. Saw the doctor a couple of times over a 2 week period, was prescribed antibiotics. They didn't work and I just got worse. I couldn't eat and ended up so weak that I couldn't even walk. I phoned the surgery and asked the doctor to visit me at home (first time ever in my life) - in fact I begged. The doctor refused and said I should go to the hospital. I don't think the doctor realised how ill I was. I'd never been in hospital before, and had never called an ambulance. I spent the next 24 hours crawling round on my knees packing an overnight bag and then plucked up the courage to dial 999. They had to carry me down the stairs. I ended up in hospital for 10 weeks. I eventually found out that for the first 2 weeks it really was touch and go. I don't actually remember much of it.

My point here is that the doctor misjudged the situation over the phone. Even I didn't realise how ill I was. If I hadn't managed to call an ambulance, I wouldn't be here.
Wednesday 20 March 2013 12.38am
Terrible idea. Not able to book appointments any more. Can only request a doctor talks to you by phone. If I could describe my problems by phone I wouldn't need to talk to a doctor - I'd look it up on the internet. I'll probably not bother. If things are bad I'll go to St Thomas'.

The other stunning failure here is the total lack of communication. I tried to find appointments online several time before I realised there never are going to be any appointments any more.

Can anyone recommend other GP practices nearby that have a patient-centred service?
Wednesday 20 March 2013 2.02am
Simon, I can't recommend Blackfriars Medical Centre in Colombo St highly enough!
I have some serious medical problems that mean I have o pend a considerable amount of time there and they are exceptional.
Wednesday 20 March 2013 9.30am
I'm registered with Waterloo Health Centre and, had I not seen the original posting on this website, I wouldn't have known anything about the new system, as I've had no notification from them. I suspect their reception staff will have a hard time of it, with people dropping in or 'phoning to book appointments to which they're no longer entitled. What particularly concerns me is that talking to a doctor is all well and good if you can do it in private. What about those of us who work full-time in an open-plan office? Do we have leave the office and stand in the street discussing our symptoms so the doctor can decide whether or not we're worthy of a precious face-to-face appointment? There’s no doubt that some things can be dealt with by ‘phone and I have, in the past, specifically booked a ‘phone appointment, but there are time when you need to see a doctor, not just talk to one.
Tuesday 26 March 2013 2.15pm
Zelda wrote:
Simon, I can't recommend Blackfriars Medical Centre in Colombo St highly enough!
I have some serious medical problems that mean I have o pend a considerable amount of time there and they are exceptional.

Tried to register there and they refused as they dont want to be seen as "poaching" the waterloo health centre patients .....
Thursday 28 March 2013 7.54am
I tried this service yesterday. No problems whatsoever. I spoke to my own GP, and resolved my issues satisfactorily. On the whole, I think that this is a good idea on several fronts.

Any time I went to the walk-in I was always struck at being surrounded by people with coughs and colds, who could have been at home self-medicating. I worried that I'd leave with a stinking cold that I did not have before. It concerned me that very old vulnerable elderly and disabled people attending for other reasons, would contract an infection that might have been fatal for them.

I watched the 24hr health service programme on tv last night where a nursing sister expressed the sentiment that we have ceased to be a stoical society and that every time she looked at the internet she 'self-diagnosed with a brain tumour'. I think that this is true to a large extent.

When I think of the stoicism of former generations, it puts us to shame.

Regarding this system, in these days of finite resources, surely there has to be some kind of filter applied so that those most in need can access better care?
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