Covid: How easy is it for patients to book a GP appointment in Wales?

"It is easier to speak to God."

This was the reply one patient sent in when BBC Wales asked how easy it is to get an appointment with a GP.

But is this a harsh assessment? Earlier this week, GPs called on the Welsh government to provide funding to improve GP booking systems, saying patients were forced into "stressful competition" with each other to access care.

So how much of a problem is getting a GP appointment from a patient's perspective?

The responses sent to BBC Wales showed very different experiences, some were happy with how their surgery works, while others struggled.

Among those who did have difficulties, two distinct issues kept coming up. The first was phoning the surgery to speak to somebody. For some, getting over that hurdle was near-impossible.

The second problem was when patients did speak to somebody, they were told all appointments were taken and were asked to call back tomorrow, often to be given the same message.

One respondent said: "Numerous times we have phoned our surgery at 8am and it takes at least an hour to get through, to be told there are no appointments and ring back tomorrow."

But others described a smooth process, praising the standard of care and defending the work of the surgery staff.

One said: "Excellent. My surgery is Dyfed Road Health Centre in Neath. Have had several appointments via telephone, usually on the same day as I book, and with my preferred GP."

John Evans, 54, is the pastor at Gendros Baptist Church in Swansea.

He was diagnosed with a long-term health condition prior to the pandemic and wants to keep on top of any health issues via his surgery, Fforestfach Medical Centre.

He is quick to praise the actual staff, saying: "Our GP has been great. The problem is the system. In fairness the receptionists are great too, it's just the system is really rather poor."

As a community priest he is in touch with a lot of people he describes as vulnerable, who have also spoken to him about the difficulty of getting hold of the local GP practice.

"First of all people will ring, and you can't get on to the queue [to wait to speak to a receptionist]. I have rung 60 times and you can't get onto the queue," he said.

"When you're working, that's not easy to do. Then you have to wait for 15-20 minutes [for an answer] which is difficult.

"It just puts me right off doing it."

At his surgery, the only way to get in contact is either by one telephone number, or by writing a letter.

He thinks using an app or online appointments would take the strain off the phone lines.

"It wouldn't make it easier for everybody but if a big portion came off that phone system it would help," he said.

"There are many health problems that have been backed up [during the pandemic]. The encouragement is to get in touch, not leave it too late. If it's this difficult in our practice, people aren't going to do it.

"When it's really easy to book a restaurant online, it really should be like this for health."

Ironically, when an attempt was made by BBC Wales to contact Fforestfach Medical Centre for a response, an automated message said that "the queue ahead of you is full". When BBC Wales called back later there were four people ahead in the queue. After 50 minutes of waiting on hold, there were still three people ahead in the surgery's telephone queue.

The surgery did send a response via email. It said: "We sincerely apologise for delays some patients may be facing getting appointments,

"We are extremely busy at present and doing our best to see patients as quickly as possible, but ask people to bear with us. We would be happy to discuss the patient's concerns with him directly."

In another part of Swansea, Catrin Lawson is very happy with her GP surgery, which she calls excellent.

She is able to use an app to report an illness and the surgery then contacts her via the app or by phone.

Catrin, 47, a teacher who lives in Sketty and uses Uplands and Mumbles Surgery, she has recently had a number of dealings with the surgery owing to a family medical problem.

She was able to get detailed blood test results via the app and found it useful and efficient having things in writing to help her remember details.

When she wanted a different set of results over the telephone, that was arranged easily, and when the GP asked for a follow up appointment in person, that was arranged for the same day.

Catrin has previously been successfully treated via the app on the same day without needing to see the doctor in person.

"Last year I had a toe infection. I sent a photo of my toe in in the morning and I was prescribed with antibiotics. The fact that I didn't see somebody in person didn't bother me," she said.

She acknowledges that there have been some frustrating times when she has tried ringing the surgery and cannot get through, but thinks this is why using a service like the app is so useful.

"This isn't going to suit everybody but I'm not blocking the phone system first thing in the morning, and the GP can access me."

The app has come in for further praise, with Fay Williams who uses Clydach surgery in Swansea saying: "I have contacted the surgery through the askmyGP app - I've had telephone and face-to-face appointments with GP's in the last few months, without any issues.

"I know there are face to face appointments available when appropriate, and have been right through the pandemic. I am very happy with the speed of response through the askmyGP app - it's a much easier way to contact the surgery. Fantastic staff who need to be praised not criticised."

Swansea Bay University Health Board, which covers these areas, said some GP surgeries are reporting a "high level of demand and more patient calls than usual."

A spokesperson added that the health board is supporting surgeries "to introduce the askmyGP online appointment and triage system, which has been used successfully by many GP practices across Swansea Bay."

But Robert Vincent, 72, who lives in Porthcawl, Bridgend county, thinks for his generation a move online is not the complete answer.

While he has a laptop and is able to use it for basic functions, he has not been able to use it for healthcare.

He explained: "There is an online system for booking appointments but I'm not very computer literate so [after trying to register to use it] I gave up."

His surgery uses the eConsult system where patients can go online in the morning to request advice, which could result in a prescription being issued or an appointment being made if necessary.

"People of my age don't have a computer and don't know how to use it," he said.

He has had two recent experiences of trying to make appointments. One was a routine letter asking him to book a flu jab. He said he tried from 8 September until 21 September before he was able to get through to a receptionist to make the appointment, which will happen in mid-October.

He wanted to speak to a doctor about two other issues but was told they could only deal with one additional concern, so had to repeat his call to get another appointment.

"The medical centre was brand new and opened in 2019," he said. "You'd think they would have enough staff and appointments. I know Covid has happened but even so."

Cwm Taf Morgannwg University Health Board, which covers the Porthcawl area, said: "Throughout the pandemic a key priority for us has been, and remains, patients being able to access Primary Care services.

"COVID-19 has meant the way our patients access their GP practice has had to change, and digital technology is part of that. However, the technology has not replaced face to face appointments, as our GP practices continue to be open and available to those who need them.

"It is really important to us that patients feedback to our practices directly, so that all of us can reflect and learn from their experiences."

Robert is not the only person who has expressed reservations about a move online or to telephone consultations. While some appreciate the convenience and time-saving nature of apps and other new technology, others said having to wait for a call back at an unspecified time is not feasible while working for example.

An NHS worker told BBC Wales she found the process "extremely frustrating".

"Having to fill in an e-consult then expected to be available on the phone the whole next day ([is] not possible when you're a frontline worker in the NHS). The few phone consults I've had have been very frustrating and unsatisfactory.

"I don't bother now, I'm just putting off issues. How can they tell anything about my physical health over the phone or from a mobile phone photo attachment. Absolutely ridiculous.

"If acute care [in hospital] can do face-to-face appointments why can't GPs?"