GHA announces new system for GP appointments

The Gibraltar Health Authority on Monday announced a major shake-up of the appointments system at the Primary Care Centre in a bid to address longstanding grievances and complaints from people who struggle to see their GP.

The number of appointments available every week will rise by 490 to 2,700 in total, with patients also able to book up to four weeks in advance with their preferred doctor.

Another important change is that the number of people manning the appointment line – telephone number 200 52441 - has been increased from two to five.

In announcing the upgrade, however, the GHA also stressed the importance of personal responsibility, urging patients only to request a GP appointment if there is a real medical need.

Seeking a GP appointment, it added, may not always be the best way of receiving the care that is required.

“When we started on this journey, some months ago, the GHA made a commitment to the people of Gibraltar that we would listen to them. And I spent the last few months doing a lot of listening,” said Professor Patrick Geoghegan, the GHA’s Director General.

“And the one thing people gave me a very, very strong message about was [that] we had to do something about our phone system, we had to do something about our appointment system to get into the PCC and to get an appointment with the GP.”

In order make the new system more effective, patients are being asked to phone at different times of the day depending on which type of appointment they require.

Between the hours of 8.15 to 11am, the five operators will deal with same-day emergency appointments only. Patients are asked to not call this number during this time unless they require a doctor that day.

From 11am to 3pm, the same phone number – 200 52441 - can be used to make advance appointments with a preferred GP or a range of other services including access to the over 70s driving medical service; the blood clinic; the well person or sexual health clinic; or the smoking cessation clinic.

From 4pm to 6pm, the operators will be able to offer emergency GP appointments that same evening to anyone who calls in unwell.

In announcing the changes, the GHA also highlighted the importance of self-assessment and the services provided by community pharmacists who, in many cases, can assist with routine medical issues.

People can also call the 111 service for urgent medical advice. The service operates 24 hours a day, seven days a week.

The changes to the appointments system will come into effect as from Thursday, October 20. As from then, it will no longer be possible to book appointments at the counter of the Primary Care Centre.

Other changes being introduced include a mobile unit, set to launch in November, which will go and park up in different areas of Gibraltar and provide healthcare that does not require a GP visit, such as blood pressure checks and blood sugar checks for diabetic patients. The GHA will provide more information on that in due course.

An app is also being launched shortly that will enable people who are registered with eGov and can already book appointments online to do so via an app.

The changes were announced by Prof Geoghegan and the Minister for Health, Albert Isola, on Monday morning in St Bernard’s Hospital in the presence of Dr Elaine Flores, the director of the PCC, and Dr Valerie Flores, the clinical director of the 111 service.

“When we started on this journey, some months ago, the GHA made a commitment to the people of Gibraltar that we would listen to them. And I spent the last few months doing a lot of listening,” said Prof Geoghegan.

“And the one thing people gave me a very, very strong message about was [that] we had to do something about our phone system, we had to do something about our appointment system to get into the PCC and to get an appointment with the GP.”

The work over the following months led to the new appointment system that will become live this week.

Each of the 490 new appointments will still be 10 minutes long, the same as the present allocated time.

In order to increase the overall number, a new doctors has been hired and some of the tasks normally handled by GPs will be transferred to clinical nurses.

“That's 11,600 appointments a month we'll be offering that equates to 139,200 a year to see your GPs. That means, in reality, each member of the public here based on your population size could have four appointments a year,” said Prof Geoghegan.

“Now I've worked in many countries, and I'm not saying we should compare everything to other countries.”

“But I have not worked in a country that is offering so many appointments to people [as] in our community.”

“And as a clinician who's worked all his life in health service, be it in UK or abroad, with that number of appointments, either we have a very sick country if they're all used, or we're abusing the system.”

“I don't believe we have a sick country. From the people I see here you get good health services. So the test is going to be, how do we use these new appointments?” he added.

He noted the abuse of the appointment system has been pointed out to him but he also witnessed it himself when, on one occasion, he spoke to a patient in the PCC who took an urgent appointment for a mouth ulcer.

It was the abuse of the emergency system that led to so many appointments being taken when not needed, he explained. This coupled with everyone trying to call at 8.15am for all manner of reasons, not just for emergency appointments.

Prof Geoghegan hopes the new system will address the issues people experience, as long as people help the GHA by calling the right number at the right time for the right reason.

This was a sentiment echoed by Mr Isola.

Mr Isola also stated that the GHA welcomes feedback on the new system, with the caveat that there will be some hiccups and things will need to be tweaked. Feedback can be provided via the GHA website.

“We will obviously take that into account and make changes as and when required. If we feel they are valid,” he said.

Speaking about the 111 service, Dr Elaine Flores said: “We're taking a lot of responsibility with regards to giving advice to patients who feel that they need that urgent help. So to reassure you, 111 has a clinical desk that is supported by staff 24/7.”

“You will have very highly experienced senior paramedics and nurses who will answer your calls, who will do an assessment, they will do a clinical triage, and they have access to your records.”

“They know your history, they know what medications you're on. And therefore, they can make a quality assured assessment on what you need at the time.”

All urgent issues will have an ambulance dispatched and all other issues will be dealt with according to the issue, even if there are no emergency appointments left for the day.

With respect to community pharmacists, a training meeting is taking place on Tuesday evening. At this meeting the pharmacists will be asked what their aspirations are and discuss how they can help the GHA.

“In other countries community pharmacists play a pivotal role in delivering health services, and also in using their premises,” said Prof Geoghegan.

Prof Geoghegan also confirmed that the next public meeting of the board of the GHA will take place on November 14.

Call 20052441

During 8.15-11am if you need to see a doctor the same day

During 4-6pm for the emergency evening clinic

During 11am-3pm for

-advance appointments face to face or virtual

- bloods

- over 70s driving medical

- smoking cessation clinic

- well person clinic

- sexual health clinic

Call 20007909 for repeat prescriptions between 11am-3pm.

Call 20072355 to cancel an appointment for a general enquiry.

Call 111 for urgent medical advice. This number is open 24/7.