Pressures at Castle Donington Surgery

Castle Donington Surgery 2023

We know that getting an appointment with the Practice can be a challenge.

To put it simply, the Healthcare system across the UK is in crisis.

GPs and clinicians are working harder than ever for our patients, but the simple truth is that for most GP Practices across the country, demand far outstrips supply. There are almost 2,000 fewer GPs in the UK than there were just 7 years ago(1) and at the same time we are seeing more patients, for more complex health needs.

(1) Source:

We understand your frustrations, and we are doing everything we can to ensure that those patients who need an appointment can get one. We do this by:

• Offering as many on-the day appointments as we can, as well as ensuring that we have a duty doctor each day for urgent on-the-day cases

• Offering a number of pre-bookable appointments 4 days in advance

• Offering pre-bookable appointments for non-urgent queries. Due to high demand, these are currently fully booked up around 4 weeks in advance

In the last 3 months, we offered over 14,400 appointments. This is 107 appointments for every 1,000 patients, every week - almost twice what the BMA regard as a safe level for clinicians. We, like all other GP practices in the country, are struggling. Our clinicians are working above and beyond to provide the best care we can for the villages we serve, sometimes to the detriment of staff wellbeing.

We cannot offer more appointments than we do. We do not have the funding to recruit more staff beyond what we already have.

We remain committed to providing care to all patients, and we are asking for your help and support to do this:

1. We have increased the number of telephone lines into the surgery and have more staff answering calls in a morning. Please be patient with the receptionists – they are doing their best to help you. They will ask the reason for your call so that they can direct you appropriately and when all routine appointments are taken, they are ascertaining if you need an emergency appointment.

2. We may ask you to see a different clinician other than a GP – this is because this is the best person for your query. Not all queries will need a GP and other qualified clinicians will be able to help you. In the last 2 years the Additional Roles Reimbursement Scheme (ARRS) has provided funding for additional roles in GP practices including Nurse Practitioners, Nurse Associates, Care Co-ordinators and Pharmacists, all of whom are well-qualified healthcare professionals who can deal with a range of healthcare needs.

We also use the Governments Community Pharmacy Consultation Service (CPCS) for referrals to local pharmacies for some minor ailments.

3. More than 79% of our appointments are face-to-face, compared with 70% as a national average. This is mostly due to patient choice - telephone appointments are offered to help those patients that would benefit from them (for example, by not having to take time off work to travel to the surgery) and to ensure we can maximise the number of consultations.

4. We may direct you to an urgent care centre. There is a finite number of appointments available and If we have no more appointments to offer , then we may have to signpost you to a walk-in centre or A&E if you feel that you need to see someone urgently.

5. Self Care - Please consider if your query could be dealt with locally. Your local pharmacy can assist with lots of over-the-counter remedies for minor winter ailments and pharmacists will be happy to advise you on which remedies will be right for you. There’s some great information on the NHS website here:

The surgery staff may also refer you to the local pharmacy through the National CPCS referrals scheme – you can find more information about that on the NHS website here: 

6. We want to help you make the most out of your appointment when you are here. There’s some really great advice here: and here:  

Above all, please be kind to our staff, we are all doing our best to help you. We know that there are more people wanting appointments than we have appointments to give.

To the small minority of patients who choose to raise their voice or make threats to our staff: please remember that there is a real human being on the other end of the phone who is trying to help you. Shouting will not make appointments suddenly available.

To the patients who are raising complaints about not being able to get an appointment: We do hear you. We ensure every month that we maximise the appointments available and have a mix of prebookable and on-the-day availability. We have tried every combination of appointments, from prebookable to on-the-day and we feel that the current system is the fairest and offers the most appointments.

We know that patients across the UK are angry at the perceived lack of access to their GP. The Government and media rhetoric - focused as it is on access to appointments - is deflecting attention from the lack of adequate funding to support that, leading to unrealistic expectations. Our Core budget was increased by 3% this year, but with inflation hitting over 10% this winter, this is a real terms cut in funding. Our running costs are increasing: energy bills are going up significantly, wages need to increase as national living wage goes up in April, and inflation pushes up the cost of all the items we buy from cleaning products to stationary. There is no additional funding to pay for these rising bills. This all impacts on the number of staff (including clinicians) that we can employ, and therefore the number of appointments we can offer You may feel it is appropriate to contact the local MP to ask why repeated promises to increase the number of GPs has led instead to a reduction in the number as so many people are leaving the NHS?

Finally to all our patients – we thank you for your continued support, and for the kind words we also receive from many of you, they do mean a lot to us.

Thank you,

The Partners, Clinicians and staff at Castle Donington Surgery