The PCSO idea has come to the nhs

Another Labour invention. I'm sure that the next government will be all over it.

We have loads of foreign doctors. Our surgery seems to only have Nigerian doctors. Why are we not putting our own students through medical school?
Even though we have this foreign influx we still can't get to see a doctor. The system is broken.

I was able to see a nurse at my surgery within 24 hours who the reception said was "A nurse who is a Physicians' Assistant". I was impressed by the authoritative way she communicated with me. She was very focussed.

My local GP practice has employed Nurse Practicioners for years, and they provide an excellent service.

On the rare occasions I've needed to use one, I can ring the surgery, pop down and see someone the same day (I've no idea if that still applies at this time of year, of course..) and - if s/he's not sure, they'll just get the opinion of a doctor. Job done.

Just an example of the NHS making the most of resources.

Where I am it is totally impossible to book an appointment to see a doctor.

You have to contact them online stating the nature of your condition and the issue you want looked at. Some of the elderly who have never understood the internet and who in some cases might have dementia issues either have to try and get through on the phone which can be virtually impossible sometimes, or turn up at the surgery. In either case, rather than simply booking an appointment the receptionist asks the online questions and fills in the online request for them. Instead of simply booking an appointment.

But once the online form is in their system, a non-medically trained receptionist triages it to determine how serious the condition is. Depending on how this clerical - but not medical - professional rates the seriousness of your medical condition often determines the response you get. Most of the time within a couple of days you get some text message saying that a doctor will phone you on such and such a date, which is often at least a week and often more like two weeks later. You cannot book any kind of appointment date let alone time to fit around work. They tell you the day they are going to phone, take it or leave it, and if you are working that day, tough. And they wont even give you an approximate time which could be anything during surgery opening hours from 8am to 6pm. Though "opening" hours is itself a misnomer since the waiting room is permanently locked and almost entirely empty, with access only granted to anyone with an actual appointment, usually to see a nurse for something, very rarely an actual GP.

And many of us of course cannot answer phones in our jobs, and in any case if the medical matter is highly personal we might not want to discuss it in the presence of work colleagues. Anyone with a driving job of course cannot answer their phone. Even in my retail job I cannot answer a phone and discuss medical matters whilst the customer waits if I am sat on a checkout. And if I happen to be out collecting trolleys and it is raining I cannot have my phone on me because the rain is likely to get at it and screw it up. So if I get given a call back date on a work day I either have to do without the appointment or arrange for my employer to give me the whole day off just for the doctors convenience. You can on the forms give any dates and times you are not available but this often seems to be ignored in practice.

And sometimes when waiting at home all day for the phone call they say you'll get on that day, you get no call so a day wasted for nothing. If you enquire as to why that was it is usually because the doctor wasnt there due to an emergency medical matter. At least this is the the favourite excuse because you cannot really be unreasonable about that. Though I suspect that is just the stock reason given if the doctor has decided to take that day off or just doesnt get to you in time. In any case they dont bother to tell you they are not going to call so you are left waiting all day for nothing. And if your medical situation is growing worse, you can easily end up having to go to A and E or call 111, potentially even 999.

I myself have ongoing mental health issues, type 2 diabetes, and Parkinsons Disease, yet it is three years now since I last had a face to face meeting with a GP. Local GP health cover has collapsed and the rest of the heath service - hospitals, the private sector, community nurses - are all having to take up the slack.

All the GPs at my surgery seem to be part time, only putting in one or two days a week. I have the suspicion that they are spending more time in the lucrative private sector where I doubt that their private patients have any trouble getting to see them, though probably having to pay through the nose for the privilege.

GP services seem to be slowly going the way of dentists, ever less NHS cover forcing ever more people to go private, and those who cant afford it, too bad.

Mine too and they are good, and there are many things a trained nurse can do well, like take blood samples and send them off, do regular checks of long term conditions such as diabetes and suchlike. But this was always complimentary to the ability to see a doctor if you needed to, and not a substitute for it.