Seeing a doctor isn't what it used to be. Gone are the days when you could phone a doctor's surgery and be confident of getting an appointment that day - or even within the week - with the same doctor who had been seeing you and the rest of your family for years.
It's no secret that pressure on the NHS is greater than ever. Funding is under threat while the number of patients increases regardless, and many doctors who choose to stay in the service are severely overstretched. With patients allocated just 8-10 minutes per appointment, doctors become stressed out and struggle to deliver the level of care they would like to. Yet despite these stringent appointment rules, the extent to which demand outstrips capacity is alarming: according to the 2016 GP Patient Survey, 11% of patients were unable to get an appointment at all, and 38% got an appointment a week or more later but wanted to be seen sooner, which may explain why so many people turn up at A&E hoping to be treated there instead.
But it's not just a case of appointments becoming more scarce; the surgeries themselves are disappearing too. According to a Freedom of Information request by Pulse magazine, the number of GP practices that shut down or merged with others last year meant that around 265,000 patients had to change surgeries - a 150% increase from 2014.
Although NHS England has promised an extra £16m this year to help struggling surgeries, the problem lies in getting that funding to practices that need it most. Complex application procedures hamper access, according to the British Medical Association's GP committee, with local Clinical Commissioning Groups failing to deliver the funds efficiently.
Add to this the slow-down in the number of doctors entering the NHS, and the health of GP services looks even bleaker. While 5000 more doctors are planned for 2020, the NHS needs to do a good PR job on its incoming workforce; 13% of GP training places went unfilled in 2016, and one can only assume that the current pressures faced by doctors will do little to tempt potential recruits. Furthermore, one in three of the 32,628 doctors in England are considering retirement in the next five years, meaning the net number of doctors will be lower than it currently stands.
Against this worrying backdrop, it is little surprise that a recent YouGov study found one in four people would pay for a GP appointment. With the latest generation of GP services emerging, this is now becoming a real alternative. These new healthcare options are addressing one of the main bugbears that patients have with the NHS - the lack of appointments at times that suit them - by enabling them to choose an appointment on the day they book, and even access walk-in services.
This is clearly an attractive proposition for those most frustrated by the common two-week wait time for an NHS appointment. DocTap GP, reports that 75% of its patients are between 20 and 39 years old - people often in full-time work and who lead busy lives. Furthermore, its patient base is split equally between men and women; significantly fewer men than women visit NHS surgeries. With more men than women working full-time, it is understandable that short-notice, flexible appointments are essential for these patients.
It is not just same-day appointments that make alternative healthcare options so appealing. Booking is online, so it can be done from any computer or smartphone; no more waiting in queues on the phone during a designated 'appointment window'. This makes a lot of sense to patients who are already used to arranging their lives online, and in a world of on-demand services like Spotify, Uber and Deliveroo, on-demand healthcare seems a natural addition.
Many doctors, too, welcome these new GP services. For example GPs who work for DocTap are either locum doctors working across several surgeries, or doctors who work part-time during hours that they're not working for the NHS. Patients are given 15 minutes with the GP, and that extra time leaves doctors feeling less stressed than a packed shift of 10-minute NHS appointments. Doctors who work solely for the NHS benefit too: if patients who need appointments at specific times are prepared to pay for them, that takes some of the burden off the NHS, freeing it up to care for patients who can't afford to pay or can be flexible about appointments.
No, seeing a doctor isn't what it used to be. In many ways, it is starting to get better. In a climate of unpredictability, new GP options coming on the scene can only help patients regain some control over their healthcare.