'We're not Rottweilers': Behind the scenes at a GP 8am scramble
Anyone who has ever tried to get a GP appointment in England will be familiar with the "8am scramble", as you phone your local surgery desperately hoping to get through.Many surgeries - like the Tudor House Medical Practice - open their telephone lines at 08:00, meaning that if you want an on-the-day appointment, you have to phone on the dot at 08:00.This can prove a source of frustration, with Jayne Bond - part of a four-strong team at the increasingly busy practice - often at the sharp end of patients' upset."Some people think we are Rottweilers, and we are trying to stop them getting appointments," she said.The practice invited the BBC to watch them at work first thing in the morning during the busiest part of their day, when those phone lines open.
"When the phone lines open, it just goes manic," fellow receptionist Sandra Brewster said.She knows the scene at the practice, in Sherwood, is repeated at surgeries across the land when they release their same-day bookable appointments first thing."It is mad - we try and grab a cup of tea before the phones open up," Sandra added. Often potential patients can get frustrated when receptionists ask for more information.Jayne, 66, said: "We are on the ball - we have to be."Some people think we are nosy, but we are just trying to get them to the right person."Eighty per cent of face-to-face GP appointments at the surgery are bookable on the day and released first thing, and typically within half an hour, they are gone.
We observed the pressure on a typical Wednesday morning. Jayne said: "We normally call it 'wacky Wednesday' - it can be a very busy day." Only five minutes after the lines open, more than 30 people are queuing to get through.The telephone system has recently been upgraded, with an option for people to request to be phoned back without the caller losing their place in the queue.But despite this "improvement", high demand will mean some inevitably miss out.Sandra, also 66, admits receptionists can't always give people they want."People have said to me, 'well if I die it will be your fault'. "There can be verbal abuse - you just have to go home and forget about it and remember it is the situation, not personal, but they are the calls you remember," she said.We observed that 50 people were booked in at the surgery within 25 minutes.
This relentless demand for appointments is a picture repeated across the country, and has seen the government step in earlier this year.The Labour government had pledged in its manifesto to end the early morning phone "scramble" for appointments, and in February, confirmed a deal to give an extra £889m a year to general practices.The new contract says patients should be able to arrange appointments online throughout working hours, freeing up the phones for those who need them most, and making it easier for practices to triage patients based on medical need.Practice manager Tricia Gibbons said patients were "getting more used to not always seeing a GP".The 56-year-old said: "When I first started 11 years ago, we only had access to GPs and trainee doctors."The surgery now has an expanded team of health professionals to complement the work of family doctors, including an advanced nurse practitioner and a clinical pharmacist, which can see patients.Tricia stressed, though, that "the doctors are always there to offer back-up"."This model is about giving doctors more time to focus on more complex cases," she said."Other members of the team are well placed to deal with the more minor illnesses and ailments."
Dr Jonathan Lloyd, a GP partner at the surgery, said demand for primary care had gone up hugely since he began working as a doctor almost 30 years ago."The number of appointments the average patient has each year has increased, and people have got older, and there are more people with dementia and chronic disease," he said. "The number of GPs has not increased at the same rate, so there is more pressure on doctors."He said accessing primary care across the country was a "big problem", but felt most patients were "comfortable" knowing they might not always see a doctor.He said six out of 10 GP appointments were in person, with the rest on the phone, which "many people are quite happy about"."Our patients have control over that - if they want to see me face-to-face, they can," he added.
'Nowhere near a solution'
Latest annual figures from NHS England show that record numbers of appointments - more than 370 million - were offered by GP surgeries in 2024-25, with almost two-thirds face to face, and the rest virtual.Four out of 10 appointments at surgeries are with doctors, and the rest with other health professionals.More than half of appointments were booked at least a day ahead, with the rest on the same day. Katie Bramall-Stainer, who chairs the British Medical Association GPs' committee, previously told BBC Breakfast that the new government deal could see patients begin to notice a difference in six to 12 months, but said the overall situation was "nowhere near a solution".So for now, the likes of Jayne and Sandra will continue to keep an eye on the clock as 8am approaches.
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