An appointment with your GP will become increasingly rare as Norfolk and Suffolk health chiefs try to cope with the rising pressure on doctor's surgeries.
A national recruitment crisis and the growing population has meant the number of patients per GP has leapt seven per cent in the last three years in Norfolk, Suffolk and Cambridgeshire to 1,600.
To meet the demand, East Anglian health chiefs are looking at how to revamp GP practices.
Ideas include:
•Turning the Norwich walk-in centre on Rouen Road into 'hub' for more NHS care;
•Basing extra services out of GP surgeries such as pharmacists and physiotherapists;
•Having surgeries working closer together to share more services;
•Sending paramedics and nurses on home visits to patients rather than making a GP appointment.
The NHS in Norfolk and Waveney is currently being redesign through a five-year strategy called a 'Sustainability and Transformation Plan' (STP) and that could lead to a smaller number of larger doctor's surgeries offering a wider range of services to keep patients out of both hospitals and the GP's consulting room.
The STP will need to bring the NHS back on budget, leading to fears it will mean large cuts for our services over the next five years.
But Dr Tim Morton, chairman of the Norfolk and Waveney Local Medical Committee, said money needed to be invested in GP surgeries now to cope with the strain.
He said two practices in Norfolk had already considered merging to cope with the pressures.
There are currently 17 GP vacancies at Norfolk and Waveney's 90 surgeries and Dr Morton said research by the LMC showed Norfolk and Waveney needed 100 new GPs to meet demand and current workloads.
The pressure on GPs is being particularly felt in the area covered by the South Norfolk Clinical Commissioning Group (CCG) which stretches from the fast-growing market towns and villages along the A11 corridor in the south to Dereham in the north.
The CCG's job is to commission health services to meet the needs of patients in the area.
In Dereham all three surgeries - Toftwood Medical Practice, Orchard Surgery and Theatre Royal Surgery - are closed to new patients.
And thousands of new homes are planned for centres including Wymondham, Attleborough and Hethersett over the next 20 years.
Wymondham Medical Centre's practice manager Kevin Baker said the challenges they faced were typical of the country.
He said: 'The big question is how do we go forward with a health service that doesn't have the number of GPs that we have traditionally had?'
Mr Baker said that while patients asked to see their family doctor, the system could be streamlined if patients were more flexible about which clinicians they were willing to see.
Several patients registered at the centre said they could not get an appointment with their GP for three weeks.
In response to pressures, four GP services in Breckland have formed a 'Breckland Alliance', to work closer together and share more resources.
And to address the recruitment crisis, South Norfolk CCG said they were working with Health Education England, the Royal College of General Practitioners and the UEA to encourage new GP graduates to come to Norfolk.
In Norwich, GP practices are also looking to share more services.
A Norwich CCG spokesperson said GP practices were in the 'very early days' of coming up with a strategy on how to meet future demands.
Plans include putting more health services into the walk-in centre on Rouen Road.
More services could also be based around GP practices, which could partner with other organisations such as social care, the hospital, community nursing teams and mental health teams.
That would lead to larger GP surgeries offering more services. But health experts would also look to keep patients away from GP surgeries by having more community care.
Dr Simon Cooke, Norwich GP and Chair of the group leading the work, said. 'This whole programme of work is about how we transform care to meet the needs of 21st century patients by considering where people live and the demographics of the local population.'
Plans are also underway in north Norfolk to redesign GP services.
Sally Ross Benham, from North Norfolk CCG, said they were working closely with GPs on a 'primary care strategy' and supporting them to share resources.
Andy Evans, chief executive of Great Yarmouth and Waveney CCG, said: 'We are also working with practices to develop a strategy to support workload and workforce issues.'
The CCG has also advertised GP fellowship jobs to boost the workforce.
The future of your GP?
Five GP surgeries in Norfolk and Waveney are run by East Coast Community Healthcare Trust which has services including district nursing, physiotherapy, speech and language therapy and specialist nursing care.
The range of services it has means patients calling up to see their GP might instead be visited at home by a paramedic or nurse.
Dr Noreen Kushen-Brewster, director of quality at the trust, said they had been trying out new ways of working over the last five months at their surgeries - The Nelson Medical Practice in Great Yarmouth, Bungay Medical Practice, Falkland Surgery in Bradwell, Kirkley Mill Surgery in Lowestoft and Westwood Surgery in Lowestoft.
Pharmacists work in all of their surgeries and patients can get advice and prescriptions from them rather than seeing their doctor.
They also have a paramedic and physiotherapists to visit patients at home, again saving the need for a GP appointment.
Dr Kushen-Brewster also said staff, including receptionists, had been given more medical training to take on extra tasks.
It means receptionists are better qualified to point patients towards the different areas of care when they phone up for a doctor's appointment. She said this had all been done with existing funding
'It is having an impact and we are evaluating as it goes forward,' she added.
A five-week wait, but brilliant GPs
Readers have been sharing experiences of their GP surgeries on our Facebook page.
•Mick Betts: 'Easier to get an audience with his holiness, the Pope than a doctor's appointment at our surgery, and at my last visit the GP misdiagnosed kidney stones as appendicitis! 'Got better care in King's Lynn in the fifties, where every doctor at our local surgery.. was a family friend who really took time out to diagnose exactly what was wrong.'
•Jenny Keeler: 'Loddon surgery there's usually a two-three week wait for an appointment with a doctor, although they do have same day appointments with nurse practitioners for emergencies.'
•Rachel Thurlow: 'There's a five-week wait for a routine appointment at our doctors. They can't cope with the influx of new houses being built in the area.'
•Gemma Ann Hobbs: 'Stalham and Ludham Green surgery - fantastic, same day if needed, definitely when it comes to children. No rushing, always going the extra mile, fantastic team of doctors and nurses Dr Sale, Dr Morris, Dr Christie, Nurses Dawn and Eileen they are brilliant.'
•Jane Chapman: 'Loddon Surgery is brilliant can always get seen same day unless you need to see a specific doctor at a specific time on a specific day. But I wouldn't expect to be able to do that. If you are ill they will see you same day, no questions.'
•Chris Hardy: 'Rosedale surgery. Doctor calls back within one hour and appointment same day if required. Excellent.'
•Sarah Carver: 'I'm at Beccles health centre you can ring and get seen the same day brilliant surgery.'
•Jenny Saunders: 'Plowright Surgery never had a problem getting appointments very supportive surgery.'
•Helena-Marie: 'Collins Park surgery in Yarmouth is excellent, appointment same day and doctors never make you feel rushed.'
How you can help
Health bosses urged patients to do the following to ease pressure on GP surgeries in the region.
•Think before you make an appointment and tell your GP practice if you need to cancel an appointment so they can offer the slot to someone else
•If you have a minor problem such as a cold or short term cough, then you can treat yourself.
•Ask your local pharmacist for advice.
•Try www.nhs.uk for advice on all sorts of conditions.
•Make sure your medicine cabinet is well stocked
•You can buy over the counter medicines like paracetamol or ibuprofen from pharmacies cheaper and more quickly than asking your GP practice
•Call 111 or use the Norwich walk-in centre when it's urgent.
•Do you have a health story? Email nicholas.carding@archant.co.uk
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