Introduction of an appointment system in a general practice: surveys of patients and staff.

To aid discussion on the introduction of an appointment system in an inner city practice with a 'walk-in' (non-appointment) system, we surveyed, firstly, patients' and staff members' attitudes to appointment systems, and secondly, aspects of the functioning of the current system. Of 250 patients in the first survey 73 per cent were against appointment systems while 24 per cent indicated that they would consider registering with another practice if such a system were introduced. Adverse comments about appointment systems greatly outweighed favourable ones. Staff members perceived clear advantages and disadvantages of both methods of consulting e.g. the 'walk-in' system was thought to be stressful due to the unpredictable workload but thought to reduce the demand for housecalls. Appointment systems were seen as giving staff more control over consulting but as less flexible for the patient. In the second survey of 352 patients, 17 per cent estimated a wait of 10 minutes or less for their consultation, 62 per cent estimated it as 10 to 20 minutes and 21 per cent as more than 30 minutes. Further, 68 per cent of patients estimated that their consultation lasted five minutes or less and 27 per cent indicated that the doctor seemed rushed. As a compromise between the wishes of patients and the needs of staff, 'walk-in' morning surgeries and appointment-only evening surgeries are now offered.