I'm not sure if your angry at the system or your practice, admitedly, one is easier to change than the other.
Access isn't always as good as it could be,
Patient access survey scores fall slightly in 2009/10 | Healthcare Republic as your scenario describes. Interesting point about measuring who doesn't get an appt. Thought long and hard about the system myself, the bottom line is that there is so much demand, with only so much capacity.
The capacity has been bolstered, 8o'clock openings, Saturday surgeries etc, but of course more would be good. How this is achieved? I've not got that figured out yet. Options would include employing more docs and nurses, but that would take resources which aren't available. Perhaps we need to look at the bigger picture-I suspect we need to look closely at what we are employed to do-improve health, and scrap all the other boll*cks that don't make a difference. (And believe me, there's a lot of it.)
Other alternatives are to look at the consultation itself- generally GP's get 10 minutes per patient. I suspect making this tighter (shorter) would not reap many benefits. Perhaps we should ask the patient how long they think they need? May be a useful experiment.
My own feeling is that we should bolster up the skills of others in the system, but unfortunately, there's nothing like a nurse for never missing an opportunity to miss an opportunity.
(Does it really need a doc to manage your cholesterol and bp?)
The demand is increased, 10 years ago your doc got paid by the number of patients on his list, didn't really matter if he spent all his time talking about football with his patients, he still got paid the same. Now it'sslightly different,he has to at least demonstrate some useful outputs. (Which, I think, is beneficial to the patient).
We've fiddled about with looking at demand-walk in centres, nhs direct etc, but have these really made a difference, (or do they just create greater demand?). Perhaps centralisation of assesment may work-I'm not convinced-people come to see me because they trust me, which maybe part of the problem. (I'm a nurse in a gp practice.)