I increasingly feel for those working in General Practice. They have a microcosm of everything that's working badly in the NHS , and can only patch up the cracks, and not deal with the fundamental problems.
There's the lack of continuity of care, valued by many patients, and in particular those with chronic conditions - extremey difficult to manage given the pressures coming from the demand for quick appointments, and more appointments. (I do wonder if more could be acheinved with the use of Practice Nurses to give more continuity of care)
Instant appointments? A lot of conditions don't need to be seen by a doctor the next day, but it can be very difficult for the worried patient to tell the difference, so 'everyone' demands to be seen straight away. Would increased use of AI help here, but that requires investment in IT and for the worried well to both use and to trust the AI
Too many appointments - yes, increasingly, as pointed out above many conditions and issues don't need professional medical intervention, but again it can be difficult for many people to understand the difference, particularly those whose parents dragged them along to the doctor with the slightest sniffle. Despite my initial misgivings, many years ago, the use of community pharmacists has been a success in keeping some patients away from the appointments desk, and I feel more could be done, perhaps, again, using Practice Nurses to do more triage.
Investment in General Practice is a murky pool that I still don't understand. Most GP practices are private businesses that contract to the NHS, and are therefore responsible in part (as I understand it) for investment in their own businesses - what is the incentive to invest in advanced AI and other technology to improve services for their patients? Dunno.
What we've also seen upthread is the inconsistency of approach between GP practices (and possibly between individuals in the same practice) - to some extent this is inevitable, but I do wonder if more standardisation might temper patient expectations (eg around repeat prescritions, and in appointement booking systems).
Equally, there does seem to be - and I've experienced this - an occasional malicious attempt on the part of surgery management (lay managers) to deliberatly piss off the customer by making the appointment process as difficult as possible. I suspect this is in a misguided beleif that the 'worried well' will give up and go away, but the really ill pateint will persevere - which is wrong on so many levels. Thankfully my experiences of this show these efforts only last a matter of months before sanity prevales - YMMV.
GPs are also bearing the brunt of the increasing backlog to surgery and other services caused by The Plague, not to mention caused by chronic underfunding of services such as mental health. Mrs M is a prime example of being 'at the top of the waiting list' for surgery almost 2 years ago, and now in chronic pain and depressed with it. The GP can do nothing at all about the causes, just apply the best possible sticking plaster and hope it holds just long enough.
I can't see any solutions to this jigsaw of problems, and I don't think that just throwing money at General Practice will solve the root causes. Other solutions may be politically (and socially) extremely difficult. Again - dunno!