Urgent Appointments

Permanent changes to Urgent Same Day GP appointments


As we have seen across the NHS, including many GP surgeries, the Practice has seen an unprecedented increase in demand on all our services, including exceptional demand for urgent on the day GP appointments.

Our current system of having limitless urgent on the day appointments has now become unsustainable and affects our ability to safely look after our patients.


Over the past few weeks, we have had the equivalent of 1 GP managing over 100+ patients each day. This level of work is something that would be unimaginable in any other NHS service including A&E, Walk In Centres, and GP Out of Hours!

We are not an unlimited resource; every patient contact takes time and involves a decision-making process. Recent British Medical Association (BMA) and Royal College of General Practitioners (RCGP) guidance is that there is a point where we should declare ourselves ‘full’ when we feel we have reached our capacity to effectively deliver safe care.


As a result, we will be making changes to the way we manage urgent on the day demand.


With immediate effect:

There will be a set number of urgent, on the day appointments, each day for patients who feel that they need an urgent GP appointment.

Once all these urgent appointments have been taken, we will declare ourselves ‘full’ and will be unable to offer any more appointments for that day. At this point, patients will need to contact NHS 111, visit a pharmacist, attend a walk in centre, or in very urgent cases, attend A&E.


Who needs an urgent appointment?

An ‘urgent on the day problem’ is defined as something that cannot safely wait for another day, cannot wait a routine appointment, and requires a GP.

When requesting an urgent same day appointment, be aware that you are using one of a finite number of appointment slots and that other patients may, as a consequence, miss out on an appointment.


Why is this happening?

The pressure the Practice has been experiencing over the past few months, is reflected nationally across the NHS and General Practice. We have always gone above and beyond, however this is now unsustainable, and we have to make these changes to protect both the safety of our patients and staff.


What about routine appointments?

These changes do not affect non-urgent and routine appointments with GPs. These changes do not affect appointments with Practice Nurses, Practice Pharmacists, and First Contact Physiotherapist.


Alternatives NHS services

  • You can find self care information on our website www.torkardhill.co.uk/health-advice
  • Visit your local pharmacy for advice and treatment – find your nearest at www.nhs.uk/service-search/pharmacy/find-a-pharmacy
  • If you need to speak to someone regards to your mental health, or are in mental health crisis, please ring Nottinghamshire Mental Health Helpline open 24/7 on 0808 196 3779
  • Ring NHS 111 or visit NHS 111 online 111.nhs.uk
  • Visit a walk-in centre:
    • NHS Nottingham Urgent Treatment Centre (Seaton House, London Road, Nottingham, NG2 4LA)
    • Newark Urgent Care Centre (Boundary Road, NG24 4DE)
    • Ilkeston Community Hospital (Heanor Road, Ilkeston, DE7 8LN)


We regret having to take this course of action and we understand that it may be inconvenience some patients, for which we apologise.

We thank you in advance for your ongoing support and understanding, and would ask that you continue to treat all our staff politely and respectfully.

We are all working extremely hard to offer the best possible service for our patients, with the resources that we have.


A huge THANK YOU to so many of you, who have left wonderful comments over the past few days – it is highly appreciated! 💙
As a Practice we want to be open and honest with you, therefore the announcement of the changes to our acute care was delivered with a full explanation and statement. We thought long and hard about this, and explored ALL options.
I am disappointed that the Practice has been unfairly singled out for an approach that has been commonplace across many Hucknall and Nottinghamshire practices for some years, and that both local press and politicians appear to be both misrepresenting the issue, lack understanding, and are creating unnecessary worry and fear amongst some in our community. We do not want patients to be deterred from accessing care!
Some members of our wonderful community have asked some EXCELLENT questions on Facebook over the past few days 👏, and I thought it would be useful to publish responses in the FAQ below – please take a look below!
❓: Are you saying the Practice is closed?
▶: Absolutely NOT! The changes announced only affect a small proportion of GP urgent same day care. Everything else stays the same! You can make routine GP appointments, urgent and routine nurse appointments, appointments with practice physio and practice pharmacist – all as normal!
❓: Can you tell us how busy you are?
▶: In the last 12 months, the number of urgent appointments has increased daily by around 40%, and on some days, up to 250 urgent appointments – if we put that into some perspective, an A&E covering around 1 million people would assess the same in an 8 hour period. We sadly don’t have 40% more time, or 40% more doctors.
❓: A&E is already busy – why are you telling patients to go there?
▶: You should only go to A&E if you feel extremely unwell. Let’s be honest, some people do need to attend A&E because they are very poorly! Conditions that would be appropriate include chest pain, difficulty breathing, weakness, paralysis, not able to pass urine, severe pain, drowsiness, severe head injury, seizures, difficulty walking.
People should also attend A&E, or the Urgent Treatment Centre, if they have an acute musculoskeletal injury, such as possible fracture (this is usually dealt with in the “minors” part of A&E), because they have xray facilities and mobilisation accessories.
❓: What other NHS services are there?
▶: Other services include NHS 111, community pharmacy, Nottinghamshire Urgent Treatment Centres, GP Out of Hours, The Nottinghamshire Mental Health helpline.
❓: Why don’t you just get more doctors or ask the nurses to help out?
▶: We are trying to recruit more doctors into the practice, and in the meantime employ locum doctors on days where we can. Nationally there is a major shortage of trained GPs, and disappointingly there are fewer full time equivalent GPs now than there were in 2015 (despite governments promising more). Hucknall is no exception to the rule, and many would know that there are fewer doctors today than there were a decade ago.
Our amazing Practice Nurses 💙 are also incredibly busy doing what they are trained for – they are not substitute GPs, in the same way, GPs are not substitute nurses – we have very different skills and training.
❓: Is this an issue unique to Torkard Hill Medical Centre?
▶: No – and we are disappointed that this conversation appears to unfairly pick on our Practice. The NHS is under unprecedented pressure right now across the board. I am sure many of you would know, if you have accessed health services over the past year, whether it be a trip to A&E, a visit by a district nurses, picking up a prescription at a pharmacy, or tried to contact a midwife or health visitor.
All GP practices in Nottinghamshire are under stress with many on “high alert” for weeks, but we have historically never really communicated that very well with the Public, and often our work is misunderstood and unseen, even by other parts of the NHS.
One of the reasons why we have this Facebook page is to have better communication to our patients - something the Practice is very proud to do.
❓: Why don’t you stop registering more patients?
▶: Practices are not allowed to close their list, or change their “catchment” area, and must continue to register anyone who chooses to do so. We have also seen small numbers register with our practice, from other Hucknall practices.
❓: Why don’t you make more urgent appointments and fewer routine ones?
▶: More than half our appointments are targeted towards urgent same day care and we have at least 2 GPs focused solely on that, for the whole day. We must not ignore the fact that patients do want to make preplanned appointments, and there is a need to have follow up appointments that can be made later eg for review of an ongoing problem, a new medication, results of tests etc. This is bread and butter GP work which is the complex work that GPs are specialists in.
❓: Won’t it all be better after the Winter?
▶: We used to talk about “Winter Pressures” in the NHS, but it is now an “All Year Pressure”, because of the significant resource and pathway challenges that exist.
❓: Is this not all because of Covid?
▶: Covid had a small role to play, but challenges with access to GP, community and hospital services were present way before 2020.
❓: What additional pressure does Hucknall have?
▶: If we look at a map of Nottinghamshire, you will see significant variation of numbers of patients per GP, with one part of Nottinghamshire have one of the most favourable ratios in the entire country. Sadly, it is well recognised that health resources are often inversely proportional to the need.
Hucknall also has 50% more patients living in care homes, than the national average, with seemingly new, large, luxury care homes, popping up on a yearly basis – with no additional resources for the existing practices to cope with.
The area, due to it’s past proud mining and manufacturing history, has higher rates of chronic conditions including chronic lung disease, and we have large proportions of older people, and children under 5.
Thank you for reading 🙂,
Dr Kachhala