I have spent months battling for the right to basic NHS GP health care. Nothing fancy. Just me wanting to be seen as a whole person. Not a separate shoulder, eyes, and feet, all individually diagnosed, without cross-checking, without looking for a central theme. A person is not just a piecemeal of anatomical structures, but an integrated whole.
I can hear some people already saying:
“That’s what the NHS is these days.”
“Really, what did you expect?”
“They are overworked and underpaid, give them a break, they are doing their best.”
You are right, of course, but we have gone backwards. Patients were already struggling to get an appointment, and then during Covid, GP appointments were hugely restricted giving GPs a “breather” from their patients. They mainly spoke to them on the phone. They didn’t “see” them anymore. Then Covid became less of an acute threat, but GPs had gotten used to telephone appointments, and many still don’t “see” their patients unless they feel they really have to.
The 8am calls to get an appointment – or not
It feels like we are supposed to analyse what is wrong with us, guess what it might be, perhaps have a little dabble on the internet to see what we might have, and if it doesn’t frighten us too much, and we live to see another day, we think “now is the time to talk to the doctor.”
At my surgery, access to healthcare feels like a daily competition. Ring at 08:00am and hope you get through before all the appointments disappear. For months I could not understand how calling at 08:30 consistently left me as caller number 21, speaking to someone only after all the appointments had gone. Eventually I discovered the surgery hours had changed and the phones now opened at 08:00am rather than 08:30am. The change had been updated on the website, but there had been no direct communication to patients. I only found out by accident.
That, in itself, says something about modern primary care. Patients are now expected to constantly monitor websites, understand appointment systems, self-triage symptoms, and navigate access barriers just to speak to a doctor. My surgery has not progressed past the Covid “ring first thing and try to get an appointment.” There is no booking online, or through the NHS App, and you cannot do it in person. It is 08:00am or nothing at all.
A systemic problem
The experience of feeling processed rather than seen is not unique to one surgery. Before the pandemic, around 80% of GP appointments in England took place in person. That figure has since fallen to almost two thirds, confirmed by NHS England’s own published data (NHS England),, and it has stayed there. The shift was born of necessity during Covid, but the necessity passed and the model did not. What was an emergency measure became standard practice.
Patients have noticed. Written complaints to primary care services (GP and Dental) in England reached nearly 143,000 in 2024-25, an increase of almost 9,000 on the previous year alone, according to NHS Digital (NHS Digital). These are not people who enjoy complaining. They are people who expected something and received something else.
A new NHS contract that came into force in April 2023 means that GP staff have to let patients book consultations in advance or refer them to other services, such as a pharmacist, rather than tell them to call back later or the next day. This requirement comes directly from NHS England (NHS England). Practices across England were given £240 million to pay for new technologies designed to ensure patients get the care they need as quickly as possible.
Guidance accompanying the reforms states that if a patient requires urgent care, they should be given an appointment on the same day. Non-urgent cases should be offered an appointment, either face to face or via a video call, within around two weeks. Alternatively, patients should be referred to NHS 111 or a local pharmacy.
The gap between what the contract says and what patients actually experience is, for many surgeries, still very wide.
Complaints can get you taken off the GPs list
I am going to start at the end rather than build to a reveal. Today, I received communication from my surgery which was the ultimate betrayal. I had always thought that the surgery, in general, couldn’t care less about my general wellbeing, but to receive a letter literally kicking you off the island really does say it all. They have given me 30 days’ notice that they are removing me from their list. I live in a village. There are no alternative practices within the catchment area. Under NHS rules, surgeries generally do not accept patients outside their designated area. In practical terms, this was not simply a warning letter. It was the possibility of having no GP at all. They might as well have stamped “problem patient” across my records and closed the file.
The reason given? Unreasonable behaviour. Now before you assume I deserve everything I get, we are not talking about abusive behaviour. We are talking about me standing up and saying these things have gone wrong and I want them righted. Missing symptoms. Medical notes changed. Three attempts at a referral for an x-ray, not one of the people who did it authorised to do so. The wrong hip asked to be scanned at an MRI. A referral sent to a specialist consultant without any clinical history. A prescription issued without any explanation of why the drug was necessary. Four years of no blood tests. A swollen limb for five years. About another half a dozen other things besides. I didn’t choose for these things to go wrong. It is not my fault they went wrong. But it seems that if you care about your health and complain, you are out.
They say I complained too much. There is, I agree, an awful lot of correspondence. But the majority of it is me responding to correct things they got wrong, or reframed, or allocated to the wrong clinician, or simply forgot. If you don’t correct an incorrect response, what was the point of the exchange in the first place? And then there are the snarky replies advising me that they have received “yet another” email from me, as though I get pleasure out of responding to their inaccurate answers.
Information about a patient’s health not shared with the patient
It took four months to obtain a letter from another service provider, on the grounds that the provider was the data controller and not the surgery. I do not claim to be an expert, but I do know that when a doctor’s surgery receives a letter with my name on it, talking about me, I am entitled to see it. Four months of them saying it was my problem, and me saying it was theirs, until the Integrated Care Board (ICB) advised them that I was right and they released the letter.
Everything before the removal letter could be explained away, individually at least. A missed result here, a rushed referral there, a consultation that went badly. The NHS is overstretched. Clinicians are human. Mistakes happen. But the removal letter cannot be explained away. It is not a mistake. It is a deliberate act. It required someone to sit down, make a decision, write a letter, and send it. The reason given, “unreasonable behaviour,” with not a single specific example provided, is transparently a reframing of the word complaint.
My health seemed less important than their inconvenience
I spent months telling myself they didn’t care enough. That the failures were systemic rather than personal. The removal letter strips that away entirely. It says to me: we know you are right, we know you have evidence, and our response is to make you someone else’s problem. The betrayal is not just that they removed me. It is that in doing so they confirmed everything I suspected but tried not to believe. That my health, my fear about my eyesight, diabetes, a swollen foot, five years of unanswered questions, none of it mattered as much as the inconvenience of having to answer for it.
I remember my grandmother knowing her doctor’s name, and the doctor knowing hers. What I mean is that they took time to read the notes before seeing a patient, looked at the history, and were sufficiently able to act as though they knew the person in front of them. I am not claiming they were better doctors. In fact one such doctor insisted to my grandmother, and to me, that she was “as strong as an ox” and there was nothing wrong with her, and in less than two months she died from Motor Neurone Disease. But there was something in that older model, imperfect as it was, that at least attempted to see the person rather than the presenting symptom.
See a person, not a condition
What healthcare is supposed to look like is joined-up records, clinicians communicating, patterns being noticed, and, most importantly, someone taking ownership. Understanding how physical, emotional, social, and lifestyle factors interact. Not just treating a sore back, but exploring whether stress, posture, sleep, or other conditions are contributing. Chronic fatigue might be linked to diabetes, Vitamin D deficiency, depression, or thyroid issues. That is not idealism. That is basic medicine.
Instead, a joint discussion about my foot produced this: “I’ve had a discussion about your foot with my colleagues, and we all agree that it’s just gravity and your age and nothing can be done.” Helpful.
Striking patients off for advocating for themselves is not the answer
There are not enough doctors, not enough resources, and practices need to be efficient to look after their patients as well as they can. I understand that. What I do not understand is how removing a patient who asks questions, corrects errors, and refuses to be fobbed off constitutes good care, or good faith, or anything other than an admission that the questions were too inconvenient to answer.
