"THIRTY meetings with no agenda and all actions depend on you."
That is how Greenbank Surgery GP Andy Davies described a typical day for doctors in the town.
But after spending time with the team at the Manchester Road practice on Friday, it soon became clear there was so much more than just patient appointments to deal with.
During a 12 hour day for Dr Davies he also had 78 letters to read, 15 test results to go through and after a road accident in the town was delayed carrying out three routine home visits.
He added every hour in the surgery also generates another hour of admin on top of typists behind the scenes writing letters for insurance claims, information needed by the DVLA and the department of work and pensions and referral letters.
It all means the chairman of Warrington CCG barely has time for a bite to eat or drink, never mind taking a lunch break.
He added: “The number of GPs are exactly the same and yet the number of patients is going up with increasingly complicated needs.
“There are days where I haven’t eaten, had one or two drinks and I’m physically and mentally exhausted making thousands of decisions.
“The problem we have is every practice is different which is why patients have different experiences.
“Funding per practice can be almost 100 per cent different from lowest to highest and I have had a 30 per cent pay cut in 10 years to pay for services for the practice so we can keep ahead.”
ONE of the biggest complaints about surgeries across the town is difficulties getting an appointment which often puts the practice’s receptionists in the firing line with police called out three times in the past year.
Nicky Twiss said the attitude to staff can be frustrating and upsetting but they cannot take it personally.
She added: "Sometimes patients speak to us like we're holding appointments back but that's not the case and doctors are seeing patients constantly.
"It's getting busier and busier here now and people are very demanding and want things done yesterday.
"I think if they realise the inner workings of a surgery and that there's a lot more to the process with something like prescriptions than it just being signed they might change their view."
TO improve access to appointments, Greenbank surgery has introduced a drop-in session between 8 and 10am where any patient can be seen without an appointment between those hours.
There have been times where it is standing-room only in the waiting room but on Friday 29 patients were seen for problems including sore throats, snuffley children, swollen legs, chest pain and rashes.
It leads to another problem for GPs as Dr Davies found half of his drop-in patients the previous day could have been seen by a nurse or pharmacist with things like common coughs and colds.
One patient also admitted she always uses the drop-in session even when it was not an emergency as she could ‘never get an appointment otherwise.’ GP Mike Northey, who has been at the surgery for five years, said: "A big concern was patients not being able to get access and waiting two weeks for an appointment.
“The drop-in session means less routine appointments and to an extent we have had to sacrifice continuity with the same doctor for better access.
"We're always trying to tweak the way we do things but we always try and make sure if an ill person feels they need an appointment they're spoken to on the day."
NATIONAL headlines warned last year of the ‘strain’ on the NHS but last month 167 people did not turn up for appointments which could have been given to other patients at Greenbank.
Dr Davies added if people could be more reflective when they use the health services it would make a difference.
He added: “People saying 'I think I've started with a cold this morning but thought I would come in and check' is the most frustrating thing.
“Because the appointment is free, it has no value but it’s actually just cost the NHS £26.
“We have to educate patients and promote what else is available.”
Despite the stresses, strains and ever increasing workload, all the GPs we spoke to said it is the patients that keep them going.
Dr Davies added: "In a survey most GPs said they were not satisfied with their job but despite everyone feeling overworked they also said they wanted to improve access for patients which I think is pretty special and that’s the kind of people we’re dealing with.”