What to do when the practice has no appointments left

Like all other NHS services, we do not have infinite capacity. Due to the constantly increasing workload, decreasing staff and real term paycuts to GP practices we are unable to offer the service we once did. We must consider the BMA guidance on safe working practices in order that we maintain the safety of our patients and the welfare of our staff. In 2018 the government and GPs agreed on a new contract to support practices however to date, the government has yet to fully implement any of the contractual promises. Please see the Almond Group Practice’s 2018 contract tracker here.

When we ran out of appointments in the past, the GPs in the practice would see extra patients on top of their already full surgery and there was also a ‘duty’ GP that would have an open ended appointment list to take patient calls and see them in the practice. In recent times this has become an exhausting and often impossible task with our GPs often seeing 60 patients per day + prescriptions + letters + sicknotes + blood and scan results + housecalls. The recommended BMA maximum is 25 patients per day. Due to the effect on our family life and our mental wellbeing, we have now decided to limit ourselves to 30 patients per day (still more than the maximum recommended) + the other admin as mentioned which is still above the maximum recommended. We will no longer have a duty GP but this will actually increase the number of bookable appointments we have to offer.

All the GPs and other clinicians will continue to work hard and strive to do the best for our patients. We genuinely care for the towns of Kirkliston and Winchburgh and helping people is hugely satisfying and gives our jobs genuine meaning. To that end we will still offer more appointments than the average practice benchmark (50 per 1000 patients per week) and we will continue to develop our un-rivalled customised IT processes within the practice which automates many of our processes to save unnecessary appointments.

If you feel General Practice is an important service that you would like greater access to and adequately resourced rather than the current government policy which is causing practices to close their lists or return their contracts to the healthboard (12 in Lothian so far) then you should to contact your local MSPs.

Kirkliston and Ratho – Alex Cole-Hamilton

Winchburgh – Fiona Hyslop

We have already met both MSPs to discuss our concerns.

Non-urgent advice: Emergencies

It is not appropriate to contact your GP about emergencies as these are best treated in Hospitals.

Please phone 999 for the following:


Please attend Accident and Emergency for the following:

Severe allergy

Tingling, numbness or weakness in a limb or face

Abdominal pain (severe)

Bleeding (heavy)

Blindness, sudden, one or both eyes

Breathlessness, new

Burns, severe

Broken bones

Head injury

Lethargic (drowsy), feverish child

Fits, seizure or uncontrollable shaking

Nose bleed, not stopping after 30 minutes

Overdose of medication, poisoning, accidental or intentional

Lacerations (knife wounds, cuts), deep

Meningitis, suspected

Self-harm or Suicidal Thoughts

Non-urgent advice: Mental Health Problems

Please use the self-referral and self help resources available from the front page of our website.

Please phone 111, 999 or attend Accident and Emergency if you are feeling Suicidal.

Non-urgent advice: Infectious Illness

The vast majority of infectious illnesses (Chest infections, Tonsillitis, Ears infections, Sinusitis) that we see at the Almond Group Practice are viral infections or mild bacterial infections that do not require antibiotics and go away with time.

Read about how you can manage your symptoms or condition here.

See your local pharmacist and they can often advise or prescribe medications as necessary.

If your child is unwell read about how to care for them here.

Non-urgent advice: Problems you think are Urgent

Please use the self-help resources here and phone back the next working day at 8 am when we open. We have relatively good access and usually don’t run out of appointments until late morning / early afternoon. If it is a Friday afternoon then please consider phoning 111 or attending your nearest Accident and Emergency.

Consider using 111 online to advise you of the best course of action.

Non-urgent advice: Routine Problems

Read about how you can manage your symptoms or condition here.

Consider using 111 online to advise you of the best course of action.

Consider booking a routine face to face or telephone consultation. We have appointments available up to four weeks in advance.

See your local pharmacist and they can often advise or prescribe medications as necessary.

Explore the front page of our website to see if there is anything you can self-refer yourself for. You can self refer for Podiatry, Counselling, Psychology, Cognitive behavioural therapy, Drug and Alcohol Misuse, Travel advice and vaccinations, Weight Management Clinics.

Non-urgent advice: Medication Reviews or Problems

You can submit medication problems via our front page. This will go to our pharmacy team to deal with and they will be in touch with you.

You could also ask our reception team if one or our medication eReviews would be suitable.

Alternatively you can speak to your own local pharmacist or read about your medication here