The Pedalling Swan - Four hours on a Monday: the waiting room is calm because the work has moved
It looked peaceful. Reception had space to breathe, someone dropped off a urine sample, and the BP machine did its gentle whirr. If you judged us by chairs-occupied per minute, you’d think general practice was on a go-slow.
Here’s what actually happened between 08:00 and 12:00 on Monday 13 July.
We completed 631 actions in four hours — that’s one every 23 seconds. Of those, 272 were consultations. A lot weren’t in the room: they were on the phone, by online submission, or via messages that needed a clinical decision. That’s why the waiting room feels calm; we’ve spent five years pushing care to the best channel for the job. Calm is not quiet. Calm is good design.
Prescribing was the other big engine: 252 prescription tasks. Some are straightforward repeats (163 routine). Many are the fiddly ones (89 non-routine): dose changes, supply problems, alternatives for shortages, or reconciling hospital letters with what’s actually in the dosette at home.
Documents and results tick away incessantly: 57 documents processed (clinic letters, discharges, ambulance notes) and 36 results reviewed and turned into actions. 14 medication reviews to keep long-term treatment safe.
Who did what (because people always ask)
Duty GP : 196 actions — 117 consultations, 65 prescription tasks, plus results and med reviews. It felt like sprint-intervals: acute chest pain to school-avoidance anxiety to a shingles photo to an urgent fit note before someone’s shift starts.
One GP was a one-man prescription service: 245 actions in total — 47 consultations and 163 prescriptions plus results and med reviews. If your statin got fixed and the inhaler shortage found a workaround, that’s probably hi
The “invisible glue” were the document/results people: quietly making sure your cardiology letter isn’t lost and your discharge meds actually land where they should. Without them, the whole thing stalls.
That’s just a sample; others chipped in with targeted lists and urgent tasks. The point is that the work is real, constant, and mostly happens off the waiting-room radar.
Why we sometimes say “this is one for the pharmacist”
Two reasons:
Right care, first time. Many problems are pharmacy-first by design now — uncomplicated UTIs, sore throats, shingles, impetigo, contraception advice, supply issues, and OTC symptom relief. Pharmacists can assess and treat on the spot, often faster than we can offer a GP slot. If your issue is essentially a supply problem (“my brand is out of stock”), a GP appointment introduces delay without adding clinical value.
The GP contract. Our core day is undifferentiated illness, long-term disease, multi-morbid prescribing, results, safeguarding, and diagnostics. When we protect GP time for those, outcomes improve — and you feel the system working because you get the right person for the job. Directing pharmacy-appropriate issues to pharmacy isn’t “fobbing off”; it’s how you get seen sooner and keep GP capacity available for the stuff only GPs can sort.
The media says surgeries are quiet. They’re not wrong about the vibe — they’re wrong about the workload.
You’re meant to walk into a room that feels under control. That’s not a cover-up; it’s the result of channel-shifting huge volumes of care onto phone, online, workflow queues and prescription platforms. On 13 July that looked like:
272 consultations across phones, online, and in person.
252 prescriptions, of which 89 needed actual detective work.
57 letters placed correctly in the right record, so your hospital plan isn’t guesswork.
36 results turned into action — calls, meds changes, scans, referrals.
14 medication reviews to keep people safe.
That’s 631 actions in four hours. The room was calm because the engine was running well.
If you want the nerdery, here’s the split for the morning: GP -1 196 actions, GP-2 245, GP-3 39, admin team 1 23 documents, admin team 2 18, admin team 3 11, with the rest spread across nurses, HCAs, reception and pharmacy colleagues who don’t fit neatly into one column but keep the show on the road.
And yes — if you came in with something best handled by a pharmacist and we pointed you that way, it’s because we’re trying to save you time while keeping GP hours for the things that genuinely need GP risk-holding. That’s the contract, that’s common sense, and on Mondays it’s the difference between an ambulance call-back in ten minutes versus two hours.
Thanks for reading — and for putting up with a health system that’s constantly being rewired mid-flight. We’re keeping it calm so you don’t have to see the turbulence.
Data source: practice activity export (13 July, four-hour session). Totals — consultations 272; prescriptions 252 (routine 163, non-routine 89); documents 57; results 36; medication reviews 14; all actions 631