Appointment System Explained!

Following feedback to the City Walls Medical Centre (CWMC) Patient Participation Group, it is clear that many patients would like clarification on how the current Appointment System operates.

New Triage-First Model (from 7th June 2023)

As of 7th June 2023, we are introducing a new system to improve access to our GP services.

The new system requires patients to complete an online form to request access to the service(s) they need.

Patients select the type of problem they want to contact the Practice about. Then answer a few easy questions about their problem in their own words.

Each form will be assessed by a clinician who will assign each patient to the appropriate healthcare professional.

During the completion of the form, if you are requested to answer additional questions and/or a questionnaire, please DO NOT skip these.
The additional information helps with the overall efficiency of the system.

Clinicians are now part of our triage team to ensure the correct care is provided for each and every patient and to make sure appointments are made efficiently.

To use our online form, you must either; register an account with our online consultation service, use the NHS Login, or continue as a guest.

We recommend registering for an account so you don’t need to enter your details each time you use the service. An account keeps a record of your requests and, in the near future, will also give you access to all our online services, such as repeat medication requests, condition monitoring and appointment bookings.

Note: An email address is currently required to use this service. If you do not have an email address and do not wish to create one, please call the Practice. A Patient Coordinator will fill out a form within our clinical system for you. This form is similar to the online form and will allow you to access our services similarly to all other patients.

(Please select Contact my GP practice)

No Internet or Email Address?

For those without access to the internet or who are unfamiliar with the process, please call our reception. Our Patient Coordinators can help you fill out the form.

If you need to book at the front desk, one of our Patient Coordinators will help you fill out the form.

Our aim is to make sure that all our patients get seen by the right person at the right time.

Phlebotomy (blood test) appointments can still be booked online via the various online services, such as Patient Access, the NHS app, the myGP app, and others.

Patients who have an urgent medical problem when the Practice is closed should refer to our Out of Hours Services and Self Care pages.

Appointment Requirements: Each appointment will only address one problem per patient. If you have more than one problem, please request a double appointment.

To Summarise:

  1. You complete an online form
  2. Your form is assessed by a clinician
  3. You are offered the help you need. This may include sending you a message, calling you on the telephone, or booking an appointment with the appropriate healthcare professional
    • Appointments may be a face-to-face consultation, a telephone consultation, or a video consultation
    • Admin requests (e.g. a 'sick' or 'fit' note, forms, letters) - You will receive a notification once this has been actioned
Online consultation patient workflow

The online consultation service currently used by the Practice is called PATCHS.

PATCHS: Online consultation service

What is PATCHS?

PATCHS is an online consultation service designed by GPs to make it easier for you to access GP services and save time.

PATCHS is designed to help Practices enhance patient access, improve practice efficiencies, and signpost patients to the right place at the right time for their care.

It allows patients to submit their symptoms or requests to their GP electronically. Just answer a few simple questions, and PATCHS quickly gets you the help you need.

It also offers around-the-clock NHS self-help information and signposting to services.


Contacting us using PATCHS (instead of by telephone) has a number of advantages for you including:

  • Getting help quicker from a GP
  • No queuing on the telephone
  • Unlike a telephone call patients can complete a PATCHS form at a pace that suits them
  • You may not need a trip to the surgery and your query may be resolved with a phone call
  • Submitting requests on behalf of someone you care for
  • Patients can request sick/fit notes and test results without the need for an appointment saving patient and practice time
  • Patients will get a response by the end of the next working day or sooner
  • If the doctor or nurse decides you need an appointment, they will contact you to book an appointment ASAP
  • Under Consideration*: The ability to submit requests any time day or night (we can only respond during our opening hours)
  • Under Consideration*: The ability to do everything you need to online including prescriptions, consultations, sick notes, checking results, etc. (You shouldn’t use PATCHS for emergencies)

* We don't want to introduce too many changes all at once. We will assess our new triage system at regular intervals, and if the addition of the above ideas will be beneficial, we will introduce them on a trial run.

Using PATCHS also has advantages for us including:

  • Seeing your request up front in writing helps us plan our work better
  • It allows us to signpost patients more efficiently improving appointment availability
    • Reduced inappropriate appointments (those that can be seen and treated either through self management i.e. purchasing medication at a pharmacy, or by another more appropriate healthcare professional)
  • It frees up the telephone access for people that cannot use PATCHS e.g. those with emergency problems or those that cannot physically use the internet
  • Helping us deal with the most serious cases as quickly as possible

Why Are We Making This Change?

General Practice is currently facing a national problem. There are not enough GPs to meet the ever-increasing demands on the service, coupled with the increasing complexity of cases from an ageing population.

If you would like to understand more, please see the House of Commons Health and Social Care Committee Report: The Future of General Practice (latest publication at the time of writing)

Recent changes to the GP Contract have addressed this problem; Patients must be offered an assessment of need or signposted to an appropriate service at first contact with the Practice.

The Practice aims to help patients access the right care at the earliest opportunity. By introducing our new triage system, we plan to achieve this and manage the increasing demand with strict signposting to the appropriate healthcare service.

This may mean you are redirected to another service, e.g. mental health support, community services, community pharmacy, 111, urgent treatment centres, etc.

If you are redirected to another service, the decision will have been made by one of our clinicians. They are responsible for ensuring you have the most appropriate appointment in the quickest time possible. They do not direct you elsewhere to ease the demand for the Practice.

As a result, we have more availability for appointments that require the expertise and skillset of a GP or Nurse Practitioner.

Appointment Changes

At City Walls Medical Centre, we are committed to meeting the needs of our patients in a safe and effective manner.

To achieve this, we follow the guidelines set by the British Medical Association to ensure that we provide sufficient appointments while staying within safe limits for both our patients and doctors.

We now offer 15-minute GP appointments, as permitted by the GMS contract, which includes necessary note-keeping and housekeeping between patients, to ensure that our patients receive the highest quality of care without the need for repeated consultations.

Online Access

This provides an alternative channel for patients to:

  • Make routine appointments (currently Phlebotomy only. All other requests are triaged by a GP)
  • Order repeat prescriptions
  • Review their medical records

To use the online system you will require a unique User ID and Password – contact CWMC Reception or see the Online Services page for details.