Getting back to the OP’s complaint. To be fair, it doesn’t seem that you need help drafting a letter, just copy-paste what you’ve written here. As I say on most of these types of post neither I nor anyone else I know who works as a practice manager is all that bothered if the letter isn’t perfectly worded, provided we can get the gist of the issue we’ll be okay and it’s normal practice to confirm the issues with you in our initial holding response. It’s perhaps easier for me to break down each of your points. So: 1. People waiting outside – this is something that they’re choosing to do, the practice cannot and do not control what happens outside the building an hour before they open. If they were to open the doors any earlier then people would just arrive earlier to be at the front of that queue. 2. Appointments are a finite resource, if the number of people outside matches the number of available appointments then there are none available to release for online booking. The online booking systems I’ve used do release appointments at 8am, but only if they’re there to be booked. Likewise over the telephone, if a significant proportion of the day’s available appointments have been booked over the desk, then the remainder will very quickly be taken up over the telephone. You can apply this rationale to any of your issues around availability of appointments, once they’re booked – they’re no longer available, ie: 2/3 days in advance. My colleagues in reception can complete a telephone booking in about 15 seconds, during our morning rush our phones ring continually so the three receptionists are taking at least 4 bookings each per minute. So in those six minutes that for ‘some reason’ all of the appointments have gone, my team will have booked 72 appointments if they’re available. 3. It is indeed a contractual requirement that we accept bookings over the phone, it would seem that the reason you can’t always get through is that the practice is busy fulfilling that contractual requirement with other patients. 4. If you’re concerned about a ‘Soviet Era’ queue, speak to your MP. Practices are doing all they can with what they have. 5. As Bazza so rightly says, the answer to a shortage of ‘cake’ is not to slice it differently. As I mentioned in my other post, clinicians are working at and beyond capacity, many practices have GP vacancies that they cannot fill and if only to make matters worse, consultation rates have steadily increased. So, perhaps – rather than saying “it’s disgusting”, have a think about how you believe the practice can improve. Put simply, there are no more appointments, we’re not at the golf course, we’re already doing 12/14 hour days and we too have families and lives outside of work. Get out of your head the romanticised idea that being a doctor or nurse is a vocation, it’s not – it’s a job. Someone mentioned earlier, ‘make them commit more hours’ – yeah that’s going to solve the recruitment crisis in a heartbeat. “Hey Kids, wanna be a GP and spend your every waking moment in an office listening to people grumble about a sore throat that started this morning and how they want antibiotics because their Aunt Jane had them and they worked in 1963?” This misconception that if a GP is off, they must be working privately, and they’re all earning over £100,000 a year – do you not think that if there were really the case there’d be a recruitment crisis? The ones I work with take an afternoon / day off every few weeks to keep from burning out, not sitting in another consulting room with a debit card machine on the table.