It’s 8am on the dot – and already dozens of unwell people across Reading are on the phone, waiting for help from the supposedly 'worst' doctor’s surgery in town.

The Reading Chronicle has been given the chance to see behind-the-scenes during the early morning rush for doctor’s appointments at Melrose Surgery, a medical practice that was called 'exemplary' during a ministerial visit earlier this month.

But recent reviews online have been less glowing, with one review on Google from just over a year ago saying that Melrose Surgery was 'the worst ran place I've ever come across - 1* review is an insult to anywhere else I've given 1* to before.'

More than 100 reviews have given the medical group a one-star rating, calling it a 'joke' with 'front desk staff…less then helpful, and the GPs are so busy they barely have 5 minutes to speak to you.'

Now staff are in the process of making a range of changes to turn around the reputation of the organisation, which has practices in Alexandra Road and London Road, serving more than 15,000 patients.

I joined the team for a morning shift to find out - why has it been so hard to get through on the phone, and will their new system allow you to beat the 8am rush to secure an appointment with a doctor?

Seconds after 8am, receptionist Sandra Bartlett can see on her computer that there are 20 people queuing to speak to a member of the team.  

The system shows that several calls have already been attempted sometime between midnight and 7.59am.

Handling the calls – which remains at a steady 20-person queue for half an hour – is Supriya Dangal, while also fielding calls is a team of a dozen NHS receptionists working remotely across the UK.  

Meanwhile Papia Bhattacharya sits at the front desk – and quickly finds herself trying to support half a dozen patients who have turned up in person to book an appointment.

Within 30 minutes, the four doctors in attendance at Alexandra Road are close to being fully booked.

This is a typical day – and if this level of demand seems unsustainable, staff would agree.

Sandra said: “The NHS is still in crisis. The time between referrals and patients being seen in hospital is still too long. We have got used to being in crisis. We are used to it now.”

By 11am, the surgery and remote teams have answered 153 phone calls, while 61 calls were abandoned by the caller. The average time in the queue has been two minutes and 23 seconds. Those that get through spend more than 10 minutes on average speaking to a receptionist.

And these conversations increasingly see patients expect impossible outcomes from the stretched team, according to practice manage Beverly Manton.

“They expect us to provide a miracle for them,” says Beverly, who has been working in the NHS for more than 40 years.  

“We do get a few calls where they say, ‘I'm going to sue the surgery.’ They say, ‘if I die that's on you,’” according to Sandra.

Often these calls are over relatively minor ailments – which patients have not attempted to treat at home, according to the receptionist.

She adds: “The amount of people that call up with flu like symptoms - you would be surprised at the amount of people who don’t take anything like Lemsip before they call.”

Adding to the strain is aging software – the back-office booking system crashed four times in as many hours – as well as a ballooning patient list that includes a significant number of people who don’t speak English as their first language.

This is why Sandra calls her colleague Supriya a 'God send.'

The Nepalese national – who earns just over £11.60 an hour - is easily able to communicate with the surgery’s thousands of Nepali-speaking patients, including the 600 Gurkha veterans who live in Reading.

“They are so polite,” she says. “They always salute you.”

Supriya is part of a team that speaks close to half a dozen languages and has access to an NHS interpreter service, but the sheer size of the patient list remains a huge issue.

One doctor has seen his patient list rise from 1,800 to around 2,600 over the span of ten years, while Alexandra Road and London Road continue to see more and more patients join the books.

Dr Aparna Balaji, who has been at doctor at Melrose Surgery for eight years, says: “We have seen a general increase of a few hundred patients each year.”

When the team tried to take on more staff to support this growing list of patients, they found themselves short on space.  

“I had to have meetings over the phone in my car because the room issue was really, really bad,” Dr Balaji says.

In August, the medical group moved from its Eldon Road premises to Alexandra Road to address the issue.

The move was part of a series of changes to improve the service for patients and the workload for staff.

Melrose Surgery has hired three new doctors in the last six months, and earlier this month it has launched a new online triage system.

This sees patients directed to an online form, which is examined by a team of surgery GPs. An AI software assists the team by automatically colour-coding the completed forms, so doctors can quickly tell which patients need an urgent assessment.

In terms of ‘beating the rush,’ staff hope the triage system will deal with the problem.

Forms can be completed from 7am, and the surgery promises to respond by 5pm on the same day, with assistance to complete the forms available over the phone or in person if needed.

Vulnerable patients – those who have a cancer diagnosis, or are over the age of 80, or babies under the age of one - can access reserved slots each day.

“In the first week, 20 percent of bookings were online, 80 percent reception,” Dr Balaji says. “One week later, it’s 30 percent reception - 70 percent online.”

Despite it being early days, staff report that the system is easing the strain, as more patients are directed to more appropriate care elsewhere.

It’s these changes that had Melrose Surgery called “exemplary” by care minister Stephen Kinnock during a visit earlier this month.

While he was in Reading to launch a nationwide conversation about improving the NHS, this reporter asked the minister if he had looked at any feedback about the surgery he was visiting,

Swerving the question, he said he was focused on “the national picture.”

But staff at Melrose Surgery say they have taken onboard the local criticism – as difficult as it has been at times. 

Referring to the reviews, Dr Balaji says: “They are the bane of my life.” 

Despite the surgery being rated Good in all areas by health watchdog the Care Quality Commission, the negative reviews leave staff feeling “deflated,” according to practice manager Beverly.

Beverly says: “We do get people saying, ‘your receptionists are sat there just twiddling their thumbs.’

“It does make you feel like what are we doing, what can we do to help people."

Sat behind her computer, working to accept dozens of new patients who have registered with the surgery, Sandra says: “We are doing our best.”