You can now book online to see your GP. But is it any easier to get an appointment?

GP Dr David Turner no longer sees patients on a Wednesday morning.

Instead, he spends that time sifting through the online appointment requests to work out what each patient needs. Last week there were 84 requests, and the week before it was more than 100.

"It's relentless - you get about two minutes to look at each," Dr Turner says. "We're getting lots of requests we would not have had previously - questions like, 'Should I take this food supplement?' Previously patients would not have bothered GPs with things like that.

"Obviously, the concern is there is something serious buried in there - I know of a practice which only realised at 6:20pm there was a patient that needed an urgent home visit. If they had come through on the phone it would have been recognised straight away."

Dr Turner's Hertfordshire practice started complying with a new government directive to offer online booking across England in September.

The idea is make it easier for patients to book non-urgent appointments or ask questions - and end the 08:00 scramble to get through on telephone lines. But the increased administrative workload for doctors means the practice is now offering fewer appointments overall.

"I'm not sure the government has properly thought this through," Dr Turner says.

His union, the British Medical Association, is so worried it has opened a formal dispute with the government about the new approach, warning GPs are going to be overwhelmed and that could put patients at risk.

This opens the option of the BMA introducing a work-to-rule limiting the number of patients GPs will agree to see.

But how do patients feel? Members of the public told Your Voice, Your BBC News that while the online system is welcome it is being undermined by the long-standing problem of a lack of available appointments.

Jo, 53, a former finance director for a private hospital who lives in Kent, has tried using the online system - but there have been no slots available.

She has regular contact with her GP surgery as she is on thyroid medication after having half her larynx removed because of a benign tumour.

"My practice is meeting the requirement for online booking, but what's the point if you can't get an appointment?"

However, Jo's dissatisfaction goes further than just getting access.

"I know staff are really busy, but sometimes their attitude is so dismissive and frankly rude," she says. "I went in for a blood test recently and the nurse was so abrupt. They don't realise how frightening it is when you are concerned about your health. If they did, they would show more empathy."

But Jo acknowledges there are other aspects of the digital evolution in the NHS that are improving services. She is able to order repeat prescriptions online and after getting her blood tests done she accessed the results on the NHS app.

"It does make it so much easier for someone like me, but we need to remember not all people are digitally savvy," Jo says. "My dad hasn't got a smartphone - so someone like him won't see the benefit."

This is something feedback to Healthwatch England has found too.

Over the last month it has been monitoring what patients have been reporting to its local branches about the online appointments system. It says while some have reported it has helped speed up bookings, others fear being marginalised because they are not comfortable with the technology.

Rakesh, who lives in Southampton, has had a similar experience to Jo.

"I've tried the online portal and you can book for six weeks in advance, but there are never any slots available. You are then stuck on the phone hoping to get through."

"You have more chance of winning the lottery than seeing a GP," Rakesh says, jokingly.

The 65-year-old says he is lucky though as he remains pretty healthy and does not need to use his GP much.

"I feel sorry for people with health problems who need to see a GP regularly. It's definitely got worse over recent years. I noticed a change after the pandemic - it got much harder to see a GP, certainly in person."

Rakesh, who used to be a merchant shipping captain and now works as a safety auditor in the industry, feels GPs should be doing more to improve access – or at least the GP partners that run the practices.

He points to the profit they make - GP practices are effectively small businesses and the latest available figures show the average partner earns more than £150,000 each year.

"They are very profitable businesses," Rakesh says. "I don't think this is a matter of money."

His displeasure is clear - and it is something many share. The long-running British Social Attitudes survey shows satisfaction with GP care hit its lowest level since records began last year with fewer than a third of people happy with services.

Not everyone is dissatisfied though. Stephen's practice introduced online booking a year ago and he has used it three times to great effect.

"Each time, I've got a message back quickly offering an appointment or asking for extra information. On one occasion I even got a same-day appointment," says the 67-year-old, from Chelmsford. "It's so much better than being stuck waiting in a phone queue."

The most recent time Stephen used the online booking system was as a result of pain and weakness in his hand. He was referred for physiotherapy and was able to receive treatment at his local GP practice.

This is part of a nationwide scheme launched by the Conservative government giving practices extra funding to recruit physiotherapists, pharmacists and dieticians.

"It's really convenient," says Stephen. "I've also seen a pharmacist for a medicine review for migraines, and I've had a blood test done there too. In the past we would have had to go to hospital or elsewhere for these."

Patricia, who is in her 70s and lives in Surrey, is sympathetic to the pressure on GPs.

She, too, has found it hard to get appointments through the online booking system, but says it is at least easy to use.

"When I last tried to use it there was nothing for weeks, so you still have to rely on getting through on the phone."

Patricia suffers from back problems and needed some medication to control the pain. "It is something that flares up from time to time. I once had to ring 999 and paramedics came out. But they could not issue a prescription - they had to phone up to get one. It all seems so inefficient," she says.

"But I know the service is under tremendous pressure. I think we need to re-think our approach."

Patricia has a house in France and has used GP services there. "You pay small fee to go - and it is so much quicker and easier. It would encourage the public to use services more responsibly. You would need to have some form of means testing. But we pay to see a dentist, why not a GP? It's worth considering."

This is an idea that has been suggested many times over the past decade, including by former Chancellor and Health Secretary Sir Sajid Javid. A number of European nations have some form of charges, as do Australia and New Zealand. The argument put forward is that it would raise vital funds and - as Patricia argues - encourage more responsible use.

But experts at the King's Fund think tank have argued that the cost of introducing the system coupled with the exemptions that would need to be put in place would mean the "pain is not worth the limited gain".

The government believes it has the right building blocks in place. Health Minister Stephen Kinnock says the steps being taken are having an effect, pointing out there are now more appointments being booked online than via phone for the first time.

And, after years where the number of GPs has hardly risen despite increasing demand, he also says a relaxation in funding rules has led to an increase in GPs by 2,500 over the past year or so (although some of these are part-time).

"The tools and resources are there to deliver a modernised service fit for the future," adds Mr Kinnock.

But this has not translated - at least yet - to a significant improvement in access. The most up-to-date polling is produced by the Office for National Statistics, which is carrying out monthly surveys on access to NHS care.

It last asked people in late September and early October about their experience over the previous four weeks - this covered a period by which time GP numbers had gone up and when there was already significant access to online booking. While it only became mandatory to offer online booking on 1 October many practices had taken the step before then.

Just over one in five respondents said they were not able to contact their GP practice on the day they first tried - similar to the situation the year before. Although there has been a small reduction in the number not able to get through at all - a year ago it was nearly 5% and now it stands at just over 3%.

Professor Kamila Hawthorne of the Royal College of GPs says it is clear there are still challenges - and she is not convinced it is a given that access will improve in the way the government believes.

She says some practices have struggled to introduce online booking because of outdated IT systems and while the rise in GP numbers was welcome, many thousands more are still needed.

"Practices are telling us that despite patients crying out for appointments they don't have the funding to employ the GPs they need."