A GP surgery says it is under so much pressure it has been forced to stop allowing appointments to be booked in advance.

Instead patients of Fusehill Medical Practice in Carlisle can only call up on the day to ask to be seen, or use the NHS 111 helpline. All calls to the surgery will first be assessed by phone, and appointments only offered if deemed necessary by the doctor.

The practice, which has surgeries in Fusehill Street and on Scotland Road, has blamed a shortage of GPs and rising demand.

Charlotte Asquith, a GP partner at the practice, said under the previous system, patients were regularly being turned away because all available appointments had been taken. A decision was therefore taken to move to a same-day service – meaning there will no longer be any pre-bookable appointments.

She said: “We have not made these changes lightly and have given a great deal of thought as to how we can safely manage the needs and expectations of our patients in very difficult circumstances.

“Our pre-bookable appointment system has become unsustainable with patients ringing at 8am day after day only to be told ‘there are no appointments left’.

“This is a concern because serious conditions could be missed. In response, the practice has taken the decision for a doctor to triage by telephone all requests for medical advice.”

Dr Asquith said this has advantages as patients don’t need to ring back repeatedly, problems are dealt with the same day, and serious illnesses will not be missed.

If an examination or intervention is necessary the doctor will arrange this immediately, or book an appointment. Sometimes patients will be directed to speak to a nurse or pharmacist.

She added that feedback from patients so far has been positive, and said that health checks to monitor long-term conditions are still pre-bookable with clinical staff.

Geoff Jolliffe, interim clinical chairman at NHS Cumbria Clinical Commissioning Group (CCG), himself a GP, said across the county practices are having to change. “We know that a lot of practices within Cumbria, and across the UK, are struggling at the moment,” he said.

“There is a national shortage of GPs. The reality is that General Practice has to change to be able to meet a growing demand, and patients will have to get used to some changes, whether it’s the way appointments are made, or seeing other clinicians including the practice nurse.”

The CCG is looking at ways to help practices tackle the doctor shortage, including offering a £20,000 bursary for trainee GPs.

Dr Asquith said they are having to deal with increasing demand due to rising numbers of elderly people, who often have several different chronic conditions and need regular care.

Meanwhile they are unable to fill GP vacancies. She added: “When I joined the practice in 1997 there were six doctors for 8,400 patients.”

“Today, despite nationwide repeated attempts to recruit more staff, there are just three doctors, one of whom is on leave due to bereavement, to care for 8,600 patients.

“A significant number of GPs are nearing retirement age and there is a lack of younger doctors willing to commit to a career in General Practice. This is particularly marked both in Cumbria and specifically in Carlisle. The situation can only worsen.”

It is hoped the new same-day service will also help tackle missed appointments, of which they have about 40 a week.

In Carlisle, three major practices – North Carlisle, Brunswick House and St Paul’s – are in the process of merging, believing that sharing resources will help to improve services for patients.