I’m a GP Practice Manager - AMA

[Menora]

My background - I am 40 and previously my whole NHS career has been in Community Services, so I am more of a fresh set of eyes in primary care. I started out as a receptionist many years ago.

I will and do answer telephones when the practice is busy, there is no job I won’t ask my staff to do that I wouldn’t do myself.

I deal with a lot of complaints, mostly about frustration with services and commutation. I can advise you how to make a good, effective complaint and how to get the answer you want from your practice.

There is a new contract change this year, with regard to access. I can answer how GMS operates

I can answer general questions people have about primary care, although I understand all practices are run differently so I might not be able to answer something very specific. I am also not a trained clinician so I can’t answer anything medical.

Ok I would ask your local Integrated Care Board as this sounds like a contracting issue. Google your area and ‘integrated care board’ and contact them to ask who/why can refer for MRI. It may be that they have contracted only MSK to have access to MRI to manage the demand. I assume they do a physical assessment to determine suitability. If you do not get a response contact NHS England

https://www.england.nhs.uk/contact-us/complaint/

@Oblomov23 I feel your pain. I paid.

It is hours, stress, targets and running a business really. The profit isn’t really enough to make you rich, and being a salaried GP has no incentive as you don’t get any profit. A lot of GP’s are female and it doesn’t go well with family life if you are doing 3 days a week 8am to 8pm and still logging in on your other 2 days off to do your admin.

Thank you kindly OP. I will look into this.

@Menora I think you misconstrued my comment. I would never say that, but when, for example, prescriptions have not been dealt with or referrals made, I have said "I'm sorry but this is the third time I have had to follow this up and every time, I have been assured it will be dealt with urgently", the receptionist has responded "well, this is the NHS and it's free so you can come back for it" when I have reasonably, in my opinion, requested something be posted when I have been to the surgery already three times for something promised and not delivered.

Also, if receptionists and GPs are all on first name terms together, why can't everyone be on first name terms all the time.

Hi OP
Do your GPs really believe it is sensible to refer severely obese patients to slimming world? Are they on board with it or do they just do it because that's what some guideline says?

This is the weight management programme option available. They did not purchase or procure this. What options would you like to see? You could write to your ICB about weight management options. This is in tiers and you can’t get to stage 3 without going through stages 1 and 2. GP’s can’t really manipulate this system either

You say that you are not allowed to be friends with your staff but I know of a surgery where the practice manager has employed two of her close relatives. Surely this shouldn't be allowed either?

I didn’t have any context sorry. Their response is not acceptable so you could speak to the manager about it and let them know this has happened and happens regularly to you.

It needs a specialised psychologist/therapist and should be classified as addiction. You don't send a drug addict to 'get clean world'.

I choose not to be friends as it’s too difficult. People aren’t really your friends if they just currying your favour. Yes people do this, I don’t agree with it. This is down to the partners to address as employers.

If this isn’t available they can’t access it for you. This is something to take to the commissioners, your ICB. There might be something in mental health services which deals with food addiction you might need a referral to your local team see if they can help. I just assume that this is very specialist and not easily accessible

Thank you for taking the time to make this very informative thread 🙏💙

Thanks. Personally I think GPs have to mistreat a lot of overweight patients by sending them so slimming world. It's a dysfunctional program and doesn't teach healthy eating habits even for those where that's the key problem. For many people it is not. It is a coping mechanism just like drugs learnt in childhood and it takes serious therapeutic work to undo this.

Bit of a personal one, but is it possible for next of kin to request a deceased patients medical records under Freedom of Information?

My dads surgery claimed it was against GDPR but from what I’ve found out since this would only apply to a living patient.

I'm not sure I want to pursue it now but would be interested to know what your take is.

How do GP practices interact with/feel about 111? It doesn't seem like the system works well. I called 111 recently about my DD, because when I rang the GP they didn't have any appointments. 111 went through all the questions and said "you need to see your GP." I explained that the GP's answering message was saying "no more appointments today, ring 111 if necessary" but all 111 would do was say, no see your GP. So I rang the GP and explained that I knew they were out of appointments but this is what I'd been told. How can that system work when two services just point people at the other?

Op, I have complained to ICB.
But realistically that isn't going to help is it. Any complaint, to pals, ICB, anyone, takes 3 days to be seen. A response within 25 days. They'll give me some bland budgeting bullshit excuse.

This doesn't help. On a day to day basis. Your suggestion of a complaint doesn't help me, practically.

What else am I supposed to do here?
Years ago, I had a frozen shoulder and after a lot of problems and being sent to the wrong place and seeing a physio that was useless and being sent to virgin care who lost my notes. Eventually my GP referred me straight to the nhs consultant who ordered an MRI and said as a type one diabetic, you should've been sent to me long ago because type one diabetics never recover themselves from this, and always need surgery. I had the surgery and everything was great.

Now I can't even get a referral straight to the consultant. GP says they can't do this. They have to go through MSK. but MSK is not fit for purpose, with a 13 week. Just to be seen. Before I start my fight to get an mri, or be seen by an actual consultant.

this is no good to me. I can't see a consultant, I can't get an MRI, I'm getting nowhere and your suggestion of making a complaint will just take up more of my valuable emotional energy and won't actually get me anywhere on a practical level.

Please do you have any other suggestions suggestions?

How often do you have Receptionist meetings and how do you tackle admin errors and spelling mistakes?

I'm a Receptionist and I notice errors made, e.g. registering new patients and omitting to add in a title so future letters will be sent to Jones not Mr Jones. Booking in patients and spelling tonsillitis (tonselitus) incorrectly or other admin things that cause additional work. I've been told not to mention it but to tell the PM but nothing improves. Do I pay too much attention to detail and think stuff it or should I just get more frustrated in a job I enjoy? Thanks.

Thanks Menora,

I am a new mum and even 9-5 is depressing and you feel you never see your little ones. Super mum guilt with that.

Is that just the job, or are there other countries who do it better? And if so do you know what they do. Just going on the junior doctor - we are moving to Australia. Is it just they are paid more there so it makes it worth it and the job is always like that because well it is a stressful job. Or is there ways they have that reduce hours and make it more palatable.

@Oblomov23 please write to your constituency MP.

I feel your frustration. I broke my back, I knew I had, the local hospital misreporting the fracture. The GP insisted I was wrong before giving me the radiology report. A hospital error led the GP refusing to refer me back to the rheumatologist I was already under. They all blamed each other. My MP had it unlocked in 6 days.

Ah, my pp raises another question. When the practice says it's the hospital's/CCG's fault; the hospital says it's the GP/CCG's fault; and the CCG says they don't really know and their commissioning lead is on holiday for three weeks, do GP practices get pissy when patients go to their MP to get things sorted out because nobody in the healthcare economy locally can be arsed or to take responsibility.

Who would be best to talk to regarding a complaint about a nurse who administered vaccines incorrectly please? The practice manager or Partner? Also, who sets protocol or guidelines when vaccines are given to children, so that I can check if these were followed? Thanks for starting the thread!

I have to ask for a levothyroxine prescription every month. I have been taking the same dose for 17 years and it seems crazy.

Snap @Iwasafool. It's ludicrous. I would have hoped that GPs would have argued against this for people like us. What with all their superior knowledge and levels of overwork. I'd venture they can't be as overworked as they claim. However, even though we don't pay, every time a pharmacy raises a prescription they get a payment so I suspect it has something to do with health economy funding overall and if the GPs are pushing ever more of their responsibilities to the pharmacists, the CCGs can't afford to upset the pharmacists. Therefore the patient suffers because we are at the bottomnof the bureaucratic heap.

Even the 56 days would be an improvement for me. It takes about a week from ordering to collecting and before you know it it is time to do it again. Holidays like Christmas and Easter are also a pain as I have to give an explanation for why I am ordering early.