Is a GP "practice manager" a GP?

[Paq]

I'm submitting a complaint about my GP practice over a decision that the practice manager made about my post-operative care. Basically, the surgeon asked for the health centre to carry out a task through my discharge summary. The practice manager refused to schedule it because reasons. So this has not been done.

I'm cross and concerned, obviously. But before I submit my complaint, I wanted to know if the practice manager is a doctor or other health professional who who have made a clinical decision on denying/delaying my follow up care.

For those who want more information, the task was a full blood count as I was anaemic post op and they wanted to know if this would resolve itself on its own or if I needed additional treatment. The practice manager decided that the discharge summary was not sufficient authorisation for a blood test and wanted a form to be filled in on a system. The hospital ward/doctor had never heard of the system so couldn't/wouldn't do it meaning that I'm stuck in the middle not getting the information I need for my recovery.

No they are essentially an business manager.

No

Not a gp but they would have been acting under instructions by the gps.

Your practice manager might have a healthcare background, but its not essential for the role.

Not a GP. Submit that complaint. They should have made an appt with the GP surely?!

Reading your post again I'm not surprised it was refused. It was requested by secondary care therefore needs to be organised by secondary care especially if not actually clear what they want. Primary care are within their rights to refuse.

Not a doctor no. I'd be concerned they were the ones making medical decisions re the interpretation of discharge treatment plans..

I’ve had hospital specialists ask my GP surgery to do blood tests and they always did them without complaint, why wouldn’t they?

I can't see why they would refuse. Call up and speak to a GP directly. I just ask when I need a blood test, never been declined. (I have medical needs, but clearly so do you).

Post-op care is the responsibility of the hospital. This includes wound care. Hospital staff often expect GPs to carry this out and most GP practices used to do it, but they aren't contracted to and aren't paid to. With the current pressures (and a bit of infighting between primary and secondary care) GPs are beginning to say no.

The manager would have end of school leaving qualifications at a minimum. They have not done medical studies and are not a medical specialist. A GP has to follow a hospital specialists recommended tests and follow up. The practice manager therefore has to organise the tests the qualified doctor wants you to have. I hope that you complain . The practice manager has no say in your medical treatment.

Yes but why on earth would a GP need authorisation from a hospital doctor to request a blood test? GPs are fully qualified doctors, and a full blood count is a completely standard test, which presumably they would quite happily request if a patient attended a GP appointment with them with symptoms which merited one. So for a patient whose discharge summary asks for one to be done, they should just be able to go into whatever order comms system they use and request one. The patient then might be able to have the blood sample taken at the GP practice, or might need to go to the local hospital. What authorisation was the GP wanting?

It's perfectly normal for a discharge summary to ask the GP to arrange further tests /investigations - there is something called the eDischarge Summary standard (published by the PRSB) which even specifically lists actions for the GP as something which should be part of a discharge summary if applicable.

Well a GP is a job, right. So the
PM could be medically qualified without working as a GP. In the same was as I could have a teaching qualification but not be a teacher.

Because they don't have to.

Using the OP's example, what happens if the test reveals that the patient is severely anaemic? Whose responsibility is it to remedy this?

Post-op care is the responsibility of secondary care.

The practice manager hasn’t made a clinical decision here, it’s a process one. They are the right person to make this decision. Usually post op care is hospital (secondary care) responsibility. Hospital can request GP does this and explain the reasons why but GP practice can decline. Your complaint may be better to hospital pals.

While GPs can obviously request the blood test, they only need to do work for which they are paid.

Historically GPs did a lot of dogsbodying for everyone else without really checking if they were contracted to do the work.

Now GPs are massively short staffed and snowed under just doing their contracted work, let alone any extras. So they have started saying no to anything they aren't paid to do.

Given this is post-op follow up it is unlikely to be GP work unless there is a specific contract for it and so the hospital needs to organise it themselves.

I am a practice manager. I am not a GP or health professional qualified to make minor and major decisions about patient care. This is why GPs study for the length of time they do.

Sorry this happened to you.

In my area (SW) there has been a lot of politics about who does blood tests. It started during COVID when there was a shortage of equipment and seems to have carried on.

This happens all the time at my GPs. Consultants and doctors say you need a blood test and receptionists won't give you an appointment because they don't know anything about it. I asked for a repeat order of a medication and my receptionist wouldn't forward my request to the doctor because I couldn't remember the exact name, even though I gave the exact date it was prescribed and what it was for.
Receptionists rule the world at my GPs.

Practice managers are not GP. It depends on the actual circumstances whether this should be followed up by primary or secondary care but I am inclined to think your GP is at fault. It is the partner who run GP practices and they are responsible for everything that goes wrong with your practices.

No, but it sounds like the hospital were at fault as much as the practice. Or you could have seen a GP to get the required blood test paperwork. The Practice Manager wouldn't have been able to do that (but could have suggested a GP appointment) or arrange blood tests without the correct form.

I have re-read your post. In this instance, your GP should have followed up with a blood test as this was anaemia related.

It sounds like a miscommunication more than anything else. The doctor from the hospital wouldn’t have been able to arrange a blood test at your GP practice. However your GP could have arranged it. Not sure why it wasn’t suggested that you see your GP.

The hospital doctor should have given you a blood form so you could go back to the hospital for your post operative blood test. It isn't the GP's responsibility.
Speak to PALS.
Once the hospital has the result they should prescribe whatever you need and write to your GP.
GP may then wish to follow up after your course of treatment.

Yes a practice manager can be a GP or otherwise medically trained. It depends on the structure/size of the practice.

It actually doesn't sound like the practice manager has either made a decision about your post-op care or refused a request though, just referred things back to the hospital to be done correctly. Maybe a tad pedantic depending on what the hospital actually put in the discharge summary but the refusal part was from the hospital doctor from what you've written.

Sounds like your complaint may need to be directed to the hospital if you wish to go ahead with it.