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.

[monte8]

All NHS surgeries have a policy that Blood tests need to be requested by their own GPS only. So if I need a blood test, I need to book a GP appointment first. Was the online form an e-consult with the practice GP?

[Paq]

@CornishGem1975

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).

It's impossible to speak to a GP without an appointment. The next available appointment is July.🥺

[Paq]

@LadyGardenersQuestionTime

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.

It's a simple blood test.

[endofthelinefinally]

However, if the surgeons suspected a haematological condition that should have been in your discharge letter for your gp information.
The truth is, everybody is trying to get somebody else's budget to fund things.
I have all my blood tests at the hospital because my hospital consultant is managing my condition and she sends me the forms.
If my gp wanted to investigate something they picked up, they would request the test and give me the form.
(My gp doesn't do bloods anyway).

[Quveas]

@RuthW

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.

^This ^
The hospital is responsible for scheduling and carrying out related tests or treatment. Having had several surguries over the years, everything is done by the hospital, not the GP surgery.

[Paq]

Sorry, also just to clarify that I have been anaemic for years, diagnosed and treated by my GP through B12 injections (and OTC iron supplements). I was managing but obviously the op pushed me back into low levels of iron.

[TidyDancer]

Actually, can you afford to have the blood test done privately? I have relatives who use a private GP for certain things like this so they don't have to wait around for NHS appointments/clinics to be available. The private GP can then send the results back to the NHS practice you're registered at.

[endofthelinefinally]

What does your discharge letter actually say?

[Sandylanes69]

@Paq

It's a simple blood test.

The simplicity or otherwise is irrelevant; others have explained that this is about budgets, commissioning and process. Go back to the hospital and complain to them. The practice manager isn't at fault here.

[endofthelinefinally]

@Paq

Sorry, also just to clarify that I have been anaemic for years, diagnosed and treated by my GP through B12 injections (and OTC iron supplements). I was managing but obviously the op pushed me back into low levels of iron.

Ah. Well that is a completely different scenario.
I suggest you write a letter to your gp and deliver it by hand.
They have to read it and you bypass everyone else.

[swirly3468]

Just make a GP appointment and ask for a blood test? Explain you were anaemic and need it re checking....

[Littlefish]

Was the hospital/surgery private or NHS?

If Private, then the GP surgery is able to choose (within their own/area guidelines) whether they support you or not.

[Sandylanes69]

The root cause here is the bewildering multiplicity of commissioning systems, providers, budgets, contracts etc etc etc. The poor patient is piggy in the middle. But individual workers are also piggy in the middle facing patients' frustration and anger.

[endofthelinefinally]

And put ALL the relevant information in the letter.

[Paq]

@Littlefish

Was the hospital/surgery private or NHS?

If Private, then the GP surgery is able to choose (within their own/area guidelines) whether they support you or not.

All NHS.

[endofthelinefinally]

I can understand the surgeons not wanting to get involved with your B12 deficiency. You didn't mention that in your OP.

[Hbh17]

Presumably, if the GP practice is not going to be paid for whatever this follow up work is, then the practice manager is absolutely right to refuse it. It is literally their job to manage and protect the business. (And, yes, GPs are independent contractors running their own business, even though they offer their services on the NHS - always have been, ever since 1948).

[BluePoolNoodle]

Practice manager is not a GP.

But hospitals dump a lot of work and discharge stuff on the GP, where they are not set up to do stuff in the time frame and don’t have the information. Hospitals use GPs as their junior doctors and admin and the hospital should have followed it up or given more information of requested.

[Sandylanes69]

@Paq

All NHS.

Irrelevant. There is no such thing as "the" NHS.

[Lapland123]

@Sandylanes69

The root cause here is the bewildering multiplicity of commissioning systems, providers, budgets, contracts etc etc etc. The poor patient is piggy in the middle. But individual workers are also piggy in the middle facing patients' frustration and anger.

This is the problem

[Lapland123]

If they’re not paid to do it, then they won’t do it.
It’s not about whether it’s ‘a simple blood test’. Who is to pay for the ‘simple blood test’?

[Whenisitsummer]

Our gp practices do follow up blood tests for patients post op if we ask them with no issues- perhaps it’s at the individual practices discretion? Practice managers aren’t usually gps and often aren’t health care professionals at all. Unfortunately the nhs is in a bit of a mess , there aren’t enough staff anywhere. In secondary care, our work load has increased massively as we tackle more and more problems that are really the remit of a gp. The number of patients sent to secondary care simply because gp s don’t have any appointments left has tripled. I don’t know what the answer is but I think a bit of give and take between primary and secondary care is necessary really. If gp practices start refusing to do simple follow up blood tests, that will have a knock on effect on the number of referrals we can accept from them.

[Paq]

@Sandylanes69 I was replying to @Littlefish's question.

[Sandylanes69]

@Paq

@Sandylanes69 I was replying to @Littlefish's question.

Still wrong though; there isn't one NHS, there are a huge array of Trusts, commissioning bodies etc. and they all have different processes and parameters.

[Paq]

@Lapland123

If they’re not paid to do it, then they won’t do it.
It’s not about whether it’s ‘a simple blood test’. Who is to pay for the ‘simple blood test’?

They were happy to do it as long as the hospital filled in a particular form, but the hospital did not know what they were talking about.

However, fundamentally, they put their administration ahead of my care. And didn't tell me that's what they were doing. I had to phone up and ask.

I'm able to advocate for myself and have people around me but what if I was really unwell, or elderly, or alone? Or otherwise vulnerable? What comfort would the practice manager gain from following admin procedures if it meant a patient came to harm?