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.

[Dubaibutwhy]

I'm a hospital consultant. I hate the widening division between primary and secondary care, but as others have said it's the result of commissioning systems, falling GP numbers, the ageing population and the increasing complexity of medical care.

It is very common for GPs to decline to do this sort of task these days; firstly because they are not being funded for it and secondly because they do not want the additional responsibility and workload of managing secondary care conditions.

In the OPs situation, I'm sure the GP would be equipped to deal with an abnormal FBC, but in many cases - GPs are being asked to request blood tests, for which they then have clinical responsibility, but they would not be able to act upon the result. This means that they end up having to chase the secondary care team.

Obviously it would be much better for the pt to have the test taken closer to home and in an ideal world a pt could have a bloodtest requested by Dr X and then go to any hospital/GP surgery in the country with the result going back to Dr X. Unfortunately the system is not set up like that.

If I have a pt that needs repeat bloods after discharge we usually get them back to our day unit. If they live some distance from hospital we do occasionally ask the GP, but will ask the practice to email the result straight to us (and provide telephone contact details for our team in case of any urgent issue with the result)

[Rowthe]

@Blort

This is infuriating to read! Can you get an emergency appointment with gp?

No cos they're filled up with 50 other people wanting to discuss requests the hospital said they should have
🙄

GP dont have an endless supply of appointments.

This is just another GP bashing thread.

The hospital said you need the test but didnt arrange for you have it done and obviously it's the GP's fault.

It would be better for patient care of you complained about it to the hospital so they dont keep making the same mistake again.

The amount of complaints we get from patients because of unrealistic expectations due to the hospital is huge. Obviously gets fed back to the hospital but it doesnt stop the complaints.

The worse ones are the patients who ring up thinking we can fit them in for emergency blood tests the same day because the hospital told them we would - we find it difficult enough to do the blood tests that we think need doing never mind any that get pushed on us.


And for those saying GP's used to do these tests,.obviously if everything was funded properly and there was goodwill in the system they would happily do extra work without the extra pay, but there isnt and like all public services more and more work is being squeezed out,.which may just explain the current shortage of GP's.

In answer to the OP, even if the Practice Manager isnt a clinician the Practice probably get enough of these requests a week that they have a pathway for these requests.

And by asking the hospital to request the blood tests they are actually going you a favour,.where I work the patient gets directed back to the hospital so the hospital can arrange any investgations however urgently they feel it is needed, rather than pressuring a service already under enough pressure.

[Rowthe]

@olympicsrock

At the end of the day the health care system should be for the benefit and convenience of the patient not the system!
When patients are accessing tertiary services it is jot reasonable for those parts of the care that can be done in the community to be done over an hour away.
These days Hospital doctors can see the results on our systems so there is no need for the patient to travel to have it done.

This is a great idea.

If only there were clinics set up near the patients home where they could have these tests done.

At our surgery there isnt any give, every single appointment is accounted for.

[Riverlee]

“However, to reiterate, my issue is not the broken process, it's the fact that the practice manager only focused on getting the right form filled in and at not point (that is apparent to me) did anyone consider the ongoing welfare of the patient, nor communicate with me.”

Actually, ‘by getting the right form filled in’, you could argue that the practice manager is putting the welfare of the patient first. Why? Because he/she was ensuring they were getting the correct list of blood tests that the hospital consultant requested. They weren’t actually refusing it as such, but just not carrying it out until they got the correct clinical information. Good practice!

[Paq]

@Riverlee but as a non-clinician, not involved in any way in my care, that is absolutely not their call to make. Practice managers, AFAIAA, do not make decisions on individual patient care, and certainly should keep the patient informed.

Neither did the practice tell me this was the reason for the hold up.

[Riverlee]

You’d actually be surprised how many non-clinical staff work in a gp’s surgery, and process letters.

[Paq]

Happy to admit complete ignorance about the workings of a GP's surgery but I would be surprised if anyone thought that non-medical staff making decisions about medical care was a good thing.

[Roselilly36]

Most Practice Managers I know are non-clinical staff, and are business managers.

[Sandylanes69]

@Paq

Happy to admit complete ignorance about the workings of a GP's surgery but I would be surprised if anyone thought that non-medical staff making decisions about medical care was a good thing.

They're not. They're making decisions according to the processes they are TASKED WITH FOLLOWING.

[WhatADrabCarpet]

I'm probably being a bit dim here but I'm wondering if the problem is with the fact that GPs are private and cost their procedures accordingly which , with an NHS contract , they can accept or dismiss certain procedures.

Hospital consultants are employed by the NHS.

Dunno.

[VWT5]

Your GP should have had sight of the hospital discharge summary with the request for blood test and would/should have put that on the system to be carried out.

A Practice Manager would not be part of the clinical decision making process.

[2bazookas]

Just ask for GP appt and when you get there, ask the DR to do the blood tests required by hospital.

[Riverlee]

@2bazookas

Just ask for GP appt and when you get there, ask the DR to do the blood tests required by hospital.

That’s the whole point. The surgery didn’t have the specific details of which blood tests were requested and so needed further info from the hospital.

[MumblesParty]

@Paq

It's a simple blood test.

There’s no such thing as a simple blood test.

[cptartapp]

@olympicsrock

At the end of the day the health care system should be for the benefit and convenience of the patient not the system!
When patients are accessing tertiary services it is jot reasonable for those parts of the care that can be done in the community to be done over an hour away.
These days Hospital doctors can see the results on our systems so there is no need for the patient to travel to have it done.

That's fine in theory.
But then don't complain when your baby's eight week vaccinations can't be done until they're eleven weeks old because the nurse's clinics are full of blood tests.

[Paq]

@2bazookas

Just ask for GP appt and when you get there, ask the DR to do the blood tests required by hospital.

The next available appointment is in July.

[Paq]

Really @MumblesParty? I'm not asking for globs screening, just to check my anaemia. I've been having them regularly for four years and no one has batted an eyelid until now.

[Paq]

*global

[Sandylanes69]

@Paq

The next available appointment is in July.

I hope you've booked it?

[RichardMarxisinnocent]

@Riverlee

That’s the whole point. The surgery didn’t have the specific details of which blood tests were requested and so needed further info from the hospital.

Yes they did, according to the OP it was a full blood count.

[Paq]

I didn't book an appointment in July because I will resolve the situation before then and I don't want to waste the GP's appointment time with a complaint. And I don't need to see a GP to get blood taken.

[TheIsaacs]

@Paq

@Riverlee but as a non-clinician, not involved in any way in my care, that is absolutely not their call to make. Practice managers, AFAIAA, do not make decisions on individual patient care, and certainly should keep the patient informed.

Neither did the practice tell me this was the reason for the hold up.

But this is exactly the situation as it should be. It’s not up to the practice manager or the GP to tell you they’re not doing the test and the practice manager didn’t make a clinical decision. For their job admin DOES come first.

They will have sent it back to the hospital to sort out. The practice manager is not at fault here, it’s the hospital at fault for not knowing how to request a blood test.

[Saschka]

I am a hospital doctor. The fault lies with your surgical team - if they want a blood test repeating, they need to organise that. We have surgical assessment units, medical assessment units, same-day emergency care units etc, to follow this sort of thing up. Definitely not the responsibility of your GP.

[Paq]

@Saschka most of my pre-op care was done through the GP surgery. So for example I needed an injection a month before, the GP surgery did it for me.

I live in a large rural county, if simple blood tests can be taken locally it's a lot better for patient care. The integrated care board (lol) strategy is to deliver non-acute care locally where possible.

[Madwife123]

@Paq

Happy to admit complete ignorance about the workings of a GP's surgery but I would be surprised if anyone thought that non-medical staff making decisions about medical care was a good thing.

They are not making medical decisions though. If the GP wasn’t given a blood request form then it wasn’t requested. The practice manger didn’t deny you a test, the test wasn’t requested by the hospital. That’s the point. Mentioning it in a discharge summary isn’t a request. I could put in a discharge summary follow up blood test required. That doesn’t mean I’m asking them to do the blood test. Just informing them.