I know it has been done before in various veins but, IABU to think doctors receptionist....

[Dunkling]

… that are not medically trained, are not in a position to triage you and decide yay or nay, are not the gatekeepers of all appointments placed there to keep the appointments empty (see my experience about this later), and at the very, very least, should be trained to understand the reason for appointment rules re; routine, same day urgent and the reason for this. And also, know what a receptionist is? The frontline font of knowledge to pass between the two parties?

This morning feeling increasingly ill after a procedure, and all advice, including from the doctors mouth, being to get checked out asap if any sign of infection shows (I had increased pain, the runs, nausea and terrible fatigue), so I phoned.

I was told I couldn't have a same day appointment only routine, currently 3 weeks away. Same day are for urgent, so heart attacks and strokes, that kind of thing. I repeated routine didn't help me and I needed same day, even with a nurse was ok. Nope...… same day are urgent, and for heart attacks and strokes. I asked her really? Are you really telling me that when people have a heart attack, they ring them for an appointment. Yes, they do. I asked, so you have appointments open today, the same day urgent ones, and you keep them because when someone has a heart attack, you book them in. With an appointment. The ire was lost. And the sense.

Previously, after numerous (ongoing problem) appointments and being told to book in for a blood test at each, even these appointments were like rocking horse poo. 2 and 3 week waits. What happened to a GP asking you to roll your sleeve up for a 60 second procedure? Each time I was told to avoid waiting, to go to a walk in, the doctor would print a sheet to take with me to marry up my test with me. I decided to wait for all but the last time, and so asked the receptionist for the sheet I had been told of, to get from her, 30 seconds earlier. What sheet? And where is this other NHS clinic please? What clinic?... no idea! Good job I'm internet savvy, and can drive. What if I was 70, and confused?

You can tell me IABU. But god that rant felt better! The evil very upset part of me wants to post them a link to this!

I am luckier than many because I'm quite clued up but what if you are more vulnerable or confused? It does hep to be able to discuss matters properly and understand what's being said.

I also once had a sick baby who’d had a fever for days and a rash.
A Health visitor or pharmacist can also help.

If my GP wants me back he makes an appointment there and then, so he can decide whats a long wait or not.

Yes, there will be some Dictator receptionists, but most are good and are just following orders or instructions. Some patients can be a PITA too and start demanding things that aren't available. I agree though if you shout too much they will slot you in but it's not normal policy. There's nothing wrong with them asking a brief outline of what is wrong so you can be treated quickly and appropriately.

Definitely BUT sometimes the receptionist doesn't realise the seriousness. If I ring up and say I have tonsillitis, they might give me a next day appointment or the day after that. When I actually need a same day one

I think ideally you'd have some sort of computer system that has the option of alerts that pop up, eg. Mr Jones is immunocompromised and always needs urgent appointment for any high temperature.

Mr Jones is immunocompromised and always needs urgent appointment for any high temperature.

This definitely. That is what my GP, my rheumatologist and haematologist have told me. How do I get the receptionist to understand though?

And I think there is a big difference between a receptionist explaining that there are no appointments but offering a telephone consultation or sign posting other services and a receptionist giving specific medical advice.

*I also once had a sick baby who’d had a fever for days and a rash.

A Health visitor or pharmacist can also help*

Maybe it’s just my area but I never found the hv useful for anything medical. Any issues raised were met with see a GP. I’m not sure if it’s a reluctance to take responsibility for saying something is fine but it’s frustrating.

My dd needs to see a physiotherapist on advice from the hv. First GP I saw couldn’t have been less bothered that there was a suspected issue and now I’m battling to get an appointment with a different doctor who may actually look at what’s going on. Unfortunately as I don’t class it in anyway deserving of an ‘urgent’ appointment it’s a case of ringing on the day they open the next batch of prebookable routine appointments and hoping there’s some left (there never are). It’s a joke, all I want is a referral to someone who knows what they’re looking at!

That’s before I even get to myself - a couple of ongoing-not-urgent issues that need assessment and prescription only treatment. Instead I’m walking round in daily pain, uncomfortable because it’s just not possible to get bloody seen.

Conversely when I had a chest infection and was struggling to breathe they had a same day slot which was awesome and I can’t fault at all. Apart from the fact the dr who saw me commented on my incredibly obvious condition and how uncomfortable it must be and when I said I was finding it difficult to get an appointment and hadn’t brought it up because of their strict ‘one appointment one problem’ rule, just smiled and sent me on my way....

The problem is that there simply is no system and it isn't realistic to expect a receptionist to remember that Mr Jones is immunocompromised or Mrs Smith has dementia and you need to speak to her daughter or all the personal situations of all the patients.

SnuggyBuggy

I wouldn't expect the receptionist to remember. There are 15 thousand patients at my they can't remember details about that number.

But they access info about patients when booking appointments, so they can see my name, dob, phone number etc. At times they've been able to see test results, hospital letters etc. Surely a warning notice could be added to the info that they can see?

Try telling that to management. The NHS has a weird attitude to the use of modern technology in admin and communication.

I am not in the UK but when I ring either of the practices I use I get a phone message that tells me if I have x,y,z symptoms then to hang up immediately and call the national number for our ambulance system. Otherwise you stay on the line, wait for the spiel to end then you get put through to a receptionist to make an appointment etc. Seems sensible.

My GP used to use this triage system I never go to GP unless I feel its really needed but when I finally get an appointment often after waiting a few days to see if things clear up on their own, then ringing and being told all the appointments have gone try again tomorrow
When I eventually got to see Dr to be told why on earth didn’t you come sooner?! Then being sent straight to hospital in one case they rang DP to collect me or insisted they would call an ambulance
Now we have a system where GP rings back within 2 hours and assesses your need and offers appropriate time scale for appointment either same day or 1-3 days depending
It is still a nightmare trying to book advance appointments for routine stuff or if Dr says come back and see me in 2 weeks - but you can’t then book an appointment to do just that
They currently keep sending me letters for an asthma review but when I try and book one can’t get an appointment!

SystmOne allows you to put notes on the front screen (first screen) but it depends on which system is being used I suppose.

Our surgery also has the public information screens and will tell you how many people failed to attend their appointments - it's usually around 200 per month. That's just one practice. Add them all up and there is probably over 1000!

It also gives advice on healthy lifestyles, exercise, flu jabs etc

I don't know what they can do to make it efficient but working with the public is a nightmare.

The computers at our practice have a system so that a note or alert can be put on the screen. My ds has a genetic condition and often doesn't present with typical symptoms - e.g. when he has low sats the tugging at the throat and heaving chest is not obvious. He has a note on his screen that basically says to 'check everything, if in doubt send to hospital and listen to the mother!'

I wonder if the receptionist has been told "only urgent cases for urgent appts" and has made up her own mind what this means? I struggle to believe she has been told to reserve them for heart antra is and strokes as, as you say, these people should go to A&E.

I would contact the practice manager and ask for clarity on their policy for urgent appts and if necessary ask that the person concerned is retrained. If the receptionist was correct I would put in a complaint as that is utterly ridiculous!

"If you can get on GP at Hand..." Aka back door privatisation? Which requires people to deregister from usual nhs GP? Er no!

Training is but a part of how good anyone is at any job, but particularly one like this. It also requires that the right people for the job are hired.

They need to have common sense, lack delusions of their medical knowledge, be good listeners (a skill that is about more than understanding what the patient says at a surface level), patient, firm but fair and efficient (receptionists that I've witnessed have included such things as blethering on about the wild weekend they've just had, to the point they're booking in patients as "late" when they weren't! Messing about decorating the area for staff members birthdays etc, waffling on giving "old wives tales" based "medical" advice - including downright dangerous advice!) I've had in the past receptionists that I know will tell me there's no appointments when there are because when I've called asking to speak to X receptionist by name instead suddenly appointments were available, I've had receptionists tell me I don't need an appointment "just cos you get bad periods" (endo), or that I "just need to take some painkillers and go a walk" (spinal condition that when it's bad I'm told NOT to move by specialists), or "it's probably not really asthma it's probably just a panic attack" no it's asthma else the specialists wouldn't have me on a meds regime and it wouldn't be triggered by allergens! Or "it'll just be trapped wind just take some rennie" inflamed ovarian cyst actually.

They should definitely not be giving medical advice.

My current surgery are pretty good and don't mess about. But it is VERY difficult getting an appointment.

Partly not enough GP's, (which is partly due to allowing too many GP's to work part time imo, but also yes recruitment issues), but also partly because they don't have a system for booking appointments in advance unless a dr or nurse says you can - so it's the constant redial as soon as the clock hits 8am and hoping to get through and then hoping there's any appointments left. But I think because they won't do advance appointments that then means ALL patients are phoning sometimes for several days - I recently spent 11 days in a row calling get an appointment for dd. She can't call herself because she's working when you need to call.

Where they are better than most is that within the surgery it's easy to self refer for many basic issues (podiatry, physio, audio, midwifery) and the practice nurse is highly qualified, can deal with low level stuff like colds & flu, stomach upsets etc and can prescribe most meds commonly used. Plus there's an in house pharmacist that's very knowledgeable for meds queries.

They also do telephone appointments, which while not appropriate for every situation are certainly perfectly OK imo for anything that doesn't require the GP to see you in person, so if they don't need to examine you eg if it's to discuss a change in meds where no obs need done, for mental health issues or recurrent minor physical issues where the patient is confident they know what's wrong and the GP knows they're a reliable reporter of this eg eczema flare up

JuniLoolaPaloosa - I too remember GP's doing house calls, but I don't accept it's purely due to the nhs being mismanaged. GP's now don't want to work outside office hours. Sorry but if you go into a career like medicine you need to accept its not going to be office hours, patients get sick 24/7! If that doesn't suit don't go into the job.

There are far more apply than get places to medical school so clearly we could be training more, and we could be weeding out any not fully committed to what a careejr in medicine entails.

"Primary care is in a shocking mess." On this I wholeheartedly agree.

MadisonMontgomery

You are defending these receptionists who think someone having a heart attack should wait for an appointment with a GP, rather than get an ambulance to A&E? They will likely be dead before the appointment.

Receptionists are human beings, capable of making mistakes. That's a biggy however, you'll kill people doing that. They aren't doctors, they don't need to know why you need seen. Mine don't request to know those details, they just book me in. That's their job. And they are good at it if they stick to the job description. These ones aren't.

It does need reported to someone higher. Either someone has told these receptionists to say this or they are very mistaken. But someone is in the wrong here and it needs corrected.

If your Practice is online you can make appointments on a computer or app. You don't need to be the phone for hours for non urgent matters.

I’m a Channel Islander, so no NHS, though specialists and antenal/maternity care free and GP/ambulance/prescriptions/A&E free on benefits.

We have nowhere near the wait times you describe, if you ring at some point in the AM or earlyish PM then you will be offered an appointment - in the AM, often a choice of Drs and times. When a Dr recommends blood tests, you’re often offered to wait 10-15 minutes for the nurse after your appt. When I’ve been to OOH/A&E (share a waiting room) it has never been rammed.

Of course, it’s a double-edged sword. I remember spending at least a week in bed as a child with what I assume was a flu or similar, vomiting water, having accidents and having fever dreams with no GP visit as it costs money.

But I think even people who currently have free GP appts due to benefits are more appreciative of them due to being used to them costing money.

From what I’ve heard from family in the UK and threads like this, it really can’t go on like it has. Either move to a model where some things cost money, or raise taxes and funnel the money to the NHS.

My GP's surgery has a recorded message when you phone saying amongst other things to call 999 if you are having chest pain, difficulty breathing or signs of a stroke.

Our drs receptionist retired andwe have young woman in her place.Now that she has settled in and knows the ropes she is like a breath of fresh air.I am in a lot at the moment and it makes a refreshing change.
Her helpful,nonconfrontational approach is running off on the other receptionist too.
So not all bad,I hated having to lock horns wth the old one.

It's not just money though.Not many Dr want to do further training to be a GP and so we have a shortage and in some areas a crisis.

We had the system mentioned by several posters whereby you could ring in and request a call back later in the day from the doctor. It seemed to work very well.

Recently the practice plus two others have bern combined. I recently rang on a Wednesday and asked for a call back: "Doctor only does his call backs on Tuesdays" . WTF? Wait a week for a phone call?

If your Practice is online you can make appointments on a computer or app. You don't need to be the phone for hours for non urgent matters.

6 weeks I've been trying to book an online appointment. They release so few of them so that slots are kept for those with no internet access etc.

Lobby for extra funding to expand the GP services then.
The reason it's so hard to get appointments is that demand is vastly higher than supply.
We need to either reassess what we think the NHS/GPs should be providing or reassess how much we are prepared to pay for it. RepeatAdNauseum
My practice has an above average ratio of GPs to patients. We still have a three week wait. I still work 3 hours overtime every single day. I'm exhausted and considering quitting.

SerenDippity the one I work in has too but you'd be surprised how many people ignore that message, book an appointment over the phone with me, don't say a word and see the Doctor about chest pain later on in the morning.

Also they ring with chest pain and stroke symptoms and ring the surgery. I've had patients insisting on speaking to a Doctor to clarify their symptoms even though it's glaringly obvious they need to ring 999.

So who would You have sat at a reception desk? A qualified doctor or a nurse? Just so they can diagnose a symptom?