I thought GPs were supposed to be open?!

[DrPatient]

So, I had a routine appointment booked in to check my anaemia - cancelled due to Covid back in March and they'll let me know when I can have it. Fair enough, I get that. But it's now July and they're still not ready. Then, I tried to make an emergency appointment as was told that, no, they aren't doing any emergency appointments and to phone 111. I phoned 111 and they said to book a GP appointment or go to A&E - but I obviously can't book a GP appointment because they said no. I received the letter saying I should book my son in for his one year vaccinations. When I tried to book, they said they aren't doing vaccinations due to Covid - but everywhere is encouraging parents to still vaccinate during Covid. I'm due a smear test - can't book it "due to Covid".
I've had issues with my GP in the past, for example they refuse to provide contraception at all - they tell me to go to a private sexual health clinic about half an hour away instead, and I needed a medical check done for a new job and they flat-out refused. It's very difficult to get an appointment at the best of times with the receptionist demanding to know every minute detail in order to decide whether or not you're "worthy". This was all prior to Covid.
AIBU to think they should be doing appointments now? Are other GPs back up and running?

@EnglightenedOwl

GP receptionists ask what the problem is because that is what their employers - GPs - instruct them to do. They do not deserve abuse for following their employers’ instructions.

It is extremely helpful for GPs to have a basic idea of what the problem is in advance.

Let me give you an example. Let’s take a GP practice with a telephone triage system, where anybody with a new problem rings the surgery, and the receptionist puts them on the triage list to speak to a duty doctor that same day.

Now, a particular GP is doing triage calls until 10:30am, and then they have a full surgery of patients booked in for face to face appointments.

At 10:20, this GP has just finished a call. They only have 10 minutes until their first patient’s appointment is due to begin, so they don’t have time to be taking on a complex phone call.

If the patients ringing up to be added to the triage list have told the receptionist what their problems are, then the GP can scan down the list and select a problem that they know can be resolved within 10 minutes.

If the patients have all refused to tell the receptionist, then the GP could end up calling someone in the middle of a mental health crisis, who needs and deserves far more than 10 minutes - meaning that they’ll be running extremely late when they start seeing patients (something which patients are never happy about).

By giving the receptionist the briefest idea of what the problem is, you enable the GP practice to operate far more efficiently and effectively - GPs can allocate their time to different patients and problems as appropriately as possible.

It's a scandal and a disgrace, the way that a lot of GPs have treated (or not treated) their patients.
I work alongside 6 surgeries and dont know any GPs who would venture out to see a patient at all. Even the most vulnerable of patients. It's all throw some broad spectrum antibiotics at them and hope for the best.

Meanwhile the community nurses, the reablement workers, the carers, physios, speech therapists, OTs and the paramedics have carried on holding the fort.
We could employ at least 4 advanced practitioner nurses for the price of one GP and I would have more faith in them.

There definitely seems to be wide variation. I have had a telephone appointment for DD followed by referral for paediatric bloods which was done that day. I have also had a routine hospital appointment and my husband has had a consultant telephone appointment.
My mum went to her surgery last week for bloods after a telephone appointment with the GP. She and I have different gp practices but both are still working, albeit more remotely.

please don't tar us all with the same brush... I have been seeing patients doing visits and working damn hard putting myself and my family at risk . I and the colleagues I work with have NOT done the things you sweepingly accuse the profession of.

[quote lydia7986]@EnglightenedOwl

GP receptionists ask what the problem is because that is what their employers - GPs - instruct them to do. They do not deserve abuse for following their employers’ instructions.

It is extremely helpful for GPs to have a basic idea of what the problem is in advance.

Let me give you an example. Let’s take a GP practice with a telephone triage system, where anybody with a new problem rings the surgery, and the receptionist puts them on the triage list to speak to a duty doctor that same day.

Now, a particular GP is doing triage calls until 10:30am, and then they have a full surgery of patients booked in for face to face appointments.

At 10:20, this GP has just finished a call. They only have 10 minutes until their first patient’s appointment is due to begin, so they don’t have time to be taking on a complex phone call.

If the patients ringing up to be added to the triage list have told the receptionist what their problems are, then the GP can scan down the list and select a problem that they know can be resolved within 10 minutes.

If the patients have all refused to tell the receptionist, then the GP could end up calling someone in the middle of a mental health crisis, who needs and deserves far more than 10 minutes - meaning that they’ll be running extremely late when they start seeing patients (something which patients are never happy about).

By giving the receptionist the briefest idea of what the problem is, you enable the GP practice to operate far more efficiently and effectively - GPs can allocate their time to different patients and problems as appropriately as possible.[/quote]
No sorry it's not a non medically qualified person's job to be triaging

How can they not be doing baby imms!! DS has his a few weeks ago now and tbh when I called to enquire a few times I did get conflicting information from each person I spoke to. I would call again to check about the vaccines, the last thing the NHS need is an MMR outbreak so vaccines should def be going ahead.

@MadisonMontgomery

So what would you prefer, that you ring up, ask for an appointment and the receptionist just says okay and books you in with a GP? What if you had chest pain and needed to be given advice to go straight to A&E? What if you wanted a blood test and actually needed to see a phlebotomist and the GP appointment would be wasting your time & theirs? What if you had a UTI and needed to provide a urine sample before the samples are collected at lunch? What if you had a back problem and could be booked straight in with that clinic and bypass the GP altogether? And then, when all the GP appointments were booked up with things that didn’t need to see a GP at all I bet you’d be the first to moan that there were no appointments left.

I'd prefer not to disclose medical information to a receptionist

How can they not be doing baby imms!! DS has his a few weeks ago now and tbh when I called to enquire a few times I did get conflicting information from each person I spoke to. I would call again to check about the vaccines, the last thing the NHS need is an MMR outbreak so vaccines should def be going ahead.

No sorry it's not a non medically qualified person's job to be triaging

Did you read anything I wrote?

The non medically qualified person is not triaging. They are simply typing a few words alongside the patient’s name, to allow the medically qualified doctor - who does ALL the triaging - to do so more effectively.

E.g. ‘Infected insect bite’ or ‘Sore throat three weeks’ or ‘Bereavement’

@TroysMammy

Enlightened Owl we ask the problem because the GP's want us to ask what the problem is. I don't care if you have thrush, athletes foot, urine infection, a boil on your nether regions or have bleeding haemorrhoids but having to ask could ensure someone having chest pain is not waiting for a telephone call later in the day from a GP but being told to ring 999.

We are not allowed to give out medical advice but can advise on the best person to consult whether it's a GP, Practice Nurse, Pharmacist or a Paramedic.

What is your training that allows you to decide who someone gets to see?

EnlightenedOwl Receptionists do not triage. Receptionists take messages. The GP triage. If you choose not to tell the Receptionist what you need to consult with the GP then to the bottom of the list you go whilst the GP's triage urgent and more seriously ill patients who have disclosed what is wrong.

@TroysMammy

EnlightenedOwl Receptionists do not triage. Receptionists take messages. The GP triage. If you choose not to tell the Receptionist what you need to consult with the GP then to the bottom of the list you go whilst the GP's triage urgent and more seriously ill patients who have disclosed what is wrong.

Wow. Do you enjoy your power trip

EnlightenedOwl you've obviously got an agenda to draw Receptionists into your arguments and wrongly perceived ideas. Actually I love being in a position of power, I absolutely revel in it. I believe it's called a God complex.

Toodle pip EnlightenedOwl off to bed now where I do sleep soundly as I have an early shift tomorrow wielding my staff of power.

I've been called for a routine blood test, but I'm waiting for my mask to arrive before booking it. DH has not been able to get his acupuncture done. DS was prescribed painkillers for a painful shoulder icebergs phone. So although they are working it's not like they normally do.

Letters asking you to book for childrens vaccinations and for smear tests come from the health authority not the doctors surgery. They are issued by a computer
which has been programmed to send.
CCG check if the GP practice is up to standard.
Have you asked for a prebookable appointment or asked for one that day. Does your surgery offer phone consultations first. This is then up to the GP to offer you an appointment. Ask if the practice manager could contact you for advice on what to do.
Don't go in guns blazing at the receptionist she is only following orders from her manager who is obeying the orders from the GP.

@MaxNormal

The cervical screening programme was paused in March due to Covid, as were many of the screening programmes. It wasn’t your GP’s decision. Many of the laboratory staff were requisitioned elsewhere- even if they wanted to do the test the GP couldn’t as only certain smears were being processed. The programme has just restarted in Scotland- they are starting with the overdue who were early recalls and then moving on to the rest. It is going to take time to catch up though.

GP’s were told to stop doing quite a few things- such as non- essential/private services like medical/insurance reports or HGV medicals. GP’s were also told to stop minor surgery/joint injections. There were told to extend time between some procedures- e.g. B12 injections (haematology advised that this could safely be done less frequently), coils/contraceptive implants
and routine chronic disease monitoring. They were told to stop doing some procedures like spirometry and peak flow monitoring as they are “aerosol generating procedures”.

Specialists changed lots of usual monitoring for things like disease modifying drugs for patients who had been stable in them for a while. GP’s were told to ensure patients did not have open access to the practice, that all patients had to be screened for covid before entering the surgery premises (effectively meaning all patient’s have to be telephone/video triaged) and all should be in the building only if required and for the minimum time possible. Instead, GP’s are strongly encouraged to use video or phone appointments rather than in person.

Immunisations are not managed or booked by GP’s in Scotland, they are managed by a child immunisation team which is run by the local NHS board.

I’m not excusing those practices who are not seeing patients who clearly need to be seen, as actually they should have more time to dedicate to those who really need seen. I think those practices who were struggling with workload/demand for appointments before lockdown won’t suddenly be fine now. Clearly, if practices aren’t providing those services they should be then that is not good enough and I can’t excuse it- I’m trying to help people understand what is and is not within their control. I’m a Dr, not a GP, so no personal axe to grind.

My surgery has been amazing. Both I and my other half have had cause to request appointments and have been called back by a doctor within the hour. Brilliant!
I so hope telephone consultations continue when we get through all this.

Sounds awful op. There are some lazy practices who will be taking every opportunity to reduce their workload. I used to work for a GPs surgery and some of them were horrendously lazy - some were great though.

I think complaints going to the CCG? It would have been the old health authority but believe it's the CCG that commissions their services.

@TroysMammy I was completely on your side until you said this: to the bottom of the list you go. That's disgusting. Punishing people because they won't tell you their private medical information? You don't actually have a right to know. I understand that it's helpful but it's the patient's private information and you have no right to demand it and shouldn't be punishing people because of it. That's just nasty and entitled.

What a nightmare...

Mine have been good so far.

DS had his injections
I've had two appointments with nurse for pill injection
Then I've had an ongoing issue so had an appointment via telephone with nurse practioner, swabs taken by nurse, GP appointment for examination and referral for an ultrasound (yet to happen)
Also have had two prescriptions for son sorted fine.

However, I wish routine appointments at clinics or hospitals were back running as we are awaiting three since January

I’ve read patchy bits of the thread but no they are likely not getting all of the funding they previously were, as they can’t carry out some of the work (IUD fittings, minor surgery etc). They may get an average of some funding based on previous quarters. Where I am this is how it is going

Some surgeries have struggled due to an older, more vulnerable demographic of staffing, some surgeries have done better as they have a workforce who isn’t shielding and the resources to make the surgery a safe place to be

A lot of ‘red tape’ as proof that you are able to provide a safe service and if you can’t, you can’t open up yet. Some surgeries have got a lot of tech, some don’t. I have to risk assess and provide proof it’s a safe place for patients to visit and the staff to work. GP’s often do not have a large workforce of back up to pull from and locums can be very expensive

Care navigating is what a lot of people assume is ‘triaging’ and receptionists are expected to ask patients by the GP’s themselves. They do not like a list of 18 patients none of whom they know what their issue is. When receptionists do not ask, you can end up with a list of people asking for camp America letters and even heart attacks which should not have been booked in. ‘Safety netting’ is for the patients too. And yes people do come to the GP with chest pains clearly having an actual heart attack. The receptionists can also identify something that is very urgent and flag it up, like small babies who are ill. At the start of COVID a lot of people lied to GP’s about their travel history or exposure and it has really scared a lot of them

In my own experience there is a clear split between the terrified and the brave in primary care - some GP’s are very keen to see patients again, some prefer to do it all on the phone for the foreseeable. It’s caused quite a split where I work of those who will and those who won’t, and causing a lot of friction

You should write to the practice manager the local CCG and also NHS England if you are not happy with the service you are receiving

As for the argument about receptionists I have already mentioned this but the GP’s want the receptionists to make a note of the presenting complaint on the appointment screen.

On a daily basis you have X number of appointments. If 70% of them are taken up with ‘admin’ tasks - which a lot of queries are - where is my hospital appointment/can I have a blood test (may not even need a consultation for that)/repeat prescriptions (again may not need a consultation), I need a letter for work, I have a holiday insurance form etc, you are screening these out to make way for people who do need the appointment. This is how it ought to work

For as many people as it may annoy, I am fairly certain it has also saved many lives. My reception team have so much experience to flag something serious to a GP immediately including young sick babies, poorly children and people with chest pain

[quote DrPatient]**@TroysMammy* I was completely on your side until you said this: to the bottom of the list you go*. That's disgusting. Punishing people because they won't tell you their private medical information? You don't actually have a right to know. I understand that it's helpful but it's the patient's private information and you have no right to demand it and shouldn't be punishing people because of it. That's just nasty and entitled.[/quote]
I wasn't shocked that's gp receptionists for you. They love it

Immunisations should be done really but they were given a red/Amber/green list of services to reopen

Baby imms - essential
Preschool imms - not essential
Women who require smears after a HPV or cell chances result - to resume
Routine smears - not essential
IUD’s - non essential (longer appointments as well, which is partly why)
Spirometry - absolutely not available