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?

@Menora

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

I just feel numb reading that. Smears non essential, immunization not essential...

Your GP is crap.

I had to take baby DD in for something minor. She has weight issues and while I was there I mentioned the baby clinics weren't running. My GP told me to just come back for another appointment with them solely to weigh her.

They sent a letter inviting me to book DS vaccinations then a reminder when I forgot. Same for DDs.

Appointments etc are available as usual, just full PPE, no waiting room (dr or nurse collects you from car park), hand sanitizer and temp check on way in.

I’m not a GP receptionist but quite honestly if you don’t let them know what the problem is, they can’t triage you effectively and so of course you’ll go to the bottom of the list.

I’m not a GP receptionist but quite honestly if you don’t let them know what the problem is, they can’t triage you effectively and so of course you’ll go to the bottom of the list

This.

@EnlightenedOwl

This is just during the peak, from March until June when things began to reopen. It’s not supposed to be long term. They had to try to minimise face to face contact. A lot of pharma companies extended the life of things such as contraceptive implants
They also then expected GP’s to manage all of the shielding patient lists and the thousands of queries, the blood tests for high risk medications etc and basically the shut down of outpatients and routine surgery where do you think all those patients ended up - calling their GP. Then there is the massive impact on mental health too

Our GP surgery has been great - wrote to my Mum, urging her to book a routine but essential blood test, reassuring her that social distancing would be used. Telephone consultation to change Mum's medication, then the pharmacy adjusted her already dispensed dosette box, so Dad didn't have to think about what changes to make.

Today, I had a phonecall from the dental practice, postponing our end of July appointment to December.

My practice is still doing phone only consultations, they are very speedy, and usually good... until I had an issue which I should be on an urgent referral pathway for, should be two weeks, it's eight and they won't make it until they can see me face to face.

You also have to remember that when it comes to something like immunisations there is a difference between a baby who has had no vaccinations at all, and a 3yo who is having a preschool booster. They need to have it, but this can be delayed slightly whereas baby imms should not.

For smears, you are going to prioritise the high risk patients over the routine patients. The entire NHS has had to do this for this period. High risk patients should be receiving the treatment they need while resources are restricted.
Everyone has been afraid and scared and doctors are humans too with families and their own worries, it’s affected everyone mentally and will do for some time

That's shocking what they told you about 1 year jabs. My son has his one year jabs next week although they are sending Rome to a different practice he still is having them done!

@DrPatient

NHS England are right now pretty useless I think. They were not even taking complaints for a while

The CCG will be your local commissioning group for the area you live in. Whilst GP surgeries are independent they are delivering a contracted service via the CCG, it is called a GMS contract. If they are not fulfilling their contract then the CCG will be able to give you information, you can also formally complain to the surgery. I would try to register elsewhere. You do not give any details as to the size of your practice, some are very small and have struggled very badly, you also don’t give details as to whether it’s likely that the GP’s may be unable to provide services due to their own health issues - if you have a 3 partner practice and one is near retirement the other pregnant then it’s really unlikely they will be managing well on 1 GP. If it’s a huge 20 doctor practice then you probably will have better access and that would be harder to understand.

I personally am registered with a small village practice in this position, with older Male partners who seem to be at risk and are struggling to keep things running. I had a very bad pneumonia and asthma flare up in March and they would not even consider seeing me and it was all over the phone, took me weeks to get better and it was quite scary. I ended up with the doctors I work with doing my obs. We have to collect medication in the car park and all the doors are locked and no reception open. But where I work, we have a completely different set up

DrPatient that's what the Doctors did before we had Ask My GP where you have to tell the GP or Receptionist what's wrong. I really don't know where everyone gets this notion that GP Receptionists are in control of the GP's workload and patient list. We are just message takers and earn minimum wage as well. If someone tells the Receptionist what they need to speak to a GP about eg a flare up of eczema over someone who says it's personal who do you think the GP will prioritise?

Schools have been slammed for not opening fully for thousands of children yet somehow GP clinics can't operate on an appointment basis for much fewer people? Mine still isn't taking appointments. There are no cases of corona where I am at the moment. I have friends who are working in the NHS who run other clinics who are not front line and have been left with very little to do throughout this crisis as their clinics were and still are closed. There has been a massive spike in deaths (non corona) over this period and there will be more of appointments etc. Don't get going again.

@TroysMammy Maybe they get the idea that the receptionist is in charge of the list by receptionists like you going on the internet and saying that you get to decide to put people to the bottom of the list if they don't tell you? Maybe you telling people that you have the power is the reason that people think you have that power?

It is tbe GP making the decisions though. Not the receptionist. The receptionist just writes doen the issue and passes the details onto the appropriate clinician. Either a nurse prescriber or GP who than triages by phone. Subsequently they can than decide whether a face to face appointment is necessary. My smear was just booked in immediately.
Works well in my practice.

That seems bad 🤔 I phoned up to get my pill and was reminded of and OFFERED my smear (which I then had in the surgery 2 days later!)

[quote DrPatient]@TroysMammy Maybe they get the idea that the receptionist is in charge of the list by receptionists like you going on the internet and saying that you get to decide to put people to the bottom of the list if they don't tell you? Maybe you telling people that you have the power is the reason that people think you have that power?[/quote]
And where exactly on the list do you think you should go if you don’t let them know what the problem is?

They won’t put you at the top; if it was an emergency that needed quick triage you’d let them know. So of course you go straight to the bottom because you haven’t given them information to effectively triage you.

DrPatient you obviously don't get sarcasm.

The whole thing at our GPs surgery's has been a bit of a farce imo. The first time I had cause to ring for my 6yr old ds I was put on "the list" for a phone consultation only for the doctor never to ring despite ringing back twice (fortunately the problem resolved without medical input). The second time ringing for my 3 yr old ds I was told to use the e consult request (they say they'll respond within 3 days) only to find you can not use it for anyone under 18. Rang back to be put "on the list". That requires you to be with your phone for an unspecified length of time as the GP can ring at any moment. We missed the call by seconds - rang immediately back to be told by the receptionist that we had missed the call so that was that and to repeat the process tomorrow! We kicked up a fuss and the GP rang back and after various text messages with photos medication prescribed. My 17ds has ulcerative colitis and had a routine blood test at another location (fine) but when the GP contacted via text to say results were satisfactory ds was relapsing and asked for help - the GP never responded. He is now refusing to involve the GP and went straight to ring up the hospital who have prescribed steroids. The doors are locked at the surgery. The only way of contacting is via the e consult or ring, which requires at least 15 minutes of trying as there is a long message about NOT bothering to contact them if you think you've got covid they won't see you and then if the phone isn't answered within a time frame it cuts you off. Phone consults are fine but it's not acceptable just to say it could be at any time - a reasonable time period during the day of 1 to 2 hours must be possible!! Or even just tell you "morning" or afternoon" An automated text to say what time period that will be should be possible. I also don't believe they've been that busy either. Ds got an ear infection and I chose to use 111 on Sunday morning. The out of hours GP callback was within 5 minutes - yes 5 minutes on a Sunday at 10:30 am!!
A&e, on the other hand and dealing with the hospital has been generally easier!!

@heartsonacake It's amazing that you can't comprehend the idea of asking questions that don't require knowing the ins and outs of someone's problem. Like "were you directed to us by NHS111 for an emergency appointment?" or "do you need an appointment today?" or "is this regarding a medical issue or do you need some paperwork doing?". See how all of these could help determine where you sit on the list without demanding your private medical information?
You could use the patient's age as an indicator, whether they phone up every week with the same mild headache or you haven't heard from them in the eighteen years they've been registered.
These could all help to find out some level of urgency without demanding to know and assuming that anyone who won't say doesn't deserve any help.

Also, you seem to be struggling to realise receptionists can't say that a) they have no ability to decide and b) they can and do decide. Those two things cannot both be true.

@TroysMammy Which bit is supposedly sarcasm? I think you've used the term incorrectly.

I wouldn't go anywhere near a surgery that doesn't do contraception. Fuck that.

My docs have been good throughout - two lots of dc vaccinations at height of lockdown, all fine, phone consultation and sending pics to sort out dd skin problem.

Nope, OP, none of those questions you’ve suggested would effectively triage you.

I’m not talking about what receptionists can and can’t decide, I’ve absolutely no idea. I’m talking about you keeping them in the dark and them being unable to put you anywhere but at the bottom of the list as a result.

@TroysMammy

DrPatient that's what the Doctors did before we had Ask My GP where you have to tell the GP or Receptionist what's wrong. I really don't know where everyone gets this notion that GP Receptionists are in control of the GP's workload and patient list. We are just message takers and earn minimum wage as well. If someone tells the Receptionist what they need to speak to a GP about eg a flare up of eczema over someone who says it's personal who do you think the GP will prioritise?

That sounds all very well, but I would feel much more comfortable with something like Ask My GP than actually opening up to the receptionist. I have nothing against GPs' receptionists, but in a village practice like ours everyone knows everyone else. Plenty of people do not feel comfortable giving such personal information to the receptionist, even though I know that they too are governed by confidentiality regulations etc.

I am dubious about receptionists doing any form of triage of patients by phone. How do you know that the person who will only say that it is personal doesn't actually have an extremely serious issue that they are too embarrassed to talk about over the phone? Something could easily be missed if you simply decide that they cannot be priority and relegate them to the bottom of the list?

I actually like and trust the receptionists at our GPs' surgery. They seem professional and nice. However, at my parents' surgery (a bigger town) the surgery itself has an appalling reputation for even getting the phone answered, let alone ever coming into contact with a GP. When people do get in there the receptionist has often been seen just filing and laquering her nails whilst often ignoring incoming phone calls. I wouldn't trust them to triage my dog (though the vet's receptionists I have met have all been pretty good at that, thankfully).

@TroysMammy that makes sense. I'll remember that in future when they want to know why I'm phoning. Not that I mind telling them but I've always wondered why.

Didn't think of the reason you gave to be honest.

Ours has been open throughout, by appointment only. There isn't a drop in (never was though) and same day appointments are only for proper emergencies now, whereas before they were for anyone. Where possible it is a telephone call appointment initially, and then invited in if required.

I had an appointment - spoken to by telephone, then went in the next day for blood tests,, etc.

My routine consultant appointment at the hospital was done in the same way.