To want email appointments with my GP due to my disability?

[TrolleyProblem]

I'm disabled, housebound and I can't physically speak, I can only communicate by email. The GP receptionists say they're not really supposed to arrange email consultations because they're not as immediate as a telephoneconsultation (which is however impossible for me); they can only pass on my request and then it's up to the doctor whether to grant an email consultation or not.

So every time I need the GP, either the doctor communicates with me indirectly via my family members (with whom I also have to communicate by email), or I email the receptionists with my problem and if I'm lucky they tell the doctor or forward them my email and then the doctor tells the receptionists what to reply. The doctor won't email me directly "because doctors aren't supposed to give their work emails to patients" (though a previous GP did communicate with me through their NHS email) and it's therefore impossible to have any discussion with them.

This situation has been going on for years. Back when I could physically speak they refused to schedule proper phone appointments, the doctor would call me whenever they had a spare couple of minutes between their real appointments, so again I didn't get a full appointment. It's frustrating and makes me feel like a second class citizen.

I would like it recognised that email consultation is my only option and therefore it is not "up to the doctor" to grant it, it's a reasonable adjustment as per the Equality Act 2010 and my legal right. Scope have told me it's not ok for me to be treated this way; I would also like to know please if the practice's treatment of me up till now is illegal or just kind of not good enough.

TIA

(I didn't mean to create a vote but have at it )

Have you written to the Practice Manager telling them this? That might be the place to start.

Hi. I can't help you as I know nothing, but felt I couldn't just run after reading.

What a frustrating situation for you. In my
Opinion, I don't see why you shouldn't be able to get email appointments. You can't be the only person in the UK to be in this situation, and it's worrying they don't have a firm solution for patients in your position. It could be that your practice / trust aren't set up for it. Do you know anyone else in a similar situation? What happens at their GP?

I would argue they aren't making enough changes to suit your requirements. At our GP there are posters all over the place saying that they're obliged to make changes for patients, such as arranging appointments for those with access needs on the ground floor, arranging interpreters etc. I'd argue that they're entitled to give you email appointments. It's irrelevant that you shouldn't have the GP's email address. I'm surprised there isn't a centralised one you can use.

Good luck

Can you use a more typical text communication system that they might be familiar with using for other patients eg speech to text programme? I agree that they should be accommodating your disability

RelayUK for example

I’ve no advice but that sounds really shit OP

@Ullupullu

Can you use a more typical text communication system that they might be familiar with using for other patients eg speech to text programme? I agree that they should be accommodating your disability

I agree with this.

I can see why trying to conduct a consultation via email would create issues. Unless it’s something very personal then having a relative on the phone relating your typed messages would probably make it easier for a GP to effectively discuss the issue.

We use email to communicate with a number of DS consultants between appointments which works well for minor thing but for anything more important or urgent then it wouldn’t really work as effectively

There may be GDPR & local rules about email contact here- I certainly know NHS organisations where ANY work emails containing identifiable information must go via the NHS email system only- so effectively emailing a patient is banned. Which is annoying. A different NHS organisation nearby says if the patient gives consent & emails the healthcare worker, we can reply as you've given consent to communicate via an insecure email address. Any email address outside the NHS system is regarded as not being secure. Do you have a text-to-speech program you could try? Or really I'd think you're within your rights to insist on home visits so you can type a conversation! I agree they have to do something, and you wouldn't be the first in that scenario.

Unless you have an NHS email account, email will be insecure, and therefore the practice will not be able to use it.

Text to voice software sounds like a good idea, or can your carer help?

I was thinking something like text to voice or even video calling apps like Zoom/Skype/Teams as you and the GP could see each other, the GP can talk to you but you can type a text reply?

Can you use a more typical text communication system that they might be familiar with using for other patients eg speech to text programme? I agree that they should be accommodating your disability

Unfortunately I can't because often I can't type more than maybe 50-100 words a day, and that's pacing it out over the whole day, e.g. my OP here took me weeks to draft. Today is a good day but this thread will probably take days to recover from.

Plus even assuming I could, I can't tolerate noise at the volume of a text-to-speech, I'd need ear muffs to muffle it, over an earphone so I could hear the doc, and I can't use a laptop so I'd have to be holding one smartphone (with the text/speech app) against another (making the phone call) and it's just way too much for me to cram into 10 minutes I'm afraid. Home visits are knackering even if I just nod and gesture. It's less damaging to my health just to do without a doctor as I largely do now.

So what are you asking for OP? Many reasonable suggestions as to why email cannot be an option. Maybe you need an advocate who could help you communicate, write out your concerns in advance?

Unfortunately your last post also highlights why you emailing isn’t really going to work. Because for each email in the chain you send when you feel well enough to do so that means the GP will have to get your notes out and refresh himself on where things where up to so it would become very time consuming.

As you obviously have very complex disabilities how do you communicate with other HCPs?

I like your user name

Definitely write to the practice manager & if you have a favourite GP who would listen, include them in too.

Yes they can do this, our surgery have allowed this for DD & she doesn't have half of what you have going on

Can you have a friend or relative as a nominated advocate (you need to write a letter that they are your advocate first) to speak to them for you ,via phone or Skype from your home? I know in MH cases with patients who have financial issues,that's how banks get round confidentiality & patients who are too unwell to speak themselves. The MH unit guy in charge of patient benefits, etc will sort stuff like that on their behalf if they're not well enough .

It is seldom permitted for GP direct emails addresses to be handed out to patients for a variety of reasons, both for your protection and the doctors. I would, apart from anything else, be very dissatisfied with a "consultation" that stretched over weeks., and was in no way "in person". There is far too much room for that to go horribly wrong.

Can I ask, you say that even with relatives support, you can only communicate over weeks. So how would you communicate a more urgent matter? You can't really wait for weeks to communicate everything.

And what have SCOPE suggested the doctor do - could they not, with your consent, speak to the practice to see if there is some compromise? It is your right to reasonable adjustments - but I can see many reasons why what you are asking is not reasonable, so it needs to be considered more carefully and a balanced view taken that SCOPE ought to be able to facilitate. And actually, it may be up to the doctor on that basis. The Equality Act doesn't give the right to have what someone wants, the ask must be reasonable. You have a right to health care yes, but you may need to be more forgiving of how that happens. Why can you not have more home appointments?

How would an email consultation work if you can't type more than 50 to 100 words a day? I'll check in for your reply tomorrow as presumably you won't be able to reply now that your quota of 100 words has been used up in your post at 7.20.

They should be doing home visits for you then. They surely can't refuse health care at all.

Unless you have an NHS email account, email will be insecure, and therefore the practice will not be able to use it.

But the surgery - [nameofpractice] @nhs.net
emails me just fine, it's the individual doctors who I'm told won't. I'd be ok with the doctors replying using the surgery email, it's just having my medical consultations in a relay with the receptionists that causes problems.

With a previous doctor I suggested writing a private post on my blog and sending them the link, then they could reply by commenting privately on the blog, so nobody else can access that webpage and there's no emailing per se. Would that work? (This was the GP who gave me his NHS email.)

I think they just won't go out of their way unless they're forced to. But if I force them via a complaint they may resent me and that doesn't help me either.

I don’t think the blog thing would work, no. But email the practice manager, there must be other people in this situation somewhere

Email consultation doesn’t make any sense. A consultation requires two way conversation, be it verbally or instant messaging such as a chat function. Your subsequent posts about how long it can take for you to write 50 words makes email even more unsuitable, the consultation could take weeks or months at that rate. I think another solution is required, what have you done in the past?

I’d have thought you need home visits
I’d feel, if I were a doctor, very uncomfortable prescribing on the basis of short emails that could be misread. Surely you need to be seen?

There shouldn’t be a problem with you emailing the surgery email, and the receptionists forwarding it straight on to a GP.

Our local surgery is doing this with photos of skin complaints at the moment. You email it to the surgery email, and a receptionist checks the inbox every half hour and forwards each email to the GP who is dealing with that patient.

And no, the blog thing wouldn’t work. There is no way a GP’s insurance would pay out if they made a mistake while treating a patient via a blog - they’re not insured to practise like that, so they can’t do it.