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

As a doctor, I agree that handing out email addresses to patients can often be abused. I’ve made that mistake before and won’t make it again.

AttendAnywhere (the videocall system of choice for doctors in Scotland at least) has a text chat feature. Would that work for you?

My GP has an email address they give to some patients who have difficulty with the phone.

A consultation needs to be a two way exchange of information. I can see how emails wouldn't work due to the delay between replies if it could take hours/days/weeks for you to type, the Dr has other appointments with 100's of other patients and has to keep referring back to and updating your notes for every email and reply. It would become a long drawn out, resource sapping process.

Working with the GP via a trusted advocate who is familiar with your disability and issues you need the Dr for prior to the appointment does seem the most practical and efficient for all.

I think the difficulty would be the accuracy & timeliness ie the GP will want to ensure they understand your reason for contact & as you can only reply in a limited way each day there will nit be a timely diagnosis.

Do you have a primary physician who is a specialist in your condition? How do you best communicate with them? Can they liase with a GP directly for you?

If it truly takes you a day to write an email then how would that work? It does need to be a conversation.

You don't specify the reasons you need all these adjustments, but with volume concerns etc it suggests that there might be some underlying mental health issues, are you getting these addressed to minimise limitation to your life?

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.*

I can see why they might not want to do this. A consultation conversation is even more confidential than your medical record because it doesn’t get recorded verbatim. Giving anyone with access to the surgery email account access to your consultation would be so far outside GDPR you’d need a new law to cover it.

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.)

How on Earth do you maintain a blog at a typing rate of 50-100 words per day?

My surgery has an app called askmygp.uk.
It isn’t exactly an email conversation as I send an email and the GP replies, by email, when they have time.
I have always received an email reply the same day.
Occasionally when my GP isn’t available another has replied.
You can then reply to this email if you don’t feel the problem is solved.
It works very well for me. Occasionally the GP has asked me to come in but if you are unable then they should arrange a home visit.
I hope you can find something to help you. I have a friend in your situation and know how difficult it is.

Could you do a Skype or similar conversation with the doctor but have a family member there present who you've written down the issues already for? That way it would be an instant conversation, you could hear what the dr has to say, and feel part of the conversation, but don't need to type immediate responses? And you could request the dr asks yes or no questions as much as possible, to which you could nod or shake your head to if you would be able to do that? You might have to type something for your family member to relay to the dr but it could be shorthand whereas I'm sure your emails take longer as you're formulating well written sentences.

How do you communicate with family, friends if your condition means you can talk and unless a good day cant type any more than 100 words?
Is it a long term condition? Are you able to use sign language?
I would try get a home appointment from a GP. Hopefully whatever way you communicate with family will work with Gp face to face.

Do you have care in the community type support? Your needs sound very complex so surely you do.

I can see why they might not want to do this. A consultation conversation is even more confidential than your medical record because it doesn’t get recorded verbatim. Giving anyone with access to the surgery email account access to your consultation would be so far outside GDPR you’d need a new law to cover it..

Ahh, is this why the doctor prefers to tell the receptionists what to tell me (or indeed prefers the phone) instead of writing to me themselves?

How on Earth do you maintain a blog at a typing rate of 50-100 words per day?

That was years ago, I don't even maintain Twitter now

There are so many legal issues I could foresee with using email.
Off the top of my head - liability issues if you email with something serious/urgent and it’s not picked up for hours, an inability to have a meaningful 2 way dialogue within a reasonable time frame coupled with an inability to see you makes diagnosis hard, it’s very time consuming, data protection and IT issues, how can they be certain it’s you emailing, if your unable to type much a lot can get lost in translation if you’re answers are short etc...

Many patients with serious illness and/or disabilities have to use advocates. I get it’s not ideal, and yes GPs do have to make reasonable adjustments to accommodate you (and should do so without making you feel like a problem), but I think bearing in mind the issues with email appointments what you are asking for is unreasonable.

Have scope suggested any solution other than Emil?
Have you communicated with the Practice Manager to ask them to help find a way to make this easier for you?

Sorry I do think an advocate is the way to go, as much as they should accomodate your disability, it is where possible, with email it doesn't seem to be. As others have pointed out it's not secure, delays in response, the doctor can't be bouncing back and forth emails, if something was urgent and there was a delay it could put you at risk. If you can only type 50-100 words a day how would emails work for you if there were questions?
I would ask if home visits are available for you

Home visits, surely?

How many times a week/month do you have to speak to the GP?

Is it for repeat prescriptions or separate issues?

I get why the GP doesn’t want to give his email out as someone could send them many emails every day mithering them. I’m not saying this would be you - but others absolutely would. No patients have a direct line to there GP. Every one has to go through the receptionist. so they can field what the GP is dealing with.

It’s a pain in the arse. I get your getting frustrated. We had to wait six hours during lock down for a telephone consultation and the GP still has not returned to the practice.

If it’s an emergency use your advocate. If it’s repeat prescriptions plan in advance when you have to send them in

Also they have to be very careful that no one sends them viruses via there email as that could be catastrophic for other patients

OP, you've written hundreds of words on this thread in only 3 hours.

I suspect that an advocate may be the way to go.

I was about to come along as say it's discrimination but then all the other points made it clear this is just an impossible situation unless you use someone else.

I'm very hard of hearing. I'm pretty much deaf now without aids. Phones are always a major problem and people and companies have a duty to accessibility. Most don't, but many will respond favourably when you point out the law.

Our GP now offer a service called askmygp and it's Great for me. I fill in their form and message them and they reply in their own time (it's always been the same day the twice I have used it), you can request an appointment, phone call, or email (emails are dealt with via the app, which you sign into so secure) I requested an email, the second time he did call but asked if I was able to hear and then invited me for a appointment, but wanted me seen quickly so it was easier to phone. He was really considerate of my hearing loss in the appointment too.

But, in your case, it's just very complicated, you say you can't write more than 50 words a day, which makes very little sense given your posts, but if that's the case how would that work via email? It won't. If the doctor needs more information and you have used up your 50 words then he's not going to be able to effectively treat you which makes the service ineffective.

I think you are going to need some sort of advocate. It's no ideal I appreciate but email is not an effective suggestion.

OP I don’t see how this would work practically. Can you get an independent advocate if you don’t want family around. If typing this email genuinely wipes you out I suggest you don’t waste it further on this thread.

You can already do this

www.nhs.uk/using-the-nhs/nhs-services/gps/gp-online-and-video-consultations/

I find it very useful. A gp will always get back to me usually within a day or two 😊

I understand a home visit would exhaust you but it seems the safest and most practical option to receive medical care. I don’t think YABU but the fact you’re limited with typing is an issue. If you emailed to say you’re feeling breathless, it could be so many things and if a doctor email replies but you’ve exhausted yourself and don’t respond, they may be concerned.
From all the options, a home visit sounds the least worst.

Are you able to learn sign language? The doctors must have a sign language interpreter they use for deaf patients.

There are all types of way a GP can do remote consultations. AskmyGP uses a messaging service. This is separate from emailing the GP who like all of us will receive 100’s of emails everyday, about admin, the business, NHS regulation, professional regulation and so on. You don’t want to be in that mix. It’s not the forum or medium for carrying out consultations. I expect there are valid regulatory reasons why not.

If your GP uses phone consultations then ask for an advocacy service. Or change to a practice with more modern messaging services.