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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

From GP practice managers

314 replies

Bagamoyo1 · 20/05/2021 17:02

m.youtube.com/watch?fbclid=IwAR2ZqCHbGq9Tn0WtOYD5B8y8CnjF-MjkmH2tAEz42wEArKz-pl0QRb5s9hI&v=3ru4QhVZ2a8&feature=youtu.be

OP posts:
CrystalE · 21/05/2021 00:33

GPs are private. Just can't wean themselves off those public sector funds.

Bagamoyo1 · 21/05/2021 00:34

Actioned not auctioned

OP posts:
Staffy1 · 21/05/2021 00:37

@HmmmmmmInteresting, i think we should. I used a private gp two days ago just to avoid the whole unpleasantness and waste of time trying to get an nhs appointment which, once booked, probably have been a waste of time as they so often are. The private GPs at least take the time to listen and do their job, which is just as well for £95 a go.

Staffy1 · 21/05/2021 00:39

Its not so much the lack of appointments that gets to me, although obviously it's a problem! It's the unpleasant attitude right from the start of the person answering the phone.

Bagamoyo1 · 21/05/2021 00:43

@Staffy1

Its not so much the lack of appointments that gets to me, although obviously it's a problem! It's the unpleasant attitude right from the start of the person answering the phone.
The two cannot be separated. If there was endless capacity for doctors and nurses time, the receptionists would be permanently happy and welcoming to all callers, as they’d know they could give them what they wanted. As it is, every time they answer the phone they’re braced for aggro.
OP posts:
Staffy1 · 21/05/2021 00:48

I'm going to regret being drawn into this instead of going to bed half an hour ago, but just to answer what could be done about lack of appointments. Stop insisting that all appointments must be téléphone ones to start with and then deciding if the person needs to be seen which takes another appointment. What used to be one appointment is now often two, meaning less appointments available for other people. Allow online booking again, and not so many people will be trying to phone at 8:00am every day.

Staffy1 · 21/05/2021 00:54

@Bagamoyo1, i don't think our receptionists would ever be happy. All they have to do now is say politely, "I'm terribly sorry, all appointments have gone", not "morning surgery" in a tone that implies "eat shit and die" and then aggressively saying there are no appointments, tough luck. It's not just appointments, i have found them so unhelpful and downright rude and unprofessional with various queries that they could help with.

Taliskerskye · 21/05/2021 00:58

So you think it’s fine to run a private business where you also think it’s fine for your staff to have an attitude that they were bracing for attitude.

Get more staff answering the phones. Set up online booking. Make an app. It’s not hard.

Cull your list, if you can’t cope with the amount of patients. Oh sorry I forgot you get paid per person on your list. You just hope they aren’t too demanding.

BoomBoomsCousin · 21/05/2021 01:21

@Bagamoyo1 The two cannot be separated. If there was endless capacity for doctors and nurses time, the receptionists would be permanently happy and welcoming to all callers, as they’d know they could give them what they wanted. As it is, every time they answer the phone they’re braced for aggro.

These things definitely can be separated. Staff who are going to be having difficult conversations a lot can be trained and provided with support to do so without being unpleasant from the off. It won't necessarily happen by itself, hiring, training and ongoing support for staff to cope with the emotional work involved is required. But it can be done.

On the doctors' capacity problem, I understand you worked a 12 hour day but according to the NHS 90% of GPs work part time. That's an incredibly high percentage. Any ideas how the NHS can tap into all that training and experience to fill the shortages?

Bagamoyo1 · 21/05/2021 01:25

@Taliskerskye

So you think it’s fine to run a private business where you also think it’s fine for your staff to have an attitude that they were bracing for attitude.

Get more staff answering the phones. Set up online booking. Make an app. It’s not hard.

Cull your list, if you can’t cope with the amount of patients. Oh sorry I forgot you get paid per person on your list. You just hope they aren’t too demanding.

We can’t recruit staff. No one applies when we advertise. And even if we had 100 people answering 100 phones, what use is that if they can’t offer enough appointments? And we’re not allowed to cull our list. We aren’t allowed to turn people away unless they’re out of our area. Trust me, there is literally no limit to the amount of work given to GP surgeries.
OP posts:
Bagamoyo1 · 21/05/2021 01:30

[quote BoomBoomsCousin]@Bagamoyo1 The two cannot be separated. If there was endless capacity for doctors and nurses time, the receptionists would be permanently happy and welcoming to all callers, as they’d know they could give them what they wanted. As it is, every time they answer the phone they’re braced for aggro.

These things definitely can be separated. Staff who are going to be having difficult conversations a lot can be trained and provided with support to do so without being unpleasant from the off. It won't necessarily happen by itself, hiring, training and ongoing support for staff to cope with the emotional work involved is required. But it can be done.

On the doctors' capacity problem, I understand you worked a 12 hour day but according to the NHS 90% of GPs work part time. That's an incredibly high percentage. Any ideas how the NHS can tap into all that training and experience to fill the shortages?[/quote]
Many GPs work part time because it’s the only way to survive. I work part time, which actually adds up to about 45 hours per week. Full time GPs would be nearer 60 hours per week. I can’t manage that as I’m a single parent and I couldn’t cope.

OP posts:
BoomBoomsCousin · 21/05/2021 01:37

@Bagamoyo1

So it's a matter of the NHS having more realistic expectations for, what, appointment length, or the like? So that working full time job is actually 40ish hours with 100(*) appointments and all the subsequent paper work etc., not 60 hours with 150 appointments?

And that would indicate that the GP shortage is actually more acute because estimated need is based on an unreasonable idea of what can be done in a work week?

  • Just an easy illustrative number. I have no idea how many appointments or other activities are expected by the NHS for a "full time" GP.
Bagamoyo1 · 21/05/2021 01:48

GP shortage is a massive problem, and will only get worse. Secondary care will take years to catch up on the delays caused by Covid, so will keep passing more and more work back to primary care.

OP posts:
BeaLesshasty · 21/05/2021 01:51

To be honest threads like this make me wish primary care would hurry up and break

I'll turn your words back on you @Dunlin - shame on you for wishing such a thing on patients.

Your DH is clearly unsuited to the rigours of general practice. Could he go part time - all the GPs at our surgery are pt and they are wonderfully chilled.

Oh and the video was ill judged and poorly executed.

BeaLesshasty · 21/05/2021 02:08

OP - there's no point pitting patients against GPs and vice versa. The GP service in the UK has generally always been a bit shit or a lot shit depending on where you live.

It killed my mother in the late 1970s (I'm not being melodramatic) and it wasn't until I moved to this village in my 50s that I found an excellent practice.

The bloody NHS is sacred in this country but it's not fit for purpose. Instead of clapping for it we should have been howling for it to be put out of its misery. European/Scandinavian countries do it better.

LangClegsInSpace · 21/05/2021 02:12

My Mum died a few weeks ago and it was partly her GP's fault.

There has been a shocking lack of face to face primary care which has resulted in poorer health for people with long term conditions, missed diagnoses leading to preventable deaths, and a total breakdown in end of life community care.

I can't write any more because I'm still too angry Biscuit

BeaLesshasty · 21/05/2021 02:22

I'm so sorry to hear that, Lang

Graphista · 21/05/2021 02:34

The reason people get angry is because they can’t get an appointment. The reason people can’t get appointments is because there aren’t enough GPs.

I actually no longer believe this to be true. I swallowed this for a while but based on personal experience including that of my dds healthcare, plus the experiences of other relatives and friends, plus what I hear from former colleagues (I'm an ex nurse myself) not just nurses and hospital drs but also radiographers, physios, pharmacists and even administrators what's actually the problem is that gp's don't understand how the nhs operates and don't wish to and make decisions based on how the outcome directly affects them or their practice

They were never truly part of the nhs refusing to be so right from inception and causing problems even then. Nye bevan was incredibly frustrated and disappointed in how they behaved.

Personally I think at that point what should have happened was the nhs gradually used those GPs who were and still are essentially private practitioners sub contracted to the nhs less and less and recruited and trained AND KEPT WITHIN THE NHS PROPER new GP's

Another factor in my opinion is that patients have to see Gp's repeatedly for the SAME health issue because instead of properly investigating, testing and diagnosing and treating those issues GP's at most prescribe medications that temporarily mask symptoms leaving patients to suffer for long periods even decades in some cases

Also because they don't like referring to a specialist as it impacts them/their practice (which is a separate business to the nhs) negatively financially.

I have endo, I presented to multiple gps with textbook symptoms I would say on average at least once a month for 14 years, so that's at least 168 appointments when if I'd been referred to a gynaecologist at the start rather than being put on the pill at a young age and given medication that barely helped with the pain and bleeding and anaemia etc I reckon probably 100 or so of those appointments wouldn't have been necessary. And that's without also considering the cost to the nhs of several a&e visits due to fainting due to blood loss/anaemia/pain, the miscarriage treatment and several surgeries - the last of which the surgeon mistakenly thought I had not reported my symptoms accurately or timeously. When I put her in the picture she was appalled and shocked at what I had been through unnecessarily in her opinion

My dd was born with physically visible symptoms of her disability that were ignored, again we went repeatedly to gps with symptoms for almost 13 years until a locum gp referred us to a specialist who instantly dx dd before she even sat in the chair in the specialists office. A dx that was later confirmed by various tests, and again the specialist was appalled that we'd not been referred earlier but this time was unsurprised as she found it a common occurrence

If those issues had been dealt with correctly and promptly hundreds of appointments would have been freed up and several hospital visits avoided altogether saving the nhs goodness knows how much money!

It's not a safe, sensible or financially appropriate way to practice!

My mothers cancer was dx later than ideal due to her being fobbed off with "oh it's just your age"

2 of my relatives HAVE actually died due to gps ignoring important symptoms.

I have little to no faith in GP's in this country at this point.

I also have friends and relatives who are receptionists and quite honestly they have seen enough that they rarely would see an nhs gp for a symptom they felt might indicate something sinister, they'll either go private or attend via a&e which I and they know they shouldn't but their own experiences both as patients and working with them is what's led to that. One of them is the next of kin to one of the people that died after being fobbed off.

It's FAR too difficult to:

Get rid of bad gps even those who are plain dangerous it's a long route to do so and requires a ridiculous amount it proof

To move gp without having a "good" reason like moving house

To complain about a gp - it may not be officially what is supposed to happen but it can and does happen that patients who complain are "black balled" if you live in an area where there are few gps available anyway it's really not worth the hassle.

The whole system at primary care level is a MESS and it's NOT just about underfunding, lack of resources, difficulty recruiting etc it's because for too many DECADES Gps have been allowed to call the shots!

Look at how hard it is to just get an appointment, look at the fact that unlike when I was a child (admittedly 3 decades ago now but not that long ago in the grand scheme) gps VERY rarely do house calls, those in regular practices nowadays very rarely if ever provide evening or weekend cover, continuity of care has gone right out the window! I was asked recently who my named gp was and I couldn't answer because the person I was assigned to when I first joined the practice has since retired and I've never been informed of who I'm supposedly registered with now - even when I've asked! That was an interesting and bizarre conversation as I was basically told off for not knowing when I had no way OF knowing and the person asking could check for me but they wouldn't and wouldn't tell me. Half the time I've no idea who I'm speaking to as I never get the same gp twice in a row.

This video - well I hardly know where to start!

Firstly of course nobody should ever be verbally or physically abused or threatened that is never ok and I would hope anyone that is reports it and the perpetrators dealt with

BUT many of the comments cited could have very different meanings IF we knew the context in which those comments were made.

Patients who are SCARED, in pain and suffering SHOULD be able to see a gp when necessary.

Personally I think telephone appointments WHERE APPROPRIATE are a great idea. I'm housebound due to agoraphobia among other issues and until COVID I had to fight to get them! Even when I was promised by the practice manager that a note had been made that I could and should have telephone appointments. Most of my appointments are regarding mh and repeat prescriptions.

BUT there are some situations and conditions that require a physical, in person assessment and that gps FAILED to do this during the pandemic is unconscionable. Hospital hcps continued to treat and support their patients, as did community hcps in other areas using Ppe and other protective measures where appropriate, what the hell made gps think they shouldn't continue to do their jobs that they were still being PAID for during I crisis of the like the nhs had never previously seen?! It stinks to high heaven and frankly in my opinion they should have had their pay docked! If you're not doing your job properly you don't get paid! They are not gods, they are not kings they are employees like any other and should have quickly got over themselves.

I've heard several reports of some gps STILL refusing to even attend the practice office let alone see patients.

Again - if they're not doing their jobs they shouldn't be paid!

I accept of course this won't be all gps, I know about 1/3 of the gps at my surgery continued to attend and saw patients when there was a clinical need. I am hearing through various sources that there is considerable...friction...between those that carried on and did their jobs and those that basically ran away! I totally understand that and in their shoes I'd be furious with colleagues that let me down in this way.

The video is extremely ill advised, unprofessional and to be honest embarrassing! If the people appearing in it keep their jobs I think that would be a mistake. I'm
Wondering if their bosses even knew they made it. It seems to be endorsed by their professional body but I wonder if that body actually knew the scathing and yes antagonistic tone it would take towards patients. Dreadfully tone deaf idea all round

MercyBooth · 21/05/2021 03:04

. Perhaps some may see how a blended or pay as you use private alternative (as found in many nations) may be an answer so that idiots understand the basics of preventative health and wellness and not cause unnecessary harm to themselves and others trying to help them

The preventative health and wellness which was taken away when they shut the gyms and other aspects of lockdown.

TheTeenageYears · 21/05/2021 03:19

There are always going to be people who moan or are abusive in any given situation, generally speaking its the few and not the masses.

Part of the problem is people have had wildly different experiences of GP practices over this period as they would do normally. It's a strange set up really. GP surgeries are as I understand it private practices usually with a partnership structure. As a partner in a practice you buy into the partnership. Practices are paid by the NHS to deliver services to patients and their income depends on the number of patients they have registered with them and the services they offer them. It's not a one size fits all approach and the GP's are not being paid a salary by the NHS.

Like any business there will be differing levels of service given to customers (patients in this case). My local rural GP practice has offered face to face appointments through this whole period. They have gone above and beyond for so many people and are very well regarded in the area. Some people decide not to move out of the area because medical provision is important to them and they know they won't get the same care elsewhere. It would be better for everyone to stop thinking of the NHS as a whole and start breaking it down into all it's component parts. At times the system seems broken but that's because it's not a whole, it's the sum of it's parts.

BeaLesshasty · 21/05/2021 03:19

Do GP receptionists only earn minimum wage? Why don't GPs pay them a living wage?

Genuine question btw.

DifficultBloodyWoman · 21/05/2021 04:51

@Staffy1

It's worth pointing out that until I lived in this country I had never seen aggressive signs up saying abuse of staff won't be tolerated. Because it was never needed. I had also never come across such hostile, rude staff that are so rude and confrontational. If you talk to customers/patients with politeness, respect and sympathy the same will be given to you.
I hadn’t considered this but it is absolutely true. That has been my experience as well.

Only in the U.K. have I seen such signs.

purplebagladylovesgin · 21/05/2021 05:08

Our GP receptionists are truly amazing. According to a recent survey, some of the best in our county. I have no complaints. Superb service over and above what anyone could expect from all staff, always.

user1497787065 · 21/05/2021 06:10

I did this job for six months, paid minimum wage and treated poorly by both the public and the doctors.

The receptionist is really not interested whether you as a patient, have an ingrowing toenail or a sore finger. She has been asked by the doctors at the practice to ask these questions. If all the appointments that have been allocated to the doctors by the doctors have been taken she cannot 'magic' another one for you.

In the area in which i live these jobs are always minimum wage jobs. I have never understood why. What it means is that there is a high turnover of staff and the knowledge level of the staff is low and that the partners of the practice do not value their staff.

It is a difficult job with little reward.

TrufflyPig · 21/05/2021 06:25

I'm still disturbed by the amount of 'obviously abuse is wrong but...' posts on here.

These staff (mainly women) are telling their honest account of what they face in the workplace every day and the overwhelming response seems to be 'well maybe you should be less shit'.

I posted on here about a year ago about key workers being abused after an incident in my pharmacy left me so upset that I ended up leaving the sector completely (a massive pay cut was far preferable to continually taking abuse). I received nothing but support from MN. I think it's just GP surgeries that bring out the worst in people on here.

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