30 minutes to negotiate with the GP receptionist for a phone appointment

[Gakatsbsk]

Hi,

I am an nhs nurse, and so I realise this is not all GP receptionists but I have just spent 30 minutes speaking to a GP receptionist to try and negotiate a GP over the phone appointment.

It seemed to me like I was wading through excuse after excuse, in a hospital none of these excuses would wash.

The first excuse was that despite registering five weeks ago they didn’t have my medical records (I’ve moved between UK nations) and ‘there was no possible way’ to determine what previous medications I was on, my suggestion that they could be confirmed with me, the patient was of course completely ridiculous and I could be maliciously seeking meds (which are non opioid, non addictive and not remotely interesting to any one).

The second excuse was that I couldn’t have a GP appointment because I’d not had a GP appointment there yet and ✨ covid ✨. In secondary care we haven’t been able to use covid as a reason to not see any new patients, and of course how can I have had an appointment without having an appointment.

The third excuse was an altered replay of the first one, that doctor won’t be able to prepare for your consultation without your medical records. Doctors do this day in day out.

The fourth excuse was a lecture about how busy the nhs is, how covid is surging at our local hospital and how there’s so many covid patients in critical care. At this point I told her I work as a staff nurse in critical care at said hospital, and that this conversation was dragging on and could I please be given a GP appointment, or ANP appointment, or do I need to register elsewhere. At this point I was granted a phone appointment (anytime until 8pm so don’t go anywhere was the warning).

I do realise our colleagues in primary care are stretched, as we in secondary care are but this was ridiculous and it saddens me that vulnerable people probably miss out on health services because of attitudes like this. If I spoke to anyone on the phone in my job role the way she did, I’d end up facing disciplinary action if the other party complained.

Is it just me being completely unreasonable ?

Many thanks

@Cheerio21 or anyone, Who runs eConsult? It doesn't seem to be the practice. Is it a separate company and can they sell our information?

@CommanderBurnham

♥️ ♥️

Pure madness.
Honestly, the best thing that has happened due to lockdown is our GP surgery introducing eConsult so you don't have to deal with their receptionists!! (apologies to anyone who's a GP receptionist but most really are a certain breed!)

I don't know what the answer is; encouraging more GPs in from overseas?

Getting more staff from overseas should always be seen as an admission of systemic failure in the running of the NHS. There is not a shortage of people in the UK who (after training) would be able and willing to fill NHS posts. If there's a shortage of staff it's because the NHS hasn't planned adequately, or isn't paying adequately.

I suspect that depending heavily on imported staff is "cheating" by our government-run system, in the sense that instead of paying what the market rate should be to fill enough posts with UK candidates, they can dangle the incentive of UK residency in front of people who regard this as a benefit, and that way on average underpay for staffing.

This is why government shouldn't run things, it creates a conflict of interest. In this case, in their role as controllers of immigration they are having a double standard, making allowances for themselves as employers that they wouldn't generally make for other employers.

It reminds me of the conflict that I think used to exist in housing: local councils putting up hideous tower blocks for social housing. They would never have allowed private developers to build similar properties. There was a conflict of interest because the same organisation that was required to provide social housing was also in charge of planning approvals.

(I have no general objection to either immigration or tower blocks, what I object to is what I see as a form of corruption, substandard practice due to conflict of interest. I also dislike market forces being overruled by government, that in itself is mild form of economic cancer.)

in a hospital none of these excuses would wash

Really? So you take an unlimited number of patients on your ward/operating theatre/outpatients dept (or wherever you work), do you?

In hospitals, except A&E, there are natural controls on workload. A ward can't have more patients than it has beds, and wards will close if sufficiently under-staffed. An outpatients dept will only offer a certain number of appointments. Even A&E will sometimes divert to another hospital, or keep patients in ambulances.

In general practice, there are none of these natural controls. GPs are going under because of the volume of demand, and the levels of abuse they are experiencing. One of my colleagues had a breakdown yesterday, so the rest of us will now be picking up her work too.

I’ve been having a nightmare trying to get through to our GP too.

My DD has Tourette’s and one of her tics is her hands lock into fists. It can last an hour, or days and depending on the position of her fingers, can be extremely painful and her fingertips end up blue. When it first started happening our GP gave us a box of diazepam for her to use to relax the muscles and unlock the fist. When we got towards the end of the box, I started trying to get hold of the GP to get another box. I rang - never any answer, sent emails and used the e-consult - no reply, over and over. We ran out

The inevitable happened, her hand locked and 48 hours when it was still locked and still no one from the GP was responding, I called 111 and we were sent to A&E - who gave us another box and sent us on our way.

Since then, I have been trying to put something in place to ensure we don’t run out again.

After days of calling, I finally got through to the surgery the other day and ended up going round and round in circles with the receptionist.

Told me I needed to send an e-consult - I have, several and had no response.

The GP couldn’t prescribe the medication without an appointment - ok, can we have an appointment then please

No, it’s not the sort of thing the GP is seeing people for at the moment.

Ok, how about a telephone appointment- no, he needs to see her face to face.

Ok, so how are we going to deal with this then. Receptionist tells me they are not dealing with these kinds of complaints at the moment and DD will just have to put up with it.

I don’t know how I kept my cool, but replied that wasn’t acceptable and could we have a telephone appointment anyway, the GP could then decide whether he wanted to see her.

Finally agreed to the telephone appointment but that it had to be with the Practice Nurse. Nurse calls, but can’t prescribe the medication, has to be a GP. Nurse books telephone appointment with GP on the system.

GP calls - happy to give me a repeat prescription now that DD is nearly 16

Honestly, total waste of everyone’s time. I was on the phone with the GP for about 2 minutes compared to the 20 minutes I was arguing with the receptionist.

GP services are broken.

It’s funny that not having your medical history was a reason, I couldn’t tell you the amount of times a GP or consultant hasn’t even looked at my history prior to an appointment.

I have had no problem re GP but I know my issue will not be dealt with NHS.
Decided to opt for private. Lo and behold they now have waiting lists.
Consultation apt 17/08

Re records. You could ask your old GP to email a summary over.
Records take months to come from some places especially England. Scotland much faster. (I'm Scotland)

Some GP surgeries must be bad but please it's not all of us. We were quiet for about 6 weeks and now it's mayhem. I'm seeing and speaking to more patients than before.
12 hour days are the norm.
We can't open up fully until social distancing goes we can't fit everyone in the waiting room and the amount of covid where I am it would spread through the waiting room rapidly so that's why we aren't fully back to face to face for everything...believe me I'm desperate. But imagine the daily mail if people started catching covid in the GP waiting room. We can't win.

Oh and some parts of hospitals have worked very hard but others haven't and have phoned patients and told them they can't see them but get the bloods done at your GP Surgery!! So it works both ways.

OP if you had been needing medication at our surgery we would just have needed your old repeat script form and as long as it wasn't anything like diazepam or controlled drugs we would have been easily able to do it. Our reception also know to get summary from old practice.

@MissLucyEyelesbarrow

Thanks for your reply,

I have worked in three critical care/ intensive care units. We have never been able to refuse admission of a critically unwell patient, we took beyond our capacity and nursed beyond our legal ratios. We had two patients to one icu bed space at times. We expanded into theatres, recovery, previous office space.

Never once were we able to say sorry you can’t access our icu service because we are busy with covid, sorry you can’t be intubated and ventilated because you haven’t been intubated and ventilated before, you can’t come to icu as you’ve never needed the nhs before, the icu doctor can’t see that unknown patient because the icu doctor can’t prepare without their notes.

I can’t speak for other areas so probably should have made that clear.

Having looked after at worst 5 ventilated patients (when it’s supposed to be 1) you have pranged a nerve. I am not disputing the caseload of GPs, I have issue with the excuses of the GP receptionist I spoke to.

Something is wrong somewhere. I assume that it goes back to practices having a lot of independence, whereas hospitals are more centralised (now not so much). GPs didn't ever want an NHS since it was VERY lucrative being a GP.
I would favour all GPs being based at urgent care type places, open 8-8 and weekends. The world has changed so that working hours and patterns are simply not viable with trying to get an appointment at 8am or wait three weeks. If you could book in like you do on eventbrite and have enough gps it would be fantastic. But then you go back to not enough doctors.

Many of us here have unavoidable health needs, but in wider society most ailments are due to self neglect and poor lifestyle. Poor quality housing, food and education have led to this crisis. I was amused at the headline of 'GPs to prescribe vegetables.' What are patients going to do? Eat them raw because they only have a kettle to cook with. Energy prices and depression of a hard life dictate that a take away is a million times more appealing than stew.

Sorry, rant over. I hope you get sorted soon, OP.

YANBU

I had a GP like that. I think everyone at that practice should quit medicine, TBH - it wasn't just the shitty triage system, it was the lack of patient care when you actually got an appointment.

I have a new GP. I am ecstatic. I can book same day phone/video consults, I can book with the appropriate health professional first time (sometimes I don't need a GP, sometimes a prescribing pharmacist will do) and I get my medicine when I need it, so my health is currently being managed. If I need to come in for tests, again, it's easy to book a an appointment and the site is very well managed. Everyone masks up and quietly gets on with it. There's no fear of running out of drugs due to not being able to get a damn repeat prescription or an appointment to discuss a drug review. It just... works.

So many GPs are utter crap.

I sympathise with anyone still stuck with a crap GP. Mine is bloody marvellous.

@Musicaltheatremum

Thanks for your reply, and for your work.

I will email, although my guess is this is what the GP surgery has done but hopefully this will speed it up.

I should’ve said in an acute inpatient hospital not hospital in general, as it a vague term.

x

I should also state, I have never spoken to the GP, or any health care professionals at the surgery. But a 30 minute negotiation with a GP receptionist for an appointment is not an effective use of either of our time.

I also don't think receptionists are to blame. They are clearly told guidelines they have to stick to otherwise they'll be in trouble. They don't know us and are doing a job for little money, therefore they may care somewhere, but they can't magic things that aren't there.

What Musicaltheatremum said but we are in England.

Why is every second thread currently a pop at GPs? It’s almost like a orchestrated campaign!

If you have a problem with your GP surgery, ring the practice manager and complain. Surely as a HCP you would know the best channels to go through and exactly what to say? I’m not sure why you haven’t addressed the problem before now if you’re now 5 days overdue meds and had to get the last prescription posted from 200 miles away? Maybe one of the consultants would be willing to write you a private prescription?
What clinical system did your previous GP use?

It seems unfair to blame the receptionists - surely they are trying to minimise GPs appointments because that is what they are being told to do? The whole model seems unfit for purpose. Shame to blame the person at the front desk on minimum wage where they probably have little to no power to change things.

What puzzles me is exactly what GPs are doing now. I understand them redirecting patients with Covid symptoms. I understand restricting access to the surgery in case someone has Covid symptoms but I don’t understand telephone appointments only.
You can’t listen to a chest, take a pulse or feel a lump over the phone.
If you do get to speak to someone it is a practice nurse and the above applies.
We used to have a GP service to be proud of,it felt safe and reliable and now it has virtually disappeared.

I see you've worked in ITU too @Gataskbsk. That's been hard. I don't think GP surgeries are managing care well just now. I am desperate to open up. It will be far more efficient.
But we have no GPs either. It's awful. Our surgery is quite well staffed and we have just managed to recruit another GP (a male GP too as we are all female!!) but I'm off in 2 years to retire. So we will be back to square one again.

YANBU. Where we live now has been my most positive experience of using a GP but if we ever live in a city again I'll be forking out and going private. It's not worth the hassle. It's horrific if people can't afford to do that though.

@riseandshine2021

YANBU.

All GP surgeries are using covid as a reason not to do anything. It's beyond a joke.
I have several chronic health conditions that need to be regularly monitored - I became extremely ill because the receptionist kept putting me off refusing to give me an appointment which could of easily been avoided.

all surgeries? you know that for a fact do you? Right OK.

YANBU.

Very fortunate here that throughout the GP surgery has been running an effective system, every time we have had to see someone in person we have had an appointment the same day (even if not phoning first thing in the morning). Not sure how they have managed it as they cover a huge area and haven't had any extra HCPs brought in, but very thankful.