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

To add, they even have an outdoor appointment area now for those with symptoms if needed, or will come and see you in the car fully PPE'd up. Really impressed as how they have adapted, and really sad for those where this isn't the case.

I spoke to the actual GP over the phone just now. I can’t fault her. Very good. A 3 minute appointment because I am able to get to the matter quickly, prescription sorted with no issues about medical records, I will pick it up later. A blood test is being arranged - in my area it is a hospital based phlebotomy service that offers this, but as I usually do I can get a colleague to do them if need be.

However, it should not take that much negotiating with a receptionist to book the appointment. Especially for a 3 minute appointment.

We have one part time GP at the moment and a paramedic apparently, 7000 patients on the list. Its madness and our town is currently having a house building frenzy. Trying to get past the receptionists is impossib le. I had a major major op a couple of months ago and have had no input or after care at all from our surgery. Its not all down to covid, they were like this prior. Sadly the other surgeries in the town dont have any better reviews.

Yes, this is what my GP surgery is like, much worse after Covid because at least before you could queue on the day and practically be guaranteed a same day appointment. Now it's hours on the phone and, if you're lucky!! a telephone consult at an unspecified time in the future with a nurse even when you specifically ask to see a GP for a complex problem

I hear you. I contacted my GP regarding a new cardiac issue.
They failed to get back to me within the promised 2 days, so I went into the surgery.
I was offered a telephone appointment in 7 weeks time.
I despair.

This is why A&E departments are being swamped with patients who can't access help from their GP.

YANBU.

Close family member had a similar experience in January. He really needed an in-person GP appointment, but found it impossible to get one, though he did have multiple phone appointments during which he was basically fobbed off.

The end result was that he had to go to A&E and was admitted to AAU for several days, which since he has a long-term health condition and is immunosuppressed, was something that we really wanted to avoid (and could have been avoided by a change in medication).

I have had a similar issue. Things were going well then a GP receptionist, who had been fired, was allowed to spend 10mins deleting vital medical information. But the management didn’t even realise until patients started complaining and asking for repeat meds that didn’t exist on the system. In a hospital this would have been caught quickly.

@Gakatsbsk I don’t understand- on what basis does Covid stop the doctor from talking to you on the phone? Isn’t the whole point that phone appointments have become the norm precisely because of Covid?

I’m sorry you have had such a hard time. We’re they suggesting it was your fault that the records had not arrived? Did they say what could be done to get them? (I thought they were all held centrally, but maybe the intratable-U.K. move was the issue there).

Our surgery (North London) have a really good system. You call in the morning and they get a doctor to ring you back. Yes, there is a slot of a few hours rather than a fixed time, but it’s bearable. I’ve never had to fight to get an appointment, for things like child with allergy problems, me with gastric reflux issues, eczema flare-up etc. They send you a text and you can reply to it with photos, which was great when my son had allergy rashes. Doc calls, you discuss and if a prescription is needed it goes straight to the local pharmacy. If they want more tests you might be asked to pick up a sample container from reception and when you go it’s all labelled up and waiting. If they want to see you face to face you get an appointment same or next day.

All very very smooth, much better than pre-Covid when phone consultations were not offered.

@Musicaltheatremum

I did not mean to start a GP bashing thread, if that is what this has turned out to be.

I just really do think that many will slip through the cracks if they have to go through the negotiation I had to, just to book an appointment. What starts out as a mild chest infection ends up being a CAP requiring intubation , what starts out as a urinary infection ends up as urosepsis. But I realise that you will know this only too well.

The GP herself was excellent, but I’ve had an easier negotiation with an extremely arrogant orthopaedic surgeon than I did with the receptionist this morning.

I'm a GP, I've worked flat out (currently on annual leave, before anyone starts). I'm working 14 hour days. I'm exhausted.

It's impossible to explain all the details of why we're working so hard - what people don't see is all the stuff that goes on in the background. Just as an example - a patient might normally be admitted to hospital with a set of symptoms, they'd stay in for a few days, have some tests, get some treatment and be discharged. Now they're seen on an assessment ward, sent home still unwell, and a message is sent to the GP asking us to do the tests, get the results and sort out the treatment, all in a couple of days. That's on top of our own work. So basically because the hospitals are drowning, much of their work is getting shifted to GPs.
Also you have to understand the effect covid has had on people's coping strategies. Many people simple can't function. Mental health problems now make up about half my workload. There are helplines set up, but patients prefer to speak to their GP. Simple issues that people were previously comfortable to deal with themselves (sickness bug for example) they now can't manage. Lockdowns and anxiety has made many people incapable of dealing with things they could previously cope with. We have a population of people who are in a state of permanent fear, and they turn to their GP.
Oh and lets not forget the vaccines. We've delivered over 7000 vaccinations, while still offering the same number of appointments and all the same services. We did this by working more hours. We worked weekends and days off. We were given funding to employ locums to help, but there aren't any. We can't get anyone to help us.
Last week I was online filing blood test results and reading hospital letters at 2am.

But don't worry, all you GP haters - soon you won't have to put up with us. Many of us are leaving. I am going next year, 10 years earlier than I should, because I can't stand it any more. And threads like this make me more sure than ever that it's the right idea. I used to be proud of what I'd achieved, when I qualified 30 years ago. Now I wish I hadn't bothered.

I have been quite lucky and seen my GP twice in the last 18 months. I do have a concern and wonder if anyone can advise me.

I have a 17 year old GS, he wants to see a GP, he doesn't want to discuss the issue so I'm not sure what it is. His mother has told him he is not allowed to see the GP. I told him (yes I know interfering grandmother) that at his age he could make an appointment. This certainly used to be the case, I was pregnant at 17 and definitely didn't need my mother or my husband to permit this.

So he has gone on line and filled in a request form but it won't let him submit it without a parents signature (his father is working away and difficult to contact at the moment.) I'm not sure how the signature is done, it might just be typing in her name but he won't break the rules.

Am I wrong that a Gillick competent 17 year old should be able to speak to a doctor without parental permission and if anyone works in a GP surgery what advice should I give him now?

My only thought at the moment is that in September he should speak to student welfare at sixth form college but of course if it is urgent that is a long wait.

Thanks for any help.

@Ozanj

I have had a similar issue. Things were going well then a GP receptionist, who had been fired, was allowed to spend 10mins deleting vital medical information. But the management didn’t even realise until patients started complaining and asking for repeat meds that didn’t exist on the system. In a hospital this would have been caught quickly.

There’s a permanent record of everything on electronic clinical systems used by GPs, it can’t be permanently deleted. How would it have been ‘caught’ in a hospital? Wherever you work malicious or criminal members of staff can cause a lot of damage, hospitals aren’t immune- look at Beverley Allett and others!

I think I must be really lucky with my GP. Yes, we have to ring at 8 am but I have never failed to get through. My GP has phoned back the same day and asked to see me face to face and then referred me to our local hospital. They have also been great and I have had scans and treatment two weeks later. This is inner city London and the service I have received has been fab. I'm do sorry that not all of you are so lucky.

I straddle the NHS and private sector. No way would we be able to offer service in the way some GP surgeries are and I wonder if the CQC are receiving complaint by how inaccessible appointments have become.

Our local surgery is bad. I'd already made complaint regarding my DGM, she really struggled navigating the new telephone system and a receptionist insisting she have a video call despite my DGM not having access to it. She was told she was not to come to the surgery and must travel to the local hospital. Which is a bus ride away. She is 89 and can actually see the surgery from her back window.

I had a nightmare this week trying to get dd an appointment. She is rarely ill but when she is its always her chest. We had already done a covid test a week before and it came back negative, we also did a lateral flow test just in case a few days later.

After listening to a lengthy voice message trying its very best to make me put the phone down and email various people instead of wasting the GP time the receptionist came on and told me that dd would have to have another test before we came in the surgery. We went back and forth for a bit and she said she would see if the GP would call me - with no idea when.

I had to drop other dc off in school so bundled dd in the car. the GP rang and I pulled over, she asked for a video call to see dd and that dd had to strip off so she could see her chest.

So ive got a 5 year old sat in her knickers in my car whilst the Gp is asking her questions. Gp said she would write up a prescription and I would pick it up from chemist. This was at 9;30am

12pm I called chemist. They said the would call me when the prescription was ready.

4;30pm still no prescription so they told me call the GP.

I drove the surgery to see where the script was and there are massive signs on the door saying no one is allowed in unless they have been invited and people will be asked to leave immediately if they haven't been.

So I sat in my car for 20 mis on hold with a sick kid and other dc. I was at caller number 3 for the entire time.

So I walked in to see two receptionist having a lovely chat. No phone was ringing ( as now I know its actually been outsourced which is idiotic). I asked where the script was and it hadn't even been done. One of them said I should come back in the morning which I refused to. I had to go and wait in my car till the GP had finished seeing their patient. There was not a soul in the waiting room. 15 mins later a nurse comes out with the script.

Drive to the chemist and was told they didnt have it in and to come back tomorrow so I took the script back and went to another chemist.

The whole thing is a shit show at the moment but the worrying thing is I think it will stay like this. I think this way of dealing with patients suits too many people.

@HaveringWavering
Thanks for your reply
I was unsure as to why covid potentially prevented an over the phone brief appointment, when the GP phoned me there was no issues at all which makes the whole rigmarole even more perplexing.

They did not, but when I first moved and registered I was told my old GP ‘had to’ issue my repeat prescription, they couldn’t issue it to a different country, so I had to go through 111. Weeks down the line I thought this might have resolved.

The actual apt was fine, but if the receptionist has 30 minutes to argue about it with every patient then no wonder there’s issues 😂

GP experience has been like this for me since ~2016. Only on the day appointments, no more booking for non-urgent issues, regular monitoring etc days or weeks in advance anymore

Lines clogged up the instant they open and repeat dialling just to get into the limited size queue system

I read these threads and thank my lucky stars for my GP practice, who have been wonderful throughout this. I've had better service in the last 12 months than I've ever had, and they've always been pretty good to be fair.

I suppose a lot comes down to the individuals who work on reception and how the practice interpret "the rules". In your case OP it sounds like you had a bad combination of both!

I tried to get my elderly, housebound mother an appointment with her GP or a nurse after a small fall. (To clarify, these visits have been ongoing here and haven't stopped due to covid). She just needed checking over really, but the receptionist refused and said my only option was to bring her into the surgery, which was impossible. She also told me that if I phoned an ambulance we would be charged as it was unnecessary.
I had no option but to call an ambulance, and the hospital decided to admit her for observation due to her age even though her injuries were minor. She caught an infection in hospital which killed her. We had her funeral a few days ago.

I too am absolutely sick to death of our GP practice and their attempts to bar the doors against seeing patients! They earn a bloody good wage and should be stepping up!
Yesterday again I asked why ....6 weeks after an Xray was taken, 2 weeks after a blood test was taken....( no probs making those appointments in hospitals)...we had received no results/feedback/call or indeed any contact at all from our GP's practice.
So when asked why the "gatekeeper" receptionists get all defensive and cite ...well Drs are not seeing patients atm so you will need a telephone call....Oh yes and that is to be in 30 days time!
This is for a person who is very hard of hearing, doesn't lip read & will need a second person with him . I am about to write a letter citing discrimination. This person needs a face to face.
WTF is happening here.
It was perfectly easy to get an appointment before covid, all be it usually a weeks wait. Our GP is taking the P....ss.

It is strangely therapeutic to hear this from a NHS person as when I have despaired in the past I have wondered if it is because i just didn't get it because I am not a HCP. And I have no criticisms of most GPs, it is the system which seems bonkers. YANBU

@Bagamoyo1 I'm sorry things are so hard. I think lots of issues are with receptionists, I know they have a difficult job in many ways but some do seem to like to throw their weight about. I've never had an issue with my GP, I've had a few with receptionists and once with a locum who frankly was rather strange.

Same at my GP in East London. Nightmare getting appointments there for a few months. Receptionists as gate keepers of the appointments. The power goes to their heads.

@ancientgran

I have been quite lucky and seen my GP twice in the last 18 months. I do have a concern and wonder if anyone can advise me.

I have a 17 year old GS, he wants to see a GP, he doesn't want to discuss the issue so I'm not sure what it is. His mother has told him he is not allowed to see the GP. I told him (yes I know interfering grandmother) that at his age he could make an appointment. This certainly used to be the case, I was pregnant at 17 and definitely didn't need my mother or my husband to permit this.

So he has gone on line and filled in a request form but it won't let him submit it without a parents signature (his father is working away and difficult to contact at the moment.) I'm not sure how the signature is done, it might just be typing in her name but he won't break the rules.

Am I wrong that a Gillick competent 17 year old should be able to speak to a doctor without parental permission and if anyone works in a GP surgery what advice should I give him now?

My only thought at the moment is that in September he should speak to student welfare at sixth form college but of course if it is urgent that is a long wait.

Thanks for any help.

Can your DGS call the surgery to make the appointment? I agree that it seems wrong that a 17 year-old can’t make their own appointment when, as you say, he is Gillick competent and would be able to make his own decisions about treatment. It may help if he is talking to someone as their system possibly doesn’t distinguish online between a teenager and a toddler.

@ancientgran

I have been quite lucky and seen my GP twice in the last 18 months. I do have a concern and wonder if anyone can advise me.

I have a 17 year old GS, he wants to see a GP, he doesn't want to discuss the issue so I'm not sure what it is. His mother has told him he is not allowed to see the GP. I told him (yes I know interfering grandmother) that at his age he could make an appointment. This certainly used to be the case, I was pregnant at 17 and definitely didn't need my mother or my husband to permit this.

So he has gone on line and filled in a request form but it won't let him submit it without a parents signature (his father is working away and difficult to contact at the moment.) I'm not sure how the signature is done, it might just be typing in her name but he won't break the rules.

Am I wrong that a Gillick competent 17 year old should be able to speak to a doctor without parental permission and if anyone works in a GP surgery what advice should I give him now?

My only thought at the moment is that in September he should speak to student welfare at sixth form college but of course if it is urgent that is a long wait.

Thanks for any help.

Easiest way would be to ring the practice for a phone appointment, or call 111. It depends what we wants advise on really as obviously there are other direct access services like GUM, mental health, physio etc. There’s also online questionnaires for advice which funnel you into the correct service. 111 might be the easiest for him as they can advise what is the most appropriate service and book appointments for some services. There’s 2 e-consult one as parent of child and one as patient, I think it’s just a tick box to say over 18. He may be able to get round it by ticking over 18 or by putting his own details into the parent box and putting a note on it in the free text box