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

I think if the GP surgery was already crap it will just have become worse, if it was a good surgery originally it will have been able to deal with the problems covid has thrown up.

I work in a GP surgery (though neither receptionist nor clinician). We now use a phone triage system. ie receptionist puts all patients on triage list for phone call back. Unfortunately they can’t guarantee when it will be and advise if patients won’t be available at a certain time, that they call back later and are added to the list then. In practice they usually get called back within a couple of hours or less. GP will call patient and see if they can help on phone - if it’s something like a rash, or funny looking mole, they might ask patient to email a picture in. If they can’t help over the phone, they will book the a f2f appointment. This has to be done by the GP, the receptionists are not allowed to do it.

The out of hours system can also book phone appointments with our GPS remotely.

A lot of patients are now using the online messaging service to contact the GPs. These messages are passed straight through to the GPs and are normally responded to the same day.

We were told some months ago that covid was no longer to be used as a reason/excuse for things.

Most of the patients are very happy with the new system. The ones that aren’t were never happy with the old system either!

Unfortunately, every so often (usually on a Monday morning) someone on the reception team and/or a clinician calls in sick or has to isolate and it all goes TITS UP!

@logincard - I'm sorry you find this thread so frustrating, but can't you see by these continual threads that there really is a problem with patient access to primary care?

Some GPs are clearly much better than others. What I don't understand is, pre covid, there were a lot of no-shows for appointments; that's obviously not the case now as there are very few F2F appointments and most will be arranged for the same day, so what is happening with those slots? If you phone someone and they are not there, you just move onto the next person on the list, so that doesn't waste time in the same way as a face to face no show does.

And GPs don't have to sort out pulse oximeters, people can mostly sort out their own, but otherwise admin staff can do it.

I'm not "GP bashing". I'm stating facts. I cannot get any contact with my GP for 7 weeks for a new cardiac issue. How is that ok? And obviously my next port of call is going to be A&E. I've run out of options.

@Gakatsbsk

And *@BungleandGeorge* seeing as it was only this morning i have not yet, and haven’t decided if I will

You should. Some practices aren’t operating effectively but if people don’t complain who’s to know? We do have a fairly robust inspection and complaints process against GPs, which can be initiated by complaints as well as other things

I moved during the first covid lockdown, the new owners immediately registered at the Drs so I was removed leaving me without a GP as my new area would not accept any new patients.

I have made a formal complaint as I was left with no GP to administer my B12 injections for months!! I need them or can faint and have done previously .

@logincard

I am a GP of over 25 years service and I have NEVER been so overworked or stressed as we have been in the last 6 months. Demand is insane , we now have 10x as many hone calls a month as we did 2 years ago. This receptionist sounds bonkers but my business partner and I cannot have a weeks holiday at the moment, we worked almost every weekend between December and April vaccinating ( as well as a full working week ). We have NEVER been CLOSED and we saw patients face to face all the way through pandemic. Not EVERYONE, but everyone who needed to be seen (medically) was seen.

so all you GP bashers, just please please be quiet, you have NO idea what you are talking about

Thank you - it is much appreciated and we do (increasingly) understand a little of the pressures you have been under.

I have had many years experience of private healthcare overseas previously - holding the gold card of private insurance and new hospitals full of modern art and thick carpets with quick appointments and direct charging. Honestly, cut away the frippery and the care there was not even half as good as (most of us) get at the NHS at both GPs and at the hospitals.

I know there have been some missing GPs and overzealous receptionists, but most have been working all the way through and they do such a fantastic job. I literally struggle to criticize even when I hear fair negative comments - I appreciate what we get so much and would just say be very careful of what you wish for as an alternative (whether you have money or not).

I have a lump in my boob and have been offered a telephone appointment

Mine is a nightmare
You have to ring at 8 on the dot every morning you can never get through
You Wait for 2mins whilst your have to listen to the recorded message about covid and not to ring if booking a jab ,
Then when you do get past this the lines so busy it cuts you off only for you then to have to keep redialling and having to waste another 2 mins of your life each time listening to that bloody message only to be cut off again ,
After the 125th redial ( yes that’s how many try’s took me before you actually manage to get in the phone que ) you are then number 20 in the que
When you finally get to speak to someone the appointments are all gone .
This is what it is like every single day ! Still haven’t got an appointment I gave up in the end and had to get my son seen by a private
DR and cost a fortune
But Was seen within 2 days and got the medication he needed .

Your experience sounds dreadful OP, and I've heard many like it.
I am really lucky that our GP surgery has been great - they have an online form that you fill in, you can attach photos, then they ring you back later that day for a phone appointment, and where that is not sufficient, they arrange for an appointment at the surgery, either that day or the next.
The form also works for prescriptions.
If someone couldn't use the form, I'm sure the receptionists would arrange a phone appointment.
They're also running normal things like smear tests.

I’m a GP and fortunately work in a great practice (I think).
There have been massive problems brewing in primary care well before covid. There are not enough GPs - people no longer want to do it (threads like this don’t help), the days are massively long and it’s a stressful job when there aren’t enough resources. Workload has been increasing for years for multiple reasons - ageing population, increasing population with greater health needs, increasing expectation of what the NHS can do, reducing self care in our communities, reduced public health funding etc etc. There has been a big push to move more care into the community - so there are sicker people without any secondary care input needing increasing support from GPs. More recently we are getting work dumped on us left right and centre, work which should be being done by secondary care. Not trying to blame the hospital teams - they are busy too, but we can’t manage all our own workload and theirs.

In some ways I think access to a GP has got easier for some - some patients are sending in multiple eConsults in a week (sometimes complete trivia, but a clinician still has to look at it and respond).

I agree that something urgently needs to change In General practice. GPs are literally on their knees from the workload, whilst trying to stop covid ripping through their surgeries and trying to cope with increasing demand. I know a number of GPs burning out, which leaves even fewer clinicians to try and deal with the increasing workload. But if you want someone to blame, I’d look at the government and push for change with your local MP. Constant GP bashing posts and newspaper articles aren’t helping to fix things and if anything are making things worse.

We to have to jump through the hoops too with the "medically trained" receptionists as they are called at our surgery. Sorry, but it should be for clinical staff to triage patients and not receptionists. I'm sick to death of having to tell them when I phone that I don't want to discuss my medical problems with anyone other than my doctor because its private.

The GPs at our surgery are like unicorns and I'm starting to wonder if they really exist or what you actually have to do to see one. If you can get an appointment, they are always good so no complaints about the actual care. In my experience, the biggest pain in the arse about the NHS is the admin and management of it.

@Bagamoyo1

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.

this. and this again.yu have put it much better than I can. the complete inability of the pubic to mange the simplest things with out 'checking' with their GP has added about 30% to our workload. GP was set up on the basis that the average person would contact their GP 3 x a year. The average is onw between 9 and 10 and there are many many people who call every singe week for one thing or another. I know they are worried and stressed, but the system is breaking - it has run for many years on goodwill and personal sacrifice. There is no good will left after all the GP bashing and sick stressed GP's are leaving. emigrating, retiring burning out and off sick ...

It's just over a year since DH turned yellow, he had sudden onset, painless jaundice so tried to get a GP appointment, he was triaged by the receptionist who told him it wasn't an emergency and he could wait over a week for a telephone call. Oh how I wish we could turn back the clock. Turns out DH has cholangiocarcinoma, his survival chances at 5 years are 0. Nothing about his treatment has been good or even satisfactory and we now have no faith in the NHS or in medics.

I don't think it's bashing GPs when obvious flaws are pointed out. My GP surgery is fantastic - Great team, even the reception staff are helpful and considerate. Yes they ask what the problem is. But that's so they can give you the right GP

However, my mum's GP surgery is awful. My Nan's isn't worth bothering with. Absolutely ridiculous care.

It isn't right to assume just because your own provider is doing everything they can, that all providers are

I work in the NHS. I would defend the nhs to death because, well, it's my family.

But OH MY GOD. GP receptionists, with NO medical knowledge what so ever drive me to utter distraction.

I made a complaint about mine pre covid as she wouldn't let me book an appointment without telling her exactly what was wrong. i was in an all male open plan office at that moment and didn't want to talk about my labia and vulva in front of them all!!

In response to the GPs defending themselves, I'd like to share an experience that happened way back in 2019, before Covid.

I had a minor surgical procedure at my local hospital in East Anglia and was told that I needed to get the stitches removed on day 14, not earlier, not later. At the time I was working about 100 miles away in Surrey and lodging in a friend's spare room during the week. I explained this and was told, no problem, register as a temporary patient with a GP in Surrey and they can do it.

I made an appointment with a GP in Surrey. I estimate it took 8 minutes to fill in the form and 2 minutes for the stitches to be removed by a nurse. As I was walking out, the nice receptionist told me her colleague wanted a word.

I then spent 5 minutes being told off by an irate, officious practice manager because I had temporarily registered with the practice nearest where I was working, not the one nearest where I was staying, and that was Not Allowed. At one point, she asked me "Why did you think you could do this?" as if I had actually done something wrong!

It just feels like that is the reality of primary care now; you have to negotiate a system that seems like it's set up to say No to everyone. I had obviously pissed her off because (unwittingly) I had beaten the system and got something that in her eyes I didn't deserve, to whit, a two minute appointment at her practice instead of another one 10 miles away in the same county. Fucking ridiculous.

To the GPS, have you ever tried booking an appointment as a normal person? It’s difficult, frustrating and set up to keep you away from the GP.

Course, it’s been hard for you, nobody is saying it isn’t.
But if you had to deal with it from the other side, frightened about a lump or a bump or a sick child And told, No, sorry call again on Monday, you might have a different opinion.

TipTopHat, it might be odd having a phone call for a breast lump but since the pandemic, in this area, we have been able to refer breast lumps for urgent assessment at the hospital without the need for us to carry out the examination.

I called with a breast lump early on in lockdown. I had a phone call, explained it to GP. GP gave me a time to come in for a face to face appointment, and I was seen at the local breast clinic 10 days later. 2 hours after my appointment time I was given the all clear.

I love telephone triage, though I hope there will be options soon to be seen face to face if needed before phone triage. 90% of my appointments can be sorted over the phone saving both of us time. But if I were to go back to my (open plan) office, I would like the option of not having to discuss my vagina etc in public.

@Redcrayons I get it…access is a huge problem. We’d love to see and help every single person that feels they have a clinical problem, but how would you propose doing that when you have limited clinicians and limited time?? And all that needs to be done in the right time frame (ie dealing with urgent stuff urgently and routine stuff routinely).

GPs fine when you see them, but on one occasion DH had a bullseye rash, somehow managed to get through to surgery and had a hell of a job persuading them he needed to be seen. Missed the appointment as by the time it rolled round he was in an ambulance on his way to A&E where he was found to have classic symptoms of Lyme's disease.

Also when I was waiting to hear back from the surgery about bleeding during pregnancy, the receptionist told me "It can't be that serious, the doctor's left". I'll leave you to imagine how serious it turned out to be.

I’m a GP Receptionist and she was being ridiculous. How does she think we deal with temporary patients? (where we don’t have any medical records to go on)

I had a similar situation recently where a new(ish) patient’s notes hadn’t come across and he needed his medication - I put him on a call with a GP to go through it all that day and they were prescribed.

No, you wasn’t being at all unreasonable - no wonder we have such a bad reputation!

[quote Gakatsbsk]@Palavah

Sorry you are having such difficulty.

It saddens me that in secondary care we are (rightfully) expected to hold such high standards despite covid, yet this poor practice is tolerated from primary care. I’m also trapped as I don’t want to be driving when the GP rings, don’t want to be in Tesco.

Sadly I see in my job patients who have terrible symptoms and conditions that have progressed due to being unable to properly access GP services[/quote]
The GPs themselves are great, and the practice nurse was excellent when I saw her, it's just getting to speak to them. I've been off work now for a few months but I can't imagine how I'd manage an appointment if I were trying to work.

@logincard

I am a GP of over 25 years service and I have NEVER been so overworked or stressed as we have been in the last 6 months. Demand is insane , we now have 10x as many hone calls a month as we did 2 years ago. This receptionist sounds bonkers but my business partner and I cannot have a weeks holiday at the moment, we worked almost every weekend between December and April vaccinating ( as well as a full working week ). We have NEVER been CLOSED and we saw patients face to face all the way through pandemic. Not EVERYONE, but everyone who needed to be seen (medically) was seen.

so all you GP bashers, just please please be quiet, you have NO idea what you are talking about

Why are GP's doing vaccinations at all?? That is the question. It doesn't require a GP to give vaccinations. It doesn't require a GP to run a vaccination centre. St Johns ambulance could have run the centres with volunteer vaccinators if there hadn't been a 20 page form to fill out before a person could volunteer to help. Given my experience in the Forces, vaccinations can be given by pretty much anyone with a bit of training. The issue is Government ineptitude in properly organising the programme and putting undue pressure on GP's without properly assessing the fallout.

The truth is, this government hasn't commissioned enough services for the need that there is.

I am an nhs dentist and I have an upper limit on how much I can do. The practice I work for has a total limit and I am at least 6 weeks over target even though I am supposed to space it out evenly.

The total allocated across England covers an optimistic estimate of 60% of the population. That means that the government knowingly commissions less than is required. It is privatisation by the back door.

I'm guessing similar for GPs