To think issues relating to safeguarding will shoot up if GPs continue with telephone appointments

[SpicyJalfrezi]

I’ve been unable to get any help for a relatively minor bout of depression. I’m treating it with self care but obviously not everyone has the option to do that.

Women and children must be most at risk due to this new way of working.

It's a joke. Why are GP's allowed to carry on like this?

I agree with you OP and also all the other complications.

I agree so much can be missed by doing appointments over the phone. My uncles cancer was missed for months over lockdown due to issues with seeing a GP F2F and a friends chest infection developed into pneumonia requiring hospital treatment because of GP only doing phone appointments. I think some things can be done by phone but there is far greater risk of missing things when they do not see patients in person.

It's ridiculous- making assessments of someone's health they can't physically see means they are missing the bruises, injuries, neglect. All those opportunities to see signs are being missed.

There is no reason whatsoever why initial consultations no for depression cannot be by telephone. It's not a condition where you need a physical hands-on examination.

If you mean that your GP is short of appointments (backlog of demand?) then that's a different matter, but if course telephone consuitations are a good way to tackle backlog, because in general they can be kept to time rather more effectively

There are reasons why I might not wish to talk about it over the telephone, though, which is why I’ve been unable to get treatment for it.

If that applies to me, imagine how a woman in a violent situation might feel.

I'm a GP. We've been doing telephone triage since 2013 and prior to covid I would bring in about 50% face to face, the rest were things that could easily be dealt with on the phone. In March last year F2F dropped to probably only 10%, as we would have been rightly criticised for having rammed waiting rooms (which are already busy with people coming to see nurse etc, most of which can't be done remotely). Now I would say my conversion rate to F2F is probably about one third. The difference between that and the previous F2F is at least partly made up by the ability to text photos - for a young working person with a rash this can be very convenient for them, though probably about one in five of those I end up bringing in if the photo isn't good enough or I think I need a 3D view. So basically, we are more or less back to normal. It is a myth that we aren't seeing F2F and that surgeries are shut. We are all very aware of safeguarding issues and if there is anything that twitches our antennae that way then the patient comes in.

professionals will be able to word questions during a telephone triage in such a way that people can answer without giving anything away “are you somewhere safe” is a simple yes no answer.

Telephone triage can also help them ensure that those who need to be seen are the ones that are. Plenty of things can be dealt with virtually.

I also think it must be really easy to minimise how you're actually feeling in a phone call. Not to mention how many people must give up after waiting forever and a day for the phone to be answered.

And how would that have helped say Victoria Climbie, @Sirzy?

And are you somewhere safe is far too simplistic.

You can be physically safe but controlled, verbally abused and financially abused.

@SpicyJalfrezi

And how would that have helped say Victoria Climbie, *@Sirzy*?

Was she taken to the GP regularly?

Nobody is saying there aren’t faults with any system. But we all know cases like that are an awful lot more complex than a GP phone call instead of F2F!

My gp has been doing telephone triage for urgent appointments for at least 5 years probably longer, it means the appointments go to those who need them. I can still book an appointment for a specific diagnosed health problem/routine care or I can email or call for a new problem for triage. I'm loving the email triage system myself, you put down your systems and within a few hours, sometimes minutes they are telling you to book in for bloods with the nurse, to call reception for a drs appointment, additional questions and in some cases diagnosis and tell you to pick up meds from your designated pharmacy without even need to phone.

Like the poster above, my GP surgery has been doing telephone triage for several years - much more convenient. When I called a few years ago about depression, immediate invite to go in to the surgery on the same day if easier.
Every call starts with "is this a convenient time/place to speak?"

I think telephone triage probably can work when there a will to make it work properly, rather than to avoid seeing patients.

E.g. a review for a fairly routine prescription, probably no point bringing the patient in, do it by telephone is more efficient for everyone.

However, here it takes 3 weeks to get a telephone consultation and no matter what it is , the receptionist will not be swayed that you need to see a doctor. I had my telephone appointment which raised some concerns doctor wanted to see me for. Another 3 weeks for a f2f appointment. Then I was put on the 2 week cancer pathway (which took approx 2.5 weeks). 8.5 weeks for something that was supposed to take 2 weeks.

If telephone triage was being done the day you make the appointment, it would make a lot of sense. But it's not, at least not here.

I get what you mean. There needs to be a way to alert the GP that you need to come in to talk as you can't at home. But then that still misses the people who don't know they need help.

that reminds me - I was sent an email on recognising the signal for DV on zoom the other day.
Link in case the picture doesn't work, or to read more about it.
DV Zoom Signal

@SpicyJalfrezi

And how would that have helped say Victoria Climbie, *@Sirzy*?

What? She was seen face to face at a GP surgery during her life. In fact she was seen face to face by health and social care staff many times.

There is no reason whatsoever why initial consultations no for depression cannot be by telephone.

Here's a reason:

Last year, I had a telephone conversation for anxiety and depression. The call came at a very inconvenient time (because you can't book a time slot). So I took the phone to my bedroom for some privacy. But a family member assumed I was talking to someone else and came and perched on the bed. I didn't want to spell out exactly how I was feeling in front of that member of my family. It made everything more difficult and the conversation didn't go as well as I'd hoped, which was very disappointing having finally plucked up the courage to seek help.

That's why face to face appointments, in a private consulting room, are sometimes very important.

Seeing people f2g is so important. This is why schools play such a huge part in keeping children safe. They see children every day and can be aware of safeguarding issues long before anyone else.

It’s one of the reasons we safeguarding leads were all so concerned during the first lockdown, when children without a CP or CIN plan weren’t eligible for a place in school so we didn’t see them in months.

My GP spotted a skin condition when I went in face to face for something else. Turned out the skin condition was the bigger problem!

Every call starts with "is this a convenient time/place to speak?"

And the honest answer is quite often "not really", but because someone has been on tenterhooks all day in case they miss the call, they are polite and say "yes".

Which is good, @ThinWomansBrain but there are a myriad of abuses which are not violent.

For preschool children in particular, the GP might be the only adult outside of the home who sees them. They aren’t going to know how to make a signal!

I’m not saying telephone appointments can never work but the refusal to have anything but will lead to safeguarding issues, I don’t see how it can’t, especially given the disruption to other services.

So I can see how things are being missed. How will they see if a kid is being starved? And you also don't know who is watching at home.

And the honest answer is quite often "not really", but because someone has been on tenterhooks all day in case they miss the call, they are polite and say "yes".

Exactly. When you've been waiting all day for the call and can't face waiting longer or ringing again to make another appointment, you're unlikely to say actually no, it's not a great time.

I like phone consultations. At my surgery we can get them the same day. It saves me dragging a poorly child in just so they can sit next to me when I explain their symptoms to the GP.