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.

@AnguaResurgam

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

Can you tell if they self harm over the phone?

I’ve been worrying about this in relation to health visitors, as PPs have said. My DD is 12 months old - she has been seen once, at 10 days, by a HV. She saw a nurse for her routine jabs. If I had been isolated and didn’t have contact with family/friends, I could have done something atrocious to her in December and no one would be any the wiser right now. It’s a horrifying thought.

Can you tell if they self harm over the phone?

To be fair, you can't tell if someone self harms in person either unless they deliberately choose to show you.

I could have done something atrocious to her in December and no one would be any the wiser right now. It’s a horrifying thought.

I had a chat with a family member who said similar. It's worrying when you think about how isolated some children have been, and how easily issues could have slipped through the net.

@Dollywilde

I’ve been worrying about this in relation to health visitors, as PPs have said. My DD is 12 months old - she has been seen once, at 10 days, by a HV. She saw a nurse for her routine jabs. If I had been isolated and didn’t have contact with family/friends, I could have done something atrocious to her in December and no one would be any the wiser right now. It’s a horrifying thought.

This was true pre-pandemic, too - it's weird how few mechanisms we have in place to perform even basic checks on under-5s unless their parents actively choose to engage with outside agencies, but I don't know how you could change that without doing things that many families would see as hugely intrusive.

I think that’s why, while GPs aren’t the only service for under 5s, they are one of the few likely to come across them, and this makes their role in safeguarding paramount.

While telephone appointments are great for me they can be disastrous for others if there aren't suitable alternatives available.

When my DH's depression was serious and he needed help he couldn't have dealt with a telephone appointment or even telephone triage. The prospect of making a phone call gave him dreadful panic attacks. It was difficult enough trying to get an appointment made at all.

Then he got a referral for treatment but the clinic required phone calls to book, cancel or rearrange appointments. Despite knowing that inability to use the phone was bloody crippling for him they wouldn't communicate by email or allow him to nominate someone else to speak on his behalf.

Lots of people with depression and anxiety find using the phone really difficult.

He has recently done physio via the telephone (not sure how that is safe). But the practicalities make it tricky, the call comes from a private number, if you miss the call you can't call back, if you miss two calls you are discharged.

A lot of people talking as if it's the State's job to supervise parenting. It's really not.

No, that isn’t what we are saying.

There is an enormous difference between supervising parenting, which is an invasive practice, and being alert to abuse or neglect, which is something that saves lives.

Anyone who has experience with safeguarding knows it isn’t about one thing setting off a procedure. It’s normally a myriad of small factors - a teacher reports a child seems quiet and withdrawn and tearful about going home, a neighbour hears shouting and screaming, a HV reports milestones not being met.

GPs are not the whole picture but they are part of it and an important part. By effectively removing themselves for it, there are missed opportunities and that comes at a cost.

@Grellbunt

A lot of people talking as if it's the State's job to supervise parenting. It's really not.

Well a baby can't

I know it doesn’t help, but to restore the balance I bit, I rang our surgery at 12.10 one day recently, got straight through and asked to book a shingles jab. “Come at 17.1o today” they said. Brilliant service

@Redlocks28

Phone call appointments are great if you are sitting somewhere where you can make or take the call.

Trying to get one for my DC who was having terrible trouble with acne was near on impossible. I would phone at 8am-if you were not the first 20 in the queue, it would cut off. By the time I got through, at nearing 9, all appointments for the day were gone. I did this on my day off and I work the rest of the week so unable to call. Eventually, I get through on another day off a week later, they tell me that they will call her between 9-12 that day. She is at school and they aren’t allowed their phone. I eventually managed to persuade them to ring after 4-they were not happy about it.

They then tell me I have to get DC to the surgery to have a blood pressure reading-or I can do it at home. I do it and try to phone through the reading-again, I sit on hold for 45 minutes, twice, in my lunch hour -never get through. They sent me three texts of increasing urgency, demanding the results. There is no way to email or text reply the result. Eventually, DH spends 45 minutes on the phone on the train to work and gives it to them.

Now me. I am trying to get an appointment for me-about something that I have been putting off a bit because i find it difficult to talk about. They say there is an online booking system but that is only for blood tests. I have had the same-three days of trying to get through on the phone at 8-by the time I get through, appointments are gone. Next week-I am back at work-teaching in a school, I get in at 7.30 and phones have to go in a locker. Even if I managed to get through to speak to someone, I won’t be able to answer a phone from 8-12, let alone be in a situation (ie quiet room) where I can talk about something I haven’t even told my own husband.

I hate it, I really really hate it.

How anyone can read this and still parrot “we’re back to normal and telephone appointments are working” is mental.

I wrote on a thread like this that my surgery were offering telephone appointments as needed. This has apparently changed and the next telephone appointment I can book is in 5 weeks. Otherwise I phone at 8 every day - I’m a teacher too, and obviously am still on holiday but every time I’ve tried I am on hold until all appointments are gone. Won’t be able to do that from when we go back, so I’d better get through before then.

I'm sure telephone appointments are important for some people but I'm pretty sure that due to no exact time being given or the time being given and not adhered to, people are missing out on appointments.

If you're half way round Waitrose and you get a telephone call 2 hours too early about your embarrassing gynae complaint you're not going to discuss it.

We are all very aware of safeguarding issues and if there is anything that twitches our antennae that way then the patient comes in.

Don't you think that it's less likely to twitch your antennae if you have only audible clues and no visual ones? You're working at a disadvantage

A lot of people talking as if it's the State's job to supervise parenting. It's really not.

It's the state's job to pick up on any child that is suffering abuse or neglect and help that child

I have depression and by my username I think you can tell how I cope once my children are sorted. I've given up with my GP surgery. The MH practitioner doesn't take me seriously, in fact I don't think he is even working there at the moment. My GP in general is great, I get instant help for a urine infection and menopause issues but not for my mind. Therefore I self medicate

On the most part I have been really pleased with being able to have telephone appointments. There’s certain things where I know it’s not serious but do need advice and don’t need to be seen. Previously I would have had to trudge into the surgery and waste everyone’s time. However other issues need an appointment. I’ve recently had a mental health issue and it needed face to face really. But I didn’t get it so we are where we are.

(It also didn’t help that when I got telephone advice it was at odds with everything I had read)

I totally agree. I’ve had loads of health issues since COVID (not COVID related) and I always find they won’t see me F2F when I want them to but when I don’t expect them to want to see me F2F, they do (like for a UTI)! Just doesn’t make any sense! Most of the time they just want to refer me on without seeing me F2F, like they can’t wait to wash their hands of me. It’s frustrating to say the least when you have lots of issues cropping up all over the place and seemingly no help/support.

@JesusMaryAndJosephAndTheWeeDon

While telephone appointments are great for me they can be disastrous for others if there aren't suitable alternatives available.

When my DH's depression was serious and he needed help he couldn't have dealt with a telephone appointment or even telephone triage. The prospect of making a phone call gave him dreadful panic attacks. It was difficult enough trying to get an appointment made at all.

Then he got a referral for treatment but the clinic required phone calls to book, cancel or rearrange appointments. Despite knowing that inability to use the phone was bloody crippling for him they wouldn't communicate by email or allow him to nominate someone else to speak on his behalf.

Lots of people with depression and anxiety find using the phone really difficult.

He has recently done physio via the telephone (not sure how that is safe). But the practicalities make it tricky, the call comes from a private number, if you miss the call you can't call back, if you miss two calls you are discharged.

I sympathise with this. When my MH was bad I couldn't use a phone. If that had happened I dread to think how I would have coped

I think it depends on your GP. My GP has done telephone triage for years and has worked well. Presently if you need to be seen, they will see you at my surgery. My teenage daughter has had 3 face to face appointments in the last 12 months and during the peak of Covid.
I have seen it from the other side too though and patients I have seen who did need a face to face assessment were denied this and ended up needing emergency care.

I have also seen people attend a&e with minor things that even a pharmacist could have attended to. One lady turned up for a sore toe which could have been dealt with at home with a plaster! She was in her 40’s

She may have been told to, @bakebeans

I’ve twice been told by my GP to go to A and E for something they should really have been dealing with, and I had to be quite firm about it not being an A and E matter.

@SpicyJalfreziSpicyJalfrezi no she wasn’t told to. She took it upon herself to go.

@SpicyJalfrezi what was the "matters"

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.

I disagree in people with more complex MH problems - there is a difference between someone, who has neglected their physical appearance and someone reasonably dressed. Likewise, there is a difference between someone pale, red eyes, hollow cheeks as they haven't been bothered to eat for weeks or been outside or their skin is normal and cheeks look ok. If DD is size 10 or less, we know she's not eating properly. Sometimes she lies in bed all day and doesn't drink either. I assume there are signs of dehydration? Parallel plasters on the arm are a sign of self harm.

Psychiatrists always comment on DD's appearance in their reports.

[quote EyebeIbewe]@SpicyJalfrezi what was the "matters"[/quote]
Sorry?