Being triaged for a GP phone appoitment by GPs Receptionist

[Pennox]

Curious to know if others think IABU here as this is a particular bug bear of mine. I should say that in the past I have had 2 particular concerns about GP receptionists which maybe colour my view. One, my mother was briefly a GP receptionist (not recently) and used to tell us all sorts about the patients at the surgery, much of which was personally identifiable if you knew those people in the local community. Secondly, I was given incorrect medical information by my own GPs receptionist just prior to Covid regarding my son which she shouldn't have been giving me anyway, and was given in an attempt to get me to go away and not persist in asking for an appointment, but, more importantly, because it concerned a severe allergy, could have been very dangerous if I'd not known it was rubbish and followed it. (And no I did not officially complain at the time as the practice makes that really difficult and covid kicked off, I should have done.) Anyway.

I had covid approx. 5 weeks ago and was feeling pretty much over it after 2 weeks of pretty rubbish flu type effects and then 2 weeks of fatigue, joint aches etc. So by end of last week was thinking great, I'm back! after a surprisingly rough month. I did not seek any medical attention during this time and self-managed. However, I think I've now developed a secondary chest and sinus infection which is getting worse and worse, all the usual gross symptoms which I wont detail here and got to the stage where I am feeling really rough again and cant work properly (from home). Im really behind at work after the initial 4 days off that I took and then being ill/fatigue/brian fog for another 3 weeks. So I reckon I may need antibiotics now and it wont just go away on its own - I'm not a medic but when this has happened a couple of times in the past that is what has inevitably happened. So, basically, I need a GP appt. To check and hopefully get some antibiotics. Online booking is 3 weeks out. So only option is the GP prescribed practice of phoning at 8 to ask for a same day/emergency appointment. Thisbused to involve queuing round the block at 8 as was impossible to get through on the phone. They've somewhat addressed this now so after about a 30 minute wait I got through and asked for a same day appointment and surely is a yes or no response, yes we have one available, no we do not. But they of course then ask you why. So I said I had covid recently and now think I may have developed a chest infection at the end of it and might need antibiotics to clear it up. She then started asking me a long list of medical questions about my symptoms. Was I coughing? Did I have a temperature? Was I coughing up phlegm? Was there blood in the phlegm? At this point I said can I ask you why you are asking me these questions? Is this my appointment? She said I am triaging you before putting you through to the list for a GP phone appointment (they are still doing all initial appointments over the phone). I asked if she was a nurse then or medically trained and she said no I am a receptionist but the GPs give us this list of questions to ask before we decide whether to put you through for an appointment or not.

AIBU to think that they shouldnt have non-medically trained people triaging attempts to get a GP appointment?

Its not so bad in this instance - the receptionist and the rest of the surgery now know I've got symptoms of a possible chest infection (its open plan and they're in the main reception), so what?. But bearing in mind she'd just confirmed my name, asked for my date of birth and echoed it back at me over the phone in front of who knows who standing in line in the surgery in front of her (that I can't see and could be my neighbour for example). What if it had been a call about depression or mental health/suicide or domestic violence? And more fundamentally than that, is it really appropriate to have non-medically trained reception staff, not bound by the same professional conduct standards as doctors and nurses, deciding who actually needs medical attention in the form of a doctors appt, and how quickly, or not?

I have no problem with this at all. It's actually helped me to get appointments quicker. The receptionist has also been able to point me to different services - for instance, I was going to the GP about a problem that was better dealt with by their in-house physio, cutting out the middle man, leaving that appointment for someone else. They've arranged nurse appointments where the practice nurses were able to deal with the issue instead of the GP. Seems a lot more streamlined and efficient to be honest.

I've actually really liked the new system of receptionist triage, doctor call back and then face to face appointment if needed. It saves so much time.

knowing how difficult it is to get through to the surgery phone (because of so many patients ringing up) I doubt the poor receptionist can remember who said what to her because of how busy they are.
They are doing a tick box for assessment & have been trained for this part
please be patient & remember its not personal its to try & maximise the doctors effectiveness & to treat the people who have most need. You may be referred to a nurse or a doctor according to your need according to your answers

I agree with you OP. And call handlers with 111 are probably wearing headphones/working in a busy call centre, no? So confidentiality is more likely by virtue of how it’s physically set up, vs a receptionist doing 2 jobs, one of which involves sitting by a reception desk open to the public (I appreciate this might not be the case in every single doctors surgery.)

It’s not ideal, even less so if the reason someone is calling the doctors is distressing and/or very personal, or if they’re experiencing abuse/mental health crisis etc.

My GPs are doing similar and I have found the system so much better since they introduced it. Before we had to queue round the block and then sit for ages as appointments all ran on. Now we give a brief reason to the receptionist and get a call back from GP or nurse and then they arrange to see you if needed. When I have attended there are never more than 4 people waiting and at most appointments are 10 mins late.

I suffer from endometriosis, ibs and recently had a cyst in very intimate place and am always was treated with respect and compassion by the receptionist when describing my reason for calling.

I would change surgeries if you are unhappy with their service but I would say covid has improved my GP practice.

I took medical "advice" from a receptionist once.
The allergic reaction resulted in a very very stressed practice manager, a concerned GP and a bollocking for the know it all on the phone.
I hate running the gauntlet when I feel like shit and need to talk to an HCP
It's so difficult to get through to anyone

There seem to be reasonably frequent threads where people assume gp receptionists arent intelligent or trained enough to ask some basic questions. Gp receptionists are often lower paid women. Im pretty sure there is a correlation. Ive had a similar senario, covid, chest infection, triage etc. The recptionists asked me questions and triaged me effectively. What it meant was i got a quicker apoointment because i wasnt behind a whole queue of people who didnt really need an emergency appoinment.

I think it’s normal. I like the system. They ask you a set of questions and it goes to a gp. The gp decides if you can go on the emergency list for same-day appointments. I’ve had several same-day appointments this way.

I can see the theory behind it-but isn't it just clogging up the phones?

As frustrating as this is, this is not the fault of the receptionist. They are told by the practice manager what they need to ask the patient by the practice manager.

If you are angry then complain to said manager but don’t be angry with the receptionists, the system has nothing to do with them and they are only following orders

@diddl

I can see the theory behind it-but isn't it just clogging up the phones?

It may take slightly longer on the phone, but it’s much more efficient overall.

'Sorry, its personal' works for me. No way am I discussing my medical care with a receptionist, besides which my medical history is complex so something seemingly straightforward like a chest infection could be very serious compared to a patient without my history. A receptionist has no way of knowing that.

Your mother broke all kinds of confidentiality rules, and data privacy. If that happened today, she would have lost her job.

In our gp’s surgery, we have a variety of clinicians - doctors, advanced nurse practitioners, physio, pharmacist, so the receptionists always ask a few basic questions, to determine who to book you with. I agree, they shouldn’t be saying identifying detail in a public space. It may be worth contacting the practice manager about this, and explain how you’d like your information to be kept private. You can also say to the receptionist that you’re not going to give them the details.

I don't object to being asked the questions, but the receptionist is in a public area. There needs to be more attention paid to patient confidentiality during these telephone interviews, if this is the way things are going.

They're not trying to diagnose you, they're just trying to ensure that the correct person sees you. They're trained in what to ask. When appointments are so scarce, they need to be allocated correctly.

It's normal and it works most of the time. I do find it annoying when I ask for a GP appointment for my 13 year old when he has an eye infection. Receptionist always tells me to go to the pharmacy and I don't need an appointment for conjunctivitis despite me explaining about his autism, previous cellulitis etc. I have to be quite forceful and made to feel like I'm wasting everyone's time before finally getting a gp appointment. The GP always prescribes antibiotic tablets and eye drops.

The receptionists aren't trying to decide whether you 'qualify' for an appointment, they are trying to assess how urgent your clinical needs are to pass this information onto the GPs, who review them and decide who is most urgent and needs a call in the next hour or someone who can wait until later in the day for the call.

I do think the level of patient confidentiality needs to be addressed. People waiting in the surgery shouldn't be able to hear these conversations. Have a look on the GP website and you'll probably find a complaints form.

Nobody knows who you are the receptionist doesn't put Mrs Jones on loudspeaker for the waiting room ! At worst they might hear questions the receptionist will be typing it into the system for triage !

I think it's fine. I have in the past had to go head to head with a receptionist over the urgency of an appointment for my daughter and it actually turned out she desperately needed antibiotics and then surgery as she didn't get the antibiotics fast enough. That was pre covid and the system then used to be that you phoned and asked for an appointment if same day and it was down to whether there was space or not - the end. Since covid they've brought in triaging and although there are lots of questions, it means that usually urgent things are dealt with.

What I do really dislike it that they confirm your personal details in front of the waiting room. I don't think it's appropriate. I was once sat and overhead some very personal details about someone who I vaguely knew. However since covid, the people who triage seem to be sat out the back and not by the waiting room now, which is better. You could if you wanted explain to the practice manager that you don't feel comfortable with your personal details being mentioned in front of the waiting room but honestly it feels like just an extra thing to add to the to do list for very little reason.

If you went to a&e you would have to tell the receptionist why you were there in front of a very full room of people before you would be shown a seat.

Also what would the GP do re domestic violence? Surely you’d call the police where you would speak to someone who isn’t actually a police officer but will ask lots of personal questions before directing your call appropriately.

The GP receptionist was doing her job, which is to find out how severe your illness is and who is the right person to treat you. A close family member had chest infection symptoms after having covid. The receptionist told him (correctly) that he needed to go to hospital after asking about his symptoms.

I hope you feel better soon @Pennox

I'm a GP receptionist and we don't want to ask these questions but we are a small rural surgery with two doctors, sometimes only one of whom is working that day, and three nurses, again maybe only one working.
We have a glass screen that we open if people come in, otherwise it is closed for privacy when taking phone calls. We have to put a reason down for the call back from a GP such as patient asking for sleeping tablets, bleeding when going to the toilet, back pain or whatever. Often if it is a mental health problems patients sound distressed and I don't push them for details, or if it's an intimate issue they will just say it's personal and that's fine.
Some patients call for the most trivial of reasons and others phone us when they clearly need to go to hospital for an X-Ray or something like chest pain.
I haven't had any real training in how to triage, to be fair, but it's mainly common sense.

I've had this too a few weeks ago, I rang up late afternoon as my 4 year old was pooing blood (I don't mean a bit) the receptionist said to me having asked all about the problem and why did I need an appointment ASAP that there were in fact no appointments. I said a quick phone call with a doctor if they have a minute is all I need to decide if this is serious to need urgent care, she said no sorry. So next day I rang back first thing and said I need to speak to a doctor not the receptionist, so she actually went and explained to the doctor who came and spoke to me and said to come in immediately, we were then sent to a+e from there. It's so wrong that people with touch type level 2 are deciding who does and doesn't need medical attention. We really should have just taken him to a+e in hindsight, i dont use 111 as they send an ambulance as standard, so i foolishly waited until the next day. Unfortunately it has happened before where we couldn't get in the GPS so we have gone to hospital (same child aged 2) and they were admitted very poorly. When I said I couldn't even speak to my gp because the receptionist didn't deem it serious they were as annoyed as I was.

These are the only 2 times I have tried to get a doctors appointment for my child, I most certainly only ring when I know its something that needs medical attention, I can only think other people must hammer the appointments so they put barriers in the way to make it harder to actually see or even contact the actual doctor. My mum is a nurse with 40+ years experience, she finds it even more infuriating when the receptionist is deciding whether she needs an appointment!

The privacy issues need to be addressed, but other than that I think this is fine.

Nhs scotland have an advert running telling us how Triage works they are probably sick of their receptionists getting grief!

I completely agree with you, OP. GP surgeries need to do a lot more about confidentiality and better access to someone who knows what they are talking about.