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'm fine with this. However my mum died on Monday. When I rang 999 and asked for an ambulance I was asked if she could make her own way to A and E (no because she is dead). When I rang to chase up an ambulance after 2 hours I was told the call was logged, but to ring back if there was a change in her condition (resurrection?? being more dead?). Think those scripts need an overhaul

@Spudyoulikeit

If you said you were experiencing domestic violence then I don’t think they’d continue to interrogate you over the phone. They asked those particular questions because you said think you have a chest infection. I don’t really understand why people have such an issue with GP receptionists. Unfortunately there aren’t enough appts to go round and there has to be some sort of process to direct people accordingly.

Why call a GP if experiencing domestic violence? Dial 999 and be outraged that the chief constable does not answer the phone?

I know that queuing for appointments and taking phone calls in the hearing of other patients has stopped since Covid. That's in part due to the fact that their reception has chang

You are being massively unreasonable. Of course they must triage the people who ring. How else are they supposed to weed out the time wasters.

Your mother was well out of order and deserved to be sacked for such unprofessional behaviour.

Hope you’re feeling better soon.

It's what the Drs have asked them to do.
Your mother should have been sacked for discussing patients.

I would far rather live in a world where those of us can afford to pay to see a doctor when we think we need to and actually see one. It's clear that trying to give everyone NHS care isn't working. Our expectations of care are abysmal.

I only ever ring the GP if it is for an urgent issue that cannot be treated at home, and by that point I really don't need a box ticking exercise from a receptionist wasting my time any further.

I do get this, and I am the same. But how does the receptionist know this? How do they know you have a serious problem? I think a few polite enquiries as to the nature of your issue is fine and shouldn't result in a threat to make a complaint. It's a bit OTT.

DH has a serious, potentially life-limiting, medical condition and he just politely says, 'if you look at my file, you'll see why I need to see a doctor as a matter of urgency'.

@7thHell

Just book appointments online. You won’t be triaged.

Please read the OP. They clearly said online appts are booked 3 weeks out. OP needs medical attention now.

@Narutocrazyfox

Simply say 'my condition is of a sensitive nature and I only wish to discuss it with the Dr. Please put me on the list for a call back. If you refuse to do so, please let me take your name so I can complain to the practice manager.'

Works for me! I never tell a receptionist anything other than what I want the next steps to be.

Well done for making a hard job harder.

You do know that they asked because the doctors tell them right? Guess what, if you need follow up, it’s the admins who book those or send referrals. They also have access to your files.

You’ve protected nothing and made everyone at the practice work harder. Including the doctors.

Well done.

@lovePoppy don't be so ridiculous, I haven't made anyone's job harder. If a referral is needed, the GP informs the admin staff as per the process. Me going through a lengthy checklist with the admin staff beforehand makes no difference to their time at all.

You do realise we pay for this service, through our taxes? I just don't like my time wasted. I do not require triage, I am perfectly capable of assessing when I need to see a GP. So why take up more of the receptionist's time?

I haven't had any real training in how to triage, to be fair, but it's mainly common sense.

I disagree. If it were just common sense, we wouldn't need triage, or GPs, for that matter. It might work fine for the most common ailments but you need to know what questions to ask when the patient doesn't know what to tell you or what is relevant. You might even be speaking to someone other than the patient, a carer or a parent, who might not offer the relevant information because they didn't know to ask the question of the person who is unwell.

Does your surgery at least use triage software to tell you what to ask, @Papergirl1968?

The 111 call handlers at least go through weeks of training in how to use the Pathways program. It's not as if that system doesn't have failings and the training has come under fire for being inadequate. It concerns me that GP receptionists are triaging patients with no training or have just done a 1 training day course, and the surgery may not even have software to assist them.

I'm sure you are intelligent woman but I wouldn't expect Einstein to be able to use common sense to differentiate between appendicitis and constipation or ovarian torsion or a gazillion other differential diagnoses of varying degrees of urgency over the phone without being trained in what to ask.

No, no software to aid with triaging, CheshireCat.

Haven’t read the whole thread.
There was one occasion when a receptionist repeated what I’d said to her with such horror that I wondered if it was for the benefit of an audience.
Anyway, I like Econsult. Is that impossible for you? I know it doesn’t suit everyone if you are serving on a till all day and the call back is entirely unpredictable, but I recommend it to anyone who can be available.

Blimey, if the receptionists have to plough through that great long list of questions every time someone rings up, no wonder it's almost impossible to get through.

You do know that they asked because the doctors tell them right? Guess what, if you need follow up, it’s the admins who book those or send referrals. They also have access to your files.

So are you implying that if a patient pisses off a receptionist by being what you or they perceive to be unnecessarily difficult, but they might perceive to be due to valid confidentiality and privacy confirms, then the receptionists should vindictively and deliberatley delay or interfere with any further medical treatment they might need?

If so, that would be incredibly unprofessional and only adds weight to my concerns about the role of GP receptionists in my healthcare. Thankfully the receptionist i spoke to today obviously was progessional as the GP called me back and prescribed antibiotics within the hour so she obviously did not deliberately put me at the bottom of a list or anything.

How does econsult work? I use the GPs online system to book non urgent appointments and order repeat prescriptions. Is that different? Its not terribly convenient to be called at a random time tbh, I am on calls with customers for much of the day and have headphones on. But then its no different really from the GP receptionist saying a GP will call you back 'sometime today" - I'd just stepped into the shower this morning of course. Not sure what teachers, bus drivers, shop and restaurant workers and other people that don't have constant ccess to their phones all day are supposed to do though!

I loathe it. This is a small community and I spent years chatting at the school gate with some of these women. In this case it's certainly not the same as 111 as at least there's an element of anonymity there. My health is between me and my doctors and wee Aggie McWotsit can just fuck off with her questions. I'm not discussing my vulva with her.
It's like nobody here buys pregnancy tests or viagra from the chemist. They wait to go to a big town.

Thatsba bery good point. When i call 999 or 111 its an anonymous call handler that is likely in a different town or city and neother of us know each other and wouldnt realsie if our paths crossed. The receptionists at the GP surgery have been, variously, 3 womlen with children at my childrens school, one who was one of my sons Cubs leader and woman who runsan excercise class i used to attend. One of the current ones, who is lovely, was a hca at the hospital when I gace birth.

At my surgery, you access Econsult through the surgery website. It asks fairly detailed questions including some about family history, and they are committed to a doctor ringing you within two working days. Last time I tried, about a year ago, it was that or a two-week wait for a phone appointment.
Anything in a receptionist’s script could be done on line so it’s not unreasonable to expect that option to be available.

Of course, the Econsult may direct you to ring the surgery if it’s urgent.

You do know that they asked because the doctors tell them right? Guess what, if you need follow up, it’s the admins who book those or send referrals. They also have access to your files They should only be accessing files and reading material contained within them that is strictly necessary to carry out a task they have been requested to complete.

Our surgery has been doing this for a couple of years now. They actually had a recorded message initially when you phoned to say the receptionist would be asking questions on the instructions of the doctors to ascertain the most appropriate appt/person to see. It seemed to be aimed & directing people to opticians, dentists, pharmacist, practice nurse etc.

I know when they do ask its pretty basic details they ask for

Well your mum sounds like an unpleasant gossip for telling you about her patients. If this happened now and she was reported she would get the sack. This is completely unacceptable.
Secondly, this is part of their job in many practices and triaging is put in place by the GPS themselves to cut down/ prioritise their workload.

1. They have to ask as for every person like you there are two others calling for an urgent apt who either:

• have really bad chest pain and can’t breathe - they need 999 not a GP
• have a runny nose for 1 day - they don’t need to be seen urgently in the last remaining slot for that day

If the receptionist wasn’t asking questions same days apts would be full of runny noses and cut fingers and you wouldn’t get an appointment. Say there are 40 emergency apts per day (one Gp on emergency) the practice will get 100 calls for appointments- they need to somehow figure out which 40 to see- some need 999, some can see the chemist, some need a GP, some can see the nurse or be booked for a routine apt. If they just book the first 40 calls then the last 60 people won’t get any apts and they might be the ones who really needed seeing.

GP admin staff can see your notes- nurses and doctors aren’t printing/emailing the referral letters and putting them in envelopes or opening the post. Admin staff have exactly the same confidentially requirements and training as clinical staff and absolutely should be disciplined if they break this.

Not sure what teachers, bus drivers, shop and restaurant workers and other people that don't have constant ccess to their phones all day are supposed to do though!

Not have appointments until they are literally dying and then they are an emergency.

@freshcarnation

I'm fine with this. However my mum died on Monday. When I rang 999 and asked for an ambulance I was asked if she could make her own way to A and E (no because she is dead). When I rang to chase up an ambulance after 2 hours I was told the call was logged, but to ring back if there was a change in her condition (resurrection?? being more dead?). Think those scripts need an overhaul

Yeah we had specific scripts for that So I would have asked if there was anything else I could do for you and told you help was arranged