GP appointments for children should generally be face to face

[Tootsieglitterballs]

AIBU to think that where children are concerned, for a lot of situations a face to face appointment should be offered, not a telephone appointment?

I mean, Is this the new normal ? Children (well, parents of children) being refused face to face appointments in the first instance, only offering telephone appointments.

In the last few months, we have been refused a face to face appt, and given telephone appointments for;

• an unusual, very sore rash surrounding a very infected wound under the hair (under 5 yr old)

• Episode of viral induced wheeze that an inhaler wouldn't sort out (under 5 yr old)

• chest infection (under 5 yr old)

• follow up appointment following a stint in a&e after not being able to breathe (under 5 yr old)

Obviously, all telephone appointments have resulted in needing an actual appointment.

Surely this alone is a waste of time? I completely understand the need to triage adults in particular , and I know services are overstretched, but surely there are certain criteria that even the receptionist can use their judgement on and book a face to face appointment in the first instance. I mean rashes, FFS.

My GP has seen my kids face to face whenever we have needed. Only once we've had a virtual appointment where we needed antibiotic cream for impetigo.
Complain to your surgery.

All GP appointments should be offered face to face with the option of remote where that suits the patient and the GP doesn’t think this will be a detriment.

Mine have always been seen f2f when it was necessary. Sometimes it was a simple thing that just involved answering a question or ordering a repeat prescription or something very admin. Even I had a f2f appt last week to have a rash looked at. In most cases, our GP sees the dc same day (submit econsult in morning and appt in afternoon) or next day.

Ours is same day too.

I practically had to prostrate myself to get an in-person appointment to get a lump checked out in my 10-year-old. YANBU.

YANBU. I rang for an appointment for my 10 month old a few months ago and was told they had nothing and he couldn't be seen. I rang 111 and his symptoms meant there was an ambulance at my door within minutes.

That's shocking

To clarify.

You say you were refused face to face appointments, but then say all telephone appointments have needed an 'actual' appointment.

So your telephone triage assessment led to a face to face appointment in these cases?

I don't see the issue.

Telephone triage, especially in conjunction with photos/video can be a very useful tool to manage scarce resources.

I don't see why children are a different case and rashes, which are hugely common in children, and rarely problematic can be quite well assessed from photos/discussion with parent.

Receptionists should not have to make clinical judgments on who is most in need of care. It is outside their skill set.

I agree I am currently dealing with a situation that ended with my dd in A&E, which meant GP needed to follow up. I had to wait 2 weeks for a telephone appointment taken on the hoof at work, so really hard to concentrate (am a ward sister).
I know GP are really busy but this is always there go to response, prescription and telephone consultation. The state of the NHS is just dreadful and beyond repair. As I leave work every evening, I see the ambulances and people waiting and it breaks my heart.

We should be offered the option of f2f where clinically necessary, for certain conditions, telephone consultation can work well.

My GP usually starts with an E consult and 9/10 they say bring the child in at the end of the day. I think it’s great

Definitely need a f2f but if your GP’s surgery refuses again, a medical walk in centre or urgent care can help.

My child had a rash and the GP surgery managed it all via e consult/telephone. It saved me dragging a poorly and potentially contagious child to the surgery to sit in a waiting room with lots of other people and they sent the prescription straight through the pharmacy.

I think it’s entirely reasonable for GPs to offer telephone triage as a first step and only see children in person if actually necessary.

I couldn't even get a remote appointment for my 5 year old recently. The whole system has broken. I generally know when I'd prefer a call (ie review of meds) vs them needing to be seen but often can't get past the receptionist for either

Dd is 15 and has had both face to face and telephone appointments. Couple of times we've sent photos. Got to say I can't fault my surgery. She's gone in when necessary and been dealt with over the phone when not.
I'm actually liking the option of telephone appointments and trust my doc to decide what's best.

I agree, my 6 month old was misdiagnosed because we had to send pictures to the doctor and they wouldn't see us. Misdiagnosed with a yeast infection, our baby started getting really unwell and it turns out she had a horrible bacterial infection and we were put on sepsis watch

My DS hasn't been seen in person by a GP since before the pandemic - they rely on my report of his condition, and if he is actually unwell they cover themselves by saying "if you are worried take him to A&E".

Admittedly my GP practice is so shit they have just lost their contract after repeatedly failing CQC inspections. The only thing they didn't fail on is "caring" .

Yes, the system is ridiculous. I think the best system would be to have at least one Paediatrician at each clinic. It would help so much to have the same doctor see the child as they get older, rather than one of many at a practice, plus no need for triaging children. That way, they get to know what is normal for that particular child and have knowledge specific to children that some GPs appear to lack. It would also mean that appointments for "over-anxious" parents whose child has a minor rash (fair enough, I don't know what rash is serious and what isn't!) wouldn't take up GP time for patients with other issues.

Everyone should get a face to face appointment. My GP has never tried to offer me a phone appointment even at the height of covid. I'd be really annoyed.

I agree, children are pretty bad at saying what the issue is, I often only realise mine are ill when their behaviour changes, not when they tell me, so I think they need to be examined

Depends what it’s for. I need an appointment about my DS and I was offered face to face and turned it down in favour of over the phone so that I can discuss the issue properly without having to worry about what he hears.

For my other DS a Friday afternoon phone call was very helpful as he was away with grandparents and needed antibiotics for an ear infection. The doctor sent the prescription to the pharmacy his grandparents could get to and it saved them having to struggle with a sick child over the weekend.

In the case of rashes a phone call can work and be safer - scarlet fever is highly contagious and a quick chat with the doctor over the phone got use the prescription we needed and prevented risk of him infecting people.

Generally I prefer the new system. I can understand it’s annoying that you get a phone call to then just need to take the child down but it does save a lot of people needing to go into the practice which is a huge timesaver and helps stop contagious diseases spreading. Where I am the main challenge is the wait to get through to reception but I suppose every practice is different.

Ours always offers in person appointments to children. The regular doctors are fairly blunt with parents who request urgent and it is obvious at the appointment that it didn't need to be.

Ds rarely goes in person because he can't cope with going to the surgery but he always gets a same day telephone appointment and they generally take our word for it if we think that antibiotics are required.

So everytime your child has needed to see a GP face to face this has been achieved?
Generally a telephone appt can sort many many issues and is quicker and easier for both patient and clinician. When this is not possible, a face to face appt should be offered which is what happened for you.

We've called about rashes a few times and they just get us to send a photo. I do think the photos don't show it as clearly as seeing in reality so they should maybe see in person fo that? Maybe everything doesn't need to be face to gave though I guess it depends if they can care suitable remotely

Our doctors triaged on the day emergency appointments well before covid. For a vital wheeze that isn't being managed with inhalers I'd have just gone straight to a and e

DD has had a couple of different skin infections, and we had a telephone appointment with the nurse practitioner. Not only did it work well, but she didn't have to miss school - I took photos before she went, and she didn't need to be there. On one occasion the nurse wanted to see her in person. Because all her other appointments were telephone, she could be really flexible about timing, so it was a case of stopping by on the way home from school, rather than looking for the next available 10 minute slot which would probably have been in the middle of the school day.