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.

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

Where I live it is GP or A and E. There is an out of hours clinic but that is only out of hours and you have to go through 111.

YABU.

From your post it looks like your child was offered a face to face visit after phone triage? If so the system is working exactly as it should!

Obviously in your case it's unfortunate they had to be seen anyway but that's not the case with everyone and many things can be helped over the phone. GPs and GP appointments are already scarce with this system. Are you happy to have your child wait even longer for the face to face because the GP is seeing someone who didn't need it?

In a perfect world that wouldn't be the case but successive governments have ensured no one wants to become a GP so it is the reality!

These are all really interesting points.

Our last tel appt for one of our children was 105 minutes after the allotted slot... now I'd rather that than a 2 week wait of course, but surely something that is always going to result in a face to face appointment anyway is just wasting time and recourses? A face to face could have been booked in in the first instance instead (it most certainly was something that needed to be 'seen' - due to location it would not have been appropriate at all to do via a screen or a photo.... yet still 🤷🏻‍♀️)

Another case i had forgotten about (albeit adult not children) was a lump on one of DH balls.... telephone appointment - madness! Obviously a very quick proper appointment was arranged, followed by very quick referrals which was super (and thankfully all clear) but that kind of thing should be face to face straight away!

I think most sensible adults know when they need to be seen vs not be seen.

I'd love to be offered the choice for me as an adult, the majority of the time a virtual or telephone would suffice - although I'm not even sure when I last needed the docs for myself. My children on the other hand.... certain issues (with adults too) should always be face to face in the first instance.

We don't get times for telephone appointments. The GPs fit them in around whatever else they are doing on that day although if we say it is urgent they do ring back quickly.

Just to clarify as a couple of people have mentioned;

• yes, in these circumstances, they have all resulted in a F2f which is great - my point being though that in my mind, these were always going to result in a f2f appointment, so why not cut out the middle man for certain 'criteria' as there are certain things that should always be checked out.

• we have also experienced rash appointments over the phone, sending in photos - in this circumstance, we knew they were caused by a toxic plant, so they actually didn't need to be seen, just prescribed the correct treatment over the phone. I totally understand not every rash needs an appointment, but again I would have thought most parents play doctor google before ringing and generally know if it needs seeing properly or not.

I like the telephone appointments as for kids I don't have to drag a sick child to the surgery and for me they're much easier to fit around work especially if the doctor is running late (my preferred GP always is because he takes the time to actually listen). Always managed to get a f2f when required.

I love telephone appointments! Saves me so much time, if the appointment is for me I often know what I need and can talk it through then get a prescription/referral if it’s for dc I’d not have to leave work and get them from school wasting valuable time. If we need to be seen its arranged for the same day. 1 of my dc has has a gp appointment, 5 consultant appts, scans resulting in an op. They only attended 1 appointment, the scan and obvs the op! I didn’t have to take leave for any of the other appointments and they didn’t need to miss school. So much more patient friendly

I do like the fact I can send photos of rashes to gp while on the phone. Makes it easier than dragging a sick child out. Breathing issues if want a face to face bit tbf my dr does usually offer after a quick phone triage by nurse

yes, in these circumstances, they have all resulted in a F2f which is great - my point being though that in my mind, these were always going to result in a f2f appointment, so why not cut out the middle man for certain 'criteria' as there are certain things that should always be checked out.

The problem is this leaves the receptionists to enforce the 'certain criteria' which should always be checked out and this is not fair or appropriate for patient or receptionist. Having a qualified GP doing the telephone triage and then offering an appointment to those who need to be seen in person on the same day is a better option. I can think of a few cases where my children have needed to be seen but not urgently and it was much better that someone else got the same day appointment and they got one a bit later.

I would have thought most parents play doctor google before ringing and generally know if it needs seeing properly or not.

This is one of the worst things, google does not reliably inform if someone needs to be seen and in many cases, patients panic when there is no need to and others, google downplays the seriousness of the condition and they need to be seen more urgently

Seems like a definite love it or hate it kind of system!

Perhaps I'm just old school, where children would always be seen same day.

In our circumstances, the chances are , if my child is poorly enough to need to SEE a doctor, they aren't in school and a parent is at home caring for them already.

On the flip side, If they are well enough to be in school , or it's just routine where they don't need to be physically seen, a telephone appointment is most likely sufficient, and not needed same day.

My GP surgery always has my DS come in for face to face

My gp sees all of us face to face same day.

I love our GPs system, it's just an online service where you put in the details and then can select wether you'd prefer face to face, telephone or email. You can also request who you'd like to speak to/ see. I've always been able to get what I've requested with no issue and usually very quickly.

The only issue is that I can't imagine it works very well for those who are not easily able to access/ navigate the online system. They won't let you book appointments by phone anymore which suits me fine but I'm not sure what they do for others/ I assume they probably have to make exceptions.

I do agree that a face to face appointment should always be offered to a child in the first instance should the parent/ carer deem it necessary.

I’m not sure I fully agree children always need to be seen f2f, I think with children some things don’t really need a face to face, a recent example was that my DC started to get a gunky red eye at nursery, I received a call from nursery asking me to collect the child and confirming conjunctivitis was going around the children and my child had the classic symptoms, and that I needed to get her some eye drops prescribed. I don’t really think that a face to face is necessary, neither did the GP practice, they just asked me to upload a picture for them, a doctor checked the picture and they prescribed the eye drops over the phone and told me to call straight back if no improvement (they did give me a short timescale but I forget exactly what that was) I would have been very irritated to have had to drag grumpy DC and my other baby DC to the practice for them to have inevitably prescribe antibiotics for conjunctivitis. I do agree however that if a parent thinks that a child should be seen face to face, that this should be available. My GP has a very quick triage in place, even if you don’t call first thing in the morning, and children apparently go right to the top of the list.

Our GP does everything they can to avoid face to face. You can't even speak to a receptionist, everything is done through e consult first, you fill a form out and then get a written response back, at that point you can click a button that says you would like to speak to someone and then you can be phoned by a doctor hours later (randomly, usually in the middle of a work meeting) and then they do everything they can to stop you coming in.

My dd has been diagnosed with a serious health issue this year and the only way we could get her seen is going private.

Telephone appointments should be a choice, not the only option available. Not just for children.

The government could easily insist on this. GPs would do this very quickly if the alternative was not being paid.

Ours always have to have a telephone triage appointment first but that has always been followed up with a (usually same day) F2F when needed. I
Once or twice a phone appointment and a photo or video consult has been enough for the GP to make a diagnosis though (generally for rashes/ gunky eyes).

I love e-consult and telephone appointments. So so much easier than having to sit in a waiting room full of sick people trying to entertain a child. My personal favourite instance was walking into the waiting room with my then 1yo and seeing a child I knew had chicken pox sat there. How they got past the reception I don't know!

Both of mine have seasonal ezcema - I don't need to sit in a waiting room with both children to have a Dr tell me what I know already. I can do all that with a photo and description on e-consult and a three minute phone call. Perfect. When they have been sick enough to see a doctor, we've done e-consult, had a call and either sent antibiotics to the pharmacy or asked to come in the same day.

Ours are face to face unless it is routine e.g. repeat prescription.
I am fine with sending a photo of rashes.

Are you a patient with a GP practice run by that big American private healthcare firm? This sounds like them. They do everything to avoid paying for GPs time and try to do it all the cheapest way possible. It is because it is all about making a profit.

But that's almost double appointments every time. Be more efficient to just see people F2F to begin with!

Agree. Photos of rashes has led to two cases of misdiagnosed illnesses (had one GP tell me DD rash was infected eczema, prescribed a steroid cream and said she was fine to go to nursery. Ended up being chicken pox).

I like the triage system in general, but not without flaws.

If I fill out the form in the morning for a non urgent issue, I am guaranteed a phone call back in the afternoon.

If I click any of their flagged questions to indicate urgency, I am told to call the surgery.

When I call the surgery, I am told there are no appointments and to try again tomorrow. MADNESS!

I'm sorry some of you had such shocking treatment. Doctors have always been happy to see my 2 year old face to face usually after a phone appointment. I prefer this as they some times can prescribe medication without me having to go to the GP. They will see him in person if I ask or if they think it's necessary. Recently I had a telephone appointment when my son had croup and they advised I go to a&e. Saved me time as I could go directly to the hospital.

Always same day appointment with children too. For me on the other hand it's 2 weeks

We had this during the pandemic but not post. We’ve had lots of face to face and our GP is very much on the ‘let’s check’ school of thought following e-triage/a phone call. It depends on the issue but I like e-consult in general.