To think this is what happens when receptionists are the ones who decide whether or not you actually *see* a GP? (Ear infection)

[lCantHearYou]

Wednesday last week- woke up with an intense pain in my left ear, and assume I’ve just jammed my ear plug in a bit too far, but over an hour later the pain is still there and I can’t hear out of that ear, so I ring the GP surgery.

The receptionist, based on no medical expertise whatsoever, asks what the problem is and unilaterally decides that all I need is a telephone appointment. The GP she’s scheduled the call with is well known in our community for not doing face to face appointments if she can help it and generally having the attitude of just wanting to get you off the phone as quickly as possible.

Later that morning, GP call. I explain that I’ve been having this very intense pain for several hours now that paracetamol isn’t really touching, my ear is ringing very loudly and all external sound is very muffled and barely audible.

She decides over the course of the 3 minute call that since I’m recovering from a cold I’m probably just a bit congested, tells me to take some Sudafed/other decongestant and paracetamol and it should right itself in a few days.

I start alternating pseudoephedrine, paracetamol and ibuprofen, but the pain wakes me in the night every night.

Thursday evening DH, the DC and I travel up to PILs house.

Friday morning, DH and I leave for a long weekend abroad (on the Eurostar, thank god we didn’t fly or I’d probably have at least one ruptured ear drum).

By Friday evening the pain and hearing loss has now spread into the right ear as well. Spend the whole weekend in pain and practically deaf, which kind of spoils things somewhat.

Monday evening, we all get home. 3:00 am I wake up in so much pain I can’t keep still, DH wakes to the sight of me sitting upright, rocking back and forth with my hands clamped over the back of my head. He calls 111 who schedule a phonecall with a Dr… who rings back 3 and a half hours later and says, sounds like an infection, I can prescribe antibiotics or you can just wait and see your own GP. I opt to see my own GP, so 111 Dr puts in notes that I need a face to face appointment.

So we’re back on the phone to the surgery, to the receptionist who’s halfway through saying “I can schedule a phonecall…” when I tell her about 111 Dr’s advice to seek a face to face appointment. Then she relents and schedules one with a different GP to the one I spoke to the week before. At the actual appointment, this GP barely needs to glance in my ears before saying it’s a severe infection, inner ears are very sore and red, lots of pus and gunk and, in her words, “looks incredibly painful”.

I’ve now been on amoxicillin and cocodamol (which I’m alternating with ibuprofen) for 5 days now. I can still barely hear a thing beyond the very loud ringing and the sound of my own pulse throbbing in my ears. All external sound is very muffled and distorted. If I wait too long between taking pain meds I fucking know about it… I’ve taken to sleeping with the cocodamol under my pillow so that when (not if) the pain wakes me in the night I don’t have to grope around on my bedside table to find them. Part of my job involves being on the phone, sometimes for hours at a time, so I have to jam my earphones right into my ears and turn the volume up full, and by the end of my shift (I work very late at night) I’m doubly exhausted from the effort of straining to hear anything.

AIBU to think that if, on that first day, the receptionist or indeed the GP had paused for a moment and thought “hmmm, intense inner ear pain, badly affected hearing, maybe get her in so we can see if there’s an infection”, then I could have started on antibiotics that day and at the very least the infection would likely have been contained to one ear and might even be starting to get better? As it is the receptionist didn’t bother, the GP didn’t bother, and instead of getting better it got considerably worse, the antibiotics are making fuck all difference and I’ve now had almost two weeks of intense pain and hearing loss for no good reason? And AIBU to be pretty pissed off about it?

Sorry for the twilight rant… I’ve just woken up feeling like the back of my skull is being squeezed. Again.

Honestly, I’m amazed you got a phone appointment and face to face within a week or so. We can’t get past the GP receptionists, and that’s if you don’t get cut off whilst waiting in the queue.

We pay for a private GP now when needed. Shouldn’t have to and aware that we’re fortunate to be able to.

I hope you’re feeling better soon. Do go back, you may need a different antibiotic and maybe a bit of time off work to recover properly. 💐

No, because a phone appointment takes about 5 mins with minimal prep time in between, while a f2f appointment takes 10 mins or longer with more time in between of they have to sterilise the bed, etc.

So as long as it's only a minority of patients needing f2f appointments, a lot of time is saved by doing phone appointments first.

How do people not see that this telephone triage is just doubling up the work?! No wonder people can't get an appointment.

It depends. If the average phone call takes 5 minutes and only 25% of patients actually need to be seen face to face, then assuming an average face to face first line appointment would have taken 10 minutes (because of getting people in and out, and any extra chatting that occurs) then the doctor can assess and see more people.

This. Or if you were really as ill as you're making out, to the point of rocking back and forth in bed... A&E?

I have given up on the NHS a long time ago and go private.

My ds had an ear infection for 11 days before we got seen.

I did the right thing and did pharmacy as first point of contact.

Used drops for a week as per instructions.

Day after stopping it's painful again - ring GP for apt.

None available. This was Friday and try again Monday.

Ring again Monday am as told and again - no appointments "you need to ring first thing for on the day" (it was 8.23 and I'd been on hold since they opened).

By that evening ds was in so much pain I tried again.

Their overflow emergency full. Ring 111.

Ring 111. They say they are sending an emergency referral to GP as it's open for 2 hour max wait.

Ring GP. 111 shouldn't have done that our 111 clinic is full.

Receptionist tells me to wait until surgery closes and ring 111 again.

5.5 hours later I speak to a GP. Send photo of his ear. Get flucloxicillin prescribed.

It works immediately and next day bright green and yellow pus is pouring from his ear and he's not in pain.

They had wanted a swab. But due to the difference in paperwork the GP couldn't give swab and it took 5 days to rectify.

By then there was nothing to swab!

The thing that pisses me off most is when someone has done the pharmacy and treat at home for max time it's pretty obvious they need to be seen.

Pharmacists can't look into your ears, no equipment and aren't trained to diagnose ear infections. We can supply ear drops for wax build up and for minor infections of the outer ear but if you rocked up and said you had hearing loss I would send you in the direction of your GP.

I think you should have requested a face to face appointment from the start or taken up the antibiotics prescribed by the out if hours Dr. I would complain actually and be more direct on the future. I also would have asked for a sick note as your use of headphones must be painful. Hope you feel better soon op.

Your ears are connected via your nose and throat. The whole lot could be infected which would perhaps explain why the infection spread to the 2nd ear and why OP is having squeezing sensations in her head - her sinuses are probably blocked and infected. Not a dr, just someone who has had many of this kind of infection over the years.

OP you need to go back and get checked out again. It sounds like the antibiotics haven’t been effective.

YABU it’s not the receptionists fault at all, they are following procedure.
Also YABU for not taking the antibiotics when offered by the 111 doctor
You also were able to go abroad so it can’t of been that bad

Absolutely.
I got a tick bite on holiday in the Dordogne and saw a dr who prescribed abx immediately.
Aldo French pharmacies are very helpful too.

There was an item on BBC news about a month ago re a man in his twenties who sadly died from an ear infection. He'd tried and failed to get a face-to-face GP appointment, instead he'd spoken to four different GPs over the telephone and none of them had picked up how much he was deteriorating.
IIRC he passed away the day after the last phone call. What I do remember is his poor parents saying it was hard to comprehend someone in the UK dying from an ear infection.

An NHS England spokesperson said that the NHS has made it clear that every GP practice must offer face-to-face, as well as online and telephone appointments.

Yabu. Lots of good reasoning here as to why you are wrong. No GP is going to give out antibiotics after a few hours of pain. If you were to have got in contact a day or two later then you would have been seen. Also receptionists ask for your issue so you are put with the nurse/gp with the most knowledge with that, not so they can triage you that is what the phone call is for, triage.

just curious, to all those saying the NHS is not fit for purpose and failing (which I don’t disagree with!) what’s your proposed best solution?

telephone triage is being done because demand is vastly outstripping supply. We have an ageing population with increasingly complicated medical conditions, plus a massive workforce crisis. There are not enough doctors and vast numbers are leaving because of the conditions.

so just curious, what do you think the solution is as this situation is just going to get worse? Private healthcare is no good if you have an emergency/acute problem, you just get referred back to the NHS.

This. Receptionists are only carrying out the instructions of the partners, but are often working in a hostile environment with little control over how things are run for not much more than minimum wage. It's interesting how they seem to come in for more stick and have a reputation of being obstructive more than the GPs who design the system.

I saw on Friday a receptionist looking through online appointment requests and making negative comments. "He's asking for a walking stick. Pah!' Then triaging him to the lowest. I shouldn't know that.

I requested an appointment for mastitis. Knew what it was and had a very high temperature. They initially messaged to say I'd be contacted in two days. I said I'll just go to A+E with Covid symptoms then as this could lead to sepsis if not treated - they posted immediately with antibiotics.

I will not go to the GP now. Its a battle everytime I go there. Then there is the waiting times on referrals. The NHS is not on it's knees. It's too far gone thanks to the Government.

@SierraSapphire I've dealt with some nasty gatekeeper receptionists. While I appreciate it's a tough job and they have little control....some of them love a power trip!

This is what happens when the NHS outsources their services. GPs are private companies charging hefty amounts to the NHS for fuck all, fob their patients off who then end up in urgent care costing even more for the NHS to treat.
This should never have been allowed.

Op have you let the surgery knows this? The reception and other GP? If they don't know this how can rhey improve?

I had this about two months ago, my ear suddenly went like yours, I think I spoke to 11 people in the end, I was batted everywhere but I insisted my ear needed someone professional to look into it.

It could be nothing but it also could be an infection ( which I've had before)

Eventually after many wasted resource's they let me see a doctor., The ear was fine!

But only a professional could tell. I even asked pharmacy if they could look in it they were qualified to. I rang about 4 local ear services just to see if they could look, all rammed busy.

The app with the doctor can't have been more than 5 mins probably less.

The GP will have arranged the process at the surgery, and the receptionist is just doing as instructed, so don't blame her.

Secondly, your condition deteriorated but it may not have done. Perhaps if you had stayed at home & rested because you were poorly, and not put yourself through the stress of international travel? Why are you still working, jamming ear phones into your ears and exhausting yourself? That won't help. You have an infection, you need to rest and give your body a chance to recover.

I hope you feel better soon.

Please put in a formal complaint to your surgery practice manager.

I'm so sorry you had this.

Pre covid my stepdad was given a 50/50 chance of survival when he was rushed to hospital with severe stomach pain. His doctor had persistently opted for telephone appointments, mis diagnosed and prescribed exactly the wrong thing. He had bowel cancer which had been totally missed. He is well now - but had a doctor seen, felt, even smelled, face to face, earlier on, he might have been spared three years of stoma bag.

Please complain and persist - do you know if others have had similar issues?

I'm a member of a Facebook group which now has MPs and NHS heads of departments sitting up and taking notice.

There is power in numbers.

Exactly this. If the doctor thought they needed to see you, they'd have called you in. Mine have. This is down to the doctor not receptionist.

I also told our receptionist with respect that she couldn't possibly tell me what was going on with my own ear and that I'd had both an infection and a blocked ear and if I couldn't tell which one it was ....how on earth could she?

I don’t understand why you’re blaming the receptionist when you had actual medical advice from a GP who didn’t notice the issue. That’s on the GP, not the receptionist? Especially as you say they’re notorious for not being helpful.

It's interesting how they seem to come in for more stick and have a reputation of being obstructive more than the GPs who design the system

it's cute that you believe that GPs actually have much say in how things are run either. A generally accepted number of patients per GP to manage is 1:800. This is what most European countries work to. In the UK it's now around 1:2500 patients. I'd love to see anyone devise a 'system' that manages this whilst both keeping patients safe and avoiding GPs/other staff literally dropping dead from exhaustion...

And some people defend the NHS, like a pp said the other option is not just the same as the US system!! There are plenty of two tiered system countries. I’m in Ireland and we pay (and claim back) for the GP…the receptionist doesn’t even ask what’s wrong and if she does it’s only because they are full and she will put you on the emergency list or book you for the first available/put you on cancellation list.