For thinking that it was actually less efficient and more expensive for the GP receptionist to offload me to other services today?

[Tryinghardtobefair]

I'm asthmatic and I developed bronchitis over the weekend after having a bad cold - it happens every year. Because I'm run down I've also developed a UTI (dipstick confirmed). Called the GP surgery and explained to the receptionist about both infections, thinking I would get an appointment to see if I could be prescribed a broad spectrum antibiotic to treat both issues at the same time.

The receptionist told me I can't see a GP because the surgeries new policy is to refer chest infections to be assessed by a doctor at the GP overflow clinic, and to send UTI patients to the pharmacy for antibiotics. So she's referred me for appointments at both. Which means two consultations and two antibiotic prescriptions.

If I had one of these issues I would completely get it. But on this occasion wouldn't it have been more efficient and less expensive for someone clinical to decide where I should be assessed and treated, rather than the receptionist just blindly following policy and potentially doubling both the time taken seeing me, and the cost of medications etc?

I don't work in the NHS so if I'm wrong, and this way is still more efficient please let me know 😊

that is the problem with Grey areas.
which you fit into
all very well having pathways but things arent always straight forward!

Indeed.

Instead of access to a GP any involvement with Heath services now involves a whole cascade of people. After you've run the gauntlet of all the various pathways, people & been on hold half a day. you end up seeing a doctor.

It's extremely inefficient.

So you cant see a Dr because you need to see a Dr and a pharmacist....makes sense 🤔

If the receptionist had done what you’d asked, she’d have got into trouble for not following policy.

That would have been the case where I worked, anyway.

You can't pick up meds from the pharmacy as the pharmacist is now locked in a consultation room, picking up slack from unavailable GPs.

Pharmacist becomes unavailable for indefinite length of time.

Pharmacy can't give anyone meds unless pharmacist is on floor. "He might be 15 minutes or an hour. Can you wait?" I've chosen this time to go to pharmacy as you can't turn up at lunchtime as pharmacist is at lunch and no meds can be dispensed or even sold.

Happened to me last week.

So we switch to online prescription delivery, and likely contribute to local pharmacy's closing.

Everything spirals downward

Which appointment is first? If the GP at the overflow, hopefully they can consult and prescribe appropriately for both conditions, then you can cancel the pharmacy appointment.

Alternatively, the pharmacist will hopefully also take into consideration your chest when prescribing.

Not ideal but as PP have said, she had to follow the policy, which is probably also one condition per appointment.

This is what happens when GPs have receptionists making clinical decisions. It’s often a waste of time and money and if your experience is anything like mine, one of the people you are referred to will say you should’ve sorted it out with your GP.

where is the GP triage in this instance?

I went to the pharmacist this morning as I suspect I have a chest infection. NHS guidance online says pharmacist is the place to go for this, rather than taking up GP time.

So, I schlep along there and am told that no, they can't help as they aren't a prescribing pharmacist. No mention on NHS online that there are different kinds of pharmacists. Closest prescribing pharmacist is several towns over, maybe 10 miles away. It would be unsafe for me to drive that far at the moment, as my coughing is so intense it's painful and very distracting.

So, I need to try get a GP appointment after all. Great.

Husband called with a chest infection recently. Receptionist said no but I can make you an appt at the pharmacy. So he gets an appt at the pharmacy, goes along and waits a while. Pharmacist comes out and says, we haven't had the chest infection training yet, so we can't prescribe for it....... sigh. What's the point in making an appointment for it then? So he ends up at the out of hours dr at the weekend for antibiotics.

You’re ignorant of all the other times when following this policy would have saved time.

It’s all just broken isn’t it.

Currently I have such a bad infection in my leg that I can’t sleep, can’t walk without a stick, and even then only a few steps, and it’s been like this for 2 weeks.

Because I am now so run down I have developed a whole load of other problems alongside.

The GP can see me in 5 weeks, and only for the leg issue, not for anything else.

I have no idea. I'm not even sure they have one because I've never been triaged before at this GP.
At my previous GP , they would have triaged me and then seen me for both issues if there was a possibility both could be treated by the same medication.

The overflow clinic is possibly a respiratory hub set up for chest infections to help ease winter pressures on the practice. Otherwise the GP practice would have clinics full of chest infections and have no capacity for other work. The pharmacy is set up for minor issues such as UTIs so that the practice can devote time to other things.
Really the only one inconvenienced is you, having two appointments. The receptionist is using the services correctly and the services have been provided/ funded by the NHS for this. It's just bad luck you have both things at once.

Also hope you feel better soon 💐

No I'm not. .

My title specifies this is about today.

My post also says:
"If I had one of these issues I would completely get it. But on this occasion wouldn't it have been more efficient and less expensive for someone clinical to decide where I should be assessed and treated..."

You're so desperate to have a go at someone you haven't actually read the post. You've just seen the words GP and less efficient and pounced

This isn’t the fault of the surgery. It’s the new guidelines to reduce waiting times for GP appointments. These are things that pharmacists can prescribe anti biotics for. The receptionist wasn’t fobbing you off

Hope you feel better soon . But I think this was not the reception team fobbing you off . You are the patient - you can't second guess what antibiotics you will need for what even if you do have a long term condition.
You have an apt with GP for chest - is that later today ? You can always mention you think you have a uti as well and ask if two lots of AB really necessary for that .

As a pharmacist I think probably what pharmacists get paid to deal with a UTI is peanuts compared to a GP but we get significant amount of inappropriate referrals. In this case I may have referred you back to GP depending on how ill you are.

There's lots of safeguarding built into the pharmacy protocol so we have to refer back to GP if you are diabetic, have kidney issues etc etc and lots of other things but the receptionist generally doesn't triage for this and we get patients who are not suitable for our service and they are annoyed at our inability to help them. It's worth a phonecall to pharmacy to check criteria in advance.

Whats more likely is that OP tells both appointments about the other so neither prescribes ABs in case of crossover and both send her back to GP!

Just saw message above!

its so inefficient, YANBU OP

@Blert That's really concerning. Could you call 111 and see if you can get seen as a priority?

My GP surgery has started this exact same procedure now. I went to the pharmacy back in October due to a migraine, I couldn't shake. The pharmacist was able to give me a drug that's normally only available on prescription, because of the new changes. Yes, I had to answer a series of questions but I was able to purchase the tablets (cheaper than paying the prescription price too). My first port of call is usually my local pharmacist, as he is brilliant. If he can't help, then I call my GP surgery. UTI is a condition that is usually referred to the pharmacist too now.

It's so frustrating that when you are feeling low you are passed around without a clear answer.

Two points when feeling rotten is a lot.

yeah, this is what happens at our surgery. There's a GP who does triage on requested appointments (not sure if all or just the ones that are slightly less obvious) and decides what pathway each should require. It's not left to the reception staff to handle. eg I needed antibiotics for an eye infection, confirmed by an optician. GP insisted I come in, but I only had to see the Praction Assistant vs an actual GP. Felt like the appropriate compromise.