to really have it in for GP's surgeries...

[mersmam]

Had an appointment with my community midwife today (I'm 30 weeks pregnant and haven't seen her since I was 16 weeks, which was when she made the appointment.)
Got to the drs surgery to find it locked and a notice up saying that the surgery is closed this afternoon for staff training! As far as I'm aware there has been no attempt to contact me about this! I rang the midwife's office straight away but could only leave a message and have so far had no response.
Am really annoyed as have arranged my whole day around the appointment (and DH had arranged to work from home so he could come too).
Generally I am just sick of the whole GP system - I can never get an appointment at a convenient time - when I do I always have to wait at least half an hour (no joke with three DCs under 5) and the staff on reception are rude.
I asked for a home visit once as I was ill along with all the DCs and you'd think I'd asked for the moon...

The thing with the midwife today feels like the final straw...

Should I change surgeries to somewhere further away (which would be less convenient?) or are they all like this?

strongle

The nurses in hdu were fantastic, proffessional and lovely. The ward after was awful.

Nurses in HDU will never have more than 2-4 patients. The general wards will have one nurse to 15 or more, a recipe for crap care and disaster. Try telling that to management.

I looked at it this way, in hdu, their job was alot more intense because my mum was in a room on her own on a ventilator with a blood pressure of 79. They had to be with her 24 hours a day, monitoring her constantly, their job looking after her was more serious and involved. One mistake and it could have cost her her life.

On the ward afterwards, their job was alot less serious in looking after her. They only needed to come round to her a few times aday because she was there to regain her strength more than anything. One mistake and it would have been an annoyance but not life threatning in my mothers case. She was off of all her lines by the time she reached the ward.

If hdu only had 2 or 3 patients to look after in the same way as they did on the ward, you would be right, their job would be very easy so to speak. Having 6 - 10 patients who are not as seriously ill is not more hard work in terms of patient care, but it is harder work in terms of the amount of running around they do.

MsSparkle,

When there are no beds on HDU and ITU where do you think the patients go or remain?

On the wards we often have patients who deteriorate and require high level one to one care...and if there are no beds in ITU we are stuck.

They stay on the wards with the ward nurse who gets no back up to care for her other 15 patients.

Management have made the situation on the wards so bad it is triage up there ONLY much of the time. Your mum may not have had multiple lines and titrated IV meds on the ward but her nurse's other patients may have. Mistakes on general wards often kill.

It's not as intense as ITU/HDU but the kind of patients you are seeing on the wards these days are sicker and more intense than they were 10 years ago.

Ms Sparkle -
why are you ignoring my posts?
why you are avoiding responding to my valid questions?

Please continue to post on these forums and not actually do anything constructive about the failings of the NHS system.......{exits thread ...throwing hands in the air }

Has anyone ever thought that they might sound abrupt on the phone as they have a queue of people standing there tapping their feet waiting to be served....

My GP's receptionists can be quite abrupt to me but I don't mind as I just KNOW it's because they are really busy....

Have just come back and seen that this has moved on. For me the receptionist issue is a very separate one to the NHS in general - I have always had excellent and couteous treatment from other areas. I agree with someone who said that people have too high expectations - I had an emergency CS and I think a lot of people on the ward think it will be like a hotel. Many people were unhappy with the service but I though that the people were busy and fraught but doing a good job while obviously understaffed etc. I suppose i have a good idea of how it works/what to expect in hospital having been in and out of childrens hosptial so much when I was young.

i think the NHS is a wonderful thing and many people are doing an excellent job under pressure.

Northern earlier you said why did no-one ask for a chair when we were all standing - we didn't know there were any more. I'm sure the others assumed as I did that if there were any more someone would have got them/mentioned it. And that as the people on reception were happy with women standing for hours/sitting on the floor ie they did not have the resources to do anything to alleviate it. They didn't look worried or anything.

TBH after the last time I went in and was met with the hand out/letter/your appointment has been cancelled/go home routine I was so upset that I came home and said to DH that I want to consider cancelling my ante-natal appointments. I have been feeling rather low and I was just crying for ages and TBH I just can't deal with the stress and attitude any more. I just want to not have to go there. DH is not keen on that approach but I honestly don't know what else to do.

Anyway that is by the by. Certainly at the GP the receptionists can be really rude but I think that's already been covered.

Re GP working hours, my DH is a GP. His surgery hours are 9-6pm 3 days a week, 9-8.30pm one day and one day 'morning' only. In an average week he gets home at 7.30-8 on the 'normal' days and about 4 pm on the 'morning only' day. His morning appontments are usually scheduled to finish at 11.30 so he can go on visits (and yes, he does go on visits every lunchtime as there are a lot of elderly and chronically sick patients registered) and his afternoon is meant to start at 2 but very very frequently his morning over-runs so the visits are late so the afternoon surgery starts late, etc. Then there's all the paperwork that is needed (referral letters, test results etc) which has to get done after surgery or by going in early before the appointments start. Often he has to go in on Saturdays to finish up the paperwork so that he can clear the decks for Monday morning. At his surgery there are also early morning appointments available from 7-9am two days a week and another evening until 8.30pm. In the first three months they were offering these appointments, there were an average of 2 patients per extra shift - despite being offered 'out of hours' appointments most people still wanted to be seen during the normal 9-6 day and complained when they couldn't be. So what is the surgery meant to do?

The only way to solve the problem is to train up more doctors so there are more people available to cover the hours needed for everyone that wants an appointment at whatever time of day. And to appoint extra admin staff, nurses and lab analysts for the letters, tests and so forth that will come about as a result of these extra appointments, and so on and so on. It's not simply a case of "keep the doctors at the surgery later, everything else will have to fit into the normal working day". Unless the gov't is willing to give much more money to get the staff needed, it just doesn't work. Unless the admin staff, lab staff etc are also meant to work the extra hours for free, and there's no way anyone would ever go for that.

As a receptionist myself ( legal not medical ) i do not think it is difficult to acknowledge somebody as they walk in the door if you are already on the phone or with somebody else. I find a bit of eye contact and maybe a nod will keep people happy most of the time, maybe an apology after a couple of minutes if you are still stuck. I also have found in most of the gp surgeries i have been a patient of that the receptionists ( alot, not all ) can be extremely rude, abrupt and downright nosey. I don't want to discuss my medical problems with them, if they just asked for a brief outline of the problem to give the doctor then fine but they don't, they want the ins and outs of a gnats ae. But that's just MY experience
And no i don't need a medical degree to know if someone is being rude to me or not!
BTW i think most gps are very helpful, kind and try to go out of their way for you, you just have to get past the dragons first!!

Just to make a point, no one is actually slating any medical professional on this thread, just the receptionists

roulade I think one person was slating GPs but they were off key with what the thread is about.

jumpjockey no-one else talking about anyone other than the receptionists.

oops

I have just re-read some of the advice on here. Northern you say that as i am quite nervious and scared of the receptionists I am asking for trouble - and that I should be confident and will not get treated badly then?

I used to be confident but it has been knocked out of me. I'm not sure why that means that the receptionists should treat me badly?

ttt - how about these which sound pretty anti-GP?

By fivecandles on Sat 28-Feb-09 16:37:10
I'd seriously love to believe that all 6 of the GPs at my surgety went out on house calls every lunchtime. Saldy this is not the case. A lot of GPs work shifts so they might work from 9 to 12 or 2 till 6. Such a hard life!

By MsSparkle on Sat 28-Feb-09 16:07:30
Libra i'm not saying gps shouldn't have lives, i am saying if every GP worked just one or two evening a week and took it in turns to do weekends, the strain on appointments wouldn't be so great. I don't think this is an unreasonable request.

At my surgery, all the gps go home at 6pm, the surgery is closed between 1 and 2pm and is closed all weekend.

By MsSparkle on Sat 28-Feb-09 15:46:48
"but I don't blame them for not wanting their family life disrupted by the need to sit in clinic till 8pm to suit the perceived needs of patients - some of whom don't bother turning up."

Then why on earth did they choose to become a GP in first place!? Anyone who goes into a proffession where they are performing a service to the public (who are, in fact, PAYING them to do this service) be it a doctor, policeman, fireman etc should except that they are there to assist and help the public and having sociable hours of work don't apply?

For some GPs it seems the reasons for going into this proffession is less about patient care, even if it means going out of hours and more about the pay packet and status it provides.

it was mssparkle who kind of veered off to talk about GPs themselves. I'm sorry i overlooked fivecandles comment but I think that was caused by mssparkles veering.

I am really sorry if I have reas the thread wrong. it wasn't what it was about when I went out and I admit I didn't thoroughly read all of the new comments when I got back in.

I am really sorry.

Also sorry too ttt, have had a v bad day with baby and am touchy and defensive. I guess part of it is the thread title "have it in for GP surgeries" rather than 'receptionists' if that's the problem.

I think I am going to have to have a long think about northern's advice. She seems to be saying that you need to be strong and confident and you will receive courtesy.

Although I often didn't get courtesy when I was confident and strong, it didn't matter much. Now I am feeling nervous and weak the difficulties that I am having just seem too much - i just don't want to go at all.

I will have another talk with DH about how to manage it I think.

'Nurses and docs better than anyone how and why the NHS fails. But the patients don't really have any insight.'

I think this is rubbish and again part of the problem.

Please don't assume that patients are stupid or haven't got the wit to work out how things could be improved.

Here's a very small example.

When you are waiting for an appointment either at GP or at hospital they often run late. Now actualyl there may be many reasons for this and I have some sympathy with this.

But what is to stop the Receptionist saying as you book in for your appt (which as the earlier poster says may involve no verbal interaction at all but her just holding out her hand for your letter without making eye contact) we're actually running x minutes late at the moment. Or for them to make an announcement like 'sorry you've had to wait but Dr so and so is running late and will see you in the next '.

This costs nothing and takes no time but it's never happend in my experience and yet I've had to wait ages for some appts. This is what makes patients irate - not the lack of resources etc which we often sympathise with but the basic lack of respect for us. THe sense that our time is not valuable and we're not important. And actually this is all about attitude and training and awareness. But patients are never consulted about this

and when they try to complain or discuss tehir feelings of being let down or distressed look what happens!!!

I haven't read any of this thread apart from the OP, but yes I'm fed up with my surgery. It shuts for the afternoon for "staff training" and offers no late night or weekend appointments. I think if you are going to treat GPs as private businesses with large salary increases (plus top notch public sector pensions) then there needs to be some customer awareness to go with that.

I think, in general, we're not criticising the GPs themselves and not just the receptionists but the systems that make getting an appt to see a GP so difficult. These include opening hours, Receptionists' attitudes, the need to discuss your symptoms with the Receptionists and then have them decide whether it's ok for you to see the GP or not, the need to phone the GP at a certain time and no other etc, etc.

Some of these issues (systems and strucutre) are not the fault of the receptionist but they increase the potential conflict of talking to the Receptionist on both sides IYSWIM.

As for people expecting too much from the NHS. I strongly disagree with this. In fact, I now feel like I need to apologise any time I want to see a GP or visit my hospital and get treated. I think I'm made to feel as though they're doing me a huge favour. AGain, I've seen lots of research about older people's attitudes which often prevent them complaining about the (lack of) treatment they receive. They don't like to make a fuss and as a result many suffer hugely and can end up malnourished and dehydrated for example in hospital.

"large salary increases (plus top notch public sector pensions)"

aaaaaaaaaaaaghhhhhhhhhhhhhhh when will people stop believing the government spin propaganda in the Daily Mail

GP in fact have had a pay cut for the last 4 years with no increase in their basic payments, more hoops to jum through, more money being "sidetracked" and having to fund staff increases, money for increased services, and basic inflation increases...
Their have also been significant pension changes!

Of course none of this serves to perpetuate the myth of overpaid fat cat lazy GP's that Nulab are desperately trying to push so they can privatise general practice and then blame the GP's when it all goes tits up !!

Such a pity - I trained in a 3rd world country, and trust me the NHS does a fucking marvellous job in comparison, but the changes I have seen in the 10 years I have been working in it are desperately saddening - when it is gone then you will all truly have something to complain about

In fivecandles' example yes, the patient could have phoned with the new address, but it's probably not the first thing on the mind of a young schizophrenic who may well be attempting to avoid any sort of follow up.

When I worked as a medical secretary, if someone had telephoned me to say they'd received a letter intended for one of our patients, the first thing I'd do is look out the patient's notes and phone them to find out their new address. Then I'd get all the records changed, both manual and on databases. If I had no joy with the patient themselves I'd be ringing the GP. There is no excuse IMO for more letters to be sent to the same, wrong address, especially not now we have computerised systems, or even in the days of only paper records.

IME there are some workers in the NHS who don't think things through and don't appear to care about the implications of their actions or what they don't bother doing.

My Trust does training for admin staff, but for many, many years prior to that it was unknown IME. I've seen many a post filled with people who just don't know what they are doing. There is no induction, no training and the managers (IME) haven't had a clue themselves about the role. It's always been left to colleagues who are already stretched, and who have probably been struggling to cover the vacant post so are overloaded with work and stressed, to find time to train the new person. And in doing that their own job gets behind, appointments don't get made, letters to GPs don't get typed, the phone calls start coming in because the letters are needed .... and so on.

But I maintain that no matter how stressful the job is, no matter how many rude patients you speak to there is no excuse for being rude to the next person who happens to ring. And I have spoken to enough GP receptionists and medical secretaries in my time to know that it happens way too often for it to be a one-off. There are some lovely, friendly helpful staff out there, but those that aren't are definitely there and IMO there is no excuse for it. You just don't speak to patients and other staff like some of them do.

And it's interesting that the change in their attitude when they address the GP was mentioned. That is my experience too. If I have phoned and they've missed the "secretary" part of my announcement "hello, it's Dr Surfer's secretary here" their attitude has been vastly improved just because they thought they were speaking to the doctor. I had it just last week when I was trying to ascertain some information about one of our patients - I spoke to a very unhelpful GP receptionist until the point at which I told her I was the unit's Bed Manager and I couldn't believe the change in attitude. As if it mattered who was ringing. But just because she was speaking to a manager her attitude changed.

Of course the patients insight of what is wrong with the services. That's why we have service user forums. The feedback from ours we find invaluable.