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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

to think my doctors surgery is extorting money out of its patients

107 replies

Abubu · 10/05/2010 09:16

OK, maybe extorting is a bit extreme but I'm really annoyed.

My doctors surgery have a procedure where you must call up at 8.30 in the morning to book an appointment for the day. If you dont call up pretty much in the first hour you can forget getting an appointment that day. You can book in advance but considering that most of the time you don't know you're going to be ill in advance, most people book their appointments on the day.

They have recently changed their phone number to an 0844 number. I've been on the phone for half an hour waiting in a queue before giving up.

Hubby drove down there for me (it is his last day of paternity leave and we were hoping to do something nice today after I've been to the doctor)

He booked me an apointment for lunchtime which was the earliest he could get as it was 9am when he got there.
However he said that reception had 3 people sitting there and they were making cups of tea and chatting while the phone just rang and rang.

I'm not saying the staff are not entitled to a cup of tea but why make it in the busiest half hour of the day, knowing that there are people hanging on to an 0844 number trying to get through?

I'm tempted to change my doctor over this. Am I overreacting?

OP posts:
Tidybush · 31/12/2011 23:19

MrsMicawber if only it were that simple (and I would have said the same before I came into this job).

I manage a number of surgeries over a geographical area where the demographics of the patients are very different.

For example, in surgery A there are always appointments available through the day but in surgery B we fill the appointments up by 9am and then offer around 40 call backs every day.

But on a pro rata basis based on patient numbers we actually have far more clinicians and appointments available in surgery B than in surgery A.

The difference is that the patients in surgery B are far more demanding and have many complex issues (alcohol, drugs, lots of social problems, etc).

It would be easy to say that we should reduce the number of patients in surgery B, but as we are paid per patient we would then have to reduce the number of staff and would be in no better position than we are now.

The realities of primary care are similar to in education - it's an easier job in the 'nicer' areas where you are are able to to the job in hand (dealing will healthcare/teaching) rather than having to sort out a million problems caused by deprivation, lack of education and chaotic lifestyles.

MsBazinga · 31/12/2011 23:21

fifteen the practice I'm registered with uses an 0844 number & a queueing system - which, despite being more expensive is actually preferable to the old 'always engaged' number - and you have to call as near to 8.30 if you want a same-day appointment.

At that time I'm travelling to work and inevitably if I wait till I get to work before ringing, all that day's appointments will have gone.

So I can either phone the next day (and if I'm lucky I'll be offered a 3pm appointment - so 45 mins to doctors, 5 mins trying to park, 15 mins (if I'm lucky!) at docs and 45 mins back to work - and it's time to come home again - no wonder my BP is high!) - Or I can book an evening appt which GPs have recently introduced. Only 2 of the doctors do this on a couple of evenings a week and understandably it's very popular so 2-3 weeks is the normal waiting time.

It's a nightmare - and I'm sure the practice has too many patients for a good, workable appointments system.

tribpot - thanks for the link, that's very welcome news.

Tanith · 31/12/2011 23:24

I thought the "phone on the day" style appointments was supposed to stop people forgetting their appointments or getting better and not bothering to turn up.

The trouble is, it's very inflexible. Trying to book an advance appointment in our surgery is almost impossible. I've been told by my doctor that she wants to see me again in two weeks time only to have the receptionist refuse point blank to make the appointment. I have to take my chances on the day. If I can't get an appointment when I phone? Well I'll have to try again the next day, then, won't I?

DH is on a repeat prescription that the doctor has to monitor every so often. He's due a monitoring appointment. He can't get one. They won't book it in advance and they won't do his prescription until it's signed by the doctor, who is now saying she won't sign it off until she's seen him. Perhaps he should waylay her in the carpark...

missingmumxox · 31/12/2011 23:25

I think it is worth mentioning that Gp's practices are Private and the partners in the practice can draw their wages/bonus from any profit..just saying...

Tidybush · 31/12/2011 23:26

Tanith if our Drs tell a patient they want to see them again they give them a little card to take to the receptionist who then books the appt (otherwise everyone will say they've been asked to come back).

MrsMicawber · 31/12/2011 23:26

This reply has been deleted

Message withdrawn at poster's request.

cattj · 31/12/2011 23:26

MrsMicawber RE: That list is not exhaustive, our practice has an 0844 number and they are not listed.

The original list appears to have been compiled in May 2011.

Is your surgery on this other list?

Xmasbaby RE: I thought calling at 8.30 and using an 0845 number were both standard these days. I don't think the phone actually makes money for the surgery - I've heard it's something to do with being unable to get a local number for some businesses.

It's not at all to do with the surgery or anyone else making money.

It's about the fact that they are not allowed to use any phone number that costs more to call than an 01, 02 or 03 number does.

Tidybush · 31/12/2011 23:27

missingmumxox very true but as in every other business income is going down and costs are going up (I'm not a partner btw).

MrsMicawber · 31/12/2011 23:28

This reply has been deleted

Message withdrawn at poster's request.

PeaceofCakeAndGoodWineToAllMN · 31/12/2011 23:30

How about: half the doctors treat the prebooked patients in the morning, the other half treat the emergencies and then they swap? If the prebooked patients are allowed to book a week in advance then this would really help. I often feel guilty for getting an appointment on the day (when I can get through that is) because it's not always an emergency. It would also open up the telephone lines so people are not clogging up the phones from 07:20.

Tidybush · 31/12/2011 23:31

Incentives such as the stop smoking etc vary from area to area and are also dependent on the type of contract the practice holds with the PCT.

They are not so much bonuses as a maximum that can be earned with points (i.e £s) lost for targets not met.

I do agree that there should be a better way of dealing with poor Drs and at the moment that should be the job of PCTs to stop giving them contracts.

lenfercest · 31/12/2011 23:33

Tanith, that's our experience - the whole family. We need reviews to continue our prescriptions; but we can't get appointments for the reviews. What are we meant to do? Occupy the surgery until an appointment comes up?

MrsMicawber · 31/12/2011 23:35

This reply has been deleted

Message withdrawn at poster's request.

Tidybush · 31/12/2011 23:36

But you can when enough complaints have been made but still nothing is done and the contract is renewed year after year.

cattj · 01/01/2012 00:10

The pathetic excuses offered here are typical of those found in many other places:

The cost of telephoning an 0844 number is the same as a "standard" rate BT call.

Demonstably not true and varies according to provider.

It is recognised and acknowledged that telephone calls from other providers may vary in cost depending on the "package" being provided.

That in and of itself is not the issue. Of course the various providers charge differing amounts for calling 0844 numbers.

Telephone costs for calls from mobile phones may be considerably higher.

That is to be expected. It's a mobile phone.

The fact that calling an 0844 number from a mobile phone costs more than calling an 0844 number from a landline is still not the issue.

The issue is that calling an 0844 number from a mobile costs a LOT more than calling an 01, 02 or 03 number from a mobile.

Additionally, calling an 0844 number from most landlines costs more than calling an 01, 02 or 03 number from a landline.

THAT is where the breaches in the NHS regulations occur.

The practice has no control over the telephone costs and the surgery is not allowed to "profit" from the use of 0844 numbers.

The practice does have some control over telephone call costs.

Call costs are directly linked with the type of number the practice uses.

Where an 0844 number is in use, all people calling it will be paying more than if they had called an 01, 02 or 03 number.

OFCOM recommend that 0844 numbers should not cost more than 5p per minute(including VAT).

That might be true for calls from a BT landline, but does not cover other providers or calls from mobiles.

Profit by the surgery is not the issue either. It's about callers being charged a premium for contacting their GP, a premium caused wholly by usage of an 0844 (or other 084 or 087 number) instead of a standard 01, 02 or 03 number.

However this is a recommendation and not all providers will choose to follow this.

Yeah, the previous guff was rather pointless then.

It totally misses the point: 0844 numbers cost more to call than 01, 02 and 03 numbers.

0844 numbers for GPs have been banned by the NHS since April 2010.

The site goes on to quote statements from the then Health Minister Mike O?Brien MP made on 14th September 2009 in support of 0844 usage, but fail to mention later policies in April 2010 banning these numbers.

The use of 084 numbers in the NHS will continue with the support of the Department of Health, so long as patients do not pay more than the cost of a local call;

All users do pay more to call 0844 numbers, so this is clearly erroneous.

HexagonalQueenOfTheSummer · 01/01/2012 00:26

Those of you that say that receptionists are often rude because the general public is rude, surely if someone is polite and friendly to them they should have the people skills to be polite back? Lots seem to have a chip on their shoulder and just seem to hate people in general.

pooka · 01/01/2012 00:46

tidybush no, not ring back from clinician. Just the automated thingy that means you don't have to press redial every second and constantly listen to an engaged signal. You press 5, ring back request has been accepted, and then as soon as line free, you're rung back. Then you press 1 for appointments/enquiries, 2 for messages 3 for home visits and 4 for test results (though they ask you to ring after 2pm for test results). You then wait momentarily until one of the 3 or 4 receptionists pick up, and you're straight down to business.

Sounds faffy and a small consideration, but in comparison to my old surgery where you'd almost be weeping as the clock went round and you were still hitting redial button as the clock crept towards 8.20 by which time ALL the bloody appointments would have gone it is a WONDERFUL system. :)

pooka · 01/01/2012 00:51

Plus the fact that you know the receptionist on the other end of the line will be courteous and efficient and will not ask you for details of your (or your children's) ailment so she can tell you it's not an emergency......well that's perfection to me.

Am pretty laid back and grateful for small kindnesses from overstretched services - they do a great job with their resources (at our surgery) and I cannot sing their praises highly enough, particularly in comparison to previous surgery. Previous one had worlds best gp, who had known me since I was born and who rang my mum to congratulate her on my dd being born and becoming a grandmother and then rang both of us on the day she retired to wish us well (not rural, late practice in se London). But also had very difficult receptionists and system and so as soon as she retired we jumped ship. Loved her though.

MrsMicawber · 01/01/2012 00:52

This reply has been deleted

Message withdrawn at poster's request.

lenfercest · 01/01/2012 01:13

Yes, I love the way you get bollocked for failing to navigate the system properly. Without any kind of map.

marriedinwhite · 01/01/2012 08:53

Can any of the doctor's receptionists explain this one please. It happens almost every time at my surgery.

Me: good morning, can I have the first available appointment before 9.30 please, it isn't urgent just for a review for prescription.
Recept: I've got one at 11.40
Me: Thank you but I need an appointment before 9.30, I have to go to work.
Recept: There's one tomorrow at 3.20
Me: I need an appointment before 9.30 please, next week is OK.
Recept: I've offered you two already
Me: But I have asked for one before 9.30
Recpt: Have you got ot have one before 9.30 then
Me: Yes, didn't you hear me say at the beginning that I have to go to work.
Recept: Oh, I can do one at 8.40 next Tuesday, is that alright.

Why? Please someone explain why this happens it really isn't rocket science and would make everyone's lives easier if you just listened. On one occasion I actually asked the receptionist to repeat what I had said to make sure she understood what I was asking for after a couple of minutes of this but no doubt that was regarded as rude.

HauntedLittleLunatic · 01/01/2012 11:33

I'm sorry but based on the table of data on the first page I do not pay more for a 0844 number.

I am on bt weekend and (based on that table) after the connection charge it costs me half what it would to call a geographical number.

lenfercest · 01/01/2012 15:52

I think reception staff have reverse customer service training: they are taught how to wind up and alienate patients, so that said patients learn never to bother Doctors again.

cattj · 02/01/2012 22:55

TeaOneSugar RE: But just to say that lots of practices are stuck in fairly long contracts for 0844 numbers, many of which should be coming to an end in the near future, of the 16 practices I work with only 1 now has an 0844 number and they'll be changing it very soon.

They may be stuck in a contract for telephone services provision, but they are not stuck with using an 0844 number for that service. There is a migration path from 0844 numbers to the equivalent 0344 number available. 034 and 037 numbers are reserved for migration from the equivalent 084 and 087 numbers, and 03 numbers satisfy the NHS requirements for GP telephone access. This option has been available to GPs since 2009.

There's a wealth of background information about the whole shambles at:

nhspatient.blogspot.com/2009/08/nhs-gps-using-0844-numbers-can-change.html

nhspatient.blogspot.com/2011/03/gp-surgeries-using-0844-or-0845.html

nhspatient.blogspot.com/2011/05/resistance-to-ban-on-use-of-084-numbers.html

nhspatient.blogspot.com/2011/06/nhs-gps-using-expensive-telephone.html

davidhicksonmedia.blogspot.com/2011/04/gps-now-in-breach-of-their-nhs.html

davidhicksonmedia.blogspot.com/2011/07/ban-on-use-of-084-telephone-numbers-in.html

There are several other relevant articles on that site, but those listed above look to be the most pertinent.

Concordia · 02/01/2012 23:03

i have to say that our docs is brilliant the receptionists are lovely and it is ok to get an appointmetn.
but i have been at others which are just as described. it makes me never want to move house tbh.