Who reads and triages e-consults?

[tissueboxandcandles]

Just that really. I have just discovered that e-consults are read by receptionists at my GP practice. I did one recently about a particularly sensitive subject (only way to get an appointment in reasonable time) and the receptionist rang me to discuss and book the appointment.
TBH, I was embarrassed at the thought that she had read my somewhat detailed consult. (I remember her from when our DC were at primary school and I am just not comfortable).
Does anybody work in GP?
Is this usual practice?
Frankly it has put me off using e-consults in future.

That is very similar to my surgery's e consult as well. I always just outline whatever the issue is, and go into much more detail, once I am sitting in front of the Doctor, or Nurse.

But I don't want them to know all that about me.

It’s not a consent & confidentiality issue because the receptionist is bound by the same confidentiality rules as the nurse or doctor in that they are only to use the information to perform their duties- in this case the prioritising & scheduling of appointments. That is their job.

If they wanted to then they could just look at all of your file. A few years ago a receptionist was sacked at one of the GP’s round here because her friend’s daughter had rung in to let them know she was pregnant & the receptionist text the friend to congratulate her- she didn’t even know yet!

I don’t think anyone initially does at ours.

I did an urgent one once and got an email to say received. 30 seconds later got an email to say needed to do e consult for routine.

but of course they were closed for next week because they were too full.

other than that routine ones have always been responded to by a GP

Everybody with login has access but they can only access and read what’s necessary, not just nosiness. There are strict guidelines. You read in the papers of cases where people unconnected with a case unlawfully accessed records for patients they weren’t involved with; that’s never a good idea and all this can be traced. A bit like police accessing unrelated records, I suppose.

Hmm, I never thought that. On two occasions, receptionists have saved my sanity/reputation by requesting a GP to urgently prescribe tranquilisers and then sending the prescription to the chemist near my work. I didn't even have to speak to the GP. They knew my situation and were very respectful of me not wanting to take time off work.

They also spared me from public panic attacks in my workplace by doing that, and I am forever grateful. This is going back 20 years so they are probably not allowed to be that helpful now!

GPs all run differently - you know they are run kind of separate from NHS? I think the rule is that they have to have a legit business reason for accessing a patient record but I always assumed that if they are dealing with a patient query, they can see whatever is on the relevant screen.

I hope they wouldn't risk their job by looking up info of family or friends etc.

Unfortunately, privacy has gone out of the window in many ways. I sympathise with that. I did always think the receptionist would read an e-consult though. It's the same principle as them asking why you want to see the doctor, though I realise they wouldn't ask for the level of detail you were asked for. Tbh I'm surprised at that question, that seems like one for the appointment itself.

It’s really impossible to work on the admin side of a gp practice and not be exposed to confidential medical info. But, if you disclose it improperly you will lose your job, so there are serious consequences.

Well now I know. I will be very careful about what I tell my GP in future and I won't be doing any more e-consults. I guess I am just naïve.

I read the consults add to the patients record and allocate to a doctor. I then let the patient know what time to expect a call or tell them to come in. I promise that once read it’s pretty much forgotten by me. It’s my job and I have no further interest once I have done my bit. We have a lot of patients and I don’t have the time to think about who is coming in for what.

Ours started off being gp triaged, now I think it's gone back to the receptionists.

Incorrect. I’ve worked in GP surgeries and hospitals all of my working life. If you have a log in for the records system then you have access to all of the medical records for that person. There isn’t someone sitting in an office monitoring who is looking at records!

A log in trace would only be conducted if it was specifically required for eg in an investigation.

I feel really stupid now.

I don’t mean to be flippant or rude but honestly, the surgery staff don't care about what’s on your records. We go in and out of hundreds of records weekly, there certainly isn’t time to sit and read each one and even if we do see some ‘sensitive’ info, I promise we aren’t fussed. It’s completely normal to the staff.

Clerical staff have full access to your medical records but should not be looking at them without good reason. But I'm sure plenty of them do. I'm pretty sure that a good percentage of receptionists will go look at your record to see what the consult was about if you ring in and refuse to tell them because its personal!

I work for a GP surgery and part of my job is doing all the safeguarding admin. If I have a safeguarding report come in for a child then I will go through and read back through that childs notes and if appropriate the notes of every family member. But if I am asked why I have been on someones notes (it can be audited) I have to have a good reason.

But honestly, if you ring wanting an appointment with a GP because you have a massive boil on your bum the receptionist really wont care. They will be more intrigued if you say it is private. As a receptionist I really had no interest in what your call was about but part of the job is asking so you can pass it on to the appropriate clinician.

People are getting confused between personnel knowing something vs what they may potentially do with that information.

Your doctors know all sorts but they keep it confidential and only share what is necessary in order to do their job. In that respect it’s the same for clerical staff.

Please don't feel stupid, you're not to know.

I'm a HCP in a GP surgery, and yes all staff have access to patients notes- to be accessed as per necessary for their role. That includes e-consults as well all the notes made by a clinician during your appt. So not putting it on the e-consults doesn't make a difference as your notes can still be accessed by practice staff IF NEEDED eg. If they need to check when a prescription was last done, if the Dr asked for a referral to physio etc which admin staff would usually do.
Any particularly sensitive information can be restricted- but only done in rare safeguarding circumstances.

We are all bound by confidentiality, and do take it seriously! It might help for you to speak to the practice manager who will explain the process, and put you at ease 🙂

Flippant, rude and spectacularly missing the point.

I think you are massively overthinking this .

The receptionist who you know will not care when you had sex . Reception staff are bound by confidentiality.Gossip or not can absolutely not talk to anyone outside of the surgery is breach of confidentiality.

people really aren’t as interested in you as you think .

Well, of course not everything is audited but everything CAN BE audited, hence some notorious cases you read about in the papers. I think we’re saying the same thing, that you need a good reason to access stuff.

Eg
ico.org.uk/about-the-ico/media-centre/news-and-blogs/2023/11/former-nhs-secretary-found-guilty-of-illegally-accessing-medical-records/

I don't care if they are interested in me or not.
I just think there should be a clear warning on the screen that the e-consult form will be read by clerical staff. So the patient can be aware of that when filling it in. Especially as the questions are very detailed.

But doctors are bound by professional ethics not to disclose information.
random admin staff and receptionists are not. They are not a regulated profession that will potentially remove their license if they blab

When I worked for HMRC I saw lots of personal stuff about bankruptcies and insolvencies, some of it involving people in the public eye. After a while I become inured to it. I wasn’t interested.

BUT I can understand that someone I knew wouldn’t have wanted me to see sensitive data about them, even though they’d have been aware that I would have been sacked for blabbing.

So I do not think that the OP is overreacting. The receptionist is a soft acquaintance of hers, not a stranger.

It absolutely wasn’t. Don’t be a drama queen

Your GP receptionist is genuinely too busy to be pondering over what someone is ringing/e consulting in about. Take a call - deal with it and put the phone down and then immediately take another call and deal with that. E-consult is pretty much the same but just fitted in between calls. Where I work the receptionists do 5 hour shifts with a 10 minute coffee break and honestly, they have no break between dealing with patients. The job is constant. And discussing anything is a sackable offence.

My daughter is registered at my practice. She was once blue lighted to hospital after an epileptic seizure. A colleague scanned the ambulance report onto her notes and the following day asked me how she was in front of other colleagues. The only way she could know this information was from the report she scanned onto her confidential record. I complained to management about it and she was suspended for a breach in confidence and eventually sacked for gross misconduct - although I knew what had happened she shouldnt have discussed it with me by getting the information from my daughters records.