Doctor’s appointment.

I feel the NHS, as we know it, is gradually fading away. They work for us and yet we have to do everything for their convenience. Over the next few years I think complementary and alternative therapies will become more to the front. The U.S. seem to have 'Functional Medicine' which looks at how food can aid with some illnesses. Was it Socrates that said "Let food be thy medicine"? Mind you, we would have to learn to grow food more organically, and widespread so that it doesn't stay as something only well-off people buy. All fruit and veg should be grown organically.

I think we should be able to use any method that suits us. I would rather use the internet for a not too urgent appointment than queue on the phone at 8 am.
Or phone if that is what people prefer. As long as you can get through.
Or make a follow up appointment in person if you are in the building.
It is not fair to verbally abuse the receptionist. They are just following the practice procedure. Have a go at the Practice Manager.
I decided that DH must be on a special list as he got excellent treatment by the practice, even a house call just before he died. And his preferred GP too. She also rang me the day after he died. I can’t imagine they do that for everyone.

I know I’ve already said it - but however do people without internet access cope?
The other side of the coin is that I can’t send my surgery an email. It’s either join the queue on the phone, and perhaps be in front of someone who badly needs to speak to somebody, or send a letter. Ridiculous in the 21st century. I realise that all incoming mail probably needs to be monitored, but emails would go to an approved central point.

Germanshepherdsmum

I know I’ve already said it - but however do people without internet access cope?
The other side of the coin is that I can’t send my surgery an email. It’s either join the queue on the phone, and perhaps be in front of someone who badly needs to speak to somebody, or send a letter. Ridiculous in the 21st century. I realise that all incoming mail probably needs to be monitored, but emails would go to an approved central point.

Hear, hear!

We once had email access. It was for those issues which were not deemed urgent by the patient, and which could wait between 2 - 5 days for a response.

Now that option has been removed.

You either join the 0800 scramble or fill in an e-consult form online. The form is not asynchronous (which would have been its only benefit), and has to be completed between the hours of 8-10 am, after which access is denied.

Also the form is lengthy and unnecessarily complicated - full of generalised categories, most if not all of which will not apply if you have a complex medical condition.

I am rebelling. I will not use the form, but rather a typed very short and concise note which is delivered to reception. I've done it twice so far. I don't know how long this might be tolerated.

econsult is fine if you have a sports injury, a suspected sprain or a simple one-off ailment, or a condition that can be codified in a few simple words. For anything more complex, it us useless. And I refuse to use it.

It seems these rules are set by individual practices, judging by what I read on GN. So basically nothing to do with the NHS or the government, rather what suits each practice, the way they choose to organise themselves. It wasn’t like this before covid so what’s changed? I understand that there are fewer full time GPs and greater demands but those factors don’t seem to add up to the big changes that I and others have experienced. I hesitate to criticise hard working GPs, but it almost seems that covid was the excuse they were waiting for. Sadly my husband had to write a letter to our surgery to obtain his long overdue, and thankfully clear, results.

Germanshepherdsmum

It seems these rules are set by individual practices, judging by what I read on GN. So basically nothing to do with the NHS or the government, rather what suits each practice, the way they choose to organise themselves. It wasn’t like this before covid so what’s changed? I understand that there are fewer full time GPs and greater demands but those factors don’t seem to add up to the big changes that I and others have experienced. I hesitate to criticise hard working GPs, but it almost seems that covid was the excuse they were waiting for. Sadly my husband had to write a letter to our surgery to obtain his long overdue, and thankfully clear, results.

I believe the agreements are between the NHS and the BMA.

Practises are now required to offer and promote this 'online consultation tool', along with a video consultation tool.

According to NHS England...

"These requirements are all subject to existing safeguards for vulnerable groups and third-party confidentiality. They are to be in place alongside, rather than as a replacement for, other access and communication methods, for example, telephone and face to face contact."

So yes, practises can set their own rules according to their needs and those of their patients. They only have to follow the basic guidelines.

Which of course results in a postcode lottery for patients.

You're right, it wasn't like this before Covid, but - the online consultation 'tool' was already being promoted in my surgery!

There are not enough doctors - that's a fact, and I know they work hard. My issue is the 'one-size-fits-all' aspect of this online 'tool' (as they keep calling it!). In principle, I can see that in this digital age, it makes sense to have such an online option, and I know that many people, judging by various reviews I've read, are very happy with it and found it really useful. But for some of us, it really is not the best option, and I'm sure that they realise for those without internet access and the very vulnerable, it can't be used. And that leaves only the telephone as a means of conveying your needs - which brings us back to the 0800 scramble. If I developed a problem in the afternoon and needed to speak to a GP - not necessarily that afternoon, but on a fairly urgent basis... I'd be told to call the following morning at 8am. When of course, there's no guarantee that any slots would be available.

I'm pleased to hear your husband's results were clear - but it must have been nerve-wracking waiting, and not knowing when you were going to get hold of them. How long would you have had to wait if he hadn't written a letter?

I filled in the online service link for my practice about 8 years ago. Unbeknowns to me, it had to be validated (understand that) but... that involved an unplanned phonecall to my mobile by practice receptionist, I was in a meeting at work, I left the room to answer but next office was very noisy. I'm deaf & always have been, & this is flagged on my medical records. Even after getting under a desk to try & blot out the noise, I couldn't hear what I was required to, so phonecall was abandoned. Never heard another thing. Surely they could have texted me some code or something, or to arranged a time with me at home to take the call? Anyway, this has reminded me to have another go at registering & hope for better luck this time!

I think there is a new government directive that patients cannot be told to call back tomorrow - instead they will have to be directed to an appropriate service, whether that is to a doctor, a nurse, a pharmacist, a walk-in centre or 111. Receptionists will be trained to triage and make judgements on which service is appropriate.

That's all very well in theory, and will help ministers to field questions about the NHS on TV, as they can say that nobody will be waiting more than a day for an appointment, but it won't create appointments where none exist. I'm not sure how helpful it will actually be.

So what if a receptionist misses the fact that a patients symptoms are life threatening? How on earth did we reach a point where most people can’t get a NHS dentist and now can’t get a doctors appointment? And it’s crept up on people in such a way that it’s now regarded as acceptable.

Recently have been unwell with shortness of breath . Gp said to have an asthma check with the practice nurse to measure peak flow rates. The receptionist was adamant this would be over the phone. Finally managed to convince her that I needed face to face to breathe into the peak flow machine. She was not happy !
Then had to use the automated heath check kiosk in the surgery. Took blood pressure then answered various questions. Didn't have glasses and pushed wrong button. Next morning had a text concerning my increased alcohol consumption, think I pressed the over 10 units a day by mistake !
Loved the days of talking face to face .

My asthma review is now done by phone (with some company which produces inhalers). It is less than satisfactory. No substitute for seeing the asthma nurse at the surgery. However the person who conducted the review did get me a peak flow meter prescribed. Perhaps you could request one Jaffacake, then you will have some ammunition for when you have to convince the receptionist you need an appointment.

Jaffacake2

Recently have been unwell with shortness of breath . Gp said to have an asthma check with the practice nurse to measure peak flow rates. The receptionist was adamant this would be over the phone. Finally managed to convince her that I needed face to face to breathe into the peak flow machine. She was not happy !
Then had to use the automated heath check kiosk in the surgery. Took blood pressure then answered various questions. Didn't have glasses and pushed wrong button. Next morning had a text concerning my increased alcohol consumption, think I pressed the over 10 units a day by mistake !
Loved the days of talking face to face .

Gp said to have an asthma check with the practice nurse to measure peak flow rates. The receptionist was adamant this would be over the phone. Finally managed to convince her that I needed face to face to breathe into the peak flow machine. She was not happy !

Good grief! If the receptionist doesn't have the intelligence to realise that appointment could not be conducted over the telephone, then clearly she shouldn't be fielding calls.

Why was she "not happy"? She was completely in the wrong!

Doodledog

I think there is a new government directive that patients cannot be told to call back tomorrow - instead they will have to be directed to an appropriate service, whether that is to a doctor, a nurse, a pharmacist, a walk-in centre or 111. Receptionists will be trained to triage and make judgements on which service is appropriate.

That's all very well in theory, and will help ministers to field questions about the NHS on TV, as they can say that nobody will be waiting more than a day for an appointment, but it won't create appointments where none exist. I'm not sure how helpful it will actually be.

Receptionists will be trained to triage and make judgements on which service is appropriate.

Am I the only one who finds this worrying?

We are, in a way, now going to be preliminarily diagnosed by receptionists!

It's the usual short-termist, sticking-plaster, solution to a complex problem that's been festering for years - and I'm not just blaming this current government for it, they inherited it from the previous one - which also inherited it from the one prior.

I understand that there are not enough doctors, and their numbers cannot magically increase instantaneously. But what is needed is for them to have more time available in which to see or talk to their patients - surely, there must be a way of relieving them of some of their other duties - the paperwork, online form-filling, and all the other admin jobs that they have to do?

The more that patients are able to consult with their GPs, the less likely they will end up in A&E through not being able to get an appointment.

You are not alone in finding this worrying, Dickens. Poor Jaffacake has suffered from being triarged by a receptionist. I know that there are people who have little in the way of common sense but most of us know if we need to be seen by a doctor or nurse rather than popping along to the pharmacy.

Yes I am aware of the fact that we are desperately short of GPs, but I am a little concerned that some of the work being taken on by differently qualified people may pose a risk to patients. On two matters recently I have seen an O T and a practice nurse. Neither could prescribe so I'm back in the system to consult a doctor again - all taking time which is concerning ( the practice nurse's reaction to my blood pressure reading was a splendidly unprofessional " jesus" ). In defence of pharmacists, however, I must say loud and clear that one of these saved my daughter's life by recognising that she had developed diabetes, when several doctors appointments ( well, nurse appointments, obviously) had not suggested this.

The 8.10 slot on Today this morning had a government minister whose name i didnt catch who quoted in answer to the question 'is the government ditching their manifesto promise of 4,000( or was it 6,000) new qualified doctors by next year. He just repeated that there are 2,000 more qualified doctors than there were in 2019. Plus many thousands more nurses and other para medical staff.

Whether 4000 or 6000 its strange that its now almost impossible to get an appointment.

Germanshepherdsmum

You are not alone in finding this worrying, Dickens. Poor Jaffacake has suffered from being triarged by a receptionist. I know that there are people who have little in the way of common sense but most of us know if we need to be seen by a doctor or nurse rather than popping along to the pharmacy.

I have to say, most receptionists I think would have the intelligence to recognise the fact that the test Jaffacake needed could not be conducted over the 'phone!.

...but most of us know if we need to be seen by a doctor or nurse rather than popping along to the pharmacy.

That's food for thought GSM - because you're right. By the time we hit our 70s+ we know our own bodies well enough to understand what might need a doctor's attention.

I have two semi-permanent in-dwelling catheters. One is wired into the superior vena cava and it has to be handled in a completely sterile environment to reduce the risk of infection and sepsis.

The first sign of infection, is itching / irritation. When I (a while back now) mentioned this to a receptionist, she suggested I "pop" into the local pharmacy for some "cream". Fortunately, I know that is entirely the wrong procedure. First and foremost, a blood test is required to check for infection markers, then the temperature has to be monitored (for obvious reasons). This vein carries blood to the heart!

I took my own temperature which was raised, and then - because I couldn't 'get past' the receptionist, went to A&E. And I did have an infection. Fortunately, one that was caught early and stopped in its tracks with ABs. The doctor in A&E said I did the right thing because an infection could so quickly overwhelm the system. In fact, he told me not to 'bother' with the surgery in future, but to present immediately at A&E!

Receptionists cannot be expected to understand complex medicine. And it's wrong to place such a burden on them. If I'd been less 'aware' and on the ball, I might have taken her 'advice'... and ended up with full blown sepsis.

Absolutely, Dickens. The signs can be subtle and a spot of on the job triage training is going to result in fatalities. I predict it won’t be long before we hear about them. Unfortunately when one is feeling very low due to illness it’s easy to be bullied by a receptionist - it happened to me many years ago. I was particularly ill with asthma (the hot summer of 76) and needed steroids. She had me in tears trying to prevent me from seeing the doctor.

Dickens

Doodledog

I think there is a new government directive that patients cannot be told to call back tomorrow - instead they will have to be directed to an appropriate service, whether that is to a doctor, a nurse, a pharmacist, a walk-in centre or 111. Receptionists will be trained to triage and make judgements on which service is appropriate.

That's all very well in theory, and will help ministers to field questions about the NHS on TV, as they can say that nobody will be waiting more than a day for an appointment, but it won't create appointments where none exist. I'm not sure how helpful it will actually be.

Receptionists will be trained to triage and make judgements on which service is appropriate.

Am I the only one who finds this worrying?

We are, in a way, now going to be preliminarily diagnosed by receptionists!

It's the usual short-termist, sticking-plaster, solution to a complex problem that's been festering for years - and I'm not just blaming this current government for it, they inherited it from the previous one - which also inherited it from the one prior.

I understand that there are not enough doctors, and their numbers cannot magically increase instantaneously. But what is needed is for them to have more time available in which to see or talk to their patients - surely, there must be a way of relieving them of some of their other duties - the paperwork, online form-filling, and all the other admin jobs that they have to do?

The more that patients are able to consult with their GPs, the less likely they will end up in A&E through not being able to get an appointment.

One of the reasons why I’m such a hypochondriac is because, having worked for the NHS for a long time I realise how something quite innocuous can potentially be something quite serious and something that seems quite serious actually isn’t. I don’t see how a receptionist can ascertain things like that over the phone. Anyway, weren’t nurse practitioners given extra duties years ago to take pressure off the doctors eg being able to prescribe antibiotics? Now it seems that is going to be passed onto pharmacists. Having seen a few pharmacists over the past couple of years for minor problems ( and, thinking about it I could go back many years to when I sometimes asked pharmacists for help regarding my children) I have no faith in them whatsoever. Imo they are trained to dispense the drugs that have been prescribed by a qualified doctor. Looking back 13 years did any of us foresee the state the NHS would be in ( both medical and dental) after over a decade of Conservative government. Also, given that most of us can’t get an NHS dentist are people aware that doctors get no training in anything dental and some of my doctors would refuse to treat anything to do with the mouth and would insist on patients going to see heir dentist because they weren’t qualified in that area. The whole situation has crept up on us over several years and if it had been implemented in one foul swoop the electorate would be up in arms.

Germanshepherdsmum

Absolutely, Dickens. The signs can be subtle and a spot of on the job triage training is going to result in fatalities. I predict it won’t be long before we hear about them. Unfortunately when one is feeling very low due to illness it’s easy to be bullied by a receptionist - it happened to me many years ago. I was particularly ill with asthma (the hot summer of 76) and needed steroids. She had me in tears trying to prevent me from seeing the doctor.

...it happened to me many years ago. I was particularly ill with asthma (the hot summer of 76) and needed steroids. She had me in tears trying to prevent me from seeing the doctor.

😠😠

Utterly disgraceful. I remember '76 - you must have been especially sensitive to the heat... I would've been panic-stricken.

We're going to be at the mercy of whichever receptionist takes the call. Some, of course, are really good-tempered and helpful - and knowledgeable, but there's no guarantee you'll speak to that one.

I'm not optimistic.

Nor me.

No, it feels very much like a sticking plaster solution.

Doodledog

No, it feels very much like a sticking plaster solution.

No, it feels very much like a sticking plaster solution.

Which is, of course, exactly what it is. And you know what happens with sticking-plasters after a few day's wear...

Dickens We're going to be at the mercy of whichever receptionist takes the call. Some, of course, are really good-tempered and helpful - and knowledgeable, but there's no guarantee you'll speak to that one. I'm not optimistic.

Agreed, It's worrisome.

Norah

Dickens We're going to be at the mercy of whichever receptionist takes the call. Some, of course, are really good-tempered and helpful - and knowledgeable, but there's no guarantee you'll speak to that one. I'm not optimistic.

Agreed, It's worrisome.

Judging by the calibre of a receptionist I spoke to last week, I don’t hold out much hope either!

Her reply to a question I asked about why an appointment had been cancelled was “ prob’ly the strikes or suffink.”