I hear it everywhere – patient’s feedback in the consulting room (when they finally get there), Friends and Family Test responses, Complaints & Compliments, on Radio, TV, certain sections of the print media, not forgetting Twitter, Google Reviews and Facebook. Up and down the country, similar to primary school teachers, airport staff, care workers, social workers, bin (wo)men, etc. admin staff, nurses, doctors, other health and care professionals often go beyond the call of duty to provide care. In every situation, where demand outstrips supply there is a queue which quickly descends to chaos if not promptly controlled such as football stadia, concert halls, airports, crazy sales, channels crossing. GP surgeries are no exception.
If you have read any of my articles, I regularly refer to four factors which affect our health – genes, lifestyle (and behaviour), quality of health services and the environment (physical, social and economic) we live in. The only factor you have relative control over is your lifestyle and behaviour. If you are dissatisfied with GP access you can keep very healthy and stay away, change Practice (the grass is actually brown on the other side) or stay with me and read. A little behaviour change may be required – thank me later!
GPs are expected to do so much more with fewer resources, retiring, cutting back on hours to prevent burnout or emigrating. The magical 6,000 new GPs promised by government are like waiting for Godot, BREXIT may have made the UK less attractive for doctors from Europe. Visa restrictions and ethical issues remain challenges for recruitments from other countries where the need is even greater. On the other hand, people are living longer and the old order where the doctor was next to God has been replaced by a better informed and more demanding population, advised to “see their GP” for nearly everything. Society is more vexatious and health professionals are spending inordinate time practising defensive Medicine. Times are very hard. Many people are struggling with their finances, mental health and life generally. The GP surgery is perhaps the only front door that is still open and people are desperate to see their GPs to solve social problems now presenting as physical ailments.
- GP Receptionist are Enablers not Blockers!
I am alive and well because my Patient Support Team (PST) or Receptionists take all the flak in my place. It’s actually easy to get past them. Here are some tips for GP access:
- Practice Self-Care or visit the Community Pharmacy if you think a family member has any of these conditions:
When was the last time you went into a branch of your bank to withdraw money? It’s rare these days. So why go into your GP surgery if you can use the “Practice ATM”?
- Download the NHS App. With that you can say goodbye to the GP front desk and do the following:
- get health advice
- book appointments – search for, book and cancel appointments at your GP surgery, and see details of your upcoming and past appointments
- order repeat prescriptions
- view your health record
- view your NHS number
- register your organ donation decision
- get your NHS COVID Pass
- get advice about coronavirus.
In my last blog I advised that you can do Online consultation which is available on your practice website. AskmyGP, eConsult, are some examples.
- Your Practice or health insurance company (if you have one) may have Online doctors services such as Babylon, Livy MyGP. They are options for those who want an Amazon-delivery-style primary care and no interest (for now) in establishing a relationship with their family doctor
- Three things you should prepare to tell your GP before you start the Online Consultation:
- What the problem is (for example, a medical complaint – ‘eye pain’)
- What your gut feelings are (‘my Aunty lost her vision when she was my age’)
- What you want to get out of the Consultation (‘A referral to an Eye specialist’)
- Some problems are not medical. They may be administrative such as extension of a fit note, or social (loneliness or care for your elderly Uncle who lives alone).
- Being specific about the problem helps you to get prompt attention.
- Be polite on the phone (even if you’ve waited forever on the queue).
You’re not the only one having a bad day. Many Patient Support Team (PST) members (Receptionists) have been to hell and back because of their customers (patients). If you can help it, prepare your speech. Don’t waffle. Be concise. It is not the time to give a feedback on the practice unless it is a compliment. Remember the irritating message you’ve spent almost half hour listening to, and the furrowed brow while you waited.
- Smile at the Receptionist at the Front Desk (if you must go there).
Everyone knows that a smile goes a long way. Mother Teresa said “Peace begins with smile.” Whether Online, over the phone or at the front desk of your GP Practice here are some more things you should prepare ahead of time:
- If you are certain, be upfront about the type of problem – medical, social or administrative
- If a medical problem let the Practice know your preference: face-to-face consultation, telephone call or even an SMS. Every practice can send messages to your smart phones. Some can communicate with you via e-mail. It all depends on the nature of your presenting issue.
- State if you wish to see a particular GP – by name or gender
- Inform your GP how soon you would like an appointment – same day, next day, same week, routine, anytime. General Practice is not an emergency service but by putting your cards on the table, you help your GP make an informed decision about your request.
- Signposting is key
Are GP Receptionists now doctors? The answer is obvious but times have changed, not just with online shopping or ticket purchase to watch the latest film or touring artist. Practice Receptionists have undergone further training. The days when all they did was book you with the doctor or nurse on request are over. Finito. These days they are trained to signpost you to the best help, first time. Unfortunately, this role has not been well communicated to people who initially feel offended by nosy receptionists trying to be doctors and blocking access to their coffee-drinking, leg-crossing, thumb-twiddling GPs! Another lie from the pit of hell (forgive my language).
Let us take some examples of the role played by other members of the primary care team:
- Wellbeing Team: They support people who feel lonely or isolated, have long term conditions, need support with complex social issues or help to self manage
- Social Prescribers: They help link people to services and activities within the community
- Carers Support: They lend a helping hand to people who are caring for others
- Mental Health Team: They range from ‘Healthy Minds’ for patients experiencing low level mental health issues; Primary Care Wellbeing Team who offer psychologically informed support to a range of patients in managing their mental wellbeing.
- Patient Coach: Gives advice to people out of work, looking for or struggling with work
- Physiotherapists & Podiatrists: They help patients with musculoskeletal issues such as back, neck, joint and foot problems. They assess, diagnose, give advice on management and refer to specialist services if needed.
- Practice Pharmacists: They work as part of the general practice team to improve value and outcomes from medicines and consult with and treat patients directly. In many practices, all medication-related queries first go to the Pharmacist.
Of course, there are the General Practice Nurses, District Nurses, Specialist Nurses, Advanced Nurse Practitioners and Midwives. Administrative matters are dealt with by the Receptionists, Data, HR Team or Managers. Many Practice Managers are on cliff edge. Be patient and kind to them. They are wearing so many hats, it’s insane!
Did I hear you ask with an Island accent, “So why are things getting worser?” Perhaps, it’s because you gotta cry to laugh!
When next you submit an online consultation, speak to someone on the phone or come to the front desk, the questions asked are designed to ensure you see the right person, right place, first time. You don’t want to wait two weeks to see a GP for your back pain, only for the GP to examine and ask you to book an appointment with the Physiotherapist. The Receptionists on the phone and at the front desk are not GPs. They will signpost you to the best person to deal with your problem based on the information you provide. If you prefer to see the GP despite their suggestion, your wish is their command.
All said and done, despite the best efforts of primary care workforce expansion, there are certain things that can only be done by your GP. With dwindling numbers, a little patience is required. If you really want to see a particular GP, tell the Practice in your communication that you are prepared to wait for the GP’s next available appointment! That should work.
Any UK resident who has taken ill while on holiday in USA will bear me witness that our National Health Service (warts and all) remains the last hope of ordinary, tax paying citizens. Let’s not abuse it and don’t threaten to go to A&E because you can’t get a GP appointment here and now. Live a healthy life, practise selfcare, see a Community Pharmacist for minor ailments, use other options (Private or Online GPs if you can afford or have access to them). Be kind to the gatekeepers of primary care (our Patient Support Team) and give them sufficient information to signpost you to a faster appointment with your favourite GP.
If you are not on the table, you are on the menu so find out and get involved in shaping your Practice. Nothing about You without You… more about this later.
Please leave comments below or share ideas on how to improve GP access.
Abiye Hector-Goma is a General Practitioner based in Leeds, UK who cares about his 10k patients and the local communities where his practices are based. He is keen to pursue work-life balance with the help of better-informed patients and their families.
@KayHector
ExpertPatients@outlook.com
www.kayhector-proactivehealth.com
