Patients Letters for Collection


As a Receptionist/Supervisor how would you deal with the scenario below:

A patient consulted her GP requesting a referral to a gynaecologist for a termination.  She stated in the consultation that she did not want her husband to find out. The GP wrote a referral letter, which was placed in the “for collection” box in reception. For some reason the letter was not collected.

The patient then visited the surgery 3 months later to ask for a letter for the clerk at the Magistrates court, explaining that she could not attend court due to a medical reason. The GP had the letter typed and this was also placed in the box for collection.

The patient’s husband came into the surgery 3 days later to collect the letter to take to the Magistrates court but the wrong letter was given to him. The letter he was given was the one typed 3 months previously for the Gynaecologist.

The husband took the letter to the Magistrates Court. When the Court clerk opened the letter and found it was not for them she handed the open letter back to the husband who then read the letter.

There are several issues here – can you identify what could have happened and what action could have been taken to ensure that it does not happen again.

  • All personal letters should be placed in a sealed envelope.
  • Each envelope should be dated on the back of the envelope and the “collection box” should be checked on a monthly basis.
  • Any letters that are over 4 weeks old should be opened and checked.
  1. Inform their GP that the letter has not been collected so they can follow this up. The GP might need to call the patient and ask if they still need the letter, and according to their reply the necessary action taken.
  2. If your practice asks you to follow the letter up ensure that you record the event. Enter on the patient’s records (or in a separate message log) that you have spoken to the patient about the letter and their response and the action that you have taken. Also remember to date and time the call.
  3. If the letter is not longer required remove the letter from the “collection box” and ensure that you have guidelines on what to do with it. Shred it, or other.
  4. If the letter is required and the patient is going to collect it cross off the first date and add the date you spoke to the patient on the back of the letter to avoid the same process happening again.
  • If you go to the “collection box” and identify two letters there look at the dates on the back of the envelopes, check the patient’s records and see which date corresponds with the envelope. If you are unsure open and check the letter and place it in a new envelope. remembering to add the dates on the back again.
  • In today’s society Patient Confidentiality is vital – we should be asking if we should have actually given such a letter over to her husband. But it was the patients choice to have her husband come in and collect the letter for the Court.
  •  Having it in a sealed envelope is definitely more secure than just handing over the letter without an envelope. So please ensure that all confidential letters are in sealed envelopes.
  • 99% of the time it would be safe to hand over such a letter  – but there is always that 1% that could backfire. But with everyone living such a busy life we always rely on family/friends helping out at such times. If you are in any doubt speak to your Supervisor/Manager or even phone the patient and ask if they are happy for you to give the letter to the person at the desk.
  • The 1% of this backfiring could be that when her husband read the letter which was meant for the Gynaecologist it could have caused a big problem, especially as she had already said she did not want her husband knowing about the termination. This could have led to the surgery being sued for breach of confidentiality.
  • Always think of the 1% and cover yourself as much as you can.

Does your practice have a policy on the collection of letters?

How do you give out repeat prescriptions at your Surgery?


Do you keep your repeat prescriptions in a secure box? Are they kept near to the reception desk for easy access to give to patients when they are collecting them? Do you lock or secure your repeat prescription box  during the lunchtime and at night? If not you should.

There have been occasions  (not many I am pleased to say) where the prescription box was kept in easy reach of the reception desk and they have been snatched – so always ensure that the box is kept a good distance from the desk to avoid this from happening.

Do you give our prescriptions to people other than the patient? Of course you do – prescriptions are collected for patients by family members, neighbours or carers. In today’s society people work or might be housebound and often cannot get into collect their own prescription – so we all accept that people other than the patient will come in to collect a prescription.

We all like to make things easier for our patients – after all that is what we are there for – we get to know our patients and will often go out of our way to help in any way we can. But sometimes you might think you are doing the right thing – but perhaps you are not – you need to stop and thing before you maybe “offer” that extra help.

Here are two true stories that actually happened to me when I was a Receptionist. On both occasions I thought I was doing the right thing. I thought I was being helpful when in fact I wasn’t – it actually could have backfired and cause a problem. Let me share them with you.

True Story  1

Mrs Joan Morgan came into the Surgery one morning to collect her normal repeat prescription. I went to the box to get the prescription and seen that her daughter Miss Catherine Morgan’s prescription was there too waiting to be collected. Mrs Morgan did not ask for her daughter’s prescription, but had in the past collected a prescription for her as did her daughter for her.

 I knew that Mrs Morgan and her daughter had a good relationship and lived together and they were often in the surgery at the same time. So I had no hesitation is asking her did she want to take Catherine’s prescription at the same time. She said she would.

I gave her the two prescriptions – she looked at the prescription and with a gasp she looked at me and said “I didn’t know Catherine was taking the birth pill”. I realised then that Catherine had not asked her mum to collect her prescription for a reason – the reason being she did not want her mum knowing she was on the birth pill. I realised I had actually broken patient confidentiality. I spoke to my Reception Supervisor and she advised me to telephone Catherine to explain what I had done. Thankfully Catherine was extremely good about it and said that she would speak to her mother when she got home.

It is times like this when you have a good relationship with the patients that you are able to telephone them, explain what has happened and they will understand that you were only trying your best.  I found that by having a good relationship patients they are far more understanding. They know that you are trying to help. You will also find there will be fewer complaints.

True Story 2

Mr Joe Allan came in again one morning asking for his repeat prescription. I went to the box and seen that his son Ben Allan’s repeat prescription was there too.  Aware of what had happened before I checked Ben’s prescription – it was for his asthma inhaler – and again his dad had often picked up this prescription for him. So I thought this time I would be safe – there was nothing confidential on there so I asked Joe if he wanted to take Ben’s prescription as well. He said he would.

Then at 12.55 (five minutes before we closed for lunch) Ben came flying into reception. He asked for his repeat prescription for his inhaler – he had run out and was feeling a bit poorly and needed it. My heart sank – there was no Doctor on the premises as they were away doing their home visits. Ben explained that he was come up to the surgery in his lunch hour and would not have time to go home to get his prescription from his dad.

Luckily enough we had a very good understanding with the chemist across the road from the Surgery and I telephoned them and they said that they would issue Ben with an inhaler as he was a regular customer there and had his records, but on the understanding that he or his dad dropped his original prescription in to them the following day.

Ben dashed over to collect his inhaler

So there are two different examples where I thought I was helping a patient but in fact it led to them having problems because of it.

So from then on in – unless someone  specifically asked for someone’s prescription it stayed well and truly in the box until it was requested.

Receptionists Be Aware – You Could Be Heard!


I read an article in the press recently about a woman stating that she had been humiliated by staff at her Doctor’s surgery after they allegedly left a message on her answerphone mocking her looks.

She said that someone from the practice called her and left a message on her phone and said that she could hear a group of woman in the background laughing at her.

Now I do not know the full story –so therefore can not judge – but how awful for her if this had happened.  I  had a similar “complaint” against one of the surgeries that I managed some year ago. Let me share what happened.

I took a telephone call from a woman claiming that when she had phoned the surgery earlier that morning requesting a visit from the Doctor for her sick husband  she said the receptionist had laughed down the phone at her – the receptionist had asked if he could get to the surgery instead of having a home visit. The woman said that her husband was too poorly to come to the surgery and asked if the doctor could call – she said that the receptionist laughed again, and she could hear laughter in the background which she felt was obviously directed at her.

Although I took this complaint seriously I could not believe that any one of my team of receptionists would have done this. I promised the woman that I would investigate the complaint and get back to her.

But there is that rare occasion where you are let down by a member of your team, and if this was the case then the Receptionist or Receptionists  would have been dealt with appropriately.

I went down to reception – I check the visit book to see who had taken the call and entered the visit. I was gobsmacked – the receptionist that took the call was not only one of our most senior receptionist she was one of the most professional  receptionists that the surgery had. I couldn’t believe that she could have done this But I had to investigate this complaint and hear the Receptionists version.

I called her up to my office. I discussed the conversation that I had with the woman – this Receptionist was obviously upset –  and denied that this had happened. We went over the call and the Receptionist filled me in on how the call had gone. It happened that the woman was pretty rude to the Receptionist when she asked if the patient was able to get to surgery (something we did when patients called for a visit – as sometimes we could turn a visit into an appointment freeing the Doctors to visit those that could not get to the surgery). The Receptionist said she handled the call in a professional manner and did not retaliate to the woman.

The Receptionists said that once the woman had said her husband was in not fit state to come the surgery she took the visit as she would normally do. She again denied that she had laughed. She was quite upset by this allegation.

I went down to discuss the incident with the rest of the team – as I walked into reception I was greeted with 3 girls standing laughing at a joke that someone had just told. But while they were doing that there was someone directly in front of them on the telephone. Could this have happened earlier on – perhaps the woman had heard background laughter and assumed it was directed at her.

I spoke to the girls, they all agreed with the Receptionist that she had taken the call in a professional manner as she always did – but they did confess that “perhaps” they had been ‘chatting’ at the time. They agreed that morning surgery had just finished and it had been a bit quiet in reception.

I telephoned the woman back – I had to be very careful in how I handled the call as I did not want the woman to think that I was calling her a liar. I asked if maybe she had misunderstood and perhaps had heard some background laughter – something that was not directed at her – she disagreed  – but I did hold my own and said that the receptionist that had taken the call would never had done that – I felt that I had to stand by the Receptionist as I was sure that there had been a misunderstanding and she had heard background laughter.

I assured the woman that I would be speaking to the whole team and raising the issue and I promised her that we would look at our system and every effort would be put in place to ensure that this would not happen again.

I followed up the telephone conversation in a letter again apologising for any upset she might have experienced. I enclosed a complaints form if she felt she needed to take the matter further – I am pleased to say she did not.  I logged the incident in the normal in case this incident might be raised at another time.

This is when I decided to sit on the other side of the desk to see what could be heard from the Reception area and especially for patients that might be on the other end of the telephone.

Please read my blog to see how this exercise was beneficial to me and my team

The Other Side of the Desk http://t.co/ZrJSw0pr

What was learned from this experience is that Reception needs to be kept quiet at all times, laughter can be misunderstood and certain conversation that could be heard in the waiting room by patients could cause upset.

An example of this was a group of Receptionists one morning was discussing a programme on the telly the evening before – it was about a woman who had breast cancer, the girls went into the programme in great details all giving their opinion – and unknown to them there was a patient sitting in the waiting room that has just been recently diagnosed with breast cancer. The patient was obviously upset with what she over heard.

So while you want everyone to enjoy their day, and have a laugh there is a time and place and the main Reception area should be kept professional at all times.

At all times you as the Receptionist has a duty to provide the best possible service to your patients and the dignity that they deserve.

The importance of being a good Supervisor or Manager?


Managerial effectiveness is a crucial element in the running of any Practice. But being a “good” manager is not just about hitting targets and working for the company – it is all about managing your staff in the most proactive way you can. Leadership is the only way forward. Here are some points that are vital to a Manager to help manage a good and happy team.

I will use the term “Manager” in this blog but this is also for anyone in a supervisory
role – being a Supervisor you are in a responsible role and lead a team and this is just as important as a managerial role.

LEADERSHIP

In every organisation there is a definite need for leadership. Whether it is a Team Leader, Supervisor or Manager they are vital to the practice. You will need to be goal orientated, self-motivated and possess boundless energy and have to learn how to exert influence effectively in all directions – upwards, downwards and sideways. You will need to show strong leadership both to your bosses and the staff.

You will need to earn respect from your staff and your Partners – and that comes with
time. You need to be seen to be fair, treating everyone with respect and not show any signs of favouritism.

Strict neutrality is also necessary in your dealings with staff. It is hard to maintain a strictly unbiased approach if you are particularly friendly with one or more members of staff.

The role of a Manager can sometimes be very lonely.

TEAM BUILDING

Team building is vital for the whole practice.

Communication plays a big part in Team Building. Get to know your team where possible as individuals. Get to know their strengths and weaknesses, their goals and their hopes. These will help when it comes to yearly appraisals. By knowing your staff and their abilities you are able to place them in the job best suited to them. You might have someone who has great people skills – they will be ideal to put on the front desk, and someone who has great computer skills yet not so good on people skills, they would be great at carrying out admin and computer work. By placing these people in these roles make for happier staff – they are doing something they enjoy  rather than just doing a job given to them.

You need all types of staff to have a team. Someone that is has a great telephone manner, someone who has great people skills and someone who has great organisational skills – use them to the best of their ability.

Team Building is such an important part of your job.

MOTIVATING STAFF

Motivating staff is an essential part of any manger’s work. Most staff seeks not only an
interesting job but usually like to feel that what they are doing is worthwhile and that they have job security. They need to be able to respect their boss(es) and have the respect back. Offer staff opportunities – training, learning new skills, and promotion wherever possible.

Staff are more likely to be motivated if they receive recognition and praise when it is deserved. This can be given to individual members of the team or to the team as a whole.

If you are praising an individual do not do it in front of the other members of the team. This can often lead to embarrasment on the member of staff involved and also cause bad feelings amongst others. Call them to your office and give the praise – if the praise is to the whole team give this at a team meeting – and ensure that staff that are not at the meeting receive the praise. You could verbally give the praise followed up by a memo to all concerned.

Staff will work better if the management of the practice is not only consistent by also seen to be fair.

STAFF MEETINGS

Finding time to have staff meetings is never easy. Especially in Practice as many of the
staff are part-time workers and therefore you never having everyone there at the same time.

Some practices have staff meetings in the evenings; some have “breakfast” meetings before their surgery opens. Others have staff meetings during the lunch break. One thing is for sure if you have a big team of receptionists you will never have everyone attend the meeting. Look at the best times that staff can attend. Send out a memo asking them what they would prefer. Try to rotate the meetings every time so everyone gets a fair change of attending the next one.

But the important thing is to keep staff informed if they are unable to attend. For me the best way was to have each and every meeting has minutes taken and copies sent out to all staff – those that were present and those that could not attend also copy in your manager and the staff Partner. Always keep a copy of every meeting on file for future reference.

It is important to give staff plenty of notice when the next meeting is going to take place. A good suggestion is to agree the next date at the meeting you are holding. This way you can add it to the minutes.

If you have a lunchtime meeting a good idea is to provide lunch – perhaps a nice kind rep would be happy to help.

As a Practice you will have to decide if overtime is going to be paid and at what rate or if they can have time in lieu for attending the meeting.

Let all staff have an opportunity of adding items to the agenda. Let them feel that they are part of the meeting.

In my experience most staff are happy to attend meetings if they can see the point of it and a positive outcome with direct action being taken if appropriate.

If you learn to hold successful meetings, you should be guaranteed a good attendance.

STAFF TRAINING

Staff training is vital – it is essential for every Practice to be able to move forward. Well
trained staff are confident staff.

Invest in good training. It does not always have to cost a fortune. There are several options that you can take when it comes to staff training. You can either send individual staff on training courses outside the practice – your local PCT (Primary Care Trust) usually run excellent courses and many of these are free.

You can attend courses and then bring them back to the and train staff.

You can have an outside organisation come into the Practice and train several staff at the same time – this can be some similar to a staff meeting when it can be done during a lunchtime. Again Reps are often able to help in the cost of training.

Ensure that you log all training that staff has been on – keep a training log of their individual training skills in their staff files.

Staff Appraisals

Appraisals are a two-way process. If you need to explain to staff that one of the reasons
why you wish to hold individual appraisals is because you wish to learn from them, how they feel about their particular job and their role in the practice, this should ensure that they begin to feel less apprehensive about the whole process.

For some reason staff always see appraisals as a negative thing. Try to change that.

The appraisal interview should provide a forum for feedback from the employee as well as a chance for the manager to praise past efforts and offer constructive criticism on ways in which improvements can take place. Training needs can be identified and methods of monitoring development can be set up.

It is important that you listen to their views and recommendations and, where possible implement changes that they have suggested. But do not make promises that you will not be able to keep.

And most important

COMMUNICATION

Communication is vital. Staff needs to be kept informed in anything that might involve them. Lack of communication is a good way to start rumours and bad feelings amongst staff. Keep your staff informed of necessary changes within their jobs or within the Practice.

Talk to your staff, feedback when and where possible – staff meetings are good for this as
are memo’s and talking to staff wherever possible.

And remember – there is no “I” in TEAM