Working Together #NHS #111 #A&E #GPSurgeries


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Sadly, as most of you are all aware there is a lot of negative publicity in the press at the moment about our great NHS service and sadly some of it with good reason.

It saddens me to read some of the dreadful reports about patient care and those working for the NHS being abused and often overworked. Working for the NHS and being a patient I can see a lot of this from both sides.

Doctors surgeries are busting at the seams with patients struggling to get appointments. Practices are merging together but are they able to continue to offer the service they did before?

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The Ambulance service is stretched and A&E are struggling to find beds resulting people being treated in corridors, whilst Ambulance crews are held up in the car parks with patients on board waiting to be seen and treated, often resulting in the ambulance crew not being available to go to the next emergency.

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Sadly, there are still the time wasters and abusers of the service. Those that call that emergency ambulance when all they needed was a GP appointment, the hoax callers that can tie up the emergency services for hours before they finally find that there was no “emergency” to those that present at A&E for minor ailments. Working in the past in A&E it never ceased to amaze me just what people would present with at A&E with. (I have written other blog stories when I worked in A&E)

As a Manager working in the NHS it’s a hard job. Struggling on a daily basis, trying to hit targets, wanting to give best patient care is almost impossible, dealing with staff that are forever under pressure on the front line and answering to stressful those who need to be obeyed.

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As a Receptionist, you will never please everyone, and many will be sure to be vocal and let you know how unhappy they are and often blame you for the “awful service”.  Telephones ringing constantly, people demanding urgent appointments that you just haven’t got, GP’s and Managers constantly asking the impossible from you, and all while you are working for barely more than the minimum wage.

Hearing from friends, updates on social media and press reports everyone is struggling to be seen resulting in people misusing the NHS because they had no alternative.

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A friend recently phoned 111 (for my overseas readers this is an out of hours service which covers GP surgeries when they are closed – an excellent service which gives patients 24/7 cover). My friend felt very unwell, sore throat, temperature and generally feeling very unwell. She spoke to somewhere at the 111 Service, for whatever reason the 111-service suggested she took paracetamol and phone her GP surgery the following morning. She had a bad night and phoned her GP Surgery first thing the following morning. Her surgery was unable to offer her an appointment and she explained how ill she felt, she was than advised if she continued to feel unwell to take herself off to A&E – as ill as she felt she would have never done this but many might have acted on this advice. She left it another 24 hours and phoned the surgery again where she was given an appointment for that day where she was given Antibiotic and Steroids for a chest infection.

My husband was recently poorly at a weekend, as thought he had a nasty chest infection. I phoned to see if we could get an appointment at a local Treatment Centre (the out of hours service where you can see a GP). After giving the operator all his symptoms (he was breathless due to the cold/chest infection) the operator said they she recommended that they send an ambulance out to him. The protocol said that if the patient was breathless or had breathing problems that an ambulance should be sent. There was no way that he needed an ambulance, he could have actually driven himself to the Treatment Centre, he was ill but not that ill, and even if he was I could have driven him there.

I believe that both of the above where 2 incidents where the emergency services (A&E and an ambulance) were not needed. I know that people have protocols to follow but in these two instances the patients could just have been seen and treated by a GP.

Do we need to look at the bigger picture, to look as how we can signpost people in the right direction, to ensure that people who need A&E are seen, and those that can see a GP do so? We have a great NHS, we can see a GP free, we have GP cover 24/7 and at a last resort we have a great emergency service in the ambulance service and A&E. It’s important that everyone needs to see those that are appropriate to them. Is there anything that we can do together to ensure that this happens most of the time?

I would be very interested to hear from my many overseas followers on how their GP Practice work. How does your routine appointment system work and when patients request emergency appointments what is your practice policy and does you’re A&E Departments get clogged up with people who don’t need to be there?

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When You Feel Let Down. #GPSurgery #Rejected #System #AppointmentsSystem


I am very passionate about the NHS and will defend (within reason) any criticism that I hear about anyone working in this wonderful organisation.

My experience comes with working in the Reception areas of both large and small GP Surgeries, Hospitals and for the out of hours’ service. I have seen lots of different policies and procedures, and have worked with many different set up within this different organisation – especially the GP Surgeries.

I hear a lot of people bad mouthing Doctors, Receptionists and other health care professionals, and most of the time it’s because they (the complainer) do not really appreciate or understand the system they are complaining about. There are always two sides of the story.

Sadly, I feel like “one of those people” that I dread hearing from. I have felt very let down by my own GP Surgery and I feel their “system” hasn’t helped.

Let me explain what happened.

When I registered at the practice I was told that you could only see the doctor you were registered with. When I needed to make an appointment I would have to speak to his secretary and she would offer me the next available appointment with him and him only.

In the event of an “urgent” appointment needed if he wasn’t available then and only then would you be offered another doctor.

I have an ongoing issue that has needed following up. I had to wait two and a half weeks to get an appointment with my doctor. I didn’t feel it warranted an “urgent” appointment as I very conscious about the misuse at times of these appointments and know how difficult they are to get sometimes.

So, I waited the two and half weeks. In the meantime, I started to get a bad ear, again, I felt it could wait as my appointment was due in a couple of days’ time.

On arrival at the surgery I used the check in system and it said that I was due to see the locum doctor and not my named doctor.

I was called in by the locum doctor, she said that she was there covering for my regular doctor. I explained about my ear and she confirmed it was indeed infected and issued a script for antibiotics. I then started to explain about the main reason of the appointment and she cut me dead – she said that she had already dealt with one issue and wasn’t prepared to discuss anything else in this consultation. I had only been in the room a matter of minutes. I fully understand that had it been a “urgent” appointment that I had booked that I couldn’t really discuss ongoing issues, but this was a routine appointment that I had booked some time ago.

I tried to explain that I had waited over two and half weeks to discuss the issue, to which she said I would have to make another appointment to come back and see my dedicated doctor.

I couldn’t believe it, what a complete waste of my time, I had waited two and half weeks for this only to be told I had to see my own doctor.

I left her room, quite upset by the whole thing, and more of her attitude in dealing with me, she wasn’t even prepared to listen to what I had to say.

I went to the front desk to ask about an appointment for my own doctor and was told it would be another 3 weeks ahead. So in all it will take five and half weeks to see my own doctor and thus taking a much-needed appointment that could be used by someone else when my issue could have been dealt with in the appointment I had just had.

This sadly would be one of those occasions where I don’t think I would have been able to defend the situation that I found myself in.

 

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© 2011-2017 Reception Training all rights reserved

Confidentiality and Teenagers #111 service


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A friend of mine had the need to call 111 at the weekend (the out of hours’ doctors service). Her 13-year-old daughter was very poorly with tonsillitis and she was getting very distressed as she was really feeling unwell and in a lot of pain.

 

My friend answered all the necessary questions asked by the operator i.e. symptoms, how long she had been unwell for and the age of child.

 

The operator then asked my friend if she could speak to her 13-year-old daughter, she handed her the telephone and was asked the same questions by the operator. When they were finished speaking the operator asked the girl to pass the phone back to her mother.

 

The operator then asked my friend if there was any possibility that the girl could be pregnant – to the embarrassment of both the mum and the girl she had to asked the 13 if she could be pregnant, red-faced the girl said no.

 

The operator advised that the girl needed to be seen in the local Treatment Centre and gave the mother an appointment time.

 

What i cannot understand if the operator felt that the girl was old enough to answer her questions – which she was, and if there was any possibility that she “could’ have been pregnant why did she not ask her that very personal question directly to the girl when she was speak to her.

She could have been very confidential and just said “I am about to ask you a question and all you have to answer is yes or no – coud you be pregnant” All the girl would have then had to say was “yes” or “no” simple! So why did she ask the mother?

 

Do you think I’m right – or do you think the operator was right to ask the parent?

© 2011-2017 Reception Training all rights reserved

 

 

A day in the life of a GP #The Huffington Post


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I would like to share an amazing article written by Dr Zoe Norris. (please click on the link below to read the full article)

Dr Norris has written about a typical day in her surgery as a GP. From the lack of appointments, to home visits. By 8.10 in the morning she already has 20 patients waiting on her phoning them back as well as arranging care for a dying patient. High blood pressure, chest pains, queries on patients prescriptions, reviewing blood results, letters and minutes of meetings to read are just a fraction of what she is dealing with on a day-to-day basis.

For those working as a GP, Nurse, Manager or a Receptionist will identify on too well with what a GP is expected to deal with.

For those that have not had the experience working within a busy GP Surgery it will enlighten you to the very busy day that a Doctor faces on a daily basis. A GP does far more that just “seeing” patients in surgery.

What does come through from her article is that she is a human being, with feelings who is trying her utmost to be there for her patients . But everyone has their limit!

Sadly Dr Norris is not alone – many GP face similar days.

http://www.huffingtonpost.co.uk/dr-zoe-norris/nhs-frontline-the-reality_b_6279784.html

 

Practice Makes Perfect


I was asked recently to help with some Receptionists Training at a GP Surgery.

The surgery was holding an away day for the whole Practice and they closed the surgery for the afternoon. Everyone was involved from the Partners, Business Manager Assistant Practice Manager, nursing staff and all the Receptionists and Administrators. It was really impressive to see so many staff there. There had been a lot of work put into the away day from the Partners and the Business Manager.

When I go into any surgery I never know what I am going to be met with or what I am going to witness in regards to the Receptionists and how well they understand their role especially new Receptionists that perhaps have never worked in this environment before.

Let me share with you my experience on the day…

I arrived at the Surgery at 8.30 – I was going to sit with the Reception team for the morning and see how they worked as a team – and if there was any input or support that I could give.

When I walked into the Reception area I was really impressed. The Surgery was very impressive and the waiting room bright spotless and very welcoming.

There were good signs for everyone to see and the Reception desk was most impressive.

I was met by the Business Manager who made me very welcome and was very friendly and extremely easy to chat to.

I was introduced to the team of Receptionists who were going about their tasks for the day.

I was impressed with what I seen, everything that I would expect from a good reception team. They were all polite to the patients both face to face and over the telephone, well-informed and very calm whilst doing their jobs. There were a few minor things that could be improved on but nothing that could not be rectified.

What did really impress me was the lovely working area that they staff had to work to work in – the reception desk was big and spacious as was the administration office just at the back of reception. They had good quality furniture and the office was love and bright. The team was really lucky to be working in such lovely conditions.

All phone calls were made in the back office, no telephone calls was taken at the front desk. The Receptionist was just dealing with patients.

Patient confidentiality was excellent and this was achieved by the Receptionists accessing patient information by Date of Birth – a much quicker way of accessing patients details.

The surgery closed at 1.00 and the calls were put through to the out of hours service.

The afternoon began with lunch for all the staff – everyone interacting with one another – it was obvious that this was a surgery that valued their staff.

The Partners started the session off with an ice breaking game – it brought a good laugh and really did start the afternoon off well. The feedback from the Reception team was really positive about the interaction from the Partners.

Everyone then broke away into 3 groups, The Partners, the Nursing Team and the Receptionists and Administrators and myself.

We went over Receptionist Skills, Telephone Skills, and Dealing with difficult people and patient confidentiality.

On the whole the staff were very well informed on most of these subjects. But what was really impressive was the way everyone chatted about his or her experiences, sharing good ideas and finding ways forward with different situations that could help them in the future. We all had something that we took away from the training.

It was good to go over, discuss and learn from them and perhaps remind ourselves why we have to do these things (ie patient confidentiality) and perhaps how we could improve on things we are doing.

The most important thing for me was that I could see how much their were valued as a team, and how supported they were from the Management and Partners.

Why? Because their Practice wanted to invest in them – to support them and to ensure that the patients get the best care possible.

The communication between Partners, Management and staff was excellent. 

This was achieved in their working surroundings and the fact that their practice was prepared to invest in their training needs and support them for future training.

Good trained staff are confident staff and confident staff are able to deal with every day events that they are faced with. This is vital for your organisation and for your patients.

I for one would not only be happy to be a part  of this team I would also feel extremely happy to be a patient there.

Can you say the same for your organisation?

 

© 2011-2017 Reception Training all rights reserved

The Sunshine Patient


 

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Working on the front desk as a Receptionist you deal with thousands of patients over the years. But there are those few patients that will always stay in your mind for different reasons. If I think back to the many lovely patients I use to deal with one that automatically springs to mind is Andrew (I have changed his name for this story).

Let me tell you about Andrew and how he used to lighten up my day when he came into the surgery. He was like a ray of sunshine.

Andrew used to come in on a fairly regular basis with his Dad. Andrew was 25 years old and had Downs Syndrome.

It was just Andrew and his Dad – on getting to know them more I found out that sadly Andrew’s mum had died in their house due to Carbon monoxide poisoning. Andrew and his dad were extremely lucky to pull through – but it was so obvious how they missed their wife and mum.

When I first started dealing with Andrew and his Dad on the front desk it was always his dad that made the appointments, did the talking and insisted on going into see the doctor with Andrew.

The doctor that Andrew (and his dad) used to see on a regular basis was concerned that Andrew was not being allowed to be more independent and do more for himself – but the Doctor also identified that this was mainly down to Andrew’s dad not wanting to “let go”. Andrew was all he had in the world. But at the same time it was not fair to Andrew he was being held back.

After some months getting to know Andrew and his Dad Andrew started to really come out of himself and would chat away at the front desk to me he would joke and laugh with me. I always got a great big beam from him when he came into Reception.

Andrew would happily tell me about his day – what they had done that morning and what there were going to do that afternoon. I always looked forward to his visits and the stories he had to tell.

Then Andrew starting to hold the conversation more every time he came in. Andrew even started to book his next appointment by himself and actually started going in to see the doctor on his own. I seen Andrew grow with such confidence. The doctor that Andrew was seeing was extremely supportive and understood Andrews needs so well.

When Andrew was in with the doctor one morning his dad was chatting to me at the desk. He opened up to his fears about Andrew, and confessed that he actually felt that he was holding Andrew back, but Andrew was all he had.  He confessed that he had even put a block on Andrew attending a day centre as he didn’t want to let go. I felt so sorry for his dad and for Andrew too. His main fear was that Andrew would die and he would be left with no one. The love he had for Andrew was amazing but he was holding him back.

Andrew continued to flourish and he even got a bit bold at times – in a nice way. The cheeky chap even tried to chap me up for his dad once and asked if I would go to their house for fish and chips that Friday night – it was all in good fun and he understood that I couldn’t go as I had to get home to my two girls.

Andrew’s confidence continued to grow, with the help of the GP his dad finally agreed that Andrew could go to a day centre – Andrew just loved it there. His eyes would sparkle when he told me about his days there and the friends that he had made.

But his dad’s fears of loosing Andrew never went away.

Life continued in the surgery and Andrew and his Dad’s visit became less frequent. Andrew was becoming much more independent and loved his days at the centre.

Then one Monday morning I was checking through the out of hours reports and to my horror seen that there had been a death at their address – Andrew’s dad had died of a massive heart attack.

I never got to see Andrew again – and never knew what happened to him, but one thing for sure I know that wherever he went he would have brightened up their days just like he had done to mine whenever he came into the surgery.

I would like to think that the independence that Andrew gained over the years would have given him some strength to get through the loss of his Dad.

 

© 2011-2017 Reception Training all rights reserved

Answer machine messages – get it right!


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Are you confident that your answer machines messages are kept updated? Messages can change on a daily basis and often several times a day.

  • Answer phone messages can be used to alert patients of

Your Surgery Opening times

Emergency contact numbers (when the surgery is closed)

Staff on holiday

Staff not at their desk

Other patient information such as special one-off clinics

  • Advise callers of your opening times – ensure that you have the correct up to date information available.

 

Try to keep the messages short and simple – long messages can often lead to confusion.

If you are giving out telephone numbers in the message it is often best to repeat them twice and slowly. How many times have you had to phone a number back just to be able to take down the telephone number because it was given too quickly?

Opening Times

  • If your opening times are the same every day then you can perhaps give out the times in one message ie

“The surgery is open from 08.00 am  – 12.30 and again from  2.30 – 7.00 pm  Monday to Friday. (it is important to use am and pm to avoid confusion)

  • If you have several different times (some early starts and late finishes it might be worth doing a separate message each day – leaving the message the night before for the next day) “The Surgery is open on Mondays from  08.00 am  – 12.30 and again from 2.30 –  6.00 pm ”

then for  the Tuesday change the message again “The Surgery is open on Tuesdays from  08.30 am  – 12.30 and again from 2.30 – 8.00 pm” – and so on.

  • Remember to leave emergency contact numbers – when the surgery is closed – often these numbers can change so it is important to double-check that these are correct.

For staff leaving answer phone messages

Ensure that it gives the correct information ie:

  1. “I am away from my desk at the moment, please leave your number and I will return your call”

 

2.    “My hours of work are 9.00 am to 1.30 pm. Please leave a message and I will call you back on my return.

 

3.    “I am away until Monday 29th July – please leave a message and I will get back to you on my return – or alternatively please call Joan Smith on 34565.

The three examples above both say the same thing “leave your telephone number and I will get back to you” but the actual messages are completely different – why?

  1.  Is telling the caller that their call will be returned within a reasonable time – and the call should be returned asap – the message is indicating that the person is away from their desk and should be back within a reasonable time.

 

2.  Is telling the caller their times of work – so if the caller is calling outside these times   they are aware that the person will not be available until the times given.  Good clear communication and no confusion.

 

3.  Is telling the caller that they will be away for a long period of time and giving the caller the opportunity of speaking to another person – this is important in as much as the caller might need to speak to someone before the 29th. Giving the option of the caller speaking to someone else will also take the pressure of the person that is away until the 29th and coming back to a lot of telephone messages and perhaps frustrated people.

Answer phone messages are great when then work – and can be frustrating for patients/customers when they don’t.  Not having the correct message on your phone can often lead to misunderstanding and often can cause unnecessary added work pressure on others.

Answer phones are great when they work properly.

If you say on your message you will call back – make sure you do and within an acceptable timescale.

 

My recent experience of a message only this week.

I telephone a consultants secretary on Monday morning at 10.30 to hear a message telling me her hours were 9.00 – 13.30 Monday to Friday and she asked for callers to leave their number. I took from this that as I was calling within her working times perhaps she was busy – I left my number for her to call me back.

To speak to the secretary I had to go through the hospital switchboard to be put through to her.

By 1.30 I realised I was not going to hear back from her that day. So I left it, I had not heard back by 11.00 on Tuesday so I telephoned again (again going through the switchboard). I got the same message – so I left my number again. I tried her again at 12.30 and again at 1.20 – still the same message by this point I was on good terms with the switchboard operator. I did not leave my number as I had already left it twice at this point.

By Wednesday I still had heard nothing telephone the hospital again and asked to be put through – the switchboard operator told me the line was engaged and did I want to hold – YES please, I wasn’t going to let her go this time.

I finally got through, I asked if she was the consultant’s secretary I was talking to and was told “No I am sorry but Mary is on holiday this week and won’t be back until next Monday. If you leave your number i will get her to give you a call. Arggggggg

So, the message could have been better. She could have saved me time and money on the calls and also freed up the switchboard (can you imagine how many similar calls that were being put through to that number during that week). The Secretary would be coming back to 3 of my calls and how many more people had done similar.

Perhaps she should have informed the switchboard staff that she was on holiday. This would have saved me time and calls and freed up the very busy switchboard.

Had she put a message advising callers that she was not in the office for the week of (and given dates) it would have saved a lot of time, money and frustration and perhaps misunderstanding (as I was beginning to feel that my call was being ignored).

It is just as important to leave an out of office” message on your emails too – especially if you are going to be away for any period of time – and again very helpful if you can give an alternative person that someone can’t contact in your absence.

Systems like this work well – but they have to be set up properly in the first place.