Please don’t blame the GP’s

 

Sadly, GP’s have come into attack again in the UK from the press. The main complaint is that patients are waiting far too long for appointments, and I think we can all agree with this. Waiting times are far too long, BUT this is not the fault of the GP ‘s who are trying their best to keep their patients happy.

1 in 10 GP’s are seeing up to 60 patients a day many seeing 40 when realistically they should be seeing around 30.

People that think that GP’s are at fault for the lack of appointments they just simply don’t appreciate the work that goes into a day in the Surgery.

GP’s don’t just see patients, they have letters to write from patient consultations. They have results to chase up, prescriptions to check and sign, home visits to do, meetings to attend, various insurance forms to go through, and quite often this is done through their lunch breaks or staying after evening surgery to get it all done.

Managing the appointments system is usually tasked to the Practice Manager who will work closely with the GP’s and they are constantly looking for ways to improve on their current system for the good of their patients.

Every week every single surgery has many DNA (did not attend) appointments. Patients that have booked appointments simply don’t turn up or cancel them, despite many being send alerts via their phone which are easy to cancel.

Some surgeries offer appointments whereby patients’ phone first thing to get an appointment that same day. This doesn’t always work well for people that are working because getting time off at short notice is not always possible. While this system suits some patients, others complain that they cannot pre-book appointments. As well we know any appointment system will suit some and not others.

The knock-on effect of patients unable to access appointments at a time convenient to them just don’t realise the impact that it has on the whole team. It starts with the Receptionist who contrary to belief are there to help the patients and happy to do so. They don’t enjoy having to go through pages of appointments to then tell the patient that all the appointments have gone. Or to tell the patient that the next available one is 3 weeks away. Believe me the job is far more enjoyable when the Receptionist can actually offer the patient what they want.

Another thing that really annoys some patients is when the Receptionist asks what they want to see the doctor for. It’s not to be nosey. It’s certainly not to be difficult, its simply to see if another healthcare professional could see the patient instead of the doctor. Many larger Practices have ECP’s (Emergency Care practitioner) who can prescribe, Practice Nurses, District Nurses, HCA’s (Health Care Assistants), Paramedics, Phlebotomists. By asking what the appointment is needed for can often direct the patient to another healthcare who can help. This then allows patients that need to see a doctor having better access.

Many Surgeries are now open longer hours. As early as 7.30 in the morning and until 8.00 in the evening, and some are now opened for emergencies at weekends.

We are also very lucky that we have access to a doctor or healthcare professional 24/7 by phoning 111 or in an emergency 999 or going to A&E.

The press is saying that patients are saying that afternoon appointments can often find the doctor not as compassionate as they would be in the morning. In my experience this simply isn’t true. But ask yourself, if you were working 12 hours a day with no break, trying to you best to accommodate everyone that came in to see you that day, trying to keep everyone happy would you not be exhausted. Of course, you would, GP’s are human beings too, they are victims or stressful jobs, and they get tired like the rest of us.

Where I live they are in the process of building a new housing estate which will consist of 600 new homes. There are no allowances for these people wanting to register at a GP Practice. The local practice is already at breaking point, and yet the government will expect the people in these new homes to be registered somewhere. Who will suffer the most, the new patients because they might have to travel miles to register with a GP. The local surgery will suffer if they have to take on new patients, and then in turn the patients already registered at the practice will be waiting longer for appointments than before.

Patient demands are rising. Expeditions and behaviour from a minority of patient often leading to GP’s, Receptionists and other healthcare professionals exhausted at the end of the day- and then they have to face the very same the following day.

So, next time you have to wait weeks for an appointment, remember the Receptionist doesn’t take any delight in doing this and certainly the GP’s are not the cause of it.

Struggling GP Appointments?

 

Working in a GP surgery the most complained about, and the most stressful thing is lack of GP appointments.

Patients get frustrated when they have to wait days and sometimes weeks for an appointment, and often the staff trying to deal with this often get verbal abuse from the frustrated patients.

There are only so many appointments available every day, and most surgeries will go over and above their daily appointments trying to accommodate patients that have to be seen that day.

Of course, every surgery had a large volume of DNA’s which means ‘Did not attend’ or ‘Did not Arrive’ and often these will be in fact be patients that have been fitted in the same day because they said that they were really poorly and needed to be seen that same day. Missed appointments hit every surgery and is a never-ending headache for the team.

There is a practice in Highcliffe in Dorset that have a great system that I am sure helps with their appointment system and its fairly simply and yet very effective.

They run a children’s clinic every afternoon from 4 – 4.30 Monday to Friday where parents can bring children up to the age of 16 and can be seen that same day without having to phone for an appointment. It is a walk-in clinic. No having to phone and get an urgent appointment which isn’t always possible.

In the knowledge that parents can get their children seen that same day will often have them often leaving it another day in the knowledge that if the child is still no better the following day they still have the choice to be seen, that alone takes off a lot of pressure off the parents and the appointments system and therefore staff too.

Parents are not taking up appointments throughout the day  thus leaving these for other patients.

I think this is a really good system, so all they have to do is find a way to reduce the large amount of missed appointments.

Have you got a system that works really well in your Surgery that helps with the daily appointments struggle.

GDPR Video and Quiz for Receptionists & Administrators #guest blog #practice index

General Data Protection Regulations 

You can now test your GDPR knowledge with a fantastic new quiz from our friends at Practice Index. There’s also a short video which tells you all you need to know about GDPR.

https://practiceindex.co.uk/gp/blog/gdpr-gp-receptionists/

 

 

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

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?

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.

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.

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.

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?

 

© 2011-2018 Reception Training all rights reserved

Dealing with the Bereaved #caring

It’s been a tough couple of months. 2 very close friends have lost loved ones and 2 family members have died. 2 of them young woman in their 50’s losing their life to that horrendously awful disease CANCER. Every single one of them leaving behind broken-hearted family and friends.

I have shared their journeys through the caring for their loved ones and it saddens me to hear that they had many battles along the way. Getting much-needed appointments, lack of communication between different organisations and sadly just not enough resources in the NHS to assist them in their caring. But also, the many different positive stories they shared about the many different GP, hospital staff and voluntary organisations that often helped make the day that bit better for their professionalism and caring natures.

Often when someone is ill, especially terminally life is very hard on the people caring for them. They often have very little support or no support at all. One of the carers had to give up their job to care for their wife so he could accompany her to the many appointments for chemotherapy and radiotherapy and to the many visits to A&E and the GP. They had to be the “strong ones” Every single bit of help for them (the carer) goes a very long way in their fight to give their loved one the best possible care that they can………………but they need support from so many other organisations to be able to do this.

The carers often get worn down, quickly feeling low or even getting depressed and often face financial difficulties. Who cares for the patient if the cater gets ill?

Attitude, communication, empathy, time, and listening skills don’t cost a lot but can be invaluable to the carer – and the patient.

If you are aware of such a carer needing a doctor’s appointment please communicate, have empathy and use your listening skills. Try and accommodate an appointment that will allow them to fit in around the caring that they are doing.  They might find a telephone consultation easier. Some carers are worn down by the sheer volume of the day-to-day caring and fighting for their loved one. When it comes to them seeking attention for themselves they just don’t have the fight in them anymore. You need to be their “fight” When someone is watching their loved one suffering in pain, they don’t need any extra pressure.

When I was a Receptionist I was often faced with terminally ill patients. People that were caring for loved ones with terminal illnesses and often them needed to be treated as a patient due to the stress of being a carer.

I still remember the first time I dealt with a family member who had just lost their loved one to cancer. They came into the surgery to collect the death certificate. This was the first time that I had ever come face to face with someone who had just had a death in their family. I was lost for words. I didn’t know what to say, so I said nothing and I felt bad for this afterwards. I just didn’t know what to say. I didn’t want to upset the person.

I also was “surprised” at how some people behaved when then had just lost a loved one. Some would appear to be “happy” even cracking jokes, some would come in and were obviously very upset, some would come in and wanting to blame someone for the death of their loved one, others would just act as if nothing had happened.

I had the opportunity to go on a bereavement training session and this explained so much to me. It taught me why people react to death in many different ways.

The training explained the different emotions that people might be going through immediately after the death.

Shock: It may take you a long time to grasp what has happened. The shock can make you numb, and some people at first carry on as if nothing has happened. It is hard to believe that someone important is not coming back. Many people feel disoriented – as if they have lost their place and purpose in life or are living in a different world.

Pain: Feelings of pain and distress following bereavement can be overwhelming and very frightening.

Anger: Sometimes bereaved people can feel angry. This anger is a completely natural emotion, typical of the grieving process. Death can seem cruel and unfair, especially when you feel someone has died before their time or when you had plans for the future together. We may also feel angry towards the person who has died, or angry at ourselves for things we did or didn’t do or say to the person before their death.

Guilt: Guilt is another common reaction. People who have been bereaved of someone close often say they feel directly or indirectly to blame for the person’s death. You may also feel guilt if you had a difficult or confusing relationship with the person who has died, or if you feel you didn’t do enough to help them when they were alive.

Depression: Many bereaved people experience feelings of depression following the death of someone close. Life can feel like it no longer holds any meaning and some people say they too want to die.

Longing: Thinking you are hearing or seeing someone who has died is a common experience and can happen when you least expect it. You may find that you can’t stop thinking about the events leading up to the death. “Seeing” the person who has died and hearing their voice can happen because the brain is trying to process the death and acknowledge the finality of it.

Other people’s reactions: One of the hardest things to face when we are bereaved is the way other people react to us. They often do not know what to say or how to respond to our loss. Because they don’t know what to say or are worried about saying the wrong thing, people can avoid those who have lost someone. This is hard for us because we may well want to talk about the person who has died. It can become especially hard as time goes on and other people’s memories of the person who has died fade.

The training was excellent and I would really recommend if such a training course becomes available. I understood and was able to deal with bereavement a lot better. I was also able to communicate better, had empathy and my listening skills often came into good use.  I felt I made a difference. I was more confident to talk to people and ask how they were coping and make sure that I did everything in my power to make their visit to the Surgery went as smoothly as possible.

People often appreciated this, and would often say that I would be the first person that day that had acknowledge their loss.

Being recently bereaved can often be a very lonely place.

When I was a manager I instigated a Special Needs Board – this was extremely helpful to Reception staff when it came to identify patients that had just died or were terminally ill.

See blog post:      Special Needs Board http://t.co/wnWKmxHV

As a Receptionist, its important how you react to someone who has just had a bereavement. Knowing that this person might have needs (especially if they are a patient) and how you can make such a great impact on them.

How you treat them can give a lasting impression. Make it a good impression and not a bad one.

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.

 

 

© 2011-2017 Reception Training all rights reserved

Please Quote Me Right – #NotWhatISaid

 

I was approached by another national newspaper last week The Daily Mirror  to do a piece on the bad publicity that GP Receptionists are getting recently in the press lately.

As anyone that reads my blog will know that I am not only passionate about good patient care, but also I am very protective of the Receptionists who do a very difficult and at times very stressful jobs.

The reporter more or less took me through what she wanted to write and for most of this she wrote what I had said correctly all apart from point no 2. DON’T PHONE JUST TURN UP.

I didn’t quote this and I never would. I even had a lengthy conversation with her stating that this was not an ideal solution as someone coming and presenting themselves at the surgery would not get them an appointment over someone who telephoned. If the Receptionists have appointments they will offer them – if they haven’t got any appointments free then someone standing there in front of them will not magic one up out of thin air! This would then annoy the patient and this is where they can often get the bad publicity from.

Every surgery have their own system in place for appointments, but I am confident that there will be very few if any that would suggest that patients turn up for emergency appointments rather than telephone.

The two articles I recently did for two national newspapers I did was purely to stand up for all GP Receptionists.

I never receive any payment for these articles I did it purely to stand up for all GP Receptionists and the great jobs they do, often going over and above their job description to help patients.

Here is the article – which again is a great support for all GP Receptionists across the country but again I would like to point out that I did not quote No 2.

http://www.mirror.co.uk/lifestyle/health/9-ways-you-can-make-8685940

Sadly because of this I will feel very reluctant in the future to do any more articles.

 

© 2011-2017 Reception Training all rights reserved

 

 

Just how important are Telephone Messages #AnswerMachine

Just how important are telephone answering machines? VERY important as it keeps your customers informed of you’re opening days and times.

Last week I needed to contact my dentist for an urgent appointment. He is a one-man dentist, with a hygienist and a nurse/receptionist. When he has any time off the practice closes.

I rang at 09.00 last Monday morning, the telephone just rang and rang, no one answered and there was no telephone answering message. I thought they might be starting at 9.30 so I range again – still no answer. I did think this was strange as usually when he has been away on holiday he has answered the phone via his mobile and has advised from there. This time there was nothing.

I tried again just after lunchtime and again around 4.00 pm. I wondered if perhaps he was having a long weekend off. I even checked that I was ringing the correct number.

I tried again the following morning, at 9.00 and 11.00.

The worse part for me was the not knowing. Had there been a message to say how long the surgery was going to be closed for I could have then made a decision to either wait and see him or to seek treatment elsewhere.

As I needed an urgent appointment I telephoned another practice locally and was luckily enough to get an appointment that same afternoon.

Just as well I did as I was told that had I left it any later I would have probably lost the tooth.

I have been with my dentist for over 9 years. No reason to change to be honest, I am not fond of the dentist at the best of times, but he always seemed to be good enough.

I actually found the new dentist to be extremely pleasant, she made me feel very much as ease. The surgery surroundings were very relaxed and the Receptionist was lovely, she chatted away.  I felt far more relaxed when I went in to see the Dentist and she talked me through what she was going to do. The surgery was also much closer to home and there was free parking where I used to have to pay for parking at my other dentist and to add to it all the new dentist’s overall charges were considerably a lot cheaper than my regular dentist.

Taking everything into consideration I have decided to move to the new Dentist, it suits my needs much more, but I didn’t realise that until I was forced to visit the new surgery.

Had my old dentist had a telephone message advising how long the surgery would be closed for I would probably still be going there now.

So, it is vital that you have a good telephone message set up on your phones. Ensure that the message is appropriate and you might have to change a message if you have the following:

• Morning opening times that differ
• if you close for lunch – state what time you open again at and leave any emergency numbers as appropriate.
• Evening closing times differ – again leave any emergency numbers
• Friday night – leave messages appropriate for weekend closing and again leave any emergency numbers
• If there is a bank holiday, please ensure that this is mention in the last message before the holiday.

Get someone who has a good clear voice to record the messages. It is essential that they speak slowly and clearly and repeat any emergency telephone numbers twice.

Get someone to check the messages regularly to make sure they are the correct ones.

If you do not want anyone leaving messages add this to your message and make it clear that the service does not accept telephone messages. If you don’t people will use it as a message machine.

There is nothing worse that getting a telephone answering message that is out of date or wrong!

Having the correct telephone message on your answer phone is important. You could lose customers if it’s not.

© 2011-2017 Reception Training all rights reserved

Does your Receptionist recognise signs of Sepsis. A Patients Story #Bournemouth Hospital

There has been a lot of publicity recently regarding Sepsis. This is aimed at raising awareness and those that work in the GP surgeries and Hospitals will know on too well that this will create fear amongst some patients and therefore will be more than likely phoning the Surgery/Hospital for advice.

We are being told Sepis should be treated urgently as we would a heart attack.

For all Receptionists, Secretaries and Administrators who could be faced with a query regarding this are you fully competent to deal with it? Would you be confident in dealing with a call that could be Sepsis? I must confess I am not sure I would be able to identify this emergency a few weeks ago, but I feel a lot more confident now that I have read up on it.

You probably have procedures and policies in place for dealing with a heart attack. Have you a procedure or policies in place to deal with sepsis? Perhaps at your next team meeting you could put this on your agenda or speak to your Reception Manager or Practice Manager about having one written up.

The most important thing is that you know the facts about Sepis and what is expected from you as a Receptionist if you take such a call. Don’t be one of those surgeries/hospitals that could be highlighted as missing something that might be so obvious to someone who knows what Sepsis is.

Many doctors view Sepsis as a three-stage syndrome, starting with Sepsis and progressing through severe Sepsis to septic shock. The goal is to treat Sepis during its early stage, before it becomes more dangerous.

Sepsis usually comes with a probable or confirmed infection and includes several symptoms. These perhaps can be discussed with a Doctor and the Receptionists and a guide of what questions to ask the patient.

Septis has to be treated quickly as the patient can go downhill very quickly

A chart that I found very useful to help identify some of the symptoms:

A very interesting clip from the Royal Bournemouth Hospital highlighted a patients experience and how his Sepsis was nearly missed. They are keen to spread awareness. Well done Bournemouth Hospital for sharing this short film.

Published on July 13 2016. 

Sepsis is a medical emergency, here at RBCH we are keen to spread  awarness and listen to patients experiences to improve care. 

 

Every Surgery Should Have One

This appeared on my Facebook page today – shared by a lovely friend and Doctors Receptionist.

This notice is displayed at the Royal Arsenal Medical Centre – well done to them.

I totally agree that every Doctors Surgery shoul have one of these notices displayed in their waiting room.