Please don’t blame the GP’s


 

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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.

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The New Receptionist and The Team


If you have never worked in a GP Surgery it might come as quite a shock at the amount of people who are involved in running a Practice. There is a lot of staff behind the scenes that are not seen by the general public – but they all play a bit part in the smooth running of the Practice.  Here are some of the staff that you might come across whilst working in a GP Surgery.

THE DOCTORS

  • Family Doctors are general medical practitioners or GP’s
  • Most consultants take place in the surgery, although doctors may visit patients in their home if they are too ill to attend surgery.
  • Usually GP’s will work different hours each day and some will work part-time.
  • Some GP’s will do clinics that they specialise in their local Hospital.
  • On top of seeing patients the Doctors have a pile of paperwork that needs to be completed every day from  signing prescriptions to filling out medical and insurance forms. They often are asked to sign passport forms. All of this takes a lot of their time.
  • Some of the Doctors at the Surgery will head certain parts of the Practice. You might have a Doctor that would be the staff Doctor working closely with the person in charge of staff. Or a Doctor that is the IT Doctor and will work closely with the person in charge of IT. Other areas of the Practice will also have a Doctor involved such as Flu Season and Diabetics/ heart Clinics – they usually work closely with the nurses on these subjects. This usually works well as one Doctor can feed back to the rest of the practice – and its beneficial to staff as their have one person that they can report to rather than several people.

THE NURSES

  • Most surgeries will have a team of Practice Nurses and Health Care Assistants. Most surgeries will offer a full range of treatment room services including injections, dressings, ear irrigation suture removal, smears and blood taking and many more.
  • Some Surgeries have a phlebotomist – which is a person trained to take blood. Often a Receptionist can be trained up to do this.
  • Practice Nurses also monitor conditions such as diabetes, asthma, and blood pressure and may advise well women and give travel advice.
  • HCA’s (Health Care Assistants) will help the Practice Nurse in her day-to-day clinics.

DISTRICT NURSES

  • District Nurses are registered general nurses with a certificate or diploma in district nursing. Their roles include assessing patient’s needs in their own home, checking patients following hospital discharge, giving professional nursing and advice and health education in the community. They can also nurse the terminally ill that chose to be at home rather than in the hospital. They work very closely not only with the patients but the patients family and friends.
  • District nurses work very closely with the practice to ensure that patients receive the best possible care and attention. Communication is vital and you as a Receptionist will be part of that team when passing verbal messages.

 

HEALTH VISITORS

  • Often a surgery will have a team or a single health visitor. They might also have a nursery nurse and they supply support in all areas of childcare, safety and prevention of accidents in the home. They usually hold baby clinics in the surgery which incorporate some of the immunisation programme. They may also hold a number of courses including stress management and dietary advice.

 

MIDWIVES

  • The Surgery might have a midwife. The midwife will normally come in once or twice a week and run an ante-natal clinic for pregnant mums. By having a midwife in the Surgery it means that the pregnant mums can have their checks up at the Surgery rather than keep going to the hospital.

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OTHER HEALTH CARE PROFESSIONALS

  • These may include staff you may meet within the Surgery that might include Clinical Psychologist, physiotherapists, counsellors and dietitians and other healthcare professionals.

MEDICAL STUDENTS

  • Medical students can often be attached to the Practice. Patients will be advised by the receptionist when there is a student sitting in with the Doctor. If the patient is not happy with this please let the Doctor know before the patient goes into the room.

 

LOCUM DOCTORS

  • Locum Doctors are doctors that cover a Practice Doctor when they are on holiday, on a course or off sick for some time.
  • Some Practices use locums on a regular basis and therefore become very familiar with the Practice and become part of the team.

REGISTRAR DOCTORS.

  • These are new qualified Doctors gaining experience in a Practice. A Registrar will usually shadow a Doctor and will sometimes take a clinic on his or her own. Again, you must explain to the patient that they are with the Doctor or working in place of the Doctor.
  • Registrar Doctors unlike Locum Doctors may be at the Practice for some months – therefore patients will ask to see them and they are very much become part of the team.

 

PRACTICE MANAGER

  • The patients will not often see the Practice Manager unless they have a query or a complaint. The Practice Manager is responsible for the smooth running of the practice and will usually do all the accounts HR and payroll. She will work closely with the Doctors to ensure that all areas of the Practice are running as efficiently as possible.  In larger Practices the Practice Manager will often have an Assistant Practice Manager and her own Secretary.

ADMINISTRATION STAFF

  • The Practice Manager might have a Management Team – especially for those larger Practices. The Management Team will often be made up of a
  1. Practice Manager
  2. Assistant Practice Manager
  3. Staff Manager
  4. IT Manager
  5. Accounts Manager / Payroll clerk
  6. Management Secretary
  7. Administrator
  • Some Practices will have more in their Management team – some a lot less.

 

SUPERVISOR / SENIOR RECEPTIONIST

  • Most Surgeries will have a Supervisor or a Senior Receptionist. She/he will take on the day-to-day running of the Reception area. The Supervisor / Senior Receptionist will work closely with the Practice Manager and the staff Doctor to highlight issues around Reception and staff.
  • If you have any concerns as a Receptionist your first point of contact should be your Supervisor / Senior Receptionist. You will usually notify her/him of any holiday that you wish to take – or speak to them in the event of your not coming into work due to sickness.  If you feel the need for any training you should highlight this with your Supervisor / Senior Receptionist.

SURGERY SECRETARY

  • The secretary for the Surgery is usually responsible for the typing of all the doctors’ correspondence. She has a lot of contact with the local hospitals regarding referrals and has contact with patients due to this. She will also have contact with other areas of the health care sector. You will often find that you will be directing telephone calls to the secretary – so be aware of the hours that she does – as often the secretary only works part-time.

CLEANERS

  • The Practice will usually have a cleaner or a team of cleaners. Some Practices employ their own cleaners others use outside contractors. Cleaners are still an important part of the team – their job is important – and very crucial to the safe wellbeing of staff and patients.
  • But, if you are concerned at any time about the standards of cleaning, please do not ignore it; speak to your Supervisor / Senior Receptionist who will bring it to the attention of the cleaner. High standards of cleaning are vital.

And        YOU THE RECEPTIONIST 

  •  The brief outline of staff might give you so idea of what makes a Team at a Surgery.  It takes the whole team to make the Practice a success. Everyone is like a piece of a jigsaw – and when they all fit in together the team is complete.
  • As a Receptionist you will be the first point of contact for the patient either by telephone or when visiting the surgery. Your primary skill will be dealing with people when they might be distressed, or confused, either face to face or over the telephone.
  • You will need to understand the daily workings of your surgery, who works when and where and understand the appointments system.
  • You will need to know who to contact regarding certain issues, how to record a message and how to use your judgement in matters than seem urgent.
  • You will juggle with numerous forms, booklets, lists and sources of information.  Sometimes you may be called on to help a nurse, or act as a chaperone. At times, you will feel you are doing all these tasks at once, and getting grumbled at because you have forgotten to book a patient in, or simply forgetting to make that cup of coffee you promised someone over an hour ago. But please don’t despair if it all seems too much at first. We have all been there and got through it. No-one expects you to learn the job at once; it can take up to 6 months to really start to know your way around all the different systems and clinics.
  • Do not  despair  – but remember PLEASE ask – no one minds how many times you ask – they would prefer than rather than you make a mistake.

Working as a Doctors Receptionist is like Marmite – you either love it or hate it. love it and you will get a lot of job satisfaction from it and will probably be there for years.

Receptionist Training: Taking A Message


In today’s society emails are used as a way of communicating messages. But you must be sure that you know that the person you are sending the email to reads their emails on a regular basis.

Working with Doctors Nurses and other Healthcare professionals over the years has proved that this sometimes email is not the best way to pass a message on.

I have worked with Doctors that simply do not check their emails and of course some messages will be meant for a team rather than an individual – such as District Nurses or Health Visitors. Your practice might have a counsellor or a physiotherapist that only comes in once a week and they might not have access to a computer.

Some of our Reception staff was absolutely great on the desk – but not great on IT skills and a few unable to use email so all of this had to be taken into consideration when passing on messages.

Your practice will have a procedure of passing on messages – ensure that you are fully aware of their protocol on message taking.

The practice that I worked in had several ways of passing messages let me share some of these with you.

The Doctors had a MESSAGE BOOK  that was kept  in Reception at all times. The enabled all the doctors to read the book and take the appropriate action if needed. Ensure that your message book is set out in a clear way. Have a columns for

  1.         the date
  2.        the time the message was taken
  3.        Who the message is for (Dr’s Name)
  4.        And signature of person taking the message.

Another Surgery that I worked in had a message pad instead of a book. The message pad had carbon copies and they could tear off the message and a copy would be kept in the book. Its really how your Surgery best works.

 The Doctors also had a VISIT BOOK that was kept in Reception – this had all the details of patients that had requested home visits. It is vital that you enter the correct
time the call was taken. Your visit book should have columns for

  1.        Date
  2.        time visit was requested
  3.        name address and telephone number of patient
  4.        Contact details of person requesting the visit (ie. family/carer)
  5.        Date of birth of patient (age can be imporant ie elderly/baby)
  6.        Brief details of why the patient needs a
    visit
  7.        Signature of person taking the visit.

 
Receptionists and Admin staff had a RECEPTIONIST MESSAGE FOLDER – general messages to all of the Reception team were put in this book. Everyone had to sign and
date it when they had read it – it was their responsibility to read it every day. Memo’s from various departments were also added to this folder.

All Reception and Admin staff had their own individual staff in trays – any individual message would be placed in their tray for them to read at the beginning of their shift.

All other Healthcare professionals within the Practice all had in trays and messages would be left here and it was their responsibility to ensure that the messages were collected on a regular basis. Some of the various departments had message books like the Doctors and Receptionists – but these books were kept in their tray at all times.

Here are some important tips on how you should take a message.

Every time you take a message over the telephone it is important that you take the following information:
ALWAYS put who the message if for
ALWAYS date and time the message
ALWAYS write the message clearly – someone else has to read it.

ALWAYS get a contact name and telephone number if appropriate
ALWAYS sign your name at the end of the message.

With all messages if you think that the message is urgent always ensure that you pass it onto someone for immediate attention. Do not leave a urgent message in a book or a tray.

Often you may take a message on a Monday and the person the message is meant for is not in for a few days – or could even be on holiday – without a date or time they have no way of knowing when the message was taken.

A message could be used in a court of law. It would be classed as evidence. It would be proof that correct procedure was carried out – if the time, or date of the message is not included your Practice would not be able to relay on this evidence.

It is important to sign the message – if the person who the message is for has a question then they know exactly who to speak to rather than having to speak to several members of staff get before getting the right person.

Try not to put message on “stick it” pad as often they can get attached to another piece of correspondence and often turn up in completely the wrong place and often days or weeks later.

ALWAYS take a contact telephone or extension number from the person leaving the message in case they need to be contacted – never take it for granted that the person the
message is for will have that number. You might even have reason to phone the
person back yourself for some reason.

And it is very important to store you message books or diaries away when they are full – your practice could need this information years after the entry if needed in a court of law.