Managers Training: The Other Side of the Desk


When managing staff it is always good to give them feedback. Yearly appraisals are a good opportunity for this but why leave it once a year?

Here is a little exercise I used to carry out on my Reception staff.

Sit in your Reception area at the busiest time of day. Observe what is happening in your Reception area – see how the receptionist deal with patients how they cope with the busiest time of day and how they copes with the pressure that the busy time can bring.

Put yourself in the place of a patient – see it from their eyes and ask yourself how do they see our Surgery?

Have a note-book with you and take notes – but the most important part of the exercise is not only to pick up on any negative issues but also highlight the positive issues too.

What should you be looking for:

  1.  Is patient confidentiality being broken? Can people in the waiting room hear conversations from the Reception Desk? Patient confidentiality it vital in any Practice – and more so at the front desk.
    People in the waiting room can often hear conversations at the front desk. Make
    sure you staff use as little personal information as possible. Make sure that
    all your staff has the appropriate training on Patient Confidentiality. (see
    blog on A Quick Confidentiality Checklist. http://t.co/S3E94mU8)
  2.  How does the Receptionist interact with the patients? Do they have good eye contact? Are they polite and always helpful? It is easy to be short with patients when you have a queue of people at the front desk. Training in dealing with such times is vital – train your staff in dealing with such times –
    how to move patients on quickly without being rude or appearing that they are
    not caring. A smile and a thank you go a long way.
  3. How does the Receptionist answer the phone? Is it answered quickly enough? Does the Receptionist deal with the call efficiently? Always make sure that your staff answers the phone with good morning/good afternoon – the name of the surgery and their own name. Staff than give their name takes ownership of the call more than those that do not give their name. Again, if they are in ear shot of the waiting room it is important that they remember Patient Confidentiality.
  4. What are the other staff doing whilst the busy time is happening – are they helping out?  Often in Surgeries you have Receptionists at the front desk and others doing other things such as admin, typing, prescriptions – have you got a contingency plan for such busy times – if someone is busy on the front desk or on the phone do you have someone who can come and help out for short periods of time.
  5. Can you hear conversations between Receptionists behind the desk? When the quieter times come Receptionists often will have a little chat – but they should be made aware to be careful on what they are chatting about – I had an incident where 3 Receptionists were discussing a TV programme that was on the night before. They were discussing the programme about Breast Cancer and about a lady having terminal Cancer – they talked in-depth about the programme – talking about people who had lost relative/friends to the horrible illness. What there were not aware of was a patient was sitting listening to them in the waiting room that had just recently been diagnosed with Breast Cancer – she found the conversation very upsetting. Whilst I was doing
    this exercise I also heard Receptionists discussing an issue that could have
    upset a patient in the waiting room.
  6. Is the Reception area being kept clean and tidy? It is important to
    keep your reception area clean and tidy. Not just for a good impression but for
    Health and Safety reasons too – magazines, children’s toys left lying around on
    the floor is dangerous – someone could easily slip and fall.
  7. Are the patients kept waiting for long periods of time (often a problem in surgeries) This unfortunately happens in every surgery. Observe how your patients feel about it – and how your Receptionists deal with the patients if they come back to the desk to complain/enquire about their appointment running late. Do you have a policy on Doctors/Nurses running late?Do you have a surgery policy about Doctors/Nurses running late?

After you have done your observation bring them to your next staff meeting.

I always find the best way to approach this is to tell your staff that it was not an exercise to “catch them out” but an exercise to find if and where improvements can be made.

Always start with the positive notes you have:

  •  How well you thought the receptionist dealt with a certain patient/incident.
  • How good their telephone manner is.
  • How lovely and tidy the reception areas looks.
  • How pleased you were to see others helping each other at the
    busiest time.
  • How good they are with dealing with confidentiality.

Then

If there are any (and I am sure there will be) go onto the negative things that you found – discuss them and ask your team to give their opinion. Ask if there is a better way it can be dealt with. Include them in any decision-making. Include them in your findings.

Staff do not like change so I always used to say – we can change it, try it and if it does not work we can look at it again.  This always used to work.

Make minutes of the meeting – ensure that you record any changes that are going to be made and ensure that everyone has a copy – including those that were unable to attend the meeting.

Turn those negative into positives.

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.

Repeat Prescription Collection


Repeat prescriptions are a big part of the daily workload in a GP Practice. Patients depend on getting them on a regular basis and it is vital that they are correct and issued within the 24/48 hour practice policy.

Patients have never had it easier to ensure that they get their request for a repeat prescription in on time for it to be ready for them to collect. Here are some of the ways that patients can request a repeat prescription (not all of these options might be suitable for your surgery)

  • Bringing the repeat prescription into the surgery 24/48 hours prior to collection (and if the surgery is closed the repeat prescription can be posted through the letterbox)
  • Dropping off their prescription at their local chemist who will then bring the prescription along to the Surgery.
  • Having their repeat prescription delivered to their local chemist for them to collect
  • Requesting a prescription via telephone (not all surgeries have this facility)
  • Emailing a request via the Surgery email (not all surgeries have this facility)
  • Sending in a request through the post (ensure that patients enclose a stamped addressed envelope for its return)

The above has made it a lot easier for patients that are working to be able to request their repeat prescriptions in time – a visit to the surgery is not always necessary.  Most Surgeries are opened from early morning to late afternoon/evening to enable patients to collect repeat prescriptions, and if this is not suitable the patient can provide a stamped addressed envelope for its return.

So, why is it that patient STILL continuing on a regular daily basis to come rushing in demanding a repeat prescription there and then?  As a Receptionist you will know exactly what I mean. You will find the patient will stand at the desk demanding their repeat prescription, and telling you that if you do not give it to them NOW they will probably die! Yes it happens, and of course we are not in a position to refuse them their medication and the patient knows that.

And what you will find it will be the same people month in and month out that are doing this every time, and more often than not it will be people who are not working and have plenty of time to come in on other days – preferably with plenty of notice.

What the patent does not realise is the extra work that this “urgent” repeat prescription can cause.

One Surgery that I worked in could have up to 160 repeat prescriptions to process ever day. This would involve a prescription clerk processing the prescriptions, flagging up any queries with the doctors, phoning hospitals to query changes to patient’s medications, and updating the computer system for patients that needed to come in for checks i.e. Asthma, Blood Pressure and Diabetics etc.

The prescriptions would then have to be checked and signed by the doctor and when that had been done them all files into alphabetical order ready for collection. This is not a 5 minute job.

So, when a patient comes in demanding their prescription there and then this is what it takes to get this prescription done

  • The receptionist will have to generate the prescription which means that she will have to put aside the work she is already doing.
  • The Receptionist then has to go and stand outside a Doctors room to wait on a patient coming out before she can ask the Doctor to sign the prescription. Any Receptionist having to do this will tell you that they could be standing outside a room for anything up to 15 minutes.
  • This then makes a shortage of receptionists in reception – causing patient to wait longer to be seen or worse still the telephones not being answered.

And what is unfair is the patient that is not following Practice policy is actually being put first and those patients that are following the policy are waiting 24/48 hours when in fact they could have done exactly the same thing.

How would your Surgery cope if you had half of your patients demanding repeat prescriptions in such a way?

This was highlighted as becoming a problem in one of the surgeries I worked in. The Receptionists seemed to spend more time standing outside the Doctors rooms waiting on “urgent” prescriptions being signed, and the Doctors were getting pretty fed up being asked to sign and check these requests on a daily basis.

I discussed this issue at a Team meeting – and it was agreed that we could not refuse a patient their prescription as they needed their medication. And we all agreed that there were often genuine cases where people had run out and not realised it and these we fully understood – what we needed to try to solve was the same patients that were coming in on a regular basis demanding their prescriptions there and then.

So, we agreed on a policy which we implemented and it worked.

We agreed when a patient came into the surgery “demanding” their repeat prescription that we would explain our policy of 24/48 hours notice, but would tell the patient that on this occasion we would get their prescription done – but it would not be ready until after 4.30 that same day.  This meant that the patient had to come back to the surgery to collect the prescription and hopefully make them think twice next time and hopefully start using the correct system.

Of course we would not have done this is someone did have difficulty getting back, or if they were disabled  – but it was not these patients that were causing us the problem  – it was often fit or young patients that could quite easily come back later on that day. It was not our aim to refuse or be difficult but to try to re educate these patients so that everyone was given the same service.

To begin with we had patients that were not happy – after all they were used to getting it done there and then. But this system did work – those that were genuine were only too happy to call back again at 4.30 and those that were taking advantage soon realised that perhaps they should get their repeat prescription in 24/48 hours earlier.

Within a couple of months the only requests we got were from the odd few patients that did have genuine reasons to request as urgent prescription.

A Cry For Help


It was a normal Wednesday morning and it was getting towards lunchtime. There was a Health Visitors Clinic going on at the time and there were mums and dads in the waiting room with their little ones waiting to be seen.  Often this clinic overrun and we would have to close for lunch leaving the Health Visitor to let the patients out of the building.

Most of the doctors had gone out on their visits – there was one just finishing off his paperwork at the back of reception. Some of the receptionists had taken an early lunch, so it was me another receptionist and the Practice Manager who was in her office.

Five minutes before we were due to close the Surgery for lunch a young lad about 23 years of age came up to the reception desk. I could tell that he was very agitated – he asked to see a Doctor.

I knew that the doctor doing his paperwork had visits to do and a full surgery to come back to that afternoon and would not appreciate being asked to see this patient at this point – I felt sure it was not urgent. The Doctor was in the background and could hear the conversation and did not intervene so I felt right in explaining to the young man that there were not doctors available at that time as they were all out on their visits.

I checked on the computer and saw we had a cancellation later on that afternoon for 4.30. I asked the young man if he would like that appointment. He started pacing the reception area cursing and swearing.

He then started to shout and throw his arms around – I could see the patients in the waiting room ushering their little ones towards them. They started looking worried. It was obvious that this patient was getting very aggressive and giving some cause for concern.

At the point the Doctor doing is paperwork picked up his visit sheet and left the building! The other receptionist went to the back of the reception area and telephoned the Health Visitor who came and took the patients in the waiting room into her office.

All of a sudden was alone in the reception area with this young man – who was now getting more angry and aggressive. He was shouting that he needed to see a Doctor and NOW! He then went to rip the telephone off the wall shouting if he didn’t see a Doctor immediately he would go outside and throw himself in front of a car.

He started shouting that he needed to call his girlfriend but did not have any money. He then slammed into the telephone on the wall again.

At this point I had to do something – I was hoping that the other receptionist had gone to the Practice Managers office and they were phoning the police and the duty doctor on call that day. I hoped that no one else would come into the Surgery at that point.

But at this moment in time it was me and him, and I had to avoid any more damage or worse.

The only thing I felt I could do was talk to the young man.

In a firm but soft voice I asked him to come and talk to me – I was thankful for the high reception desk that was between the two of us.  I also stood back so he could not grab me over the desk.

I told him if he stopped I would let him use the reception telephone. He stopped and asked if I would let him use the phone.  I passed the phone over to him and he dialled his girlfriend.

He spoke to her and she obviously calmed him down. The call finished and he handed me back the telephone and said thank you! He was starting to calm down.

I asked him if he was ok. He started crying. He then poured out his troubles – he had been taking drugs and had been trying to come off them and was finding it very difficult. He had a young daughter who he was not allowed to see because of his drug habit and because of her he was trying to be drug free. He had a row with his girlfriend that same morning and she had told him that it was over between them. He had just come to the end of his tether.

He said that he had spoken to his social worker that morning and she was not of much help (I did not go into details) and he felt that everyone was against him, and he needed help. But no one was helping. He felt that he needed drugs to get him thorough this, but he was fighting against it – but said he didn’t know how much longer he could do so he said he was really struggling. He felt by threatening to throw himself under a car that someone might do something to help him. He said that he would do it if it  would get him the help he needed.

I actually started feeling sorry for this young man – he was screaming out for help – I admit not going the right way about it – but it was obvious that he was frightened and very confused at this point.

I started chatting to him (I cannot even remember what the conversation was now) but he seemed to calm right down. I stood there with him until the duty doctor came back and took him into his room.

The police arrived shortly afterwards and after speaking to the duty doctor decided they were not going to arrest the young man.

The doctor admitted the patient into the local drug rehab centre for 2 weeks – the doctor said that the young man was almost at breaking point.

After lunch all was calm and everything back to normal.

Then three weeks later I was out the back doing some admin work when one of my colleagues called me and said that there was a patient at the desk asking for me. I went up to the desk and there was the young man. He  said that he wanted to thank me for all my help when he was in last. He said that all he wanted was someone to listen to him and that I had been the first person to have done that. He apologised for the upset that he might have caused and promised that it would never happen again.

He went on to say that he had got fantastic help and support in the drug rehab centre and the doctor here in the Practice and for that he and his girlfriend were on great terms and he was in the process of agreeing access to seeing his daughter. He was one very happy man.

He then presented me with a box of chocolates.

Whenever that young man came into the surgery from that day on he was always pleasant, friendly and very polite.

Sometimes people just want to be listened to and not judged.

Of course it could have turned out a lot worse. Does your Practice have a protocol on dealing with such an incident? Have your Receptionist had training on dealing difficult situations?

Does your Reception desk have a panic button?

 

 

How do you give out repeat prescriptions at your Surgery?


Do you keep them 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 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.

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. If necessary a phone call to the patient to ask if they still need the letter, and according to their reply the necessary action taken
  1. Inform their GP that the letter has not been collected so they can follow this up.
  2. 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.  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?