Receptionists tempted to help – by rationing access covertly and unethically? Confidentiality compromised..

As the pips squeak more and more in primary care provision, different ideas for limiting access and unnecessary appointments will be tried in a “free” system. A disincentive to make a claim is used by insurers (co-payment and no claims bonus), and the shaming of explaining depression or fear of a sexually transmitted disease will certainly do this….. The potential compromising of confidentiality is justified in some circumstances. In the third world patients queue in lines, and often explain symptoms in public… As standards decline could we meet the third world compromise? We do not know the make up of the group surveyed, but since it was a cancer charity it suggests that even for cancer patients symptoms have to be known by receptionists to get access. We have rationed staff, doctors, nurses etc…

In our local Hospital, confidentiality is a laugh… A doctor is admitted and the whole profession knows within 24 hours; often the diagnosis as well. General Practice has avoided this pitfall up to now. 

Image result for confidentiality cartoonBBC News reports 11th October 2016: Receptionists quizzing patients about why they need to see their GP could be putting some sick people off visiting their surgery, a survey suggests.

Of almost 2,000 adults questioned for Cancer Research UK, four in 10 said they disliked having to discuss their ills with office staff in order to get an appointment.

Many were worried about making a fuss.

Experts say patients must be forceful and not take no for an answer if they have symptoms that need investigating.

The government says it is funding training to help receptionists learn how to be sensitive to patients’ needs.

Probing questions

Receptionists are the first point of contact in primary care and it is their job to decide which patients should see the GP and how urgently.

They do a vital job, but feedback from patients reveals some can be off-putting.

In the survey, the top three barriers to seeing a GP were:

  • difficulty getting an appointment with a particular doctor (41.8%)
  • difficulty getting an appointment at a convenient time (41.5%)
  • dislike of having to speak to the GP receptionist about symptoms (39.5%)

Around a third of the patients interviewed were also concerned that they might be negatively viewed as the type of person who makes a fuss, the Journal of Public Health – which published the survey results – said.

Lead researcher Dr Jodie Moffat urged people with symptoms to “grab the bull by the horns” and seek help rather than suffer in silence.

“Don’t let yourself be put off. Make that appointment,” she said.

“Be forceful. I know that’s easier said than done. But it’s clear that a new sign or symptom, or something that has stayed or got worse over time, needs to be checked out by a GP.”

Worrying symptoms that need a medical opinion include bleeding, a persistent cough, a change in bowel habit and unexplained lumps or swellings.

‘Onus’ on receptionists

Dr Moffat said: “If you find it hard, ask a friend or a relative to make an appointment for you. Or go online. Lots of GP surgeries now take online bookings.”

Prof Elizabeth Stokoe, from Loughborough University, recently carried out a study that listened in to the conversations of patients and GP receptionists.

She found patients often had to drive the conversation to get answers.

“The onus should be on the receptionist to provide all the information, but often it is the patient who has to push to get it.

“If they don’t push then they get no service at all or they desperately scrabble to get their voice heard.”

‘Smooth running’

Dr Maureen Baker, chairwoman of the Royal College of GPs, said doctors understood that their patients would prefer to speak directly to them about their health, especially when it is something sensitive or embarrassing – but it is not always possible.

“With GPs making more patient consultations than ever before – 60 million more a year compared to five years ago – GP receptionists ensure the smooth running of the practice and do their best to help patients see a particular GP at a suitable time for them,” she said.

“However, it is important to remember that they are not healthcare professionals, and are not in a position to make decisions about our patients’ health.”

Earlier this year, NHS England announced new funding towards training receptionists, among other things.

The first £5m out of the total £45m General Practice Forward View fund will be made available to practices this autumn.

Image result for confidentiality cartoon

GP fears losing job over pledge to keep patient data private

Referral Scrutiny by CCGs , LHBs and Trusts may cut costs, but delays care, breaches confidentiality, and reduces professionalism

Yet another trust bites the dust.. and the media fail to recognise the overall implications..

Your notes are the property of the secretary of state – but he has never had them before until after death. Now he and the PM want them and their “data” before death.. is any IT handling safe in government hands?

Data Protection and the UK Health Services

9th October 2016: Dozens of NHS hospitals targeted by cyber blackmailers

BBC News 7th July 2016: A nurse has been sacked for looking at patients’ private hospital records in west Wales.

Hywel Dda University Health Board, which runs services in Carmarthenshire, Ceredigion and Pembrokeshire, has apologised to everyone affected.

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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