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Gold, incentives and meh

Having to talk to receptionists about symptoms puts people off seeing GP

Being forced to discuss symptoms with practice receptionists is one of the main factors putting patients off from seeing a GP, research has suggested.

In a survey of almost 2,000 people, which looked at the commonly perceived barriers to seeing a GP, some 36.6% of men and 42.6% of women (40% overall) said that they ‘don’t like having to talk to the GP receptionist about my symptoms’.

The Cancer Research UK analysis, published in the Journal of Public Health today, also revealed that the other main barriers to seeing a GP were difficulty in getting an appointment with a particular doctor (36.5% of men and 47.5% of women reported this) or at a convenient time (40.7% of men and 44.9% of women cited this).

Patients from a lower socio-economic background were more likely to report a number of possible ‘emotional’ barriers, such as worrying about what the GP might find, having tests and talking about symptoms, the analysis found. These patients were also more likely to say they would be put off going to their GP if they couldn’t see a particular doctor.

Not wanting to be seen as someone who makes a fuss was a commonly perceived barrier to seeking help across all patient groups (35% overall).

It comes as earlier this year NHS England pledged that £45 million would be invested over five years so that every practice in the country can help their reception and clerical staff play a greater role in care navigation, signposting patients and handling clinical paperwork to free up GP time.

Commenting on the research, RCGP chair Dr Maureen Baker said: 'While GP receptionists are valued members of the practice team and play a pivotal role in delivering patient care, we understand that our patients would prefer to speak to their family doctor about their health, especially if it is sensitive in nature.

‘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.

But she added that it was 'important to remember that they are not healthcare professionals, and are not in a position to make decisions about our patients' health'.

GPC deputy chair Dr Richard Vautrey said: ‘All receptionists receive training to help ensure that when a patient calls they are given the most effective advice about what appointment they may need, but it is always made clear that are under no obligation to disclose information they are not comfortable with.’

On the issue of early cancer detection Cancer Research UK’s GP expert Dr Richard Roope said that ‘anything that might prevent people from getting their symptoms checked needs to be overcome’.

‘This may mean more emphasis on training front desk staff including receptionists to deal more sensitively with patients.’

Dr Jodie Moffat, lead author and head of early diagnosis at Cancer Research UK, said there was 'still more to learn about the things that may put people off going to their doctor, and how important they are when it comes to actually influencing behaviour'.

She added: ‘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. The chances of surviving cancer are greater when it’s caught at an early stage, before it’s had a chance to spread, and seeking help sooner rather than later could make all the difference.’

The analysis, ‘Identifying anticipated barriers to help – seeking to provide earlier diagnosis of cancer in Great Britain’, forms part of Cancer Research UK’s Cancer Awareness Measure (CAM), which is a set of questions designed to reliably assess awareness of cancer among the general population.

Readers' comments (18)

  • Well in an ideal world....

    Unfortunately there is not, and never will be, enough money to make this a reality

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  • There is no money left as one wag put it.Soon they will be saying there are no GPs left!

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  • Vinci Ho

    Listening to the arguments on BBC news just now , nobody seems to have touched the core : this phenomenon is simply one of the manifestations of the current crisis in general practice , which is exactly fundamental to why we are fighting against the government(s) up to now. Wanting to stretch the resources even thinner exactly results in this kind of 'triage for overcompensation' at all levels , GP reception is only one of them.

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  • But then how do you make sure that patients go to nurse /Advance nurse practitioners for minor illness? They do not need to see GP& GP time can be best utilised for more complex medical conditions.
    Everybody wants to see GP & Putting posters in reception area about educating patients has not worked.
    If there was a different charge to see GP and nurse this problem will be solved in no time as then onus is on patient to book appointment with appropriate health professional and if he has any doubt he / she can questions as to whom should they book appointment with?

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  • Study finds way to reduce demand - GP receptionists. Better employ a few more!

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  • All arguments are signs of weakness. If 30 people want to see me tomorrow at 10:00 then due to the positive mindset I have from the RCGP I can not only see them all at the same time, but deal with their multiple issues all at the same time. If I then do that 24/7 then I can deal with literally 1000s of patients per week, and I will even pay them to see me. If we all do this Jeremy please can we have a gong.?I will see 40 people per 10 minute slot if you give me a knighthood (or I could do a mindless job as a government aide and get one whatever!)

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  • "Dr Jodie Moffat, lead author and head of early diagnosis at Cancer Research UK, said there was 'still more to learn about the things that may put people off going to their doctor, and how important they are when it comes to actually influencing behaviour'"
    So why in the name of all that is fair did this badly reported piece of nonsense get released. How do you think practices could survive without receptionists - and why add to the (often unfounded) worries of people wanting to see a doctor.
    Like every area of healthcare, there are good and there are not so good - doctors/nurses/porters/managers/cleaners/phlebotomists and yes, receptionists.
    This bunkum news story does nothing to help the dispirited admin teams in many practices - who now shoulder the burden for people not getting their diagnosis - and by implication their care and treatment - and thus causing hundreds of early deaths.
    Nothing to do with poor hospital pathways then.

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  • There just aren't enough GPs, it's no good just blaming the receptionist who happens to be on the front line. But then, what do I know being a mere 'back office function' making everything inefficient and hindering new ways of working.

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  • As an ex-receptionist I find articles like this, more in the general press and on TV than here, incredibly frustrating, annoying and depressing. As I’m sure is the case in a lot of surgeries, the Partners here have set up the protocol that receptionists ask for a reason so that a patient can be guided to the most appropriate clinician, but make it clear to all patients that if it’s personal they don’t need to give a reason.

    In an ideal world with lots of extra GPs and unlimited GP appointments they’d love to give every patient an appointment straight away, which would mean that no one would need to be asked. And GPs could have a morning of chest infections, smears and BP checks. Of course, then you wouldn’t need as many Nurse Practitioners, Practice Nurses and HCAs.

    It’s a thankless job at the best of times, and this kind of press doesn’t make things easier. I wouldn’t go back to being a receptionist if I was paid double what I get paid now. I’ve had enough of crying when I get yelled at and sworn at by patients who don’t get what they want, especially when it’s usually a GP who made the decision that I passed on to the patient.

    Patients are still living in a world of Peak Practice (and probably some of them Doctor Finley) and the real world isn’t like that anymore. And to be honest, I think a lot of GPs don’t realise what a tough job it is as they’re often in their room at the end of a corridor rather than in Reception listening to the abuse that receptionists get.

    Gone are the days that patients can be removed for bad behaviour, unless you have a crime number, however many posters about Zero Tolerance you put up.

    And I’m getting cross so I’m off to have a cup of tea and a biscuit!

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  • Russell Thorpe

    Early diagnosis not only saves lives it saves money. The move towards Doczilla is not going to improve early diagnosis for all the factors included in this article, not that anyone in a position of authority cares. If outcomes and service were a key performance indicator for SOS and DOH we wouldn't be going down this path.

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  • I quite agree with the ex-receptionist above.

    My reception team are paid just above the "living Wage". It is stuffed from 8am to 6:30pm (and some nights to 8pm). It is not a well paid job, and they rarely get any appreciation. They do not need unrealistic publicity such as this from a condition specific interest group (Cancer network do a lot of good but they are, after all only interested in cancer. We, in general practice have a lot of other things).

    Why don't I pay them more, you ask? Well, if I give my reception staff a pay rise of just £2/hr each, my drawing will plummet to a point where I would be better off shutting shop and working as a salaried GP.

    Perhaps, UK as a nation need to re-educate themselves. We are not in a financial position where patients can choose to see who they like. We can either agree to pay triple the current tax or manage their personal anxiety to access the right care at the right price.

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  • This is down to patient perception. Reception staff are not merely call handlers they are a vital part of the practice team. It needs to be made clear to patients what their role is and that it is necessary for them to access patient records in legitimate circumstances and to support patients in accessing the right support since there is so much more available than just a GP. If a practice has an issue with gossiping receptionists then deal with it under the practice's information governance/ confidentiality policy.

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  • where are those patients who are put off?
    one patient made appointment and wanted me to do hgv exam. one wanted full insurance exam. reception have access to full notes any way so where is problem of secreacy ? may be if patient had ED or depression then he/she can say complaint is of personal nature and reception will not ask any more.

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  • Simple partial solution might be to provide a list of problems. Tick a box and get triaged accordingly. List wont necessarily cover everything but is a start.

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  • My receptionists are all professional, patient centred, trained in confidentiality, pragmatic and have the intuition which comes only with experiencing real people and their real problems daily. It baffles me why anyone would decline to disclose the basics of a consultation request with them, but be happy to blurt out their most intimate secrets online on patient fora and social media. It's about time medical administrators and receptionists are given the credit they deserve. I wouldn't want to do it.

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  • Anonymous | Work for health provider-11 Oct 2016 12:06 pm and
    I agree with you, GP receptionists are blamed for anything and everything. It is GP's business hence GP needs to take lead to protect their receptionist from vile aggressive patients and protect from rottweiler receptionist. I hear many time oh, Dr is nice but shame about the receptionist...!! If it is real private business would the GP hide behind receptionist?
    Same goes with the patients- Patients have to understand that the receptionists are not just the dolly-birds sitting there to make it difficult to see the doctor and take abuse thrown at them from patients. If it's routine appt. pt does not have to give reasons but if it is an emergency then they should tell the receptionist a brief account. Patients will be surprised how astute these properly trained receptionists are. They can spot the emergency and they can alert the doctor or a nurse and can even save lives.
    I made receptionist to apologise to patient and also patient to say sorry to the receptionist when they had overstepped the mark. I was hammered in to me that it's my business, receptionist work for me so I take care of them and also it's the patient who pay our wages being on our list so I respect them.
    -We have a notice in the waiting area and at reception desk: "TREAT AS YOU WOULD LIKE TO BE TREATED"
    As there are awful receptionist there are awful Patients and awful doctors (that includes hospital consultant too)

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  • I wonder ... does the NHS have a plan to get rid of private GP's?
    If they make the GP's work almost impossible, then bring in GP's from overseas, that will work direct for the NHS, then they will have GP's under their control, abide by their contract and do whatever they are asked to do.
    Clever move indeed ...

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  • We aren't the gatekeepers any more, the receptionists are. Those that get through demand everything and complain if they don't, se we are the well oiled turnstiles.

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