Life as a GP practice manager

[Janey Dal]

Brilliant news on your vaccines Marilyn! By now you should have had them. I'm so pleased for you, it makes you feel just a little bit safer.

We are well on with our group 4 which is 70- 74s and patients of any age in the clinically extremely vulnerable group. We should be finished them by the end of next week.

We have had permission to vaccinate police officers BUT only if we have vaccines left at the end of the day and there is literally no other patient we can get down to the practice. This makes my blood boil!

Police officers are at higher risk than I am. What a total farce the rules are.

Meanwhile I am in a war of attrition with a patient who did not get a card when he was vaccinated. He is complaining. The cards are like business cards ie a bit of card with some writing on and were originally meant to remind patients when their next vaccine would be due. But that was when the vaccines had to be between 3 - 4 weeks apart so that has gone out the window.

We can't order enough cards because there is a national shortage , and really they are a bit of card with some hand written information on them. They mean NOTHING!

Well this guy didn't get his card when he had his jab and is proper upset about it. I advised him via the Receptionist that he could get it when he came for his second jab. This apparently is not good enough so he went to the CCG to complain who took the same stance as me.

So now he has emailed me demanding his card is posted out to him. Well I'm NOT! I'm ignoring him!

He is generally a very pleasant, if pedantic, patient and I have responded to him on several occasions but this one is a step too far.

I am working at a stress level at times that is unbelievable and he thinks his bloody card is important .

[maz]

He might think he will need the card at some point for proof he has had the vaccines. Maybe for flying, cruising etc. if he is in that age group to do so.

[Janey Dal]

You are too kind Marilyn! He is a very intelligent man who I suspect is frustrated with retirement! He is very pleasant when I have spoken to him before but is very demanding and pedantic. For example because he has not received a response from me to his emails he has been on to the CCG again this week! I have given him a solution to his problem but he doesn't like it. My problem is that if I jump to this demand (it is his third of similar ilk in the last year) he will then move onto something else.

You raise an interesting point however Marilyn in that it seems likely that some kind of proof of vaccination will be required for travelling (for example) in the months to come. I find this quite amusing because I have no doubt that many of the people who are against the vaccine will suddenly change their stance if they find their holiday to Benidorm is off limits without a vaccination .

Meanwhile we continue to be battered with ludicrous vaccine delivery schedules by the NHS. On Tuesday evening we were told we were getting 2,000 Pfizer vaccines delivered on Thursday of the same week. Luckily we were able to head them off at the pass. We simply CANNOT mobilise a vaccine clinic for that number of vaccines (to be administered within 3 days of delivery because it is the Pfizer vaccine) at such short notice.

Remember we are trying to still deal with poorly patients. The only way we could have vaccinated with that number of vaccines would be to cancel all booked appointments that week and work Saturday and Sunday. But this is what is being thrown at GP practices.

I genuinely think that GP practices are the victims of their own success. We have done so well delivering the vaccine thus far that the government think we can continue.

We can't continue to function at current levels of demand for much longer. And my argument is that if you are a healthy under 60 year old who rarely visits your GP, why should your GP have to vaccinate you? These are the ideal patients for a mass vaccination site.

Rant over .

[maz]

You did do a great job Jane, and I know will continue to do so. But yes, not at the level you have been. Your patients should also be receiving letters from the NHS vaccination part to invite them to your local mass vaccination centre(if you have one) I guess though they would rather just come along to the surgery which is closer. Maybe you will have to encourage them to travel further somehow, how I don't know.

Whilst I initially, and for obvious reasons, wanted to have my vaccine at our very local GP practice, that was a knee jerk reaction at the time of finding out we would all have to travel somewhere instead(I always have knee jerk reactions ). In the end I have to say our Harrogate GP's have done an amazing job. They grouped together to organise it at the Showground, though still organising their own patents' vaccination invitations. The NHS mass vaccination centres are a separate entity and people in our area began receiving invitation letters from them to go to our nearest one, York in our case. This caused much confusion and upset to those older than us as it all just happened with no prior 'warning'. Plus when queried, the relevant NHS folk just said there was no vaccination centre in Harrogate! After a couple of days the one hand told the other hand what was happening and things were explained. We could go to either, which ever was suitable for us, or quicker, just ignore the one you do not wish to attend and book at the other. Our area is on to the 65-70's this week. The set up is fantastic with loads of volunteers, from car parking, herding, information collecting, seating, vaccination giving, to waving you off, it is so well organised. Only thing missing was a cup of tea The nurse who gave us our vaccinations had been working at the local hospital but resigned so she could do this for the foreseeable future, just to 'give something back'! I am sure it is still giving a lot of extra work to the GP's, but at least I don't think they are having to do the actual vaccinations, though some might of course and I do wonder if they did their own Nursing Home patients, not sure. I guess the centre will be up and working for some time, and soon will be dealing with 2nd vaccinations too. Our 12 weeks is up at the end of April.

As far as proof we have had our vaccinations, I wonder in the future if some jobs will need proof, as well as some forms of travel. I guess like those 'medically exempt from wearing face masks' cards you can print from the internet, you will be able to print 'proof of vaccination cards'!

[Janey Dal]

You can already print them from the internet! Which is why I am not giving in to Mr Pedantic! This was the NHS solution to help GP practices with the shortage of cards because we've all got time to download a page of cards printed on paper and cut them out haven't we ?

Your confusion at Harrogate and York doesn't surprise me - I doubt it surprises you either. In this day of the ability to contact anyone immediately via phone or email has not improved the NHS' ability to communicate.

And to add to my point about sustainability of this initiative by GP practices - I have a day off today - simply because I refuse to lose my annual leave and I have 3 days left to take before the end of March. I spent most of the morning on the phone to work.

And no I don't mind - it was supporting some very hard working staff who needed some guidance over the ever changing rules and regulation around the COVID vaccine clinics, but we can't all keep doing this at this pace. We are dealing with staff shortages due to people isolating due to family members being in contact with a COVID positive person and people taking annual leave. Everybody is getting very tired.

The problem is that the deliveries are on a 'push' rather than 'pull' basis ie they tell us how many vaccines they are delivering and when instead of us being able to organise clinics weeks in advance and ordering the correct number of vaccines to complete them. So we are permanently organising everything at the last minutes.

Oh and Nick Hancock choses this moment to announce a reorganisation of the NHS . What an idiot!

[Janey Dal]

So this week brought a message from one of my receptionists who had put the phone down on a patient who called her a 'stupid cow'. The staff are all told NOT to accept this level of abuse and to advise the caller they are terminating the call and do so. Not a problem then.

I listened to the phone call in order to write to the patient to advise that this was not acceptable and that she was on a final warning and if her behaviour was repeated then she would be removed from the list. Meanwhile the patient rang back and asked to speak to me to complain.

She was called Courtney - not that I would judge anybody on their name . She said she was complaining because the receptionist put the phone down on her.

I said: "The receptionist put the phone down on you because you called her a stupid cow. That is what they are advised to do if patients are rude to them."

Courtney: "I did NOT."

Me: "I've just listened to the phone call and you did". They are advised in the opening information on the call that all calls are recorded.

Some backwards and forwards chat ensued culminating with Courtney advising me that she didn't like my attitude to which I replied:

"And I actually don't care about your opinion. If you speak to staff like that you deserve all you get. Goodbye!"

Courtney then put a rude message about the practice on our website .

[maz]

Do you have a way to reply to such messages on your website Jane? Or do they get deleted? I know it is only a small, but growing, minority, but the world can seem so ugly with some people behaving that way. I am sure you get many more appreciative comments, personal or on your website, to counteract the nasties.

I do love how you support your staff the way you do.

[paul...m]

Well done Jane . No need for rudeness . I have had customers in passed that have been rude or disrespectful . They are all ex customers now .

[Janey Dal]

We can respond to the posts on the website but that is all. To be fair many of them are so badly spelled and rambling that there is little need to respond because the complainant shows themselves up. It is frustrating though!

And sadly we rarely get good comments because, as I am sure you are aware, people are quick to complain but slow to compliment. I am however proud to say that we are probably the best GP practice in the town. But we work hard to maintain that.

And then on Friday I was called down to reception because a patient (about 70 years old) had told the receptionist to 'just do her f****** job'.

He argued with me that it was 'just a word' and I said 'would you like it if they said that to you?" He said he wouldn't be bothered.

Me: "Well obviously our standards are higher than yours". He then called me a stupid woman . He's getting kicked off the list on Monday for swearing at the staff.

And yes I do support the staff. They take some serious abuse at times and can't respond. I can. And I do. I really hope that it helps them to stay calm because they know I have their backs. Don't get me wrong, if they were in the wrong I would tell them. But in all the time I have been there and with all the calls I have listened to, on no occasion have I had to speak to a member of staff about their handling of a call.

And I agree with you Paul! Being polite and respectful gets a much better response than shouting and swearing.