Life as a GP practice manager

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sun Oct 31, 2021 11:20 am

Glad to hear it Marylin :lol: :lol: .

You make a good point on people not recording test results. I also think that many people who have mild symptoms are not having tests because they can’t afford to be off work. I can’t really blame them although it’s not right. But if you are on a zero hours contract and have kids to feed, what do you do?

Our latest bugbear at the practice is patients who tell us that they haven’t got COVID. If they ring for a face to face appointment and have symptoms we tell them to go and get a PCR test and ring back. “Oh it’s not COVID!” they say :roll:. If only it could be cured with denial, half our patients would be fine :lol: :lol:. I hasten to add that if they need a face to face appointment and are too ill to wait for a PCR test we send them to the ‘hot clinic’ which is set up to see COVID+ patients.

Then there are the other ones who tell us that they have had a PCR test. “Well it’s not showing on your record” they are told :roll: :roll: . They don’t realise that we can see if they’ve had a PCR test. God loves a trier.

The cynical and sad part about this is that if they phone up wanting a face to face appointment and are symptomatic, once they are told to go and get a PCR test and ring back, many don’t bother. So it was never that urgent in the first place.

I do wonder at what point patients realise that GP appointments are a finite resource. I may have said before that I had one patient complaining because they were struggling to get an appointment, having patiently explained the situation they continued to say it wasn’t good enough. So I asked “What do you suggest we do Mrs Blah-di-blah?” . Her reply? “Have more appointments!” :roll: :roll:

I will paraphrase a well known observation - everybody is a practice manager :roll: :lol: .

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maz
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Re: Life as a GP practice manager

Post by maz » Mon Nov 01, 2021 9:24 am

It must be so wearing for you folk front line dealing with people with no scruples :roll: . Roll on endemic equilibrium! ( I watched a video :wink: :lol:)

I get you on the reason some don't register test results due to money issues. It is a difficult situation, illness always is in these cases. But at the moment of course much more worrying.
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Mon Nov 01, 2021 11:20 am

Endemic equilibrium! Love it! :D :D I had to look it up mind! It’s interesting that I read an article, I think I posted about it on here, that said pandemics historically last around 2 years and then the virus that caused it becomes endemic.

They last 2 years without human intervention although the vaccines have obviously stopped more people dying. Apparently the theory is that the human race becomes more immune and the virus becomes less virulent. The two things together help stop the virus being as deadly as previously. We learn to live with it like we do flu.

People often forget that thousands of people die from flu every year. We aren’t frightened of it though! But let’s be utterly honest here: something has to help curb the population growth. And again viruses tend to target the most vulnerable people. But isn’t this just the circle of life? We are just animals and wild animals lose the weakest through predation.

Food for thought.

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maz
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Re: Life as a GP practice manager

Post by maz » Wed Nov 03, 2021 9:38 am

We do become a bit more concerned about catching flu when we get older, and of course those with respiratory or heart issues even more so, but generally yes, people in general aren't over bothered with flu. Plus the vaccine helps(we think :wink: )
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Thu Nov 04, 2021 11:39 am

It’s interesting to compare the flu and COVID vaccines I think. Even after all these years the flu vaccine changes every year to become more effective. We have different jabs for the over and under 65s now because they have proven to work better. The development of the COVID vaccine is still very much in its infancy in comparison.

I was watching an interview with Jonathan Van Tam on the TV the other day - I really like that man, he is such a great communicator! He was saying that everyone MUST get their flu jabs as well as COVID boosters this year. He said that due to lockdown and masks flu was very rare last year but then our immunity will have dropped as a result. And he’s right! We couldn’t give the flu jab away last year, nobody wanted it!

This year the uptake has been much better although interestingly not for the 2 - 3 year olds who are given a nasal vaccine. Nobody wants it for some reason.

I still think COVID vaccine should be mandatory unless you are clinically unable to have it, but our government hasn’t got the guts to be (more) unpopular. At work we were at first allowing people to self declare they had had their COVID vaccine - if they had had it abroad then it wouldn’t show on our system. Now we have to have proof because people were lying :roll: :roll: .

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maz
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Re: Life as a GP practice manager

Post by maz » Fri Nov 05, 2021 9:22 am

I would rather they mandated Covid vaccines for health/care workers also, unless reasons why someone couldn't have one. Yes the government is being soft about Covid in general just now and not really doing what they should be doing. I do think there would be more riots though, plus loss of NHS staff and we can't do with that at the moment. The vaccination reticence seems mainly to be a 'freedom' issue and 'no body is telling me what to do' situation now, with still some worry and distrust in the actual vaccine. I just wish it all hadn't become a political issue.
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sat Nov 13, 2021 1:38 pm

Well we have the decision now! Healthcare workers are to be mandated to have the full COVID vaccine programme or lose their jobs. At the moment the wording for who has to have the jab has not been decided. It is either “front line staff” which would be ALL GP practice staff, or “patient facing workers” which would take some of our admin staff out of the loop. The same will apply to hospitals.

I now have to reword our employment contract for any new staff we employ to state that being fully vaccinated is a condition of service. I am VERY lucky! All of our current staff have been fully vaccinated and we have no abstainers. I know of 2 local practices who have anti-vaxxers on their payroll.

I do agree with this law incidentally! I have seen some care home staff whingeing on the news that they are losing their jobs because they won’t have a vaccine. Face? Bovvered? Have the bloody vaccine!

In my experience the only people who are anti-vaxxers are, exactly as you say Marilyn, trying to make some pathetic political point. I am not interested. One of our GPs said “So am I allowed to refuse to see patients who haven’t had the vaccine then?”. And I agree with him. Why should the front line staff in any organisation put themselves at extra risk because of some ludicrous and very selfish personal decision based on no statistics at all?

There are some people who are saying that they won’t have the vaccine because it is ‘experimental’. I have to make the point that as front line healthcare workers we were offered the vaccine first. My goodness we all had to take a leap of faith but we did it because it was the right thing to do. There are many staff at work with small children. Why should they have to put their whole family at risk because of an unintelligent minority?

Ooh! Another rant! Sorry!

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maz
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Re: Life as a GP practice manager

Post by maz » Sun Nov 14, 2021 10:09 am

I am actually surprised at care home staff who refuse to be vaccinated. After all of those elderly care home residents who died, I would have thought they actually cared enough to think it an excellent idea. However, freedom and all that :( Just occasionally we all have to pull together for the good of all.
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sun Nov 14, 2021 12:34 pm

Absolutely Marilyn! I seriously object to people who have the freedom to make the choice not to be vaccinated and then put the rest of us at more risk. In France apparently you cannot enter a public place (cinemas, restaurants etc) unless you have a COVID passport.

You still have the choice not to have the vaccine but it stops you infecting everybody else. I think we should adopt that here but the government hasn’t the guts to do it.

So on Friday after a manically busy week (having a week off always results in me doing 2 weeks’ work in my week back!) I was asked to go and see a patient immediately after his GP appointment. So off I trotted. I don’t think I have ever had a more surreal conversation in my whole life! To such an extent that I accused the girls of planting him to wind me up :lol: :lol: .

The patient was Polish and spoke very little English so his wife was translating for him.

Firstly he was convinced the pharmacy was trying to poison him by giving him medication that he wasn’t prescribed and should he phone the police? I advised that it wasn’t a police matter but he should bring in the tablets that he thought were wrong and we could compare with what we had prescribed. “I’ve taken them” he said. “Then we have no proof” I explained. “I am the proof!” He stated :shock:.

Next he explained he was having bowel problems and demonstrated himself having a poo :shock: :shock: and wiping his bottom :shock: :shock: all beautifully translated by his wife with him doing the pantomime to ensure I understood. He had been sent for a colonoscopy but didn’t want to go. I advised I couldn’t therefore help him.

He said he had been sent for a scan of his liver by the doctor but when he got there he was having gastric problems and asked the hospital to scan his intestines which they refused. I patiently explained the system but was so tempted to say “you can’t just go to the hospital and expect them to scan random parts of your body on your request for goodness’ sake!”

He then went on to explain that he had erectile dysfunction and yes, he demonstrated that with his hand as well :shock: :shock: . His wife explained to me that he was embarrassed to explain this to his female GP (but not apparently to me with his 8 year old daughter in the room :shock:) so I advised that he only needed to request a male GP and we would book an appointment appropriately. “Oh I don’t have it now” he said :shock: :shock:.

I lost half an hour of my life to this! And to be honest I still don’t know what he wanted from me! I kept asking “what is it that you would like me to do?” And never got a straight answer.

He did ask that I spoke to his GP and ask her to listen to him more and give him more time because she appeared to be trying to hurry up the appointment . Apparently he was in with her for 30 minutes for a 10 minute appointment so I suspect she certainly WAS trying to hurry him out of the room :lol: :lol: .

And then a complaint from a patient who said the pharmacy was putting Speed in her medipack :lol:. “Which pharmacy is it?” I asked. “I may need to switch to them!”

Barking! Just barking! :lol: :lol:

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maz
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Re: Life as a GP practice manager

Post by maz » Mon Nov 15, 2021 9:23 am

You definitely have the most barking patients Jane :lol:
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sat Nov 20, 2021 11:37 am

I think I may have mentioned that the current mantra from patients if they have COVID-like symptoms and are asked to do a PCR test before they come to the surgery is: “Oh! It’s not COVID!”. This is driving all the doctors and nurses mad!

One of our doctors last week said she had spoken to a patient on the phone who had had a dry cough for 4 weeks and shortness of breath. The GP said she must go for a PCR test and the patient replied “Oh I haven’t any COVID symptoms” :roll: . I really think some people live under a rock! :roll: :roll:

On Friday we had a power cut! Everything went off, the phones, the computers, everything! So I looked at our business continuity plan and it said “close the surgery” (I hasten to add I’ve written the business continuity plan but can’t remember what is says :roll: :roll:), so we did that. We put a note on the door apologising that it was closed and we would open asap. We contacted the CCG to advise them that we were shut because they have to advise the other providers (like 111 and A&E) that their demand may increase.

A GP and a member of admin went to the practice next door to borrow a room with a computer so we could contact patients to advise them we were closed and for the GP to speak to any patients that were urgent. It was all systems go.

And then the power came back on after 30 minutes and we all went back to normal.

It was an excellent test of our plan though :lol: :lol: .

As if there isn’t enough drama at the moment! :lol: :lol:

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maz
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Re: Life as a GP practice manager

Post by maz » Sun Nov 21, 2021 9:29 am

That is one of those very happy annoying things to happen. At least if the power goes off and you go to all that trouble, it could stay off for a while couldn't it :roll: :wink: ?
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sat Nov 27, 2021 1:24 pm

That’s the problem isn’t it? You don’t know how long it is going to be off for.

So this week we are dealing with problems as a result of the power cut :roll: . The lift wasn’t working, the heating wasn’t working, the security doors were not quite right and the patient call boards were offline. Goodness knows what sort of power cut it was! So I have had a madly busy Monday sorting out all those problems. The GPs are complaining that they have to leave their rooms to shout the patients out of the waiting rooms rather than just call them on the call board. I have every sympathy!

NOT! :lol: :lol:

So a request this week from a 22 year old patient who had a security tag on her leg. She asked for a letter from the doctor to say she had problems with bloating so the tag was too tight and could the GP write a letter to say this so she could have it removed? :shock: :roll: :roll:

NO! :lol: :lol:

And then finally I had a call from a very cross patient who wanted the GP to write a letter to say her 12 year old daughter had had COVID and was now recovered. We do not write letters regarding COVID because we would never get any other work done and there are lots of other avenues that patients can use to prove their COVID status without getting a GP letter, so I asked why. “Well we are travelling to the US and she needs to have a COVID negative test and because she has had COVID in the last 3 months the test is likely to be positive so we won’t be able to travel” she explained.

The patient was right in that you can still test positive for up to 3 months after the virus, but a GP can’t write and say she no longer has it if she has a positive test. She may have caught it again. The patient was very angry with me.

:roll: :roll:

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maz
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Re: Life as a GP practice manager

Post by maz » Sun Nov 28, 2021 9:14 am

Will we ever get rid of this wretched virus when a good number of the population don't care?! I won't even mention Omicron :roll: . Oh I just did :?

I went on our GP surgery website the other day, just because... Anyway in place of the flashed up Coronavirus info usually there was a long telling off for those who verbally abuse the staff, mainly due to delays in appointments etc. So our Harrogate folk are no different Jane. I wonder if those who are rude and abusive would read the spiel :roll: . Also lots of explaining as to why the delays etc. I know it is all annoying, but being abusive to the staff is disgusting. I hope they weren't pushed to the front of the 'queue'. I remember seeing that on a few of those A&E filmed programmes. Unruly and loud patients being allowed to be seen quicker to stop them behaving so disruptively. Rewarding bad behaviour is not a good thing, though I can understand why of course.
Marilyn

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Janey Dal
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Re: Life as a GP practice manager

Post by Janey Dal » Sun Nov 28, 2021 11:42 am

We absolutely DO NOT allow bad behaviour from patients. The poor receptionists really do not get paid enough to put up with abuse. Luckily our GPs are very much on side with this stance (some practice GPs aren’t). And often, as you can imagine, the patient is as rude as they like to the receptionist and then speak to the GP and are nice as ninepence!

The receptionists are advised that if a patient is rude to them prior to speaking to the GP they must tell the GP via an instant message on our computer system. Our GPs will then do the consultation and at the end of it advise the patient that they must NOT speak to the Receptionist rudely. The patients are quite surprised by this.

It must be difficult in A&E because unless a patient is actually abusive or violent they will be obliged to see them, in case they have got something genuinely wrong with them, and you will be very aware Marilyn that trauma can make patients behave out of character. The obvious answer is to get them through quicker to lessen the disruption but I agree,it looks like rewarding the bad behaviour. I have no doubt some of them do it on purpose because they know they will get seen quicker.

Abusive patients is a constant issue in the NHS at all levels. Occasionally some do apologise and I therefore let them off entirely. We have all been frustrated by GP appointments at times and more so now. It’s the sense of entitlement that drives me mad. they all think they are ‘entitled’ to health care. Well they are but we do not have to put up with abuse for them to access it.

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