Doctors: Diagnosis By Phone

[Zebedee Tring]

Is it my imagination, or have things got worse at Melbourne Grove during the last year, at least at the first point of call, i.e. the reception or the automated phone system?

[fedup]

hi there

new to the forum, i was having a look around when i found this thread.

i too am with melbourne grove, and have been for about 13+ years.

this new system they have is sh1te.

i phoned them yesterday for some advice at 08.30, i was told that i would get a call between 09.00 - 10.00.

10.45 1st phone call, yes you are still on the list, there are 2 others in front of you. was the waffle from the receptionist.

12.45 2nd phone call, receptionist - the doctor is due to call you shortly. me - don't bother, this service is rubbish and beyond the joke. receptionist - do you want the doctor to call you then? me - NO.

this is not the 1st time i've had problems with this new system.

e.g repeat perscriptions, the tablets i'm currently taking are not the type to be handed out over the phone, yet the call back doctor wanted to arrange for a repeat prescription, going by what i have said over the phone.

i am now debating on whether to change doctors because of the insufficant system that melbourne grove are now using.

[ratty]

Like I said before - please let them know when the system is not working. We did and it has helped enormously. There is a "Contact Us" section on their website - we complained and got a personal phone call back and our problems sorted out post haste!

[Cassius]

I brought my complaints up with my GP when I saw him this morning - will have a look at the website when I get the chance.

[david junior]

This is the plight of the NHS........I received a leaflet offering me free Gym membership at the Fusion, with all their marketing buzz words and I don't know if you noticed but the leaflet had the Southwark PCT logo on it.

Then I read an article in the South London Press that they were reviewing their Gp consultations as they felt a number of these could be dealt with by a nurse.

http://www.southwarknews.co.uk/00,news,8709,440,00.htm follow the link in January when (quote from the aricle):

Dr Jane Fryer, Southwark?s Health and Social Care Medical Director, said: "We have now met with Concordia Health, who have given their assurance that delivering the highest and safest quality of care to their patients is their first priority. We will continue to monitor the situation and meet with Concordia Health to make sure that this remains the case."

Then another article appears in May 2008:

Under-fire surgery: 'It's working fine'

Tuesday, 27 May 2008

__________________________________________________________________________________________________________________________

Some patients have reported problems with the system - By Lindsay Burns

A PILOT telephone booking scheme for a doctors? surgery has been panned despite health chiefs? claims of patient approval.

Dozens of complaints have been posted on the East Dulwich Forum about a new system at Melbourne Grove Medical Centre where doctors decide if patients need appointments based on telephone interviews.

A spokesman for Southwark Primary Care Trust (PCT) said it was aware of the concerns and was seeking quality assurances from Concordia, the company that runs the surgery.

Under the scheme, callers are given a time when a doctor can phone them back but patients have reported delays and missed calls.

Writing on the online forum, one said: ?Didn?t get to my phone between 10 and 10.30 and just got a message saying I?d have to call again to make another appointment for a phone call (now between 2 and 3 also).

?I complained on the phone that this process was ridiculous and the receptionist sounded like I wasn?t the first person to have told her this.?

Concordia said it introduced the telephone system to make it ?quicker and easier? for the public to receive care and claimed a recent survey showed patient satisfaction.

A spokesman said: ?A recent survey indicates that 75 per cent of patients who have used the new appointment system have been satisfied and have found receiving care to be quick and easy.

?This is an improvement from previous satisfaction figures of 44 per cent.?

A PCT spokesman said: ?We are aware that some patients have expressed concerns about this new way of working and would like to reassure local people that our top priority at all times is ensuring that there is continuity of high quality patient care.

?We are seeking ongoing reassurance from Concordia that they are providing this.?

If anyone has any concerns about the service they can call the Patient Advice and Liaison Service on 0800 58 77 170.

___________________________________________________________________________________________________________________________

To quote from the above article: A spokesman said: ?A recent survey indicates that 75 per cent of patients who have used the new appointment system have been satisfied and have found receiving care to be quick and easy.

Is this a good measure and is this good enough when our Government forced GP surgeries to open later with extended sessions eventhough about 85% of all patients were satisfied with opening times. Should the same principle not be applied here and how many patients does 75% reflect exactly - if you survey 1000 patients out of a list of 7000 and 75% are satisfied that is 750 patients out of 7000 is actually only really 11%.

What I would be interested to know is how would the PCT regulate a practice impartially. Those involved in approving Concordia as a preferred provider over a bid put together by the good GPs of the practice (who strived very hard to make improvements at the practice whilst it was under PCT management, only later to be told that their bid was unsuccessful)are the same people who would have to performance manage the practice. Surely if the practice is failing would this not be a reflection on their ability and do you not think these individuals would do everything in their power to support the practice so that it does not fail?

I think that a private provider would in the first instance look at profits and patient care in the process may come second - look at the problems at Melbourne Grove, simple things like a light bulb in one of the toilets has not been changed for months and cleanliness, well I do not think it is of a standard for a practice that is 'innovative'

I wonder when the gains disappear....would the private provider status still be viable. Maybe then all consulations would be by email...........god help our elderly people and terminallt ill citizens who need the service most. By this time for patients like us it may be too late and the infrastructure will be in tatters so the only choice will be private!

I THINK ITS TIME TO VOTE WITH OUR FEET! I am moving to a smaller practice where the care is more personalised and I can get an appointment within 48 hours as is the government standard. I am sure smaller more traditionally inclined practices will have their own issues and finacial contraints but at least one can see a GP of ones choice.

[cate]

Hi David Junior

I did read the article in the South London Press. Have you put your complaints in writing to the surgery? I do know that they have a new practice manager who has only been there for 4 weeks and I am sure he would be keen to see comments from patients.

[Cassius]

I really am in two minds about this - I feel saddened by the downward turn (in my opinion) in patient care from the surgery as a whole, but have found, for the first time in many years, a GP whom I really like and (almost) totally trust. I have to wait a long time to see this particular GP but feel in my particular case that it is worth the wait.

Hey ho - what to do........

[Zebedee Tring]

Today I attended Melbourne Grove and was given very good treatment by a locum nurse practitioner. However, I am sad to report that the rumour was true - I was told by one of the reception staff that Dr Brewe-Graves left the practice yesterday.

[first mate]

That is terrible. ZT did you leran if she was going elsewhere?

[Zebedee Tring]

No, I'm afraid I didn't, First Mate. I was in a major hurry, since I should have been at work a long time before, and in any case I don't think that the young woman at reception would have been prepared to give me any info anyway; I just got that impression. However, my wife and I will write to her c/o the surgery to thank her and wish her the very best of luck.

[first mate]

Zebedee,

Good idea, think I'll do the same. If Dr B-G has gone to another surgery in the area I am tempted to follow.

[ratty]

Gutted Dr BG has gone!

[benjaminty]

Sorry just seen this thread.

I've been meaning to get to the quacks now for 2 months ... something I can live with but shouldnt have to and is pretty painful. I was just told on my call back that there is nothing really wrong with me and go and get some ibugel to help the ailments.

Can't help feeling I've just been fobbed off because I'm not bleeding from my eye balls.

Sorry I havent read the 6 pages worth of thread but guess the is the standard type of response being discussed (disgust????)

So I'd added my tuppence worth...

[blinder999]

Another interesting article on Concordia Medical Director and Chairman, Dr Simon Fradd:

simon-fradd-does-his-sums

Remember our practice of 7000 patients with four doctors? Supposing it was run by a private company like CONCORDIA, and they sacked three of the doctors. That would be an immediate profit, sorry, saving of ?450,000. Now suppose you employ 8 HCPs at ?30,000 a year each to replace the doctors. You are still in profit by ?220,000. And what do you think Fradd would do with that profit? He would not let the company keep it. That would be disgraceful. Fradd is an honourable man. Surely he would give the money back to the NHS? Or perhaps he would take a party of handicapped children to Disney.

[cate]

Hmmmmmm!

[first mate]

Blinder,

Good work. Wonder if the woman who did an article in SLP (?) knows about this?

[AJM]

Studies of populations within the EU have shown that most people would welcome telephone diagnosis. Certainly for working people it means you don't need to take time off work to go to an appointment at an inconvenient time.

I guess it depends on the nature of your medical complaint. From personal experience, when I go and see my GP I am rarely physically examined. It's all discourse and discussion based. Of course, if you are presenting because you're worried about a lump, then the nature of the complaint makes a face-to-face appointment a prerequisite!

Controversially perhaps, cost-cutting in the NHS is not always a bad thing. It drives efficiency by freeing up more revenue to invest into more services for patients.

[SimonM]

>>Certainly for working people it means you don't need to take time off work to go to an appointment at an inconvenient time. <<

You do though have to take time off work to await a phone call which may or may not arrive, it would seem...

I am not sure these "Studies" are terribly informative. I mean if you polled everyone sitting in a GP's surgery by asking "Would you rather you could phone a doctor for a diagnosis?" it would not be too startling if a majoriy grunted "yes!"

:))

[bubbachumps]

I have been incensed by this new system and have sent a letter to the practice manager (who has not replied to me). The nurses call you back at a time convenient to them - ie. you are expected to talk about your medical problems at your desk at work, on the train etc. If you can't get to the phone at that time you have to start the process again.

I actually needed a referral to Kings and the nurse made a mistake with the form so I had to do it all again with the doctor. It's an utter shambles. I really do think the GPs are of a high calibre there, but this new system is ludicrous. Perhaps we could organise a patient petition?!

[xxxxxx]

I couldn't disagree more. I think that the service efficiencies and scale of the new measures are likely to benefit all. As regards the telephone slots : surely some good expectation setting and planning on both sides could resolve that? Seems like a process issue to me.

[Jennys]

has anyone else had trouble obtaining repeat prescriptions? They used to do them by email but now I believe one needs to post or fax them.

[Ladygooner]

I have always posted them - didn't know they did them by email?

[Jennys]

Yes, I have always done them by email (see their website which offers this) but was told on the phone today that they would like it by fax or post.

[Zebedee Tring]

Sounds absolutely typical of the way that Melbourne Grove seems to be going at the moment i.e. backwards. Up to now I have renewed repeat prescriptions by email and will be v. disappointed if I can't do so now. Perhaps Alan Johnson should tell them that this is *OUR* NHS and is not run for the benefit of reception staff. It is also now the 21st century and it is standard business practice to use email - faxes are much less common.