Sunday, 21 November 2010

Doctor, doctor – can you hear me calling, calling?

The UK Daily Mail’s headline story on Friday outlined the government’s draft plans for axing GP receptionists in a bid to automate doctor’s appointments.

The (scaremongering?) article suggests that patients will be ‘forced to ring national call centres to make an appointment’. It goes on to say that ‘receptionists may be sacked while appointments are handled by operators hundreds of miles away’

A few blogs ago, I discussed the patient journey and it is generally accepted that the way  a patient journey starts can have a dramatic effect on the outcome of that journey. For most patients in the UK, this starts with a call to their GP.

Although sometimes referred to as ‘Rottweilers’, a good GP reception team will not only be the gatekeeper for the practice, but also the vital first point of contact for patients. It is no coincidence that in two of my recent primary care service improvement projects I have included practice managers in the communication strategy. It is not just the elderly who need sympathetic response to their calls to a GP practice. The new mother, the family member caring for a terminally ill patient, and the anxious but busy businessman all have equal right to reasonable and timely access to their local surgery.

I have cast my mind back to primary care utopia - my childhood in rural England. Our family GP was based in a town a few miles away and to see him, you called the surgery and after a quick chat with the receptionist, were given an appropriate time slot to attend that day if needed. You turned up during surgery hours and took your place in the waiting room where there was a strict rotation of chairs and you sat on the next free chair in line. There was only one green chair, at the end of the line and the rest of the chairs were various colours. Each time the bell rang (it was like the bells that used to ring in servant’s quarters in stately homes), then the person in the green chair would go in to see the doctor and everyone shifted up a chair.

This sounds quite comical, but it actually worked and I don’t remember having to wait very long for an appointment. Our doctor was a real ‘old school’ GP who held some very strong views. He didn't believe in 'molly coddling' and believed that housewives who kept their houses too clean were dampening their children’s immune system (interestingly a theory that has gained credibility over the past few decades). He used to say – ‘a bit of dirt never did anyone any harm’. But he was a wonderful caring doctor.

I wonder what he would have thought of the proposal for call centres to replace direct telephone contact with patients. Never one to mince his words, I suspect a few expletives would have been involved with a suggestion that he would rather answer the phone himself than hand over the control to a remote call centre.

But then of course, back in 1965, a GP didn’t have a consortium to run or his share of a £80 billion budget to control…..


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