Towards More Effective Remote Consultations

[Nevasayneva]

It seems clear that society is moving closer to remote consultations and distanced prescribing. This may or may not be a good thing in the long run but at present many patients have found the experience unsatisfactory and at times deeply worrying.

I personally feel uncomfortable about talking about my intimate health issues to the disembodied voice of a consultant I've never met. On occasion, I've felt angry and frustrated for example when a respiratory nurse called out of the blue to carry out my annual review. Without seeing me, without listening to my breathing, or conducting a spirometry test she concluded after a few basic questions that nothing had changed. Seriously! A lot had changed during the lockdown.

During these past months, so many of us have experienced the damaging effects of being unable to exercise, get outdoors for fresh air, or engage in normal social interactions. As a result, both mental and physical health has suffered and the need for face-to-face support and reassurances from the medical profession has grown.

Sadly, as a consequence of lockdown, face-to-face consultations were reduced to a minimum and most of us had no choice but to accept remote consultations. Now that lockdown is being eased one would expect a return to normal service. However, GPs are up in arms over a directive from the NHS England to resume face-to-face consultations with all patients. I can't say I entirely blame the GPs as in my opinion far too many people abuse the NHS by taking up GP's valuable time for minor ailments that don't need to be seen by a GP.

Either way, we are now in the digital age and I believe remote consultations and prescribing are here to stay. This may not necessarily be a bad thing. Developers are creating useful apps to support patient health and interaction with health providers. For example, some GPs have adopted the NHS-approved MYCOPD app created by My Health.com.

Meanwhile, I personally find it helpful to record all my conversations with my GP and with any consultants. Not only is it legal the NHS actively encourages health professionals to positively embrace patients' requests to record the consultation.

NHS states that patients do not need permission to record their conversations but it is a matter of courtesy to inform the health provider of your intention to record. Some health professionals might see this as evidence of a lack of trust or preparation for legal action. Personally I've never had any problem or sensed any resistance from my health providers. I find the recordings to be very helpful. I can more easily recall or research important points of information. The recordings make it easier to discuss my health issues with my family and I have more clarity on the proposed action plans.

[hypercat54]

Well if they did it in say 30 years time that wouldn't be too bad.. In the meantime the people who use the services most are the elderly and how many of those have internet access, know how to use it, or understand how to use apps? I haven't a clue on the latter.

I guess they think every older person has a younger relative who could do it for them? And take time off from work to be there for virtual conversations? Or travel a long way? How many older people will be excluded or decide they can't deal with this and stop seeing a doctor? I think this idea now is crazy, criminal, and unworkable.

[Nevasayneva in reply to hypercat54]

Hypercat54 you're absolutely right, many older people don't have access and should not have to learn new technologies. They and others who may need it should be offered the option for face-to-face or digital. Meanwhile, digital working is becoming a reality in most areas of life.

Service users can't afford to passively wait for providers to decide how it will effect us.

[Karenanne61]

Pre covid local surgeries were moving towards non contact appointments. My surgery has posted yet another message telling us they are too busy to be contacted! This time it's not covid however it's because people are mingling so 'normal' viruses are on the increase!

[Hidden in reply to Karenanne61]

Frankly that is unacceptable.

Unfortunately it seems being busy is alien to the NHS. They need to be more efficient and provide a proper service.

[Karenanne61 in reply to Hidden]

I agree. My e -notes never seem to be accessible in my local hospital, they still use paper notes . Problem is they are easily lost and not all doctors use them. It just needs a good sort out. I think they need to employ a gang of librarians (i used to be one) to sort out the information storage and retrieval as a start.

[Hidden in reply to Karenanne61]

It is unbelievable that the system is so bad in 2021. Covid is just being used as an excuse to railroad people into lousy telephone appointments - just another ploy to get the ‘number of consultations’ figure up and pretend that the health service is doing a great job when it isn’t.

[sassy59]

I’m not sure if Pete and I will ever get to actually see a doctor again. I’ve actually just waded through an e-consult because I feel I may have silent reflux. I’ve tried to accurately describe my symptoms which include a cough. Oh my! I was advised to ring 111 and seek urgent assistance! No thank you, I just want some advice and possibly a different medication from lansoprazole which I’ve been on for years. What a palaver! I’m awaiting a phone call, text or email.

I actually don’t mind not seeing a GP but for Pete it’s essential I feel. It must be really difficult for many older people to access a service they’re entitled too. I think it’s all a bit of a mess to be honest. Xxx

[Nevasayneva in reply to sassy59]

It is a bit of a mess. I experienced something similar. I just needed advice and was told to ring 111.

[sassy59 in reply to Nevasayneva]

Really ridiculous I think. Xxx

[RoadRunner44]

I can only say I am, like you I am deeply worried about the whole situation. After phoning to get an appointment for further bloodtests a recorded list of options was asked of me over a course of 5 minutes. Eventually I was told to stay on the line until I was eventually told to hold. After another lengthy period of time a recorded voice said they were very busy and to ring back later. I was then cut off! After all that! This happened throughout last Monday from 10 O'clock until 4 O lock when I was finally able to talk to a real person and made an appointment for the bloodtests. I can only wonder what will happen if I really needed to see a doctor. A very worrying time from now on I suspect.

[Nevasayneva in reply to RoadRunner44]

The situation is quite dire for some. A few months back after being in constant pain and despite being on the phone to my GP from 8:30 am I couldn't even get into the phone queue. When I eventually did get through to the receptionist all appointments for the day were taken and I was told to try again the next day. At which point despite myself I burst into tears. Only then did the receptionist relent and arrange an emergency consultation.

As patients, we need to be more proactive when possible for example by putting our concerns in writing to the PALS - NHS Patient Advice and Liason Service.The way things are going we can't afford to wait for decisions to be made about service delivery without our input.

[RoadRunner44 in reply to Nevasayneva]

Thanks for replying. I wholeheartedly agree with you. Do you have any idea or information who to contact regarding the whole state of affairs to see if something can be done? I'm sure there must be so many people all over the UK who will, at this very moment, be experiencing the same thing. In fact t, PALS will probably be inundated with calls.. Keep in touch and if you have any further ideas post them as we are all in this together.

C.

[Patk1 in reply to RoadRunner44]

Disgraceful

[Izb1]

I fear the gp's will never get back to running a normal surgery. It must be alot easier for them and they will get through treating more patients and perhaps safer for them and staff. But at what cost to patients, surely they cannot be allowed to perform a service as they are at the moment. I do think the hospitals are in the same frame of mind ,so goodness knows what our future holds. Very worrying x

[Mavary]

Our Drs are the same. If you ring at 8.30am there will still be a queue. We do however have about six people manning the phones so if you hang on itvwouldnt be long before they answer. The first time I did phone they said I was number fourteen in the queue so I didn’t wait. When I got to speak to a receptionist she told me to hang on to the phone as it was six people answering . So now I hang on and usually get an appointment. I like phone appointments in one way as you don’t have to go out but I’m sure a lot of things will be missed because of phone appointments. I phoned the Drs one day because my cat had ripped my hand. Bear in mind I’ve only got to touch my skin and it rips. And! He didn’t mean to catch his claw on me. Anyway they said they’ve wont deal with it there I had to go to minor injuries. So that’s what I did. I can remember they would deal with all that sort of things. Anyway they send you back to the Drs for a nurse to dress it.

[Nevasayneva in reply to Mavary]

It's difficult to know who is responsible for the confusion and such poor service. But whatever the case NHS England, Primary Care Providers and we the tax paying users should join hands to find solutions.

[Patk1]

Yesterday I rang for emergency telephone appointment- receptionist refused!! Said " I can give u an appointment with a different drs practise Saturday afternoon "!!!Hitler came to mind - a non medically trained telephone operator refusing to let me talk to dr - I've not spoke to gp since November '20. I ended up ringing 111 who sent3paramedics in ambulance + took me to hospital.

I'm appalled at my treatment.iv been with my gp practise for 50years..I'm now considering leaving

[Mavary in reply to Patk1]

I think you've got to be firm with them a them and explain why you need to see or speak urgently to a Dr today. If she still refuses then say to her “well that’s ok I’ll speak to PALS and see what they have to say.” Stay calm when you say it because she will then know you mean business. You also have to be prepared to follow it through and contact PALS. You have to be prepared to be given any Dr in the practice if you call urgently as your Dr may be tied up. I hope that helps.

[Nevasayneva in reply to Mavary]

I agree you have to be firm but when you're feeling very unwell that come some times be too difficult.

[Mavary in reply to Nevasayneva]

Sorry you thought I was replying to you. I meant my text to be to Pat k 1

[Nevasayneva in reply to Mavary]

No problem

[Patk1 in reply to Mavary]

Thanku.when I'm better,I am going to complain x

[Hidden]

Sadly - it is a complete and utter shambles. Like all these things destined to get worse before somebody has the guts to start making the right decisions.

[micox]

I too am concerned about this. I've just had an appointment by phone text for my respiratory nurse to telephone phone me in about 3 weeks time and I suspect this will be a replacement for the annual COPD review. I can't see how the review can be conducted professionally and effectively by telephone and if it is as it seems, I will complain straight away. Our surgery, which pre-COVID, had the highest marking from CQC, has been difficult to communicate with for the past 14 months - no e mail, no video facilities, no PPG (and I'm a member), just telephone. I think the best way forward at present is a flood of complaints.

I am, by the way, a proponent of internet remote facilities for the right reasons and in the right context - and where everyone has access.

[Alberta56]

Well done for raising this. Cut off from other people by lockdown, I have tended to think it was just our local surgeries which are problematic.

[Mavary]

I think I’m probably like a lot of others here and am letting a lot of health issues slip by the by.