E Consult - : I wish to have a rant... - British Heart Fou...

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E Consult -

MyJinksy profile image
17 Replies

I wish to have a rant about the "improved Service" the E consult...

I find it difficult and awkward not to mention de humanising to try and deal with the endless pages. It maybe okay for people with one issue but when there are more complex health problems it is difficult. Then when you get the reply and try and make the appointment, the receptionist argues and told me that 80 year old's find it a really easy system. I have trouble believing that!

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MyJinksy profile image
MyJinksy
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17 Replies
Sunnie2day profile image
Sunnie2day

I have multiple heart conditions+a few other conditions. All seem to 'work together' and it can be complicated at times.

I find I actually quite like the virtual contactless consults. That said, however, I feel the reason I'm fine with it is down to my medics - I can telephone and usually either am put straight through or receive a call-back within a few hours. My cardiologist (and the GP on cc) are very responsive to an email exchange we started once it looked as though the lockdown (I'm in Scotland) was about to begin. One exchange went on back and forth far longer than a face-to-face would have and the result from that exchange was much more effective than a ten minute in-office visit would have yielded.

But. Every patient and every medic is different. As you are having unsatisfactory results using the virtual consults, perhaps you could speak with the practice manager and get face-to-face appointments booked. Most surgeries and clinics have a plan in place for consults that must be made in-person.

I've had two in-person visits (one for a pericardial friction rub 'listen', and one for bloods to be drawn) - both times the medics were in PPE, I was gloved and masked and bins for disposing of my mask and gloves were parked at the exit to make it quick, simple, and safe.

MyJinksy profile image
MyJinksy in reply toSunnie2day

Glad to hear you are having success with that system. So far since my heart attack and stent I have felt abandoned and a nuisance to the practice, and I know they are very busy so I have not chased them up. It is when I have to get medication that they have stopped prescribing without consultation that it becomes difficult. You seem to have a clear idea about your condition which is great. My situation was different.

MyJinksy profile image
MyJinksy in reply toSunnie2day

You may have had a good response from your virtual appointments and I am pleased for you.

My situation was just trying to get an appointment whether virtual or in person for blood tests and medications review they had asked for. As a result of not being able to get either and lockdown, the chemist cannot issue me with the medication I need.

The frustration of dealing with the Gate Keepers and trigger words that inform you that you require urgent medical help mean that you have to toggle backwards and forwards to remove any trigger words e.g. breathless, heart, blood sugar left me in tears and wanting to give up. In spite of the glowing reviews they claim, I wonder how many will give up and not see a Doctor because they can not deal with a system that is not user friendly.

Sunnie2day profile image
Sunnie2day in reply toMyJinksy

As I wrote in my reply to you, everyone, patient and medic, is different. I hope you can give talking to the practice manager a go. If that doesn't help, would you be able to go private?

And I know just what you mean about gate keepers - the ones at the surgery I was registered with before moving house two years ago were the dictionary definition. Their gate keeper behaviours meant I gave up for years until the house move.

The new surgery is quite different. If you can't get help from the practice manager or go private, could you change surgeries?

Eadaoin profile image
Eadaoin

I agree. It is de-personalising - the last thing we are asked (I clicked to move on to the next page 52 times) is our name!! The doctor’s written replies are anonymous. On a phone reply it does not sound as though the doctor has read even our recent medical history and is only dealing with the item on the form, out of context. I don’t like the idea that algorithms are setting the direction of our econsult especially if we happen to make a mistake completing the form.

080311 profile image
080311

Hi, can I ask what is E Consult ?

I live in Scotland and over the pandemic have had telephone appointments and video appointments with our GP, have sent photos of a rash my husband was struggling with, by email, from that had an appointment at the hospital to see the dermatologist, but have never had to fill a form in on line, waiting for my video appointment I sit! in a virtual waiting room while music plays waiting for my GP, to come on line, normally I have a coffee in hand!

Have to be honest love this way of appointments, husband as had a stroke so my blood pressure and his I take along with oximeter reading and forward on, he needed bloods taking last week and the nurse came to the house and did them here in full PPE, the only thing if a stethoscope needed putting on us that might be a problem!

Hope you can get sorted,

Best wishes Pauline

MyJinksy profile image
MyJinksy in reply to080311

Hi Pauline

The E Consult is an online application to see if the issue warrants a visit to a Doctor or if it can be dealt with by phone. It requires filling out various questions and describing why you think a Dr visit is necessary. Depending on your answers it maybe necessary to go back and forward on the pages before you can move on. A logarithm generates more questions from the information entered. When completed and submitted for clinicians viewing, they decide whether or not your issue can be dealt with by phone or if a person to person visit is required. You then get an email back informing you of the outcome.

As you have probably gathered I am not a fan at this time especially as it took me 2 hours 15 mins to fill out the questionnaire ( first time user) Then had to deal with Receptionist the following day, telling me I had to fill out the E Consult. Took me several attempts to get her to listen that it was the Clinician that had sent me an email asking me to make the appointment. Very time consuming and frustrating. I said I was not a fan of the new system and was told in no uncertain terms that it is a wonderful system and they have only had excellent comments from all the patients. Including 80+ year old who find it a doddle to use.

That was me told!!

Sunnie2Day also finds it very good and convenient.

Sunnie2day profile image
Sunnie2day in reply toMyJinksy

I do find it useful - up here in Scotland it's called Patient Services - we can request repeat prescriptions, book appointments, request a GP to telephone us back, check referral appointments, a few more things depending on the trust.

I had a few hiccups at first, the practice manager kindly walked me through it (this was over a year ago) in her office - turned out my browser was out of date and my security settings were blocking important aspects of the app.

MyJinksy profile image
MyJinksy in reply toSunnie2day

I'm also in Scotland. This practise used to be really good, but it has really changed in the last 5 - 6 years. Thanks for your advice. I have just "fallen through the cracks" too often. I just do not have much fight left.

Sunnie2day profile image
Sunnie2day in reply toMyJinksy

I really do think I know how you feel - the former surgery was great then not so great then downright awful and the change took place over a year. I went almost eight years without seeing a doctor once owing to way that surgery went downhill. I told myself I would just wing it on my own as I was exhausted trying to get proper care out of that lot.

Then we moved house (sold the larger home and downsized to a property six miles closer up the glens). I was so wary and so disappointed by the old surgery I didn't want to register with the new one - it took a heart wobble my dentist caught during an appointment to make me go register and be seen.

All I can say is what a difference six miles makes! My new surgery is not perfect (there are two 'gatekeeper' types but the rest are very easy to work with) but I was seen immediately after I walked in (yes, well, staggered in, I really was quite unwell) to register and it's been smooth sailing since.

MyJinksy profile image
MyJinksy in reply toSunnie2day

The Practise used to be really good, then lots of retirements and changes to staff and Doctors. I know things change, but its the arguments from Gatekeepers and demanding information and deciding what staff you need to see or if you need to see anyone. Frustrating defeating and soul destroying. Glad your experience is now positive,

080311 profile image
080311 in reply toMyJinksy

OK understand, don’t have that I phone my surgery receptionist asks me symptoms and says Dr will phone me later, normally within 90 minutes, we have a conversation and sometimes says she needs a video call, found that scary the first time but really easy and have had 5 so far love it. Don’t think I could cope with your description of E Consult!

Just seen Sunnies post, now that I use, before the lockdown used it to book Dr appointment and repeat prescriptions, but ours is very straight forward, not lots of questions.

Thanks for letting me know

Best wishes Pauline

gladliz profile image
gladliz

I know exactly how you feel. For years our local surgery was good, old fashioned queuing system but you were seen the same day by a Doc you knew. Then they all retired within 2 years of each other, so it was locums and temps some of whom were great others not. Surgery up for sale as well, eventually bought by practice from local town and now amalgamated with them and one other. Repeat scrips which used to take a few days now take a week at least; changes to Chemists proceedure.

This new E consult is awful, I'm no stranger to on line stuff but have had to use it twice and the length of time it took me to fill it out I could have gone to the surgery ,queued been seen, and back home. From the follow-up call I had from a nurse she hadn't looked at my notes at all and asked me to phone the surgery on the Monday. That now takes hours to get through. Eventually got sorted with increased Doxazosin. It's no wonder my blood pressure is high.

Covid has not helped the situation but where I live in Wales a lot of the local surgeries have the same problem. GPs retireing and no younger ones filling the gaps. Increase in population with new housing being built, ageing population, who worked in the Pits and steel industries and are now suffering the consequences and being a GP is hard work, not glamourous and probably doesn't pay as well as being a specialist.

That's it rant over, but am still waiting outcome of second E consult. Pass me the BP monitor someone!!😤😡😠

Stumpy47 profile image
Stumpy47

I think we are going to have this as the "NEW Norm" for quite some time if not permanently with improvements along the way.

My own experience has been a positive one of my talking to the practice receptionist & my GP calling me back at a given time, discussing meds & changing them .

I have also had a phone consultation with my Cardio/EP which resulted in Email exchanges of KARDIA ecg pdf files (I know not everyone has a Kardia , but that might change to much more remote monitoring) which she has reveiwed & replied to, taking the decision to fit a 72 hour holter,much faster than would normally be through the normal appointment system .

A recent PM interrogation was done at my local hospital with staff in full ppe & a face mask for myself in & out in 30 mins with a drop off of Kardia ECG printouts which they were keen to put in my file as my PM parameters failed to pick up certain pac's & pvc's.

So in all I'm pretty satisfied so far

I guess we are all going to have to adapt & take the good & try to improve the bad.

Best wishes

080311 profile image
080311 in reply toStumpy47

Tend to agree, think some sort of remote appointments will stay, live in Scotland and have had a good few video appointments with the dr after there has always been a questioner asking how you had found it and if you would carry on using it. I personally love video appointments only thing would be if they need to put stethoscope on to have a listen. I send BP and Oximeter readings for myself and my husband, and have even sent photos by email.

If it cuts down waiting time to see the Doctor maybe a really good thing.

Prada47 profile image
Prada47

Hello

I have had a few Telephone consults and so far thy have worked fine but

My GP knows me and my notes are updated to my GP by the Heart Failure Clinic.

I do think there will be some mistakes in the future that turn out to be Fatal Mistakes, either by the Dr not quite understanding what the patient is saying or by the Patient not giving an Accurate Description.

We will all know how it is working should we hear that GP Insurance Policy costs have gone through the roof !!

I am still waiting to phone my Surgery and to have the response " The line is busy please phone Dr Google should your situation be Urgent " -)

Stay well Stay Safe.

I think Doctors should be concerned because in the long term I can't see them being paid the current salary for telephone consults

Personal Opinions

Stay Well Stay Safe

MyJinksy profile image
MyJinksy in reply toPrada47

I don't object to telephone consults or even video link consultations. It is the hoop jumping new system that starts with in 500 words describe the problems that you are having, followed by 5 pages of questions where if you use a trigger word e.g. heart, tiredness etc it tells you to seek urgent medical help so you then have to go back to the previous question and find which trigger word you have used and remove it to go on to the next question. Very frustrating and soul destroying.

All without asking your name, that comes on the last page. All this for a medication review that the doctors had asked for via the pharmacist, Who was unable to full-fill my prescription for statins, hrt and thyroid medications. All of which I need.

They used to contact people by phone or letter for medication reviews. Now at the surgery I am at, they send a note to the pharmacist to tell you and don't give you the script for the meds.

I should also mention that I have never been given a follow up re my heart attack (2 years ago). Fell through the cracks as I never made it into a cardiac ward. So was in a short term ward for 3 days, never met the cardiologist that did my stent, nobody told me it was a heart attack (just an event) and was sent home with a bag of medications and a leaflet. This whole situation has been confusing and difficult.

I have learned more on this site, so I chased up cardiac rehab and went to every session. The nurse there told me that I had actually had a heart attack.

I don't know if it is me, not asking the questions, but I don't know what questions to ask.

I did at one time phone the BHF nurse, who told me to see my GP.

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