British Heart Foundation

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Disgusted

I have just been on the phone with my local GP surgery to arrange a review of my medication as it has now been a year since my heart attack. The extremely rude receptionist has told me that the review is carried out by the pharmacist. I have every respect for pharmacists but I’m not entirely convinced that they are the right person to tell me if I can change medication or stop taking some of it or infact to discuss any side effects I may be having. The receptionist would not let me book an appointment with my GP to discuss.

😡😡😡

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No excuse for the “extremely rude receptionist”, but the pharmacist is certainly your first (and best) port of call to do with medication - they know far more about medications, their side effects and interactions than any GP. And they should refer you on to your GP if found necessary.

Unfortunately not every GP surgery has its own pharmacist, although I agree that pharmacists generally are very knowledgeable and helpful.

I find the GP pharmacist better than the actual GP tbh. The GP pharmacist at my surgery is knowledgeable, helpful and has the time to clarify points with other clinicians if needed. I think that med reviews are now being carried out by GP pharmacists rather than doctors.

Sorry to say, but Doctors to day surgery is a big business and its all about money and time, and they do not have the old bedside manner, . I retired from my Practice some 25 years ago, The Hippocratic oath has gone out the window, , its all about money, your best bet today is your Pharmacist,

Thanks, that makes me feel slightly better about it. I’m just desperate to come off as much of it as possible. I’m on blood pressure tablets that really don’t agree with me and I have never had high or indeed low blood pressure and they keep me awake at night for various reasons but the main one is getting up for a wee about three times a night!

I have the same problem not sleeping properly.....but just to put your mind at rest every pharmacist is more highly qualified than a GP but always talk to the actual pharmacist. The receptionist you spoke to needs reporting......they have no authority to refuse to make you an appointment

Rudeness aside (no excuse for that), NHS guidelines afaik are that reviews are carried out by Pharmacists or GP’s, most are now done by Pharmacists, they are better qualified when it comes to new/better drugs that are available.

Agree with others about the rudeness (sadly seems too common with GP receptionists!)

As for the review, we tend to forget that pharmacists are specialists - just as much as a dentist or physiotherapist or cardiologist.

GPs are, by definition, "general". Which is why they rely on specialists for specific knowledge.

You probably wouldn't think "They've got a cardiologist to review my heart condition but I want my GP to do it" and drug reviews are really no different!

"Agree with others about the rudeness (sadly seems too common with GP receptionists!)"

It's a qualification, isn't it? (only joking Maisiemay13)

I have an annual review with my GP (or, if there are no issues, then initially with the practise nurse). A few weeks before the review the GP arranges an appointment for blood tests. He also sends me a form for me to complete at home with twice daily blood pressure readings taken over seven consecutive days.

At the GP surgery the nurse then takes my weight, conducts an ECG, discusses exercise, diet, and how I'm feeling, she also runs through the blood test results. In particular my doctor (and I believe all the doctors at this particular surgery) are very focused on the links between heart disease and type 2 diabetes, strokes, and dementia, so the blood tests and weight checks are used to monitor your risks. If there's no issues then that's the end of it, but if there are issues you then see the GP.

The last one of these annual cardiac check ups was conducted over the phone with the nurse because of Covid, but it still followed the same pattern and included the blood tests.

I've never heard of a pharmacist conducting this annual review. In particular I don't see how they would have blood test data, which is critical for monitoring things like lipid levels and HbA1c levels for blood glucose.

My understanding is that this annual review isn't anything out of the ordinary, it's just the standard NICE advised procedure for anyone who has been diagnosed with heart disease. My GP seems a bit more on the ball than the average based on comments on this forum, but this basic review format has been reported by many other people.

I'm a UK resident but a Canadian national, from what I hear from my family back in Vancouver the Canadian annual check-ups are even more detailed, with more hospital based tests and an annual discussion with a cardiologist rather than a GP.

Thanks for that. I was under the impression that the review I was going to get was as you have described, where there are tests that can be carried out and monitoring to give a true representation of my overall health but it doesn’t sound like that’s what I’m going to get. I have changed my entire lifestyle and I’m more healthy now than I have ever been with a resting heart rate of around 55-60bpm and I walk at least 5 miles a day minimum so feel like a proper review could get me off some of the meds..........

Same here. I was under the impression someone cared how I was doing and it just appears they are deperate to put you on some medication and write you off as 'done'. My word, how things have changed. With all the new technology it ought to be easier to get a good idea of how you are doing. I have been trying to self-improve my health and it appears to be working thankfully but bypassing that with a drug won't do my mental health any good. I am not saying drugs won't help but I want to try other things first and how can you know if they work if there is no clear record. I am mystified and desperately sad at how things are turning out with the GP's et al.

Hello

Firstly never any excuse for a receptionist to be rude,I am a GP receptionist unfortunately sometimes the previous caller may have been very aggressive/rude towards the receptionist (still no excuse for it to be passed on to you,we are told to take a minute before taking next call) we would love to be able to give every patient the appointment they want, however, we have limited slots and currently a high volume of calls,re Covid etc.

I hope your pharmacist can help they will request blood test etc if required.

Nice to be able to ask an actual GP surgery receptionist this - is the correct response to a very ill-mannered self-important receptionist to politely end the telephone call then contact the practice manager?

I've done that twice, once at a former surgery where I was told off by the receptionist for insisting I needed urgent attention - she refused and I landed in A&E in an acute pericarditis flare with increasing pericardial effusion. I hand-wrote (oh the good old days) a letter to the practice manager and was told off by the practice manager.

Changed surgeries after a house move, ran into an exceptionally unpleasant receptionist who refused me an appointment during three increasingly more desperate telephone pleadings from me over three days (causing me to again end in A&E then hospitalised for days); once home from hospital I contacted the practice manager who apologised profusely and said the woman had taken early retirement after several other patients had made complaints.

Haven't had any further problems but I've always wondered if there was a better way to deal with the situation.

I can not only speak for the practice I work in,we would ask what the issue is and take it from there, if we have no appointments or was unsure if the issue needed urgent attention i would ask one of the GP for advice.

We have a Complaint form online or would see if the PM had time to speak to patient who was unhappy with situation

It must be difficult dealing with desperate people all day long but as I am sure you are only too well aware rudeness often begets rudeness which is no help to any one. It must be hard to tell people that there are no more appointments for hours. On the other hand receptionists often take it on themselves to decide who should and should not see the doctor and can get it very wrong. See Sunnie2day’s post.

At our surgery getting an actual appointment can be very difficult and sometimes impossible

Hi we never make decisions as receptionist again i can only speak about at the surgery I work at,if we have appointment patient get it,if not depending on issue,if routine then asked to call again next day,if something needs attention then we ask advice.

Agree never any reason to be rude on both sides.

I expect receptionists must therefore get some kind of training in what's routine and what's not? It sounds like you could be placed in difficult situations, especially having to evaluate over the phone.

We do get training,we as receptionist never make a decision,routine would be something like test results(if GP has not ask us to call patient in to discuss) med reviews,requesting a renewal of medical cert. Again I can only talk about were I work we always ask GP for advice,if it’s urgent

I can understand your frustration, I had a pharmacist phone me out of the blue recently to “review my medications”, most of which I have only been on for a few months so still working out doses/side effects and so on and I am also seeing a HF nurse. It was really a tick box exercise only, past reviews with my GP have been more thorough, and the pharmacist has no access to my medical notes, so pretty much a waste of time. She was obviously in a great hurry, and only actually spoke about two of the drugs I’m on. I got the feeling they must be getting paid an NHS fee for this to try to take this task away from GPs, so want to get it over and done with quickly. Tick a few boxes and take the fee, unimpressed. If I were you I would make an appointment with your GP, and discuss your meds with him/her, really none of the receptionist’s concern why you want the appointment, but if they insist on knowing, I think I would give a vague heart related reason, and then discuss meds when you get to speak to the GP. I’m getting rather frustrated about how we all seem to be left without proper follow ups when we have serious heart issues. From what I have seen here and elsewhere it seems to be standard NHS practice, not necessarily Covid related.

Appreciate that honeybee1961, I think I’ll see what happens when I have this review (which is over the phone so is basically pointless) and then book to see my GP so that I can actually get some tests done to see how I’m doing. 👍🏻👍🏻 I don’t feel bad about insisting on an appointment as before my heart attack I had only seen them once in eight years!

Definitely don’t feel bad about requesting a GP appointment, Changeling43, you have every right to expect a thorough review. But we have to advocate for ourselves it seems rather than trust we will necessarily get what it is that we need without asking for it or even insisting we get it. Could do without the stress, but seems to be the way it is.

Not sure how your practice works at the moment all of ours are telephone appointments then if doctor wants to see you they make the appointment.

Changing from bisoprolol to atenolol my practice pharmacist made a mistake and doubled the dose . I didn’t check until I started to feel awful as assumed she knew what she was doing . They are not doctors ( although some of them like to think they are ) and am with you I would prefer to be reviewed by a doctor if you are hoping for a change on clinical grounds rather than a straightforward review of long term meds. Tricky if that’s their policy . You would be better off talking to a cardiologist than a GP . If not NHS then privately if you can afford it if you are hoping to make a change . No excuse for a rude receptionist

Absolutely, pharmacists aren't doctors.

But, equally, doctors aren't pharmacists. My sister (being treated for a brain tumor) was prescribed various drugs with some pretty nasty interactions.

The confusion, tiredness and other effects were put down to the tumor by her GP.

Her hubby got her script filled by a different (not in the surgery) pharmacy one month and the pharmacist immediately queried 2 of them. Symptoms virtually disappeared within a week when she stopped taking one.

I ve just asked a hospital doctor about that . And if a doctor prescribes a drug which will have interactions that would be picked up by the pharmacist if the doctor doesn’t realise and that seems an appropriate use of specialisations . A person who has had a heart attack a year ago and is looking to drop some of his meds requires clinical assessment in my opinion best carried out by a doctor rather than a pharmacist . Others may differ in their opinion but in that situation I would rather have the discussion with a doctor who might decide further tests were needed before making a decision . Sorry that happened to your sister she had enough on her plate

Hello

I think you are better of with the pharmacists to they are more up to date with medications than your GP'S

My GP had prescribed me something only last week and the pharmacists was straight on the phone to me saying this would be highly dangerous we cannot give you this we will phone your Doctor and explain why and recommend an alternative so goes to show who knows more about medications , I think you will be more than in safe hands x

New doctor required!!

Hi, I know this comment will/may be controversial, but a GP "should" be better trained than a pharmacist! They may have more prescribing knowledge, but they do not have the years of medical knowledge and legal responsibility of a GP.

sorry to quote people, and this is only 'my opinion' reading these posts:

...."pharmacists was straight on the phone to me saying this would be highly dangerous we cannot give you" - If a GP is prescribing like this they need to be struck off!

..."my practice pharmacist made a mistake and doubled the dose . I didn’t check until I started to feel awful as assumed she knew what she was doing" - this could be fatal, why is this being regarded as acceptable?

..."but seems to be the way it is." - couldn't agree more and I dont understand why people are accepting sub-standard care.

..."over the phone so is basically pointless" - this is the result of covid and the fear created by the media, how many people are going to die as a result of 'NHSCovid'?

..."the pharmacist has no access to my medical notes," - exactly my point.

..."I am a GP receptionist unfortunately sometimes the previous caller may have been very aggressive/rude towards the receptionist " I'm sorry that this has happened and people are frustrated and scared at the moment (please dont treat us as all the same). 'other' health conditions seem to be a low priority?

..."GPs are, by definition, "general". Which is why they rely on specialists for specific knowledge." Correct, however, they seem to be pushing even more responsibility (down the chain, not up) onto 'untrained (legally, just attend a coroners case)' and again overworked pharmacists, this is wrong.

..."so I had a full 20 minute face to face consultation" This used to be the way GPs operated, now they are all privatised and work on volume rather than quality, money monet money.

..."The receptionist would not let me book an appointment with my GP to discuss." - put a written complaint into your GP!

I'm not trying to detract from the original posts and all the (helpful) comments describing their experiences. When you have a serious health condition you should be looked after by the most qualified and experienced person. I have a feeling these 'playing devils advocate' views now say that a pharmacist is more experienced than a GP?

Locked in 3..2..1

Banned in 3..2..1

I am with you on this smarticus and appreciate your honesty. I am going to have the consultation with the pharmacist but book an appointment with my GP to carry out some tests. 👍🏻

good thinking

I hope they lock it soon, I’m biting my tongue so hard it’s bleeding.

Spot on! Several times over.....

Pharmacists know about drugs and can dispense them, but as we know they can’t prescribe drugs or change a prescription or decide to stop prescribing a particular drug to a particular person. Unless they work in a GP surgery (mine doesn’t), they don’t have access to patient records and can’t sanction blood and other tests, so I really can’t see how they can adequately perform a medication review for complex medical issues such as cardiac problems. All they can do is ask a few questions and report back to GPs.

Aside from this there is what I have found to be another worrying trend in that some nurses are now permitted to prescribe drugs with certain restrictions. My heart failure nurse can make changes to my cardiac drug prescriptions as she sees fit, but can only issue prescriptions for 28 days, although it is at least 6 weeks in between appointments. I discovered it is a “nurse led” team so the prescribing doesn’t even seem to be routinely overseen by a cardiologist. Just as pharmacists seem to be taking some burden from GPs, it seems roles such as heart failure nurses have been developed to take some work burden from cardiologists because there just aren’t enough of them. I feel really unhappy with the situation and the nurses just don’t have the depth of knowledge to be able to answer my questions, so they try to side step them. I can’t get to see a cardiologist to get my questions answered, not even privately at the moment due to Covid.

It seems bizarre that we are prescribed a whole host of powerful cardiac drugs at the outset, but no one seems bothered about routinely keeping a check on how we are responding to them, if symptoms are improving, getting worse or whatever or running tests to check this out. We are just left on them for life, unless we somehow find a way through the system to get things checked out. I am finding that this can be a real fight. Can you imagine the outcry if cancer patients were treated in the same way.

An excellent and coherent response (unlike mine!) this "nurse led" practice really 'naffs me off'! from personal experience I was (and still am) left with no blood pressure test or blood work (FBC) from October last year after my second MVR due to 'Covid' It feels like unless you have covid you are not important anymore? Trying to access GPs is almost impossible, this morning at 8am I was number 14 in the queue. I gave up and had to navigate my way around the on line consultation system, how one of our 'silver tops' does that I have no idea?? GPs are seriously underfunded and overworked - I get that, but at what cost????

I find Monday morning is a very bad time to get through to appointments at my GP surgery - any other day about 2 pm is always a better bet.

I don't believe GPs are underfunded or overworked. Those at my surgery all seem to be part-time. One, I know is married to another doctor who also works part-time, so they earn enough to both be part-timers and have no child care problems because one of them is always there. A district nurse I was talking to told me she believed Covid was just an excuse for GPs to do even less than they did before the pandemic. She simply confirmed my own opinion and I'm a nurse, too.

a bp machine is cheap enough and will give you a very good idea as to your bp. You should take it about 2ce approx 5mins apart and record the lower one. Take it in the morning, possibly lunchtime, and then in the evening. Record it. You will find that it is always lower in the morning. Do this for about 10 days and then present it to your GP (if nec email it to the surgery) if you think your bp is too high and then they will have a duty to see you or at least speak to you about them.

Thank you for that Granny E. I already have a BP monitor and use it daily. Perhaps you meant to reply to Smarticus?

Well are they underfunded? - or, are they putting money into areas that are unnecessary or high profile. Basic care and understanding don't need money they should be there at the start and then built on. What about making a prescription to be signed off by the doctor in conjunction with a pharmacist before presenting it to the patient? The touble is, we have to present issues before they will look at the cause and then change the drugs. This can be dangerous let alone sickening.

unfortunately I do not believe that many doctors or pharmacists know enough or have long enough with patients to give advice on lifestyle and esp dietary changes that would help those of us with a/f, heart problems, etc that might very well have been triggered by decades of eating wrongly, and taking big phama drugs, and lack of essential micronutrients and minerals. Also we now know a lot more about how the body and the cells work than we did even 10 years ago and some of the medical profession are very conservative. I truly believe that in 20 years time medicine and the approach to health will be very different.

Me too. I have never been anywhere near a surgery for years, considered I was quite in good health, ate healthily, always cook from scratch don't drink or smoke, exercised and now at 69 this has been complete shock.

I can imagine. Good luck to you

In order to be able to prescribe medications a Registered Nurse has to complete a thorough training and pass various tests.

rcn.org.uk/get-help/rcn-adv...

Registered nurses are skilled healthcare professionals.

Often an experienced nurse guides and teaches junior doctors.

Many patients appreciate the care of a Clinical nurse specialist including cancer patients when receiving their chemotherapy.

Nurse lead care is in no way second rate care.

Yes I agree it is very worrying that the GP can prescribe a drug yet - in my case - give no advice about a follow up to see if it was working. I don't think my GP has a clue who I am or is bothered to look at her notes which I assume she made as an aide memoir. If I go see my dentist he knows exactly what happened last time I saw him etc etc of course I pay for his service .....

Cancer patients are treated the same way Honeybee. I know from personal experience. 10 operations in 4 years, no urethra or natural bladder any more (since 2015), no follow ups at either hospital or at GP, after first 12 months, no med reviews with anyone. You have your op (s) and then you get on with it. Totally agree that all is passed down line, then line runs out. Stroppy receptionists, goes with territory often. These days nobody is a special case. If you can afford private it is worth it for monitoring and peace of mind. Perhaps its a postcode lottery - but I don't think so. Good luck

They have of course completed additional training, but they don’t have the same standard of training that a cardiologist has.

Not necessarily so.

There are now many Registered Nurses, Midwives and Allied Healthcare professionals who have extra specialised training equal to that of a doctor.

Some even are Professors and have PhD's.

Eg Midwives who learn to perform the examination of the Newborn.

There are Clinical Nurse Specialists who insert Pacemakers.

Sonographers performing echocardiograms.

These Healthcare professionals are responsible for assessing the practical skills of doctors during their Cardiology specialist training such as performing echocardiograms.

I think a pharmacist review is better than a GP or even a heart consultant. The pharmacist will look at the whole picture in the round. They know how drugs interact and react with eachother. A GP will often look at what you taking for your heart, they or other conditions that you are there to discuss they won't necessarily review all of the medication you are taking. Let's say for example you are worried about your blood pressure, they will focus on that and prescribe accordingly without looking at your blood thinners, statins etc.

I for one was grateful to discuss my entire regime with one person, they made there recommendations to the GP and working together we came to an agreed programme. It is my understanding that it is almost as hard to get qualified as a pharmacist as it is to become a doctor.

The pharmacist in a GP practice will be a clinical pharmacist with prescribing qualifications. They undertake structured medicine reviews. They are part of the clinical team. They can prescribe. They can send you for blood tests. And they will be an increasing feature of the GP practice so patients need to accept this new role as much as the GPs want them as part of their team.

And whilst community pharmacists can’t all prescribe they can access GP records and can ask for a patient to be referred. The new tranche of pharmacists will ultimately all be able to prescribe. The same as a lot of nurses can. My appointment at the angina clinic was entirely conducted by a cardiac nurse practitioner. She knew exactly what she was doing, referred me for CT then for angiogram.

This is a new world. Of course there may be errors and these can unfortunately be made by any human such as a GP, pharmacist, teacher, engineer etc. Hopefully checks in place and digital systems can reduce human error. But as a pharmacist myself I don’t just count tablets. And it’s sad that some people still think we’re a waste of space.

I was a practice nurse in a GP surgery for tears and we had a pharmacist. The GP's would take advice from them as they are the specialists so dont worry you are getting the best person for the job.

Is rudeness a required skill in the job description for GP receptionists? I've encountered many over the years! Judging by the comments, it would seem that pharmacists are a good source of advice and information, so hope you will find them helpful. All the best.

So I am supposed to see a pharmacist who does not know me and presumably has no access to my medical records so knows nothing about my other medical conditions!!!???

That sounds bonkers.

When I left hospital I was told that my GP was responsible for my total care and that they would vary my pills if necessary.

Of course even before Covid that ‘total care’ did not amount to much and frankly I got sick of my GP ‘s attitude towards the consultants at the hospital (acting with mock humility towards them).

The NHS aftercare systems are unclear and in my experience don’t work.

But now I’ve read all this I’ll steer clear of the rude receptionists at my local surgery and the ineffective doctor and just head for my local pharmacist ............

From what is being said here it would appear that there are two types of pharmacists that we can routinely encounter: those based in GP surgeries and those based in community pharmacies. It seems perhaps their training, roles and responsibilities are different. I can only speak about the experience I had recently with a pharmacist who rang me completely unexpectedly. She was phoning from a community pharmacy and as far as I am aware my GP practice does not have its own pharmacist. Firstly, as she phoned me unexpectedly I had no time to think about any questions I might have about my medication. Secondly she was in such a hurry to get the whole thing over with (following a script perhaps?) she was speaking so fast that I had to ask her to slow down. Thirdly, and most importantly of all, I am currently taking at least eight prescription drugs, she only asked me briefly about two of them. I do not call that an adequate medication review.

Some medication reviews are around cost savings . The medicines management dept of the ccg have to work to budgets and sometimes they have specific drugs they are targeting and want to change patients if eg another one in the same class comes off patent and changing a lot of patients would make a big cost saving . Not saying that is what was happening in your case because I have no idea

I’m really puzzled by this. Community pharmacists don’t do telephone reviews except by prior arrangement with the patient. We do reviews but they’re based around use of medicines as in inhaler technique or taking meds so they’re properly absorbed. And we look at lifestyle and how that impacts health outcomes. I’m sorry for your experience, it’s not acceptable and not how I conduct reviews.

it is difficult for someone who does not know you to think of you as a whole person. You are presenting with x, and so all the other things you have acquired might not be taken into consideration.

With all due respect to the pharmacists and their knowledge I won’t be comfortable reviewing my heart meds with a pharmacist without consulting my Gp or my cardiologist doses need to be altered based on response duration ECG changes..ect..

tbh my own pharmacist won’t give advice in certain cases without referring us back to our GP!

there must be a miscommunication and the receptionist didn’t understand the concept of review g meds for a pt with hx of a heart attack !

Agree, and in reality this is my point. I understand that a pharmacist is best qualified to talk about the drugs I’m on but they can’t change anything. What I wanted to do was talk to my GP about my progress and get a physical review to see if I can come off some of the medication but the receptionist wouldn’t let me speak.

Trying to get anywhere with my gp is Impossible as the Gestapo on reception who are obviously medically trained??????know better than gps and pharmacist and said I have to call back at a certain time to get a call back!!and after ringing 15 times at the time she said and getting no answer they went to lunch so gave up this is also for a meds review so I spoke to pharmacist and apparently they can do a medical intervention and sort it out

My annual review last April was a phone call from a member of the Prescriptions Team at the GP practice to ask -

1. Had I got Covid symptoms?

2. Was I happy with my medication?

3. Did I know what each of my medications was for?

As I was entirely happy with my medication and my blood pressure readings had not altered over the past year, it was agreed that since the NHS was struggling with the first wave of the pandemic, I wouldn't have a blood test. I now await this year's offering. 😯

Under no circumstances should a pharmacist decide anything about (for instance) the strength of the beta blockers like bisoprolol. My GP is reluctant to do so, and says that a cardiologist should do so.

how long do you have to wait to see your cardiologist if you are not an emergency?

Yes I know. I ended up by paying to see the cardiologist I should have seen on the NHS.

Then I changed to a cardiologist at Papworth.

so did I. It was the only way I could get to see him quite a while ago now. Then saw him briefly on the NHS and he wanted another follow up, but that was put off and put off.. Have not seen him since and that was about a year ago. Thank goodness am managing OK. Now coping and taking apixaban plus supplements and diet and have got myself off blood pressure pills for the time being although in permanent A/F, although since the ablation no ectopics and huge thumps.

Our GP surgery is the same. As many have said the GP pharmacists are extremely knowledgeable and have the time too. Having not seen a GP through all this Covid the pharmacist over the phone was approachable and thorough. My husband had the same and said how good she was (high praise!) gone are the days of a sit down chat with the GP just to see how things are going. Take care

I don't think a lot of GP are qualified either to be honest

Sorry to hear that, it does happen, and should not. Did you get cardiac rehab and assigned a heart nurse? It's 16 months since my HA and I still have my heart nurse. We meet face to face and I get checked out, we talk and she tweaks my meds. It's good to have someone there for you. Currently she is also running an on-line session (5 weeks) with about 12 participants I'm included here too. PLEASE CHECK THESE THINGS OUT - YOU ARE NOT ALONE...

I agree that pharmacists can often be more helpful -- and certainly friendlier -- than GPs or even specialists.

I would suspect that the best way to do this is go to your pharmacist, see what they say, then get a referral to a doctor. But you will need a blood test, of course, and BP check etc.

My medicine review go through my cardiologists, although through a rehab cardiologist instead of my surgeon.

No one checks me they just changed my medication in guidance with the discharge letter.. HA October 2019.. my dosage was dropped on the anticoagulant prescription which it will stay at now till Oct 2022.

Having read through this thread it looks to me as if a surgery with an attached pharmacist is preferable to one without. For various reasons I have been thinking of changing my GP and this looks like a very convincing reason to do so.

Sorry not to be able to assist the original poster but would I be correct in my thinking above??

I have to say, when it comes to medication, I would trust a pharmacist over a doctor any day. My life was saved twice by the knowledge of pharmacists, when doctors had made incorrect decicions about my care. GPs are not specialists I'm afraid, (the clue is in the title), especially where it comes to medicines.

I would accept the opportnity to consult a pharmacist, then complain, in the first instance, to the GP practice manager about the receptionists unacceptable behaviour, backed up with a written complaint to the CCG and Trust. The GP is the Primary Care provider given funding because you are on their list of patients: you can demand to be seen by your GP.

You have been fobbed-off.

My heart failure nurse is my first port of call when medication is reviewed. She is not qualified to add meds and always consults the heart specialist before changing anything.

However my pharmacy is there to make sure I understand how to use items such as newly prescribed inhalers and also to tell me what over the counter meds I should avoid in case they don't work in sync with my prescribed meds. He also talks me through possible side effects for new meds. He asks me to contact him a week after starting any new medication in case I don't feel confident about taking them or am having any problems.

I would never discuss heart meds with my GP as it's not their specialist subject.

With regards to the Doctors receptionist's rudeness, rise above it. If it happens again write a letter to the surgery manager. They may not be aware of any problem.

Thanks Jo. I'll have to search out similar sites for wales but it's a start!

My review is always carried out by my GP along with other checks on a regular basis as I require regular blood tests. My organs especially liver do not tolerate the colchicine given for pericarditis. However I have been given sound advice from my chemist with drugs that have been prescribed he does not think I should take. However he always recommends seeing my consultants or GP.

No excuse for rudeness so consider an email to the practice manager. My sister in law is a pharmacist and she comes in very useful for explaining the drugs I am on, interactions etc. However she never gives me advice on doses etc, preferring to leave this to the hospitals(nurse, consultant, doctor), cardiologist and my doctor. I have had instances when the local hospital nurse says one thing and the doctor overrides the advice which leaves me confused but as I dont have access to the letters sent to my doctor I am a little in the dark and covid telephone appointments dont help as my doctor does not always have enough time.

What I would like is all letters to to come to me as well as my doctor. Is this possible please?

Thank you.

Do you live in England?

If so you should be sent a copy of all your clinic letters automatically.

Contact your GP practice and ask for copies of the letters or your local Hospital's Patient Advisory Liaison Service (PALS)

Thanks for this. Yes I live in England. I do receive appointment letter but not the results of my consultations (other than by asking my doctor for a telephone appointment). eg I had my liver scan 3 weeks ago and I requested an appointment with my doctor and was given one two weeks into the future. So about 5 weeks elapsed time when the letter I could have received after a week. Hence I am trying to get information 4 weeks earlier. Its so frustrating.

Hi, I am so lucky to have a brilliant pharmasist. He always takes the time to ask if I have taken this med before and explains what it is for and how it works. I had a new med and as he was explaining to me how it worked, I told him that my doctor recommended using another med with it. He was horrified! Under no circumstances should these 2meds be taken at the same time. So lucky.

Goodness me! I don't even trust my GP, waiting for my check up from my team. Never heard of that before.

My reviews are always done by a pharmacist. I have just come back from the dentist and commented how their receptionists should come give my doctors receptionists some lessons on politeness 😄

The first year after mine I saw the cardiac nurse at the surgery who did all the bloods and checked me over. However as I had numerous problems with the meds, it was the GP who sorted them out. Since then I have only seen the cardiac nurse; in fact having had this year's bloods done I tried to get an appointment to speak to her yesterday . It was refused and I got one with the GP Instead and- not just ANY GP but my own named GP a miracle.

There seems to be a basic confusion reflected in this discussion between an annual review and a medication review. An annual review should cover not only medication but also bp, weight, diet & blood tests - my blood tests include liver, kidney & thyroid function, blood count, blood sugar & cholesterol done by a health care assistant . Without blood tests it is not possible to identify medication side effects. Getting access to the results is a different matter - am expected to be OK with no news is good news in absence of contact from GP. Am trying to get access to my medical records online.

Sign up to either Patient Access or the NHS App and you can see your test results - but only those done at Gp. Patient Access gives you graphs over time which are useful.

I know what you mean. Rude GP receptionists seem to be a common phenomena, even the new ones when they start from the get go are rude, must be part of their job description! My parents always told me to treat people how you would like to be treated so on reception they always get the appropriate response with me.

1. I use ‘Patient Access’ app to book appointment directly online, allows me to pick time and date and completely bypass the pit bulls on reception except for picking up anything GP has left for me, really works well.

2. My lovely GP, always happy to review my meds with me, always a considered two way conversation taking into account my wider medical history. Pharmacist (who is also lovely), is also always available to discuss potential side effects etc whenever I need to.

Sorry you have had this issue. Try the app to bypass receptionists. Hope you manage to get this sorted. Good luck.

I had the same problem with my GP over 3 years ago the problem was easy to solve CHANGE YOUR GP NOW I have all the Surpport I need and more.

Good Luck 😉

I really don’t recognise the type of Pharmacy described by some of the posters above. Perhaps they never reached down as far as the East Sussex backwater where I live.

It would be nice to have a long discussion with a knowledgeable pharmacist about the 9 pills I take every day; whether they are actually doing me any good; what side effects they might/do have etc etc.

However I am not sure the people in the queue behind me buying cough medicine, toothpaste, and paracetamol would be too happy waiting......,

That’s what the pharmacist is there for. Not for selling toothpaste. There are other staff to do that....

True but I had to wait ages the other day for a prescription because the pharmacist was on the phone giving advice and the other staff couldn’t do her job . In a small pharmacy with one pharmacist on duty it can be more of a problem. People were queuing outside in the cold because they have a one in one out policy in the very small shop

Yes I think people are talking about two very different kinds of Pharmacy on here. They might both have an extremely well qualified pharmacist but the time and space they might have for a 'consultation' are not the same.

On the other hand EVERY doctor should be able and willing to do this without being reminded, cajoled or operating through 'defensive' surgery staff.

You are right. I normally have to work like that. On my own with few staff but always try and see patients. But it’s super stressy sometimes - I shall be retiring this year. I’ve been shielding and furloughed and working on a Covid 111 line remotely so I think another 6 months of being back in store will see me out. Occasional locums for friends.

I can imagine . And doing vaccinations as well ? Best wishes on your retirement, I think most people working in healthcare at present would welcome a lottery win and a speedy exit even the young ones

A lot of nurses and doctors have already left their professions

More to follow . They have been screwed by the government for at least a decade .

Actually GPs negotiated themselves a very lucrative contract back in 2013 I think it was. But it’s young doctors and those near to retirement in secondary care who are falling by the wayside.

I don’t blame you. I had my review with a pharmacist Linked to GP surgery 2 years ago and was not impressed as he told me I had chronic kidney disease, which was not the case and I was extremely annoyed. As a result I insisted on seeing the GP and ended up putting in an official complaint about the attitude and lack of people skills of the pharmacist involved. I now have my review with the GP again.

Hi Changeling, my case is slightly different. First If it were me frustrated at the response from the receptionist then I would certainly insist I talk to the practice manager. I did have a post op review with the pharmacist which was fine for the time being but as time went on and I became less tolerant to the meds I went back to my GP. Unfortunately there has been little or no management of my meds only reaction to my concerns but even this marginal. Having ended up back at A&E feeling like I was having a second HA the hospital asked the GP to my Bisoprolol dose and it was reduced from 2.5 to 1.25 (reactive). At the time I asked for referral to my cardiologist who then stopped the Bisoprolol completely, adjusted other meds and made a 6 month review appt (proactive).

In my case the Bisoprolol was making me feel really ill, lethargic and depressed. There was no real management of my case by the GP but the cardiologist acted immediately and I feel so much better. I think there can be a very broad brush approach at GP/Pharmacy level. Hope this helps 👍

When next in a pharmacy you may see the massive, general range of meds which pharmacists have knowledge of for many, many different conditions. The cardiologist is an expert in matters of the heart and associated meds!

My pharmacist is brilliant. They are far more knowledgeable regarding drug interactions than many GPs. I have no problem discussing meds with them and they will refer back to GP if they think your meds should be amended. We are all able to note down any problems we are having and keeping a record of things like blood pressure. I did not have my annual heart check this year but did have bloods taken - I don't need them to see me to tell me if I'm overweight etc. The GP reviewed my bloods and sent me a text re an alteration - perfectly adequate under the current circumstances. With regard to 'rude' receptionists, I have come across some very strong willed ones. However, I have found that being polite and not reacting to their attitude gets results. If your receptionist was rude and you were calm then, as previously stated, you should contact the practice manager.

I myself have been on the same medication now for 2years without a review, since my heart attack, it is only since joining this forum I have found out most of the medications I take have very bad comments from other hearties, due to covid cannot get appointment with GP, spoken on phone though, he is following hospitals guidelines so I need to raise this with hospital, cannot get appointment a hospital unless recommend by GP, does the phrase going round in circles come to mind, my pharmacist is very good at explaining why I take the drugs prescribed but would not dare to advise on changing any, why do these receptionist think they are more informed than GPS.

Be safe.

Mmmmm? Pharmacists are highly qualified and they probably know more about drugs in depth than the GP ....HOWEVER ...I have never known it to be the case that it is the pharmacist who actually reviews your medication.....?? 🤔

The clinical pharmacist in a GP surgery will normally conduct the medicine reviews. This is different from an annual review which is normally preceded by an appointment for bloods so GP can assess. Although I have had my annual review done by the senior nurse who can change my meds as can most clinical pharmacists. The move is that in the future all newly qualified pharmacists will be prescribers as well, although there are many that are already. Plus some work in highly specialised areas such as running the diabetic clinics in hospitals or warfarin clinics, or asthma clinics. You’d be surprised at the range of clinical skills these advanced practitioners, pharmacists and nurses, actually have. And you will see far more of them in the future.