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sofiaa

GP Receptonist and GP Medical Secretary refusing to give choice at the point of referral for elderly family member

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Posted (edited)

An elderly family member had an appointment at the GP 2 weeks ago, the GP said she would make a referral for treatment, eldery family member said she wants the referral to a local private hospital which also take NHS patients who are referred by their GP. The appointment times are quicker, the service is better and its more close to home so easier to get to.

 

GP said yes, she would make the referral, however the medical secretary made the referal to a nhs hospital instead, NO legal right to choose where to have NHS treatment was given, all that was received was a letter to say your appointment is in June 2019.

 

So I call the surgery, tell the receptionist what has happened with the wrong referral being sent out, she said she would speak to the medical secretary and then call me back, but she never did.

 

The next day received a letter for choose and book from the GP surgery which was just a copy of the appointment letter that was sent earlier in the week, there is an option to change the booking, so I login and the origonal appointment wrong referral has been cancelled, by whome I have no idea, maybe the receptionist that I spoke to?

 

Today I went to the surgery, explained to the receptionist the wrong place of referral and that no choice was given. The receptionist range the medical secretay and tells her 'She is complaining that she was not given a choive where to go  etc'

 

Receptionist after speaking to the medical secretary tells me 'NO other place for referral, this is the only place etc'

 

Receptionist now tells to 'go sit down....etc' I have 3 patients waiting behind you in the queue and (I'm) breaking patient confidentiality by standing here talking to her'

 

I tell her I want her to deal with my complaint, she tells me the go sit down again and  (I'm) patient confidentiality by standing here talking to her'

 

I ask for the complains procedure, she does not provide it

I ask to speak to the practice manager, the Receptionist  in a split second tells me 'he is in a meeting'

Receptionist  refuses to help me and is more concerned with 3 people stood behind me listening and blaming me for 'breaking patient confidentiality' because there are 3 patients she needs to serve who are behind me

 

The next day letter received form hospita to say the appoitment for referral has been cancelled

 

https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

 

States that patients have the legal right to choose where you have your NHS treatment

 

1. I have been given NO choice at all

2 .I spoke to the private hospital they confirm they are willing to accept NHS referral if the GP makes it

3. Receptionist and  Medical Secretary are saying NO CHOICE AVAILABLE  (BUT see point 2 above)

4. Receptionist and  Medical Secretary are unwilling to make the referral of choice to where patient wants to go, because it would eat into their budget or the NHS budget

 

Please I need your help to draft a letter i will send this week with your help

 

 

 

 

Edited by sofiaa
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If you start asking for gmc numbers at your surgery,  they will start behaving faster than the speed of light.

Try but don't tell them what you want to do with it, just remind them that they must disclose the gmc numbers upon request .

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Asking for GMC numbers is an option, but

a) is all guns blazing,

b) The GP is likely to say “I wasn’t aware of the issue”

 

I’d suggest making a further appointment, letting the GP know of the issue and the patient’s preference of where they want to be seen, and asking how come the referral was cancelled.

 

if that doesn’t work, then not only can you go in “guns blazing”, but you’ll also have more ammunition, having avoided the “shoot from the hip” approach.

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I will try see if they allow to see the same GP....appoitments can sometimes take 2-3 weeks to get at this surgery

 

The problem from what I see is the medical secretary that is refusing/resisting to send the referral to the hospital of choice but is sending to nhs hospital with lots of negative feedback because she wants to save the surgery money from its budget 

 

Should I complain to the GP or go direct to the GMC?

 

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It doesn’t save the GP’s surgery money.

if you wish to get a quicker resolution: go to the GP’s.

if you are wedded to not going to the GP’s : go to the CCG.

 

if you are adamant you want to go to the GMC : do as you wish. It’ll be the least speedy (and likely least successful) approach.

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OK,

you are waving a flag for a relative but what does the relative want and do you have power of attorney to jump in on their behalf?

If you havent then the receptionist has an obligation to tell you to go away,

 

THEY  CANNOT DISCUSS ANOTHER PATIENT'S MATTERS WITH YOU and even if you ahd the permissions they wouldnt want to do so in front of the queue of people and that is what they were trying to convey to you but you failed to understand this.

 

Receptionists cant cancel hospital appointments, they ahve to write notes on the ICE system that show why they have cancelled an internal slot so it isnt revenge or a whim, it is someone much higher up the tree.

 

Now as for the referral, have you considered that the GP cant refer the relative to that hospital because they dont have the specialists there or because there is no NHS space for them? The GP dictates the notes for the secretary to write up, the secretary doesnt make the decisions so.

 

go and make your complaint and the short answer you will get is that they cant discuss anything with you as you are not the patient and notes will be left on the system.

 

For all they know you are jsut a fraudster trying to get personal information  but even if that is palpably not the case they cant change the law just  because you want to cause a scene.

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Receptionists and medical secretaries don't have the power to determine where patients are referred to - only  the GP.

 

As ericsbrother has suggested there may be many good reasons why a referral has not been made to the private hospital.  One may be that it is not appropriate to refer your relative there because they don't have the facilities/expertise.  (Private hospitals can be surprisingly limited in what they can offer outside of relatively routine treatments.  There may(?) also be funding issues - I'm not sure how NHS referrals to private hospitals work within patient choice).

 

The only way to resolve this is for your relative to discuss it with the (or a) GP in question.  The relative will need to do this themself unless they've given you written authorisation to discuss it on their behalf (I don't think a power of attorney is necessary but I may be mistaken).

 

Can they get a 'phone consultation?  Nothing to prevent you being present for that or for a face to face consultation.

 

PS - if your relative has a FtF consultation but you can't be present, get them to ask the doctor to write down what the problem is - assuming there is a problem.

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The receptinist had no problem discussing my mother's referral with me, my mother spoke to her first, then I did, the receptionist had no problem whatsover, it was ONLY when a queue of patients started to build up behind me, that the receptionist told me to go sit down, before this she had no problem at all.

 

As for the referral, the GP said she would make the referral to that hospital, yet the receptionist told me its not available, then she told me if I'm not happy to go ring the number on the appoitment and request to be referred to the other hospital of choice, this is wrong information because when I rang the number I was told I had to go back to the GP surgery and request change of hospital becauase the surgery made the referral, so the receptionist told me the wrong information.

 

I have spoke to the hospital which is closer to home, has better service, quicker appoitment times etc and they have the same facilities/expertise and they accept NHS patients if a GP referral is made.

 

You have the right to choose which hospital in England to go to. This will include many private and NHS hospitals that provide services to the NHS. I have spoken to the hospital they accept patients if a GP referal is made.

 

This choice is a legal right, my mother has not been offered a choice at the point of referral, when I asked the receptionist she simply said NO (see previous posts above)

 

Please I need your help to draft a letter I can send asap to the surgery

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Hi.

 

It usually works best if you post up a draft of what you're thinking of sending for people to comment on.

 

Someone suggested speaking to the practice manager, did you try that?

 

HB


Illegitimi non carborundum

 

 

 

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Where your relative gets referred to has got nothing to do with the receptionist.  Is it possible you have misunderstood what they have said and that it is the GP who has NOT referred to the private hospital?

 

Ask to speak to the Practice Manager and ask him/her for an explanation.  If that gets you nowhere you'll have to go back to the GP for an explanation.

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The GP did say she would make the referral to the hospital of choice but the medical secretary did not offer any choice at all when she sent the appointment letter, then she told me to go ring the number on the letter to change the place of appointment when it was the surgery themselves that did the referral

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And what happened when you rang the number on the letter please?

 

As manxman said and I asked earlier, have you spoken to the practice manager or the GP? I don't think there's any point speaking to the secretary, she's unlikely to make decisions.

 

HB


Illegitimi non carborundum

 

 

 

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On ‎13‎/‎04‎/‎2019 at 17:54, sofiaa said:

The GP did say she would make the referral to the hospital of choice but the medical secretary did not offer any choice at all when she sent the appointment letter, then she told me to go ring the number on the letter to change the place of appointment when it was the surgery themselves that did the referral

 

Sorry - I'm confused.  What do you mean by "...did not offer any choice at all when she sent the appointment letter..."?  The GP decides where to refer the patient to, and the secretarial staff follow the GP's instructions and arrange the paperwork for the referral.  Do you mean that the practice wrote to the patient confirming the referral (to the wrong hospital)?  It's just that whenever I've been referred to secondary services I've only received an appointment letter from the hospital and nothing from my GP (or their staff).

 

Also, I find it strange that you were advised to ring (the wrong hospital!) yourself to change the appointment to the hospital you wanted - this makes no sense at all.

 

Are you sure this is what has happened?  Because if it is, you need to contact the practice manager PDQ because there is something very seriously amiss here.  God knows what else this secretary/receptionist is doing and telling other patients.

 

When speaking to the practice manager I would not be approaching this as a "complaint".  Just recount the facts as you've stated them here.  I would also act a little "bemused" as to why your relative has not been referred to the hospital of their choice, which you understand to be their right under patient choice.  Approach it as if you think a simple mistake has been made and you just want it rectified.  You could also "innocently" ask why the secretary doesn't seem to have followed what was agreed with the GP.  Depending what response you get you may want to take it further.

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The surgery sent a Choose and book referral letter which had only 1 hospital listed and online login to change or cancel the appointment - it was sent from the GP surgery

 

A few days later the actual hospital sent the appointment letter and in the same week the same hopsital sent a cancellation letter, which I suspect the receptionist on the telephone may have cancelled beause I could hear him typing on the keyboard constantky as I was telling him the surgery sent the referral to the wrong place, he then said he would speak to to the medical secretary after the weekend and call me back, which he never did and the cancellation letter for the appointment comes after speaking to the receptinist.

 

Sorry I don't underdstand what you mean by "bemused" how can I put that across in the complaint?

 

This is my first draft of the complaint so its all over the place and not strongly structuyred.  Please advise how this can be improved and worded please

 

[Your address]

[GP Practice address]

To [Practice Manager/ Name of GP]

Re:PATIENT’S NAME, DATE OF BIRTH, ADDRESS (if not yourself)

 

I am writing an official complaint because of problems with not being given the legal right to choose where I want to be referred for treatment.

 

Secondly for the way receptionist [ name of receptionist] dealt with my concerns on [date] at [surgery name] and for [name of medical secterary] who failed to follow up with the telephone call I made on [date] which you can listen to.

 

I was unhappy with the standard of service received from [name of receptionist / Medical Secretary] on [date] for the following reasons:

 

On [date] my mother had an appointment at the surgery, [name of GP] said she would make a refferal for treatment. My mother requested to be referred to [name of hospital].

 

On [date] a choose and book referral letter from the [surgery name] was received dated [date] . This had no choice of referral and did not have the hospital my mother requested in her appointment with [Name of GP] on [date]

 

On the same day I rang the surgery and spoke to [Name of receptionist] and explained the surgery had sent the wrong referral. [Name of receptionist] said he would speak to the Medical Secretary on [date]  and request the refferal and then contact me. This he did not do.

 

My mother had an appointment on [date] she arrived at the surgery and checked in at reception. My mother asked me to inform [name of receptionist]  that she had an appointment the previous week with [name of GP] where the GP told her she would refer my mother for treatment to her hospital of choice. My mother told the GP she would like to be referred to [name of hospital] and the GP agreed.

 

[name of receptionist] informed me no choice was available and the preferred choice [name of hospital] did not offer the treatment. This is completely wrong information given by [name of receptionist]. I have spoken to [name of hospital] they have the facilities in place to treat the patient. This will be done when [name of surgery] make a referral to them.

 

I asked to speak to the [practice manager]. [Name of receptionist] immediatley told me [practice manager] was in a meeting all day. I asked [name of receptionist] to tell me when the practice manager would be free as I would like to speak to him. [name of receptionist] ignored my requested and told me to go sit down. [name of receptionist] tone of voice was demeaning and showed signs of attitude.

 

I asked [name of receptionist]  that I would like to see the [Medical Secretary]. [name of receptionist] rang the medical secretary and told her the patient was not happy with not being given any choice for the referral for treatment.

 

[name of receptionist] told me if I was not happy with the choice of hospital I had to call the number on appointment letter and ask to change the hospital. The advice provided by [name of receptionist] is incorrect. The referral was made at [name of surgery] and not at the hospital.

 

[name of receptionist] with a patronising tone of voice told me no choice was available at all and to 'go sit down'. I informed[name of receptionist] I would be making a complaint and asked for the complaints procedure. This request was ignored and no complaints procedure was provided.


1. The patient has the legal right to choose where to receive that care. Patient has not been offered a suitable choice which was [name of hospital]

 

1. All the hospitals or services you are able to choose from provide treatment to NHS patients free of charge, including private hospitals. The patient has the legal right to choose where they are referred to for their first outpatient appointment. No choice was provided at all.

 

2. When the decision is made that treatment is required, the GP, referring clinician or local referral management organisation, should offer four or five options in your immediate area. This was was not offered.

 

Patient is eldery and disabled and requests a referral to [name of hospital] which has shorter waiting times, is closer to home and is more convienent. I have spoken to [name of hospital] and they are willing to accept the patient is a referral is made.

 

If you are referred for a first outpatient hospital appointment, you can choose to go to any NHS hospital that provides a service or a private hospital.


I am upset and stressed about these problems because I have been denied the legal right to choose where I am  referred to for my patient appointment.

 

No choice was provided at all. I am eldery and disabled and [name of hosiptal] is my preferred choice as it closer to home, less waiting  times and more convienent with good reviews.

 

And the receptionist was quite rude to me and never even apologised for the her behaviour towards me. The secretary doesn't seem to have followed what was agreed with the GP

 

I would like a personal apology from the doctor’s surgery and an assurance that I can have my choice of referral to [hospital name]


Along with answers to my questions, I would now like: [name of receptionist] attitude to patients to be reviewed.


I attach a copy of my choose and book referral letter that clearly shows no choice was provided. Appointment letter and appoitment cancellation.

 

I look forward to hearing from you within the time limits set out in the NHS Complaints Procedure.

 

I  would  be  pleased  if  you  would  carry  out  a  full  investigation  into  my  concerns  and provide a response in accordance with the NHS Complaints Procedure. I  look  forward  to  receiving  your  reply.    I  understand  that  I  will  be  kept  informed  of progress  if  I  do  not  receive  a  response  within 25  working  days.    Please  do  not hesitate to contact me if you need any further information.

 

 

 

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sofia, I think people are trying to suggest that you see the practice manager before starting a complaint. It could be that you can resolve this informally without making it confrontational. And if you do, then you're likely to get the outcome you want more quickly than if they're investigating your complaint.

 

If and when you do send the complaint, my thought is that what you've written is a long letter. In general, it's better to send one side of A4 and keep it concise, so the person reading it doesn't lose concentration after the first page.

 

HB


Illegitimi non carborundum

 

 

 

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Posted (edited)

As honeybee has said, at this stage you are NOT making a complaint.

 

Just ask to speak to the Practice Manager and seek an explanation as to why your relative has not been referred to the hospital of their choice.

 

By acting "bemused" I mean saying something like "GP so and so agreed to refer my relative to such and such a hospital, but when the referral letter came through we were puzzled to see that it was for another hospital not the one my relative wanted.  I'm sure it's just some easily explained clerical error or mistake and I'm sure it will be very easy for you to put right for us.  Can you do that please?"

 

That's it.  There is absolutely no point whatsoever in making a written complaint before you've tried to resolve it informally.

 

EDIT: I fully agree with honeybee's last post

 

Edited by Manxman in exile

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I have tried on several occasions to ask to speak to the Practice Manager this week and each time I have been told immediately the practice manager is in a meeting and to put what I want in writing to him. So can you pleae help me come up a with a letter to send to the Pratice Manager (not a complaint) but a letter,  similiar to what you have written above what I would have said to the Practice Manager if I was able to see him

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Hi

 

1. Do you have a letter in writing from said family member giving you authority to speak on there behalf with there GP Practice in any and all matters and has the GP Surgery been giving a copy and acknowledged it?  (if not sadly they will not discuss the family member with you without there express permission, patient confidentiality & data protection, which they could have explained to you)

 

2. The Practice Manager, after you have the above do not phone the Surgery but put it in writing that you want to discuss said family members treatment and a very brief outline and require and appointment arranged whether it be face to face or telephone (your preference). 

 

As Caggers have said you need to go via the Practice Manager (even with them being difficult that is why I say put it in writing (ensuring to get free proof of posting from the post office) as they will need to acknowledge that letter and record it on there records.

 

 


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1. Yes to letter of authority to speak on there behalf / GP is aware

 

2. Can you help with the letter or manxman in exile help can you help with the letter  to send to the Practive Manager?

 

3. Will out everything in writing so have a record

 

I want to get the letter sent after the weekend, so all help appreciated

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I can’t help but think that we’re massively over complicating things here, pick up the phone and ask to speak with the PM.

Explain the issue and ask them to sort it out.

 

I could solve 99.999999% of problems within an hour or so provided someone actually told me what the problem was.

By the time I was receiving letters spanning several pages and having to dig through notes and speak to people to get their accounts of what happened it could take weeks to gather the info and get replies from everyone.

 

Just pick up the phone at lunchtime on Tuesday, ask for the PM and if they’re unavailable ask when they can be contacted and speak to them so they have an opportunity to resolve what is probably a very simple issue rather than trawling out weeks of waiting. 

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My views are my own and are not representative of any organisation. if you've found my post helpful please click on the star below.

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I've already tried this last week with no luck in getting an appointment with the practice mananger (see post earlier)....hence why I want to now send an informal letter to the practice manager, anyone please help

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In fairness you’ve explained the situation really well on here, there’s no secret code or technique to writing to a PM. We’re just normal people doing a job so don’t feel like it needs to be a perfectly crafted 10,000 word masterpiece, it really doesn’t. Half a page of simply put “We’re not happy with x, please can you help us get y...” will do just fine. 


My views are my own and are not representative of any organisation. if you've found my post helpful please click on the star below.

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I agree with "think about it".  If you can't get through on the 'phone (which could be said to be a problem in itself) just send a simple and straightforward letter as you have explained here.  I think the wording I suggested earlier for a face to face conversation will do as well in a letter as in a conversation.  If you have written authorisation from your relative to act on their behalf include a copy, otherwise get written confirmation now and include that.

 

There's no special formula or wording you need to use, just explain your concerns in a non-confrontational way as honeybee suggested.

 

If English is not your first language(?) say so in the letter and apologise if your wording comes across as abrupt - say it's not intentional and you are just looking for an amicable resolution.

 

OK?

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The other thing that strikes me is that the referral pathway may necessitate that all patients are referred for initial examination at an NHS facility but is treatment is necessary then the choice of where treatment will be given is then made. It makes far better sense to have the initial appointments in one place so the the team diagnosing and setting treatment plans are centralised and then additional treatment capacity is sought from the private facility. 


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This is my letter to the practice manager (not complaint at this stage)

 

[Your address]

[GP Practice address]

To [Practice Manager/ Name of GP]

 

Re:PATIENT’S NAME, DATE OF BIRTH, ADDRESS (if not yourself)

 

I am writing this letter to you as I have tried seveal times to request an appointment to see you in person for a meeting regarding my mother's incorrect referral but everytime I've been told your in a meeting or not at the surgery.

 

"My mother requested to be referred to [hospital name] and GP so and so agreed to refer my mother to [hospital name], but when the referral letter came through we were puzzled to see that it was for another hospital not the one my mother wanted. My mother is upset and stressed because she has been denied the legal right to choose where she is  referred to for her patient appointment. No choice was provided at all I have spoken to [name of hospital] and they are willing to accept the patient if a referral is made.. I'm sure it's just some easily explained clerical error or mistake and I'm sure it will be very easy for you to put right for us.  Can you do that please?"

 

I look forward to hearing from you

 

Kind Regards

Sofiaaa

 

I've tried to keep the letter simple and used the wording manxman in exile gave which is fantastic. The letter is short, to the point and does not sound like a complaint letter. If the practice manager sorts it out then no complaint letter will be required.

 

What do you guys think of the letter, I will be sending it out soon as get some feedback on it

 

 

 

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