Will a new appointment system at a Leamington general practice ‘cost lives’?

CREDIT: This story was first seen in The Courier

As patient numbers increase at general practices around the country, many are having to think of ways to save money while still providing a good service to patients, The Courier reports.

Clarendon Lodge Medical Practice in Clarendon Street is moving to a new system of phone appointments on Wednesday September 6, where patients phone ahead and give a summary of their symptoms. The practice then decides whether the patient should come in for a face-to-face appointment, or should instead have a call back from a GP.

In a letter sent to patients, Clarendon Lodge said it was moving to the new system because its practice now looks after 13,500 patients, which has meant some are not able to see a doctor when they want to. It claims the new system will be ‘fairer to all’.

But one patient, who wished to remain anonymous, is very concerned about the new system, claiming it could put lives at risk. She used the example of her son, who she said was only diagnosed life-threatening sepsis after visiting the GP face-to-face. In an initial visit, he was diagnosed with glandular fever. He then developed tonsilitis, for which he was prescribed antibiotics during a second visit.

But as his symptoms began to worsen, a third visit allowed the GP to diagnose sepsis and he was sent straight to hospital. She said doctors at the hospital told her a delay of even a few hours could have meant organ failure for her son. She added: “If this had been a phone call she would not have seen the physical symptoms and he may not have made the full recovery he did. “In a lot of cases, a GP notices other symptoms while in a face to face consultation which would not be apparent over the phone, often symptoms not immediately obvious to the patient.”
But as his symptoms began to worsen, a third visit allowed the GP to diagnose sepsis and he was sent straight to hospital. She said doctors at the hospital told her a delay of even a few hours could have meant organ failure for her son.

She added: “If this had been a phone call she would not have seen the physical symptoms and he may not have made the full recovery he did. “In a lot of cases, a GP notices other symptoms while in a face to face consultation which would not be apparent over the phone, often symptoms not immediately obvious to the patient.”

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She was also concerned about some patients struggling to explain their symptoms properly over the phone. She said: “The elderly will suffer as many will be unable to explain their symptoms properly and will be easily fobbed off.

“Many have hearing difficulties and may not understand what a GP is saying to them and will respond either inappropriately or incorrectly. “There are many people who cannot take phone calls or even carry a phone whilst they are at work, and many more, myself included, who couldn’t find a private place to talk to a GP about their symptoms – who wants the whole office to hear?”

A spokesman for Clarendon Lodge said the new system will result in ‘significant improvements’ for patients. He added: “Following patient feedback, the practice looked at several ways to improve the system before deciding on the changes.

“A thorough consultation was held with the practice’s Patient Participation Group who fully back the improvements the practice is bringing in.

“Whilst the practice recognises that change can bring uncertainty for patients, other local practices have introduced similar changes and these have proven very effective and popular. “The practice firmly believes this will be the case at Clarendon Lodge.”

Clarendon Lodge is not the only general practice to move to a ‘phone first’ type of system. Castle Medical Centre in Bertie Road, Kenilworth, moved to a similar system known as ‘Dr First’ in February 2015 after patient surveys suggested the practice could be doing a lot better. And a doctor at the practice said the changes had been positive for the practice two-and-a-half years down the line.

Dr David Spraggett, a doctor at the practice for 30 years, said: “The main reason we changed our system was to improve patient access. “Lots of patients had expressed concerns that they couldn’t get appointments in time with us.” When the Clarendon Lodge patient’s story about her son was put to him, he said her concerns were reasonable.

But Dr Spraggett added if a patient requests to see a doctor face-to-face, the practice would almost certainly accommodate them. He also said concerns about calling back people with busy jobs, such as teachers who may only be free to take a phone call at certain time of the day, had disappeared quite soon after the new system was in place.

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