Patience the script with patients as GP receptionists are under duress
The receptionists at your GP surgery may be perceived as abrupt and rude, but have you ever stopped to think how much they have to deal with? Mark Smith reports
GP RECEPTIONISTS are among the most loathed workers in the NHS. Over the years they have gained a reputation as being “battleaxes”, “Rottweilers” and “dragons” who are an unnecessary barrier between the patient and the doctor.
But if you delve a little deeper, some would argue that these workers are hugely undervalued and should be revered, rather than despised, by the public.
Not only do they deal with frightened, angry and rude patients on a daily basis, it’s also their job to ensure the practice runs as smoothly as possible at a time of unprecedented demand.
Susanne Davies worked as a receptionist in Uplands, Swansea, for 16 years before becoming the reception manager at Tynycoed Surgery in Sarn, Bridgend, 12 months ago.
It’s her job to oversee the receptionists at the Merfield Close practice, which has more than 10,000 patients on its books.
“You get some patients who are really understanding and sensible – but there are others who simply don’t understand the situation we’re facing,” explains Susanne, a mother of two from Caerphilly.
“Some patients feel their issue is more important than anyone else’s and that it’s their right to be seen straightaway.
“You can encounter some quite unpleasant people, and it does surprise you when you first start as a receptionist.
“I’ve had new employees in tears in their first week or two because they’re not used to being spoken to like that.
“You harden up to it a bit, but you never fully get used to it. People will take your breath away at how they speak to you.”
On a typical day the Sarn practice’s phone rings constantly between 8am and 9am, while more than 20 people queue outside, hoping to be seen first.
As well as booking in appointments, reception staff are also tasked with “screening” patients to ensure the GP is the most suitable health professional to see them.
In some cases, patients are referred to a nurse practitioner, physiotherapist or other NHS expert in primary care instead.
“You cannot teach someone how to be a medical receptionist. They have to just learn on the job and ask as they’re going along,” added Susanne, 51.
“A lot of patients don’t like it when we ask about the nature of their emergency and say we’re just being nosy.
“On the other hand, some patients tell us absolutely everything and go off on a random story about all their symptoms.
“But it helps to know a bit about them as we can then try to direct them to the most appropriate doctor or nurse.”
Within the practice itself, Susanne says there is “never a dull moment” once patients begin to arrive in the morning.
“Drug taking and alcohol are a bit of an issue in the area,” she added.
“Last night, for example, I left at 5.30pm and by 6pm the girls said it was ‘chaos’ in the practice because there was a gentleman who was intoxicated and hanging around outside making a nuisance of himself.
“You also get people who are distressed and suicidal. We have had a fight in the waiting-room and had to call the police. We’ve had that a few times, actually, and I’ve only been here a year.”
Rather than being paid by their respective health boards, receptionists are given their wages by the practice itself as they are run independently.
While Susanne says she has a great working relationship with the partners at the practice, she feels receptionists are “poorly paid” for the amount of responsibility they are given.
“You are dealing with people’s health, plus all the admin staff in the background, so it’s quite a complicated and intense job,” she added.
“I don’t think we get paid anywhere near enough for the amount of responsibility we’ve got.
“But in both practices I’ve worked in, the GPs have always been approachable and helpful. They do understand to a certain degree what the job is like, but it would be useful for them to spend a day with us.
“The patients can often be really aggressive with us, but then go to the doctor and be nice as pie, so it can be really frustrating for us.”
She admitted that while receptionists can come across as abrupt, the public needs to understand the pressures they are under.
“As much as we’d like to sit and chat about their illnesses, we haven’t got time to do it.
“You have to get on to the next patient as quickly as possible as everybody needs to be spoken to.
“A lot of the staff know the patients anyway, so that builds a nice relationship. We are not trying to be obstructive, we are just doing our jobs.”
■ Julie Godwin, the team leader on reception at North Cardiff Medical Centre in Thornhill, Cardiff, has worked at the practice for nearly nine years.
The practice, which was given an impressive renovation six years ago after the previous building burned down, has 16,000 registered patients from across Thornhill, Llanishen, Cyncoed, Heath, Lisvane and Birchgrove.
“The phone lines are open at 8am and they don’t really stop until 6pm. We are inundated all the time,” she said.
“If you can give patients what they want they are normally fine with us, but if you can’t then things tend to get a little difficult.
“We never say we can’t give an
‘My staff have been in tears’ ‘The reputation of the surgery lies with us’
‘A smile can disarm a person’
appointment. We might not be able to give them the appointment they want with the person they want, but we would never turn anyone away.
“Sadly, you just cannot please everyone.”
Just like the Sarn surgery, receptionists are told by GPs to ask patients questions about their illness or ailment before they are given an appointment.
But Julie said it is in the interests of patients to provide them with a brief outline of their condition.
“Otherwise they could end up in the wrong appointment, that’s not appropriate for them and it’s wasting the doctor’s time.
“It’s all for a reason.”
Julie said managing people’s expectations was one of the trickiest parts of the job.
“If something is hot in the news – such as statins, for example – then we get loads of people ringing up to see the GP,” she added.
“We live in an age of Mail Online and Google, which prompt people to urgently see a doctor.
“Receptionists here have a longstanding joke that when people register, they should do a morning with us to see what it’s like at the other side of the desk.”
The Thornhill resident added that some days they won’t see GPs at all because of how busy they are.
“We know how under pressure they are, and they know the pressures we’re under.
“There’s not much time for socialising or anything like that – it’s full on.”
As patients walk up to the reception desk there are several signs warning of a “zero-tolerance” approach to abusing staff.
“I do feel [abuse of staff] has escalated in the past year,” she added.
“Everything comes past reception, whether it be a phone call or face-toface, so the reputation of the surgery lies with us.”
Nicola Willis started as a receptionist at Portway Surgery in Porthcawl 30 years ago and has worked her way up to office manager.
In the past 12 months it has become the only practice in the seaside town – dealing with 15,000 patients – following the closure of the Victoria Avenue surgery in 2017.
The 55-year-old said she understands why patients get so annoyed and frustrated with receptionists.
“When you are not well it is totally understandable to be stressed when trying to get an appointment,” she said.
“But staff can be put in a very difficult position when they have patients shouting at them.
“We are trying to do the best job we can.
“Sometimes people like to see a particular doctor every time they come here, but when they are on leave or on an emergency call it’s just not possible.
“But people see that as our fault.” She said the job can be souldestroying and upsetting at times, particularly when she goes out of her way to look for alternatives for patients.
“Demand is increasing all the time. Gone are the days you’d be at the reception dealing with patients one to one. Now there’s people queuing to speak to you.”
But Nicola said many situations can be quickly defused with a friendly, understanding manner.
“A smile can disarm a person,” she added.
“If you are sympathetic it can make such a difference.
“The best part of the job is being able to help people and for them to say ‘thank you’, knowing that you have made a difference.
“We do get a lot of compliments and our team are brilliant.”
GP Rebecca Payne, of the Royal College of General Practitioners, said she has a great deal of sympathy for receptionists.
She said: “GP receptionists have one of the hardest jobs in the Welsh NHS. They’re often blamed for things outside of their control; delays in appointments are because of the GP workforce shortage and the underresourcing of general practice.
“Receptionists have an important role in making sure patients are seen by the right healthcare professional the first time they come to a practice.
“I would encourage all patients to respect and listen to their advice, and I would encourage health boards to resource additional training to help them develop their skills even further.”