Telephone and Skype contact with the GP

Some people had experience of a telephone consultation (a GP appointment over the phone), which could be a quicker and easier alternative to a face to face consultation as long as the doctor doesn’t need to examine the person. It was also helpful for people who couldn’t get to the surgery easily.

When Aaron had neck and shoulder pain for several weeks, he tried to get an appointment with a doctor. No GP was available in person so he was given a telephone consultation instead. He felt that telephone consultations are ‘a great idea’, especially as doctors are very busy, but would prefer a face to face appointment next time as the pain was still there:

A GP can’t tell over the phone how stiff someone’s neck is’ or how much pain they’re in. In some situations face to face consultations are better.

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Recently I had a problem with my neck and I tried to get an appointment. And I couldn’t get one because the GP has, one of the GPs had left. And so I rang up, I went there in the morning, tried to get an appointment, no appointments, for the emergency appointments on the day because it was really bad. And that was it, they said nothing today.

So I went back the next day, said the same thing, and they said Oh the GP is doing, the one who is there, he’s doing telephone consultations. So I got a telephone call and they went through everything. And you know that they don’t want to spend too long on the phone cos they’re the only GP in the practice, and they’ve probably got a big long list of names to go through.

They only took the details of what pain I had. But I told her that I’d had the pain for about two to three weeks, and it wasn’t getting any better, it was just getting worse. And she told me to go to Boots or go to somewhere like that and get some painkillers, take the painkillers, and if it’s bad in a day’s time, to give them a call back and I’ll get an appointment.

So it’s sort of like you have to say three weeks’ or you have to say, I previously rung up to your GP or another GP and I’ve been told to call back’ just to get seen by someone. Cos over the phone you can’t tell how stiff someone’s neck is until you see them. And everyone has a pain threshold as well, so I guess it’s yeah, I thought that was quite badly dealt with. But given the circumstances, I can see they can’t see everyone, but yeah.

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Simon had had a few telephone consultations and felt that they’re helpful when people are unsure whether they need to see a GP. They’re also good for getting blood test results, though the first time he had a telephone consultation he didn’t realise that the doctor might phone him later than the allocated time. Auberon had also had a few telephone consultations. He felt they were good because they can save people making a trip to the surgery if it isn’t really necessary. Amy recalled having a telephone consultation when she’d had problems with her gall bladder, which she thought were related to irritable bowel:

Simon wasn’t told that his telephone consultation could be any time between 9.30 – 12.30. He phoned the surgery to find out why he still hadn’t heard.

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They just started doing them (telephone consultations) quite recently. So they rang me up and they said, Your blood results have come back and your doctor would like to speak to you over the phone. Can we book in a time that’s convenient with you? So, you know, I said the times and they said, Well, not that time. We can’t do that time. And so that adds a little bit of the stress. It was between 9.30 and 12.30 and they said, Oh, no your telephone consultation will be at 10.30. So obviously because I’m working this year because I’m on industrial placement, I thought, I’ll go into the meeting room at 10.30 and then I’m not disturbing the rest of the office.

So I went in at 10.30 and nothing came through and it got to eleven o’ clock and I’m thinking, Well, maybe I should have rang. Because he didn’t say whether they’d ring me or I’d ring them. In hindsight, I thought, Oh, I should have asked really.

So I rang up the surgery at eleven o’clock and they said, Well, the doctors are very busy. Your telephone appointment’s at the end of the clinic. So it could be lunchtime when he rings. That wasn’t told to me at the start. So I could have been expecting that it would have been anywhere in that time range and it did come about twelve thirty, which wasn’t a problem. But if that had been communicated at the start, that would have been helpful because then I wouldn’t have wasted half an hour sat in the office meeting room [laughs].

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Telephone consultations are good when Auberon wants to discuss his medications or mental health, but not if he needs to show the GP a physical problem.

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Have you ever had one of those (telephone consultations) before?

I have, yes.

And did you find it helpful?

Yes I did, and if the GP felt it would be relevant for me to come in, he would book me an appointment that day.

So it’s quite helpful to discuss what you’re feeling?

Yeah.

And if he thinks it’s relevant, only then would you go in, yeah.

Yeah, because it would save me a trip there and, you know, my time and, yeah.

Would you prefer to have a telephone consultation first every time?

Not really, no, because sometimes I wouldI need him to physically see something, or if you know what I mean, so it would be better than me going in and stuff. But if it’s just to discuss my mental health or my meds or something, then yeah, telephone consultations are good.

And is it usually with the GP that you like?

Yes.

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When Amy explained her problem over the phone, the GP asked her to come in. Before that she’d had telephone consultations to discuss test results.

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Have you ever phoned the GP for like having, sometimes people have telephone consultations, which is like an appointment over the phone. Have you ever had anything like that? Or did you know it was possible?

Yeah, when I had, when it, the gall bladder blew up, that’s when I had a telephone consultation to talk to them and figure out what it actually…Yeah, also to get my results because I had a liver test, a thyroid test, and things like that. So I had my results over the phone.

And you told them about the gall bladder thing?

Yeah.

What did they say to you?

They said to, Come in so we can refer you to the dietician.

That wasn’t the, that wasn’t the day that you had the, when you phoned 111?

No.

No?

No.

That was another day?

Yeah, it was after I went to the doctor’s for blood tests. Then when the tests weren’t back, I had to go get the test after that. So about two weeks after.

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Many of the people we talked to, like Paula, Nikki and Aphra, had never heard of telephone consultations. Isaac and Louis had, but had never needed one themselves. Emma liked the idea of telephone consultations and felt they were good because people could speak to a GP first and then find out whether they need to go to the surgery or not. She felt there’d be fewer people going in for coughs and other minor problems. She also liked the idea of Skype consultations, and felt that it was important for GP practices to keep services up to date using modern technology:

Skype consultations are a great’ idea because you don’t have to take time off work and you can see the health professional that you’re talking to.

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I think like more is great, less is not great. So like the more that they (GPs) can do, the better. I can’t really like pinpoint what they could do to make it a more efficient service. I guess, you know, there’s all the communication side of things from actual consultations to their trying to run on time or blah, blah, blah. But those things are sometimes out of control, aren’t they? So

How do you think they could support people better?

How could they support people better? I don’t know. Cos it’s like it just depends on the surgery I think, how they communicate with you. Cos sometimes it’s completely all by post. Other times, you know, they have an SMS service. So I think keeping up to date with modern technology is really good.

I know that they’re introducing like Skype consultations now. Which is great cos then, you know, you don’t have to take the time off work as I keep harping on about. But I think things like that are gonna make it a lot easier for people. Especially if like maybe they’ve got some kind of condition where they can’t physically get to the GP surgery. Then it’s great to have that resource of, I’m actually talking to a known professional. I can see them right there as opposed to, you know, just a message.

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Telephone consultations are really useful’ for minor issues that are hard to explain over the phone. Rowan wondered if a live chat with the GP would be quicker.

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I think telephone consultations are really useful for if you’ve got a smaller issue and you could explain it over the phone. But I’ve not needed to use that yet. But I think dad had to make an appointment, and there weren’t any slots free, and so he said, “Is there any telephone slots free?” And actually there weren’t any either, so it all seems to be booked up pretty quickly.

I think something like a live chat with your GP could also work. I don’t know if that would be quicker for them than doing it all over the phone, or if that would take longer or how that would work, but I think that could be helpful.

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Nikki, who’d had depression and self-harmed, had never heard of telephone consultations but felt they’d be good for people who can’t leave the house because of depression. She thought that they should be promoted more so that more young people would know about them.

Telephone consultations are a good compromise’ when someone needs a GP appointment but can’t get out of bed because of depression.

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So you’ve never heard of telephone consultations?

No.

Would that sort of thing have been helpful or be helpful now?

Probably yeah because when you’re really ill, sometimes you just don’t want to leave the house, and so you might miss an appointment or something like that, and that’s like reallythat’s a good compromise like in the middle; like when you need to go but you can’t feel able to get out of bed sometimes. So I think they should really promote that a bit more really, yeah.

So that you can phone in the morning and say, “Could I have a consultation with the GP?”

Yeah.

And then they, at that point, whatever time it is, they phone you back while you’re at home.

Yeah.

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Louis said that, whenever he’d needed to see the GP, he’d needed to be assessed, which could only be done in person. He preferred face to face appointments and felt they were more reassuring. Although Peter had never had a telephone consultation either, he felt that it could be hard to explain things over the phone and easier to show what’s wrong in person.

A face to face appointment feels more comforting. A telephone consultation feels like the GP’s not really taking it as seriously.

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Have you ever spoken to a doctor over the phone some people have what’s called telephone consultations have you ever had that?

I’ve never had that, no, myself. It sounds sort of more difficult to explain it because it’s always difficult to put into words what you’re feeling. It’s easier to show normally, and also if it’s something specific that you need to show them, then I think it’ll be quite difficult to do that over the phone.

So most times you would prefer to see the doctor rather than speak to him over the phone about what might be wrong?

Yeah, and also it feels more comforting, you know, to be there rather than feeling that it’s almost like they’re doing it inat their own home and they’re not really taking it as seriously.

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Jake hadn’t heard of telephone consultations either and wondered if they’d be confidential. He, like Gentian, felt he’d rather see the GP in person than speak to the doctor over the phone. Tagbo also felt that it was important to see the GP face to face because the problem could be serious but hard to diagnose over the phone.

Some people are scared of going to the doctors. A telephone consultation might stop them from going to see the GP in person.

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In some places you can have a telephone consultation, which means that you can speak to a doctor at a time that they will phone you and talk about whatever’s wrong. Do you feel that could be helpful or do you feel you would prefer to go in? How do you feel about that?

I think it reallypeople are scared of some of the issues that they have and I can understand why telephone conversations would be for them. But I feel like it should be stressed that it should be important for them to go themselves, because you don’t know what the scenario is.

People have prolonged, where they’ve waited and waited because of the conditions that they have, and it’s been too late. Because they haven’t they’re not brave enough; they won’t they’re too scared to go and face their doctor and to go and face their doctors and the GPs. I feel like theyit’s important for them to go. It doesn’t matter how embarrassing it is, it’s only between the GP and themselves. So…

And do you feel that young people do that quite a bit, or it’s mainly older people? Do you think young people also wait and wait because they don’t want to go to the doctors?

Yeah, some of them, it’s like they can’t be bothered attitude, and yeah…

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Lucy preferred to see the GP in person because she’s ‘a worrier’ – she felt that she’d worry ‘that they’re just there laughing about me’ if she had a telephone consultation.

Vinay felt that a telephone service for young people having mental health issues could be helpful as it would allow anonymity. But he felt that face to face consultations can be better because ‘you can see if the person’s paying attention’ and not ‘half-listening’, otherwise ‘you could feel more frustrated and alone’. Joanna also preferred face to face consultations for mental health because telephone consultations didn’t allow GP or patient to see one another’s body language.

When something means a lot to you’, it’s important to see that the health professional is engaged and paying attention.

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If the GP’s surgery had a telephone line that was specifically for people around your age group, where they could talk about mental health issues or anxiety about anything stress… about anything, exams or any of the situations, would you find that helpful, or do you think that you would still prefer to talk personally, you know face to face with somebody?

I think in some issues, it would be nice to have the anonymity. But in some other issues I think there’s a certain amount of, when it means a lot to you, you want to see if that person’s engaged and they’re paying attention. And I don’t know if you can gauge that over a telephone call because somebody could be just half listening to your issues, which could leave you feeling more frustrated and alone.

Yeah would you feel comfortable ever emailing, whether it’s a counsellor or a GP, about what you’re feeling, and then they email you back?

I think I’m more terrible with emails, I don’t reply as much. So I think yeah I don’t think it would work for me.

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When Sophie needed to speak to a GP about mental health, she found it very hard to open up and talk about how she’d really been feeling. She felt that it might have been easier to talk over the phone or in writing. She said that writing things down can be helpful when it’s hard to talk, and that telephone consultations are good for conditions that aren’t physical. She would have liked one when she’d had depression.

Lucy felt that GP Skype consultations and telephone appointments would be better for people going through mental health problems. She also liked the idea of talking to a professional in an informal setting rather than at the surgery. Sarah was concerned that, although there should be ways of contacting GPs other than face to face consultations, the alternatives might mean less money being spent on health services.

Sarah didn’t want health services to become privatised. She felt that automated information over the phone is unhelpful compared to face to face consultations.

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I think face to face is the safest in the sense that I think that all other ways of contacting your GP are, there’s the worry that that’ll become privatised and become, made into a mechanical voice on the phone where you punch in numbers.

And I think, yeah, there should be other ways of contacting your GP but I’d be so worried about allowing that to happen. And that would, people would see that as a way of reducing costs in the NHS, but I wouldn’t want that to happen.

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There are also commercial websites selling telephone and online consultations with private GPs, but none of the people we talked to had used these.