Reasonable adjustments for access to GP

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cab506

New member
Reasonable adjustments for access to GP

Hi all - first post on the forum for me so slightly nervous! I've had an issue for many years with trying to get appointments with GPs because of several issues, some of which are due to the autism and others due to mental health issues and IBS. I recently asked my new GP for some adjustments that I thought were reasonable but didn't get the reply I was hoping for (see below for details). I was wondering if anybody had any thoughts as to whether the adjustments (at the bottom) would be classed as reasonable?

Situation:

At my GP, you can get on the day appointments only in the mornings and only for one thing at a time (and I have about a dozen built up). However, I suffer from excessive tiredness, which is always worst in the morning, when my brain simply won't function, and decreases during the day. Between that and my disrupted sleeping pattern, it's really quite rare that I'm feeling good enough to ring for an appointment early in the morning and be sure that I'll still be OK enough to answer the call back later on - maybe happens once a month - so that essentially rules these out.

Afternoon appointments are only advance ones and the wait is about 3 weeks and when my health declined over the winter, I was struggling to make any appointments (by phone and in person) and missed so many for various different things. So I'm reluctant to make an advance appointment with the GP because if I'm unable to make one or two in a row then I don't end up getting any further forward for several months at a time.

Action taken:

Therefore, I emailed the GP to ask if some things could be done by email like sick notes for long standing issues and me sending through much of the information on my symptoms ahead of an appointment to reduce the stress on me having to remember it during the phone call. I also mentioned that I'd struggled to attend an appointment, including phone appointments for anything for several months. The reply was we can't do things by email - make an appointment.

I sent two emails in total, both of which took months for me to finish due to inertia and stress and so as a result, between that and the health issues, I haven't actually made an appointment for nearly a year now. Given that these are health issues that are causing the problem attending appointments and the GP is the first port of call to get help with health issues but says you have to attend appointments, how does one ever get well?!

These are the adjustments I'd like to suggest:
  • As a minimum: Info that would be discussed in appointment sent by me in advance in email so that I don't have to remember what I need to say. Then appmt can be just about any follow up questions from the GP.
  • Preferably, in an ideal world: GP puts follow up questions in email and have email dialogue
  • Simple things that do not require detailed conversations like sick notes for long standing issues or re-referrals etc done via email.
I think they're reasonable, given the circumstances, but any thoughts on this and how to better deal with GPs would be hugely appreciated.

Many thanks!
 
Does your Dr have on-line booking options for appointments? I use the on line site to message the Drs - can take a few days for a reply. Also I have access to my records on line so I read them after the appointment as I can’t always remember what has been said. When the Dr gives me instructions they pop it in a text for me. I’d follow your email up and quote the Equality Act 2010. If no response ask to speak with the the Business Manager.
 
I also massively struggle with the GP. They have the same system of booking same day appointments at 8 in the morning and, like you, I can’t guarantee even being awake or able to cope with the phone call. I also have chronic sleep issues and am now receiving dialysis for kidney failure that adds another layer of fatigue and sleep issues. As with you, making a regular appointment entails a 2 or 3 week wait and they can only book 2 weeks in advance so you have to keep going back in the hope there’s an appointment available.
I also have issues waiting in the waiting room due to noise sensitivities and lack of patience for waiting anyway. The surgery used to make online appointments but that seems to have stopped. I did see some research about autistic experiences of GP surgeries and plan to try to get some accommodations in place (the surgery is undergoing a change of management so I’ll wait until that’s done).
 
Thanks both for your replies!

Westwoj - apologies for the delay in replying but this week has been one of those ones where the wheels have fallen off! I did ask if the code I need to register for the online stuff could be emailed to me, but they said I had to come and pick up the piece of paper with it on, which again isn't ideal. Online would make booking appointments a bit easier, but I'd still have the problem of making the appointments.

My GP also does the reply via text thing so has replied to my emails with a text (not sure why not by email) so the texts have basically said it's not possible to progress things by email, make an appointment. I'm not sure why it's not possible to do simple things via email so, as you say, the next step is to invoke the Equality Act and say that I think my adjustments are reasonable and if they disagree, ask them to explain why they're not. Do they sound reasonable to you?

Brannovic - sounds like you're having similar issues - I thought I might not be the only one on here! I think allowing patients the ability to book appointments online is a requirement for all GPs now so you might want to ask why they're not doing it. It could be that you just have to register for another online platform like Patient Access (like me). Yeah definitely sounds like asking for adjustments would be helpful - I think waiting rooms is a common one. I just stick to phone appointments - I don't know if they're an option for you.
 
First make sure you - and carer if you have one - are REGISTERED as vulnerable. You do have the right to request reasonable adjustments that will help you safely access the medical care you need. Taking into account your own personal difficulties, unique to you.
I know of a horrendous incident where a patient had an autistic meltdown due to a misunderstanding and the police were called. In addition patient booted out from the surgery and sent to violent patient unit for six months.Turns out that the patient's record was negligently not recorded as vulnerable.
Be careful! There is much work to do. And I am on it. Shame on the health service.
 
I'm in tears reading this...this is exactly how the NHS behaves...so awfully.... discrimination and harassment...

They should now add a Reasonable Adjustment digital Flag which should be visible via the NHS spine system to ensure that any patient or care/guardian/parent of a patient (so the service user) has recorded their specific disabilities or chronic conditions that require reasonable adjustments and exactly what those adjustments are.

It's fairly new but should be implemented by June 2024. By law.

I recommend using a template letter from the Equality Advisory Service to request reasonable adjustments as this also sets out the law and their obligations.

Reasonable adjustments can and should include any communication differences you experience. So if you require written communication they should alter services to suit. I am currently waiting for one primary care service to remove the on-hold music. They plan to add a call back function.

Finding a primary care service that operates an e-consult service which is an online e-form to communicate with the NHS primary care provider.

They should also accept written communication at appointments. So if you turn up to an appointment and wish to hand over you written or typed symptom list or other enquiries the clinician should accept this form of communication.

Sorry rant over......
 
Deanna is th person who posted regarding this specifically, so probaly best ask her directly, Margot.
best wishes.
 
Margot said:
What is this template from Equality Advisory Service?
Could you attach it?
Click to expand...
This is the template from the Equality Advisory Service they have several different ones available on their website. This is the one for requesting reasonable adjustments..
D
 

Attachments

  • 405SRRA Template Letter Services (Request for Reasonable Adjustment).docx
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  • 420WRRA Template Letter Work (Request To Make Reasonable Adjustments).docx
    11.9 KB · Views: 3
What a really helpful document, Great for holding someone accountable for neglecting anyone whose voice "has not been heard". G.P or health service provider for example.
Thanks Deanna.
 
I find GP appointments impossible, I don't think I have been to doctors for a few years now, I seem to become someone I don't recognise! And just want to get out quick but worry because I know I won't be able to go back for months or years! And I always have lots of ailments which they won't talk about all at once. I have kidney disease stage 3b, itchy skin etc I also can't go to the dentist and am in pain with my teeth, I don't really know what will help me yet either, still trying to understand what I need.
 
Hi Polarbear.

It sounds like a difficult situation for you. I think start with some research. The more you understand your ailments and your Kidney disease the better you will be able to communicate what is most important. Do you keep a diary or keep notes of your symptoms and ailments?

If you are registered with a GP practice then you should be able to contact them via email. I'd start by finding or asking for an email address for the practice, you could say you have medical information to send them or some letters to deliver to the practice manager.

Then if you can write two letters.

One to inform them of your current circumstances such as not feeling able to attend the surgery and finding appointments impossible. Here you should request support with identifying how and where the practice can work with you to find solutions. Let them know that you understand that they have a responsibility under the Equality Act 2010 to facilitate reasonable adjustments to make their service accessible for all patients. Include details of your disability and your chronic illnesses. You should ask if there is a disability GP or a staff member appropriate to talk to such as someone to provide advocacy for people with neurodiversity. They should have personnel that have training or experience with neurodiversity according to the Health and Social Care Act (or the Care Act).

The other letter I'd suggest is to provide any questions you have about your current health issues and concerns. You could bullet point 3 or 4 of the most important to start and request a longer appointment or telephone appointment. Explain that you feel there may be symptoms or issues that are actually related and need to be discussed holistically with a GP and they may requiremore time to make sure they can address your health concerns.

There are some NHS primary care services that now operate an e-consult service you could try looking for a practice near to you that has this service available.

It has taken me some time to work out what might work best for me in terms of reasonable adjustments. I find I can communicate better in writing. But you may need someone to attend appointments with you and longer appointments to ensure you cover all the necessary issues.

You could try the same approach to the dentist. Personally I find dentists and their services are better at accommodating people with disabilities and differences.

Let me know how you get on. D
 
Hi Deanna, thanks for taking the time to respond in such detail! I wil start taking note of how I am, I find that difficult because I usually just ignore or don't notice illness unless I am clearly unwell like vomiting or something.
Great advice thanks again!