Getting the most from your GP
It is important to keep as healthy and as stress-free as possible. Listed here are tips and ideas to make your GP visits more worthwhile for you and the person you are caring for.
How your GP could help
You can let the reception staff know that you are a carer and ask if this could be registered on your medical record. You may also wish to inquire if the surgery has any carer's support services for you to make use of.
If you are experiencing any stress or anxiety you may wish to tell your GP. Some surgeries may offer a range of information and support to carers. The GP can also help you to get in contact with your local services such as your social service office, if for example you require a carer's assessment, or to contact your local voluntary services, such as Crossroads, if you require respite in your home.
Preparing for the appointment
It may be necessary to ask the surgery if they can take any special needs into account for your appointment, such as arrangements for the waiting room. The person you care for can also confirm to the surgery that he/she is happy to share health information about their condition.
If you know that you will be discussing the person you are caring for, to save time you should let the receptionist know that his/her notes will need to be available.
Before your appointment you may wish to write down any questions you wish to ask the GP on two separate lists, one for yourself and one for the person you’re caring for.
If you are the carer of someone who is housebound and has difficulty getting to the surgery, you can request a home visit. This is especially helpful when you are experiencing problems in booking respite or transport. The GP is able to help the patient and support your valued work as a carer.
During the appointment
It may be useful to avoid discussing both of you at the same time. It might be an idea to make brief notes of the conversation you have too.
Surgeries sometimes arrange for carers to have training information to help them care safely, particularly on lifting, moving and handling the person they care for. Leaflets may also be available on notice boards in the surgery to give information to carers about services and support which are available.
If you need a letter from your GP
If you need a supporting letter from your GP for anything, for example for housing or benefits, ask if there is a fee, as this will save any inconvenience when the letter has to be collected from the surgery. If you require such a letter you should arrange it as soon as possible, as the process may take considerable time.
After your visit to the GP
Where prescriptions are needed, ask the GP if he/she can send it to the local pharmacist. Pharmacies can be very helpful and are now recognised by the Primary Care Trust (PCT) as a service provider for carers and may be able to deliver the medication to you or the one you're caring for if needed. Your local pharmacist or the health centre nurse should also be able to advise you about medicines and their side-effects. If you are uncertain about any treatments that are being prescribed, then you should discuss this with the GP. You may not want to trouble the doctor, but it is important for your peace of mind and the health of the person you’re caring for.
Domiciliary care may operate in your area and the GP or practice nurse will be able to tell you which services are available to you. Also, if the person you are caring for is terminally ill, the Macmillan Nurses may be able to provide palliative care.
If the GP refers either you or the person you're caring for to the hospital, transport can be arranged by the GP. If more than one referral is necessary, ask if it is possible to have the appointments on the same day. This will ease the stress involved in multiple hospital visits.
Providing care at home
Sometimes you may feel that you do not have the information or training to make sure that the person you care for is getting the best help, and this worry can affect your own health.
Do you have to provide medical care, such as help with catheters, injections, or breathing tubes?
Do you feel confident about doing this – were you given training? If you need more information or training, ask the nurse at your health centre or GP's surgery.
Are you sure that your home (and the home of the person you care for, if they live separately) is as safe as possible?
What to do if you are not happy with your GP's services
In England your first step may well be to contact the Patient Advice and Liaison Service (PALS) to help and support you through the procedures described below. They are an independent body, set up by the PCT to help, advise and support patients in taking on issues like this. You should be able to get the address and telephone number of your local PALS service from your doctor's surgery, or the PCT offices.
PALS does not cover Scotland. Details of the structure of the complaints procedure in Scotland can be found by visiting the NHS Scotland Health Info site.
In England, every GP practice has a procedure for dealing with complaints. This may be displayed on a poster on the wall, or described in a leaflet available at the surgery. The procedure should include the name of the person at the surgery who has been nominated to receive complaints. If it's not there ask at reception.
The first stage of any complaints procedure will usually be that you make your complaint to the nominated person at the surgery – it does not necessarily have to be in writing, but it is usually better to put your comments down on paper. The GP should acknowledge the complaint, and get back to you with a written response within a reasonable time – for more specific timings you can ask how long it will take.
If this does not solve the problem, you can take the complaint to the PCT (the organisation which employs the doctor), or go straight here first if you would rather. They will appoint a convenor to look into the complaint. If you have not used the Practise Procedure first, the convenor will usually refer it back to the surgery first to see if it can be resolved locally.
The PCT will sometimes offer conciliation. A lay (non-medical) conciliator will be appointed to meet with you and the GP to see if your problems can be resolved by discussion.
If this fails, and the PCT feels there are unresolved issues, the convenor may decide to hold an independent professional review. This is a committee of people with a non-medical chair (often a lawyer), other lay members and clinical (medical) assessors. They will hear from everyone involved and reach a conclusion about any recommendations for action.
In very serious cases, the independent review may refer matters on either to a disciplinary procedure or the General Medical Council (if the doctor's professional competence is in question).
If you are still not satisfied with the outcomes, you can take the matter to the ombudsman.
The procedures in Scotland are similar. Basically you should initially put your complaint in writing to the GP practice, but if you remain unsatisfied can then go through the formal complaints procedure of NHS Scotland. If you do not feel comfortable doing this you can contact your local NHS Board for help with your complaint. If you are still not satisfied after going through the formal complaints procedure, you can ask the Scottish Public Services Ombudsman to review the case.
Ask your local NHS Board for a copy of the NHS Health Rights Information Scotland’s leaflet “Making a complaint about the NHS”.