On 5th November 2013, I had the pleasure of being invited by the lovely Kath Evans to speak alongside her at the ‘One Day Essentials: Child Health’ event at the Royal College of General Practitioners (RCGP). During this event I had the pleasure of sharing my experience with regards to GP services, as well as presenting possible solutions to issues that other young people and myself came across when accessing GP services. This blog serves to highlight some of the feedback I shared on the day as well as thoughts and reflections from research I carried out after the event.
Children and young people make up at least one in seven users of GP services and therefore it means that these services should take this responsibility seriously and ensure that they listen to and act on the views of children and young people. They should listen especially when what the children and young peopl ahve to say is uncomfortable or challenging.
GPs form the basis of a lot of conversation at the RCPCH Youth Advisory Panel (YAP) meetings. We admire GPs for the amount of work they have to do, as well as respect them for the amount of responsibility they have. They act as the main point of contact of care for our parents and families.
According to a document produced by the RCGP states the main roles of a GP and they are the following:
These services have worked very well, at least in my experience for my parents and their friends. However, for people like myself, GPs can often leave us wanting. It was further concerning to learn in a CYPNow article that “staff in GP, mental health and sexual health services said that they were not always trained to receive and act on complaints made by children and young people.” This is rather a disconcerting matter which I shall try to touch upon later.
The Chief Medical Officers latest report states that all children and young people with long term conditions must have a named GP, but we say it is not just important that we have a named GP, it is more imperative we have an active GP.
My experiences with my GP have been rather a roller-coaster. My GP has always been very caring of my parents and have taken good care of them. However, in my experience the GP seems to take an attitude of not wanting to treat me. Or at least that is how I felt. My GP always seemed to take the view that it was better to send me to A&E to be treated even if it was something that could be treated with their practice, i.e. a chest infection. This was down to their belief that they may prescribe me something which may interfere with the medication which I was already under due to my existing medical condition.
Thankfully, having moved to a different GP due to going to University, the GP seems to be a bit more hands on and actually willing to treat and diagnose me. Which is a bonus. Though, in finding a GP having moved to University was an ordeal in itself. Most of the practice surrounding my university were not wheelchair accessible, which more than anything was a sheer annoyance, this goes for dental practices around the area as well as London.
Another gripe, I could say I have with my experience of GP services is in regards to their operation times. They operate in a very traditional method, with bookings having to made at a specific time of the morning if you need a same day appointment and operate from 9am - 5pm. While this is the norm, it often means that if I wanted to go to see my GP I would need to either take time off school or move around my extra curricular activities in order to fit in these appointments. While working professionals and adults may say that this is similar to how they would have to see a GP, it is a more difficult scenario for young people. For starters, those with long term conditions especially, already may have to take time off school/ college in order to see to their health needs or to see their consultant which is inevitable leave. Therefore, to take even more time off to see your GP is an additional amount of time off. This has sometimes put me off seeing my GP until things got really bad.
While I thought my case may have been an isolated one, it proves not to be the case. Having looked at reports from the Care Quality Commission (CQC), Right Here, the Children’s Commissioner for England and Healthwatch Warwickshire, and heard my friends from the RCPCH YAP tell their stories, the feedback coming through from other young people seems to have common themes. I have highlighted some key quotes and findings below:
“Doctors not understanding enough and did not listen to my worries, doctors just spoke to my parents”
“Feels like they [Doctors] don’t want to be there”
“They seems to feel like they are always rushing”
“They ask the wrong questions, i.e. are you okay? Obviously I am not Okay! They should ask ‘what is wrong?’”
Young people worried about not being taken seriously and that professionals held a stereotypical view of young people.
“It is not made clear whether interactions with professionals are confidential or not.”
Traditional operation of GP services did not fit in with children and young peoples wishes, this has led to a lack of continuity and a lack of opportunity to build relationships with one GP.
Obviously the situations outlined above can be rectified, one way is through collaboration between GPs and young people. Young people should not be made to feel that they cannot speak to their GPs about issues that are affecting them, and they should not be made to feel that they are being a hassle. The relationship that exists between GPs and young people needs to be one of accessibility, communication and trust. Therefore, using ideas of how the service can be improved, combined with recommendations from members of the RCPCH YAP and the reports I’ve read, I would like to present 7 recommendations which we as service users and you as GPs and healthcare professionals can work together to improve our the provision of this service within the NHS.
While I have stood to point out the issues that young people seem to face with GP services, I have also aimed to provide some solutions and ideas in order to try and make the services better for all users. I do this because I am a firm believer that “we [young people] don’t just a want a good enough health service, we want the best possible health service”. This is why we need effective GPs in order to achieve the best possible health care. We believe that through having effective GPs we would be working towards greater levels of integration between health care serves. Which ultimately, we believe that if we were to achieve this scenario we would see GPs taking a more leading role in this.
To conclude, I would like to leave you all with 3 C’s which seem to be rather fitting for this scenario, Compassion, Confidentiality and Clarity!
Links to all documents and pages, referred to and used to help compile this blog!
Link to CYPNow article: http://www.cypnow.co.uk/cyp/news/1073938/young-people-feel-unable-complain-poor-health-services-report