NHS, reasonable adjustment discrimination?

[PotterPotter]

Hi Legal Beagles.


I am currently in a situation with the NHS and I am unsure if I am being unreasonable, or if they are.

I have agoraphobia, it is quite severe and I can't go more than about 30 yards or so from my front door without experiencing panic attacks. I also find telephone conversations extremely difficult, my mind races whilst on the phone and I struggle to properly explain myself or listen (this sounds stupid I know, but it's true)

For the past 2 or 3 years I have been trying to obtain an email consultation with my GP, or in fact any GP would be lovely. I have attempted to obtain this by emailing the surgery, and they always reply saying that they "cannot do consultations via email". They haven't provided any explanation as to why they can't, they just say they can't. This does kind of leave me in the position of not being able to have any communication with the NHS, which isn't nice.

Another issue I experienced recently happened earlier on this month. I had a dental issue (I believed I had a gum infection) I emailed Health Watch to ask them about how to obtain dental care whilst being agoraphobic, they advised me to contact the Kent Community health foundation trust about obtaining a home visit (Having people that I don't know in my home is also something that is very difficult for me, but as I believed at the time I had an infection, I was of course happy to have a home visit) however, the Kent Community health foundation trust did not email me back whatsoever.

I have now emailed the NHS complaints email raising these issues. I also contacted the equality commission, and they have informed me that the NHS might not be obliged to do an email consultation as they would not make a "reasonable adjustment" for just an individual person.

I am very confused about the whole thing, am I being unreasonable in asking for an email consultation, or are the NHS in the wrong for not offering one?

Any advice on where to go from here would be lovely.

Thank you :-)

[Peridot]

Hi PotterPotter,
Sorry to hear of the issues you're facing. I wonder whether he issue with e-mail could be to do with the fact it could be anyone writing. Could a skype or facetime appointment be arranged. Has the Health Authority offered any alternatives at all?
There may be others on the forum who have more experience of this sort of thing who may have some tips but thought it was worth suggesting.

[PotterPotter]

Hi PotterPotter,
Sorry to hear of the issues you're facing. I wonder whether he issue with e-mail could be to do with the fact it could be anyone writing. Could a skype or facetime appointment be arranged. Has the Health Authority offered any alternatives at all?
There may be others on the forum who have more experience of this sort of thing who may have some tips but thought it was worth suggesting.

Hi Peridot,

Thank you, just to keep this thread updated, I received an email back yesterday from the NHS complaints people. They have asked for my consent to contact the practice manager on my behalf. I have given it to them, so hopefully they can help to resolve it.

I will update as this goes along.

[PotterPotter]

Well I have received an email this morning from the operations manager at my GP surgery saying that if I email any "questions" I have to her, she will forward them on to my doctor.

The email in it's entirety is:

Hi (PotterPotter)



I believe you would like to have an e-mail consultation with the doctor. You can e-mail any questions you may have to this email address and I will pass onto the doctor who will in turn respond to you.



Kind regards
(Operations Manager)

I am not really sure if this means this will be an email consultation or not? Also, I have been trying to obtain an email consultation directly with them since late 2016, and have been told no consistently, the minute I email the complaints team, I have been offered this. I would like to know what has changed and why I have been previously told no, but at the same time I don't want to be a pain and harp on about it.

Also I wish to discuss mental health issues, so the idea of anyone other than my GP reading the email doesn't feel great, but again at the same time I don't want them to think that I am finding problems or anything.

[Peridot]

Hi PotterPotter,
It is progress, I appreciate your concerns about others reading your e-mail but do remember all employees at the surgery are bound by confidentiality too, not just the GP's. Maybe you could attach a letter with the e-mail. This may only be opened by the GP then? No guarantees of course but may be worth a try and title up the e-mail private and confidential.

I suspect this is not what you imagine an e-mail consultation ie back and to between you similar to speaking to each other but if you set out what your concerns are and the questions you have the GP may respond as a usual e-mail or be able to make arrangements for a skype or e-mail conversation possibly.

I would be inclined to try this method, it may work for you and would be a way to deal with the GP in the future. I can understand the operations manager acting as 'gate keeper' you can imagine the number of e-mails GP's would receive directly from patients if their e-mail addresses were known. It just wouldn't be feasible.

It seems to me they are trying to find a solution which is positive and hopefully it will work well and it can become the usual way to communicate with your GP. Of course it won't be an open door to accessing your GP as that wouldn't be fair to other patients either but in the usual course of making an appointment to see them to discuss any issues it seems a possible way forward for you.

Hope it all goes ok.

[PotterPotter]

Hi Peridot,

Thank you :-)

You make a very good point. I actually didn't know that they would all be subject to the same confidentiality rules. so that is a comfort.

On Thursday, they did email back again with this:



Hi (Potterpotter)



Further to my e-mail yesterday we have taken further advice and been advised that we are unable to communicate for a GP consultation via e-mail as although our e-mail is secure yours will not be. Which could lead to a breach in confidentiality.



We can offer you a telephone triage slot with the doctor or a face to face appointment either at the beginning of the day or the end of morning or evening surgery when it will be quieter. We can also offer you to sit in a separate room away from other people if you make this known to the receptionist upon arrival at the surgery.



Kind regards


I have emailed back again to ask if I was to open up an email account that guarantees security my end, then can we move forward.

I will keep this updated of course :-)

[PotterPotter]

Well I got this back this morning.

So I guess that's that then?



Hi (potterpotter)



Sorry about the delay in getting back to you. I am afraid that e-mail consultation is not a recognised way of legally consulting with a patient so we are unable to offer this service to you. As I explained before we can offer a telephone triage call to you or first or last appointment of the day when it is quieter in the surgery. Failing this you could register with Push Doctor who are an online organisation who will give advice.



Once again I am sorry we are not at present able to offer this service.

[Amethyst]

With regards the telephone appointment - this may be your only option at the moment and you do need to be able to speak with the GP. Although I know it will be incredibly stressful, asking by email for the surgery to set up an appointment for the GP to telephone you, is far better than them arranging for you to call the GP. Say to them in the email how important it is for the GP to telephone at the correct time ( so you're not building yourself up into a tizwaz waiting for the phone and will be prepared at the relevant time ) The GP calling you, and already having an idea of what your issue is, will mean he/she can just ask you specific questions.

Write down the main points you want to discuss with the GP so you can read them and tick off as you go through the call..... Go for a wee before the time, check the phone works, and sit somewhere calm and quiet and have a cup of tea and a pen and paper with you at the alloted time. Take it slowly and if you feel yourself start to race or panic just move the phone away from your ear for a few seconds and deep breaths, and just say 'sorry, back' when you feel able to carry on.

I love the surgery's response, grrr, going into a busy doctors surgery and trying to tell a receptionist that you require a separate room to wait due to x, y and z is an utterly terrifying thought to me.

Anyway.... you could also email / webchat Mind ( https://www.mind.org.uk/information-support/helplines/ ) and possibly email http://anxietycare.org.uk/ recoveryinfo@anxietycare.org.uk as they will have discussed with other people how to deal with going to the Dentist / GP etc when you struggle with Anxiety / Agoraphobia and what other options might be available.