Administrative & Services

When you come to the surgery to see one of our clinical team it’s possible that, due to your symptoms, they will consider you need to be seen by a specialist/consultant, and they will then refer you to them. This will usually be to see someone at a nearby hospital (also known as Secondary Care; the surgery is Primary Care).
The clinicians will task the Secretary team to complete the referral and they also advise on the clinical urgency of that referral. Where a doctor or nurse suspect that a patient’s symptoms may be indicative of a cancer diagnosis, they will raise a 2 Week Wait referral, or 2WW. In these worrying circumstances the doctor will discuss this with you explaining why they have those concerns. Our Secretary team are mandated to complete these referrals within 24hours; more likely they are completed within hours of arriving on the Secretaries task list. The 2 Week Wait refers to the timescale within which the patient should be contacted by the hospital. Urgent referrals to secondary care or the District Nurse/Community team are usually completed by the team within one or two days. For those referrals that the clinician feels are routine these are usually completed by the team within 2 weeks. Occasionally the volume of more urgent tasks means that this period is extended. Please do note that by assessing a referral as Routine this is not suggesting the referral is not important; it is however, vital that these referrals are carried-out on a clinical urgency basis.
Our referrals are sent electronically with your relevant notes and medical summary to the Referral Service, who will also assess the clinical urgency. Please note that once our team have sent the referral there is nothing they can do to hasten your appointment; unless your symptoms have worsened. If your symptoms do get worse please contact the surgery to discuss this with a doctor. The Referral Service will send you a list of available hospitals where you can be seen; note that we do not control that list or have influence over it. You do have the right to request to be seen at a particular hospital but be aware that this may not be the closest hospital or the hospital where you might be seen the soonest. You must be aware though that if you do not take-up the option to attend at your original choice of hospital, and choose a different hospital, our Secretary team will have to re-do that referral. We do not mind doing this of course, but it will have a delaying impact on when you are seen.
Except in the 2WW referral cases I mention above (where you have to make a selection), you may wish to consider not selecting any hospital until you receive that list of available places from the Referral Service. You will then see a range of available locations and you can make your choice at that stage. Any and all discussions about where you are subsequently seen for your referral should be had between you and the Referral Service. The referral service can be contacted on 0300 303 5048 or via email at bswicb.referralservice@nhs.net It is not part of the Secretary teams job to have those discussions on your behalf. We also send referrals via email to other services such as community paediatrics, orthotics, mental health services, diabetic specialist nurse and others, where this is the preferred method to send the referral.
The vast majority of referrals are funded by the NHS, but not all. In these cases, the team will have to seek ‘Prior Funding approval’ which must be granted before any referral is completed. We usually hear back from them within one month. The decisions on funding approvals are made by the Bath, Swindon and Wiltshire Integrated Care Board (BSW ICB). There is a list of funded and not funded referrals which you can see on the BSW ICB website here: bswicb.nhs.uk/your-health/what-we-do-and-don’t-fund/. Type
‘BSW ICB funding approval’ into an internet search engine and you will soon find it.
The Secretary team will also complete private referrals for patients who have their own private healthcare insurance. If you do have a specific hospital for your treatment we will address the letter to them. Please note that we do not offer recommendations for private hospitals.
In addition to the important referral work the Secretaries complete they also complete various letters and forms/reports on behalf of our patients. We produce what we call ‘To Whom It May Concern’ letter which can cover a patient’s fitness to fly, to take medication on holiday or to support a change in accommodation due to health needs. This is not a complete list. There is a charge for these letters as they are classed as private work. The team process completed insurance reports including sending invoices for their completion where applicable.
GPs have a lot of paperwork to complete which includes PIP additional information forms, Universal Credit additional information form, DVLA forms, Firearms reports, and various insurance reports, Adoption forms, this is also not a complete list. When these forms have been completed by the GP, we scan these to the patient record and post the original documents back to the requesting company.
There are some tasks that the Secretary team do not undertake which include organising Fit Notes or prescriptions, and the provision of test results. Please be aware that the Secretary’s do not book appointments and any calls to them for this purpose will be directed to the Reception team. The Reception team have the detailed knowledg

Reception Team Training

The range and cope of information the Reception Team are expected to have at their fingertips is quite incredible. One patient might enquire about a DVLA form to re-new their driving licence, the next patient may want to know why they haven’t been called for Shingles vaccination, while the next may wish to book an appointment to have their ears syringed. Our team will be expected to be able to respond to all of these enquiries.

In order to prepare our new team members as much as possible they undertake a 3-month long induction programme as soon as they join. This programme aims to cover the huge range of knowledge that the new Receptionist will need to know.

First 2 weeks

1. 4hours/day training with Reception Manager away from the telephones.
2. Over 20 modules of online training to be completed; subjects include:
Confidentiality, Safeguarding, Dementia, Prevent, Consent, Information Governance, Basic Life Support.
3. A large part of these first 2 weeks is spent learning the triage process. A senior GP has produced a list of the most common Red Flags for our team to listen out for when talking to patients.
4. This is part of ‘Signposting’ where the Reception team assess the symptoms described by the patient and, using the information given to them by the senior GP, and their experience direct the patient to an appropriate health care professional, for example, the pharmacist or Minor Injuries unit.
5. It is also vital that the Reception Team understand the role of each type of clinician, and clinicians within the same role. We have an increasing diversity of clinical staff who include: Advanced Nurse Practitioners, Paramedics, Physician Associate, Health Care Assistant, Nurse.
6. The team are expected to know exactly what each clinician does and does not do and so book the appointment correctly. (This is why the Reception team will ask you for the reason you want to see a doctor). If you are booked incorrectly, your time and our time is wasted.
7. They are expected to know that Nurse A can undertake a particular procedure, but that Nurse B cannot. They will also be expected to know that Nurse C only see’s patients aged over 12, while Nurses D, E and F can see younger patients.
8. They are expected to know which doctors can do steroids injections and those who do not, or who can do a Mother and Baby check and who cannot.
9. There is a final test to cover appointments, clinicians and services.

Remaining 10 weeks

1. First week or two - observing and listening to telephone calls with mentor.
2. Another 2-3 weeks – new staff member will now control the computer and mouse while their Mentor directs their activities and tell them what to look out for.
3. The mentor will ask the inductee what they should do with each call and then discuss if that is correct, or if it not will explain what the correct response should have been.
4. Another 2-3 weeks – inductee encouraged to take-over on the phone while the Mentor listens to their call and offer guidance.
5. New team members are not left on their own in the first 3 months.
6. Induction timings are flexible to take into account how the inductee is progressing.