How to train your “Dragon” : the clinical roles of the GP receptionist

Problem

The receptionist is the front line for the GP practice and the first point of call for patients accessing GP care often being perceived as a “dragon”(Hammond et al., 2013). The receptionist role is of increasing importance given the changes to primary care and its structure which include the management of chronic illness in primary care and consequent increasing demand for the service and primary care practices functioning as self-directed semi-independent agencies. To help lessen the workload of already overstretched medical staff, the receptionist’s role is being extended and often now includes some basic triage, reporting of clinical information to patients and supporting the process of repeat prescribing. However as there is little understanding of the clinical component of the receptionist role, this research examines its extent, how it is perceived and its consequences for the practice and care of the patient.

Approach

An integrative literature review drawing from both qualitative and quantitative research scoped and synthesised the existing research in the field to; identify current knowledge about the clinical roles undertaken by the receptionist; highlight gaps in the current understanding.

Findings

GP receptionists do indeed undertake a clinical role. They are seen to act in a de-facto triage capacity, judging the urgency of the patient’s care in terms of appointment availability and directing patients to seek urgent treatment for specific conditions (e.g. Stroke). The receptionist is also involved in the repeat prescribing process, using their judgement to ensure patients receive the correct medication. Finally they give out clinical information to patients in the form of reporting blood test results, providing information on symptoms and medical conditions, or sexual health issues. They often undertake these roles without formal training, in either communication skills or basic clinical information among others

Consequences

There are obvious consequences for patient care; a lack of formal training can mean that clinical information given is incorrect or ill-informed; furthermore patients do not necessarily want clinical information from a member of the team who does not have the necessary training. The review therefore suggests the need for and direction of further research. Whilst there are benefits to medical staff (freeing up time and capacity for patient care) from receptionists undertaking these roles what is clear from the review is that there is little evidence that looks beyond the nature of these roles they undertake to explore factors that influence the adoption or practical experience of these roles. Furthermore what research exists is outdated and does not reflect the current situation of the GP receptionist.