Delays, miscommunications and cancellations: switching to Claypath and University Medical Group

Content Warning: mentions of depression, eating disorders and suicidal thoughts. 

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A number of students have detailed their difficult experiences of making the transition from their hometown General Practice (GP) to the Claypath and University Medical Group, as part of a Palatinate investigation into the service in Durham.

This transition, encouraged by the University in anticipation of students’ arrival in Durham, is intended to give students guaranteed access to appointments and medication at either the Claypath or University practices. The option of registering as a temporary patient at their previous GP practice remains if appointments are required at home.

However, many students have found this process incredibly convoluted, resulting in delayed medication, renewed waiting lists, and many having to choose to remain registered with their hometown GP. In particular, students on longer-term or pre-existing treatments for mental health conditions, chronic physical health conditions, or recovering from injury or illness, have found that the transition has caused serious negative or prohibitive impacts on their wellbeing.

One recurring issue mentioned by students was the difficulty with the initial registration process for the Claypath and University Medical Group. One student explained how it took two months to start her antidepressant prescription with the Claypath practice: “I’m from Scotland, so different service, but I signed to Claypath two months before starting uni and when I got there they kept saying they had no record of me having a prescription for antidepressants, even though my GP in Scotland sent multiple messages to them transferring my information. I would have to go home every other week to pick up my prescription. It was a nightmare.”

“The GP in Claypath refused to see me unless I registered permanently”

Another student registered for the Claypath practice during Freshers Week in 2021, but was only successfully registered with the service after eight weeks, which was an issue as the student said: “I had prescriptions which I needed a lot and I was not able to get them.”

A third student who had chosen to remain registered with their home GP has also expressed difficulty in becoming a temporary patient with the Claypath practice: “I have a complex medical history so wanted to keep my home GP. But, earlier this year I got tonsillitis and wasn’t getting better for weeks.

“The GP in Claypath refused to see me unless I registered permanently, wouldn’t let me temporarily register and told me to get a phone appointment with my home GP. [The] Home GP understandably said they can’t help me over the phone and that Claypath had a duty of care. But, they still refused to see me. I temporarily registered with a GP in Gilesgate in the end and needed antibiotics.”

Once registered at the Claypath and University Medical Group, many students still experienced severe delays in their treatment for a number of serious health issues. Beyond a simple inconvenience, many students who experienced delays said this had a debilitating effect on both their studies and quality of life.

One student, who has since graduated, detailed their experience last year in seeking treatment for severe back problems: ”I had agonising back pain for weeks on end [and was] taking daily ibuprofen. This was during my Epiphany and Easter term, including exams. I put in a request for a meeting in March and only yesterday [7th September 2022] did I get a phone call.

“I had completed my degree before they could give me a phone call just to tell me to move more. Despite me doing daily exercise and playing a range of sports when I’m not suffering, nothing has been done. I’m still in pain.”

“This has had an irreparable effect on my Uni experience this year. And it all could have been prevented if the GP surgery was more organised”

Another student had similar issues with delayed communication from the practice last year, this time concerning “letters for appointments delivered months late”, resulting in those appointments being missed. They explained that “because I switched GP to Durham, I was unable to access mental health services in London over the summer. I have since switched back to my former GP surgery but am now concerned about access when I return again to Durham. Quite the nightmare.”

A student’s experience with antidepressant withdrawal — a result of a call being cancelled by their GP — exemplified just how debilitating an absence of care can be for vulnerable students:

“Earlier this year, my antidepressant repeat prescription request was declined. (I misplaced my meds, it happens). Upon phoning, the reception was unable to offer me an appointment that day to reissue my prescription — because I ‘hadn’t called at 8.30 on the dot’. I was told that I’d have to wait until the next working day (three days later) to phone to book an appointment, and that there was nothing they could do to give me my medication.

“The Monday after, I phoned again and (after about 50 phone calls) was given an appointment, but the GP never called; I was told that they had cancelled. Fortunately, they managed to sort it the next day, but this experience left me with four days deprived of the antidepressants basically allowing me to function as a normal human being.

“TCA (tricyclic antidepressent) withdrawal symptoms include physical debilitation, psychosis, and suicidal thoughts — all of which I was enduring throughout peak formative/summative season for at least a two-week period. This has had an irreparable effect on my uni experience this year. And it all could have been prevented if the GP surgery was more organised.”

Mental health and counselling waiting lists have also proved to be long, leaving students struggling to cope in the meantime. One student, who is on a waiting list for sexual assault and rape recovery, has to wait nine months for treatment. They added: “I also have severe depression and anxiety and have been on the counselling waiting list for 7 months bearing in mind I couldn’t complete some of my exams [scheduled in Easter term] due to this and missed a huge amount of classes.”

“I had already been waiting nine months with no therapy”

One student found their waiting list progress directly affected by the transition from the hometown to Claypath GP. At the time of their testimony, they stated: “I have suffered from an eating disorder for eight years, and have been seeking treatment for about two years. I also sought treatment for depression at the same time. 

“I was first prescribed antidepressants in February of 2021, and since then my dosage has been increased twice. Getting onto the list itself took two months due to blood tests, weight, height and ECG assessment, and the waiting list time for therapy was given to me as 30 weeks. I had not received any therapy before coming to Durham in September 2021.

“The process has had to restart since switching practices. I got a call from my local GP and I was told that although it said on the university website that I could be registered at Durham, but  still use my local GP in the holidays, this wasn’t the case. My GP phoned me up and told me that because I had moved I would have to restart the eating disorders process in Durham. 

“By this time I had already been waiting nine months with no therapy. I have a basic assessment coming up this month, but this, along with every interaction I’ve had, including discussion on upping dosages, besides my first appointment, has been over the phone.” They later added that they had since been forced to resort to using private therapy.

In response to the testimony included in our article, Dr Michael Smith, PCN Clinical Director at Claypath and University, stated that the Medical Group would review and act upon the feedback provided as part of this investigation.

Smith said: “We absolutely understand and share the frustrations of patients who experience a poor transfer of care between areas of the UK in the NHS. To that end, we have invested a huge amount of time and effort to make the process as seamless as possible.

“We encourage all students to fully register with a practice in Durham when they arrive. Registering with a local practice offers lots of benefits to the student population. A direct benefit is that the local surgery will have access to the student’s full health record, which ensures safe and efficient care.

“We too are frustrated when patients are told they will be removed from the care of a specialist service in another part of the UK because they have moved to Durham”

“Practices are funded based on the number of fully registered patients. If students do not register in Durham, the local practices will not receive funding. They will then only be able to deliver a poor service or potentially no service at all. Temporary registration is intended for patients on holiday or visiting family and friends. It is not suitable for large student populations.”

On the issue of the transfer of patient care, Smith explained that “we too are frustrated when patients are told they will be removed from the care of a specialist service in another part of the UK because they have moved to Durham. This results in delays and frustrations for patients and additional work for our practice, which in turn means we are less available for other matters.

“To that end, whenever we receive reports of this nature, we immediately write a complaint on behalf of the student to the service that has discharged the patient highlighting why this is practice to be avoided.”

He also said that “we regularly meet with the University administration and the Durham Student Union Welfare Officer attends our patient participation group. We also meet with advocacy groups and secondary care teams in areas that disproportionately affect young people – such as eating disorders – to ensure their needs are met.

“A recent outcome of such a meeting is that we have offered up our estate – at no cost – to the eating disorders specialists to reduce the travel time for students who might otherwise have to travel to Teesside for clinics.”

Smith also noted that in its most recent patient survey taken in September this year, 95% of the 274 patients who attended an appointment with the Medical Group said that they were either “very likely” or “likely” to recommend the service for care.

Image: Roger Smith via Wikimedia Commons

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