Reception staff at three “inadequate” GP practices have been described as “unqualified gatekeepers” who aim to “offer the minimum possible care”, in a new report analysing patient feedback.

A healthcare watchdog compiled the report after a third surgery in the south of Waltham Forest received the lowest rating from government healthcare inspectors last month. 

The Ecclesbourne Practice, the Francis Road Medical Centre and Crawley Road Medical Centre are all under close review by the Care Quality Commission following damning inspections in the last year. 

Healthwatch Waltham Forest has now warned that a lack of face-to-face appointments is undermining patient trust in their local GP practices. 

In its report, the watchdog wrote: “[Patients] are more likely to perceive reception staff as rude, and the relation with them as adversarial; they may be seen as unqualified gatekeepers whose goal is to offer the minimum possible care. 

“If they are offered remote consultations (for example, a call back from a doctor on the phone or an online consultation) they are likely to see this as being of lesser quality.” 

One anonymous patient at Crawley Road Medical Centre – which has been given a final warning to improve – said they get a “sick feeling” about having to deal with reception staff. 

They added that receptionists are “patronising and act as gatekeepers” to accessing medical care from a nurse or GP. 

At each practice, Healthwatch Waltham Forest found that two-thirds of patients spoke negatively about the service offered, particularly about reception staff acting as “adversarial gatekeepers” for appointments. 

Speaking at a health and wellbeing meeting on March 15, the local watchdog’s chief executive Dianne Barham said the pressure on GP practices is causing some to “show outbursts”. 

Her report on patient feedback found that if patients are unable to get a same-day appointment, they are given “no appointment at all”. 

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Lorna Hutchinson, assistant head of primary care at NHS North East London, said her team is “streamlining intervention” to support practices that fail inspections. 

She added that NHS North East London is also able to monitor the “contractual levels” of service practices are delivering. 

Despite widely voiced concerns about “gatekeeping” and triage of patients calling for appointments, NHS North East London, which commissions GP services, insists that appointments are provided according to “patients’ preference and clinical need”.