Who's who at the GP surgery

Receptionist

The receptionist is a good place to start when you want help. Not only do they know what's available at the practice, they often have a great deal of knowledge about health services in your local area.

One of the most common complaints about receptionists is that they're obstructive and don't want anyone to get past them. It's unfortunate this is how they're perceived, because in the majority of cases it couldn't be further from the truth.

The main role of reception staff is helping you in getting the help you need. If it's an appointment, this is usually straightforward. If it's medical service advice, they may have to ask you some questions if they're to guide you in the right direction.

In many practices, receptionists also have other administrative roles such as ensuring letters, patient notes and test results from the hospital are filed correctly, and dealing with telephone requests and queries.

Practice manager

The practice manager is responsible for making the surgery run smoothly. This means organising staff, paying the practice's bills, buying supplies and ensuring the practice is paid for the work it does. If reception staff are unable to answer your query, the practice manager will be asked to help.

The main reason you would need to approach a practice manager directly is if you want to make a complaint.

Data input clerk

Many practices have appointed a dedicated data input clerk, as much of a practice's paperwork and records are now stored electronically. This person will fill in at reception or switchboard when needed, but in general has little contact with patients.

Practice nurse

Most surgeries now have at least one practice nurse, who can help you with:

• Blood tests or cervical smears
• Dressings that needs attention
• Blood pressure checks
• Travel advice or immunisation
• Blood pressure checks or immunisation
• Blocked ears that needs syringing
• Healthy living and family planning advice

In recent years the role of the practice nurse has gradually expanded, with many now running their own clinics looking after people with conditions such as asthma, high blood pressure or diabetes. They will ask the doctor for advice if necessary.

Some practice nurses have completed extra training to allow them to triaging (sorting and prioritising) urgent problems, seeing patients with minor ailments such as sore throats, cystitis, skin rashes and blocked ears, and they can prescribe medication where appropriate. These nurses are known as nurse practitioners.

Nurse independent prescribers are able to prescribe any licensed medicine for any medical condition – including some controlled drugs - provided they have undergone appropriate training and have the skills and knowledge to do so.

Locum doctors

Locum doctors are an essential part of the NHS workforce - most surgeries employ them at some time. Locums are simply temporary 'stand-in' doctors who are taken on while the regular doctors are away on holiday, study leave or off sick.

They must be fully qualified as doctors. This means they must have completed a medical degree and then full vocational training in general practice, as well as holding the appropriate medical certificates and criminal records bureau (CRB) checks.

What motivates a doctor to work as a locum varies. Some do it to fill in between permanent jobs, or until they find the job they really want. Others do it because of constraints such as family commitments or doing further training. Many use it to supplement their regular part-time GP roles and only work for a few surgeries so they do get to know the practice and patients.

There are considerable disadvantages for both doctors and patients - it can be quite an isolating job and locums may not get to know a particular practice, group of patients or local area services.. There may not be the same chance for them to take time out to update on new treatments or be included in local or practice educational meetings, so they may be less knowledgeable.

There has been criticism that some locums are not very good doctors who move from surgery to surgery as or before their bad practice is discovered. But the rules about working as a locum have been tightened and most locums are reasonable doctors who simply haven't yet found a local permanent job that suits their needs.