To be annoyed with my friends GP? (and can anyone help - Named referral)

[ASorcererIsAWizardSquared]

My best friend is ill, but the GP are doing so little to help her.

Her symptoms are indicative of her having Crohnes disease, mouth full of ulcers, sudden weight loss, nausea, unable to eat...etc.

My brothers DP has crohnes and spoke to her Consultant about my friend, and the Consultant said my BF should have been seen by a consultant ages ago, that the rapid weightloss and mouth ulcers alone should be screaming REFER TO GASTRO at them, and told brothers DP to tell my BF to go to her GP and tell them to refer her straight to her.

She said as its a named referral, bf's GP legally had to make the referral.

BF been to her GP today, and they have refused to refer her, stating they want to do more investigations and get her in counselling for her anxiety before they will refer her to a gastro consultant.

Quite frankly, by then my friend will be dead, she can barely eat, her weight has dropped from her being a size 12/14 to a size 6 in the space of 4 months, she is wasting away in front of us and her GPs are being assholes and there will be nothing of her left for them to refer by the time NHS counselling materialises!

What can we do? I'm lost and i cant bear to see my friend so ill and being messed around like this, the GPs can't do anything, she needs to see a proper Gastro Consultant!!

[midnightvelvet01]

Can she change doctors? Ask for a second opinion?

Could she maybe go to the Walk In centre to covertly get a second opinion?

[ButterflyUpSoHigh]

I have crohns and there was a 12 week wait for referral. My parents paid privately. After the initial appointment they transferred me to Nhs with the same consultant.

I would get her to go private if she can. Alternatively complain to the practice manager at the GP.

[OldFarticus]

Could she afford to see the consultant privately and get on her NHS list that way? For self funding patients it will probably be about 120 quid (and my DH often doesn't bother to invoice PP's who are seeing him because their GP is tooling around and there is something seriously wrong).

[LazyLouLou]

Contact the practice manager today. Tell them about the named referral and insist they sort it out as a matter of utmost priority.

[ASorcererIsAWizardSquared]

she is on benefits (ESA) and cant afford to go private.

She recently changed GP as she was being messed around by the other local one, this one is actually attached to the bloody hospital.

[PHANTOMnamechanger]

gosh your poor friend. for the record, those symptons could also be down to coeliac disease.

I agree that they need to buck their ideas up and get her referred for more tests asap.

[ButterflyUpSoHigh]

She will need tests to confirm I had blood tests, barium swallow, sigmoidoscopy then colonoscopy.

[Gottagetmoving]

If she is that bad, I would take her to A&E.
This happened to my mother years ago and in the end we had to call the doctor out to her because we thought she was dying. She couldn't eat and could not get out of bed. At that point the GP called an ambulance and had her admitted via A&E

[PHANTOMnamechanger]

see coeliac uk website for more info, and guidelines on getting tested/eliminating some possibilities.

it is a disgrce that your friends condition is not being fast tracked when she is so ill so quickly. but sadly I know loads of cases where GPs refuse to believe they don't know best. some think coeliac disease is only diagnosed in children not adults etc etc, but it can also come on suddenly.

[ButterflyUpSoHigh]

I disagree, this isn't a case for A&E.

[ASorcererIsAWizardSquared]

she's already had several tests, she does not have coeliacs, nor a stomach ulcer, its not gall bladder, nor is it reflux.

the only test they haven't done is the colonoscopy, which she is waiting for.

The fact is, the consultant wants to see her and TOLD HER to ask for a 'named referral' straight to her ASAP, and the GP has refused.

[PHANTOMnamechanger]

What are the symptoms of coeliac disease?

Symptoms range from mild to severe, and can include bloating, diarrhoea, nausea, wind, constipation, tiredness, mouth ulcers, sudden or unexpected weight loss (but not in all cases), hair loss and anaemia.

[ASorcererIsAWizardSquared]

Gotta, last time she attended A&E on instruction of the OOH nurse, she had a mouth full of ulcers so bad she couldnt eat, drink or swallow, they were tracking down her throat, and the A&E sent her away for wasting their time.

[ButterflyUpSoHigh]

Who organised the tests she is having? My GP only did blood tests then all the other tests were done by the consultant. Who are the results going to?

[PHANTOMnamechanger]

sometimes, people can have no choice but to go to A&E in sheer desperation.

an elderly neighbour had weeping bleeding 'bedsores' (so the GP said and prescribed cream) his poor wife could not cope with all the changes of dressing and washing the sheets, but you know, you believe the GP because they know what they are doing. the poor guy had advanced skin cancers from a lifetime of working outdoors with his shirt off. he was admitted to A&E after a visit from the district nurse.

[LazyLouLou]

I can only repeat, contact the Practice Manager, now. If the named referral means what you think it means then they will act, independently of the GP.

Having said that, you say that this is the 2nd GP who has 'messed her around' and A+E have sent her away. Might there be something else going on? Crohns isn't that hard to diagnose....

[electionfatigue]

I'm a GP.

Let's start with: She said as its a named referral, bf's GP legally had to make the referral.

That's rubbish. Go in with that sort of attitude and it will deteriorate rapidly.

then let's move on to and the Consultant said my BF should have been seen by a consultant ages ago

if true, that is unprofessional as the consultant is only hearing the story second hand.

Your friend should see her GP, or another one in the practice explain the symptoms and the weight loss and ask politely not demand with threats of legal action, to be referred. Go with her if you feel she needs support.

As stated, it sounds like very poor care from the GP, but none of us go into work aiming to kill people and there may well be more to the story than you know.

[electionfatigue]

BTW with a mouth full of ulcers, has anyone done an HIV test?

[ASorcererIsAWizardSquared]

election, i can only go on what my brothers DP told me her consultant said, which was that she needed to be seen, and to request a named referral to her as her GP legally has to do it if its put in as a named referral.

[ASorcererIsAWizardSquared]

" Go in with that sort of attitude and it will deteriorate rapidly."

why will it? do you refuse referrals just because a patient is belligerent election?

she's had endoscopy, blood tests and ultrasounds, she has had everything they have come up with so far, ruled out. She is losing weight hand over fist, can only eat 3 foods without vomiting. She is in pain, and no-one is listening to her.

Her brother has Crohns disease and they are refusing, despite not being able to get to the bottom of whats going on, to refer her to a gastro consultant.

Time for being nice about it is over, she weighs less than 8 stone and its still dropping. she can't afford for them to carry on pissing about with gp outpatient tests.

[SociallyAwkward]

Sorry, a consultant takes a brief medical history from a random third party during the third partys own appointment then says "tell her to tell her GP to refer her to me" and starts spouting the legalities of this.

I don't know where to begin with how unprofessional this is, if it's true.

[ButterflyUpSoHigh]

I have never heard of crohns causing vomiting it certainly hasn't with me. Mine started with mouth ulcers, diarhoea 50 + times a day, severe pain, tiredness and weakness.

[OldFarticus]

I agree with Sorcerer

I was at that post.

OP I have no idea what the NICE guidelines are for gastro referral, but there will no doubt be some. I suggest you print them out and go with your friend to the appointment and calmly explain why you believe a referral is appropriate.

But don't forget to be polite - any sniff of belligerence or dissatisfaction may result I your referral being refused

[electionfatigue]

what my brothers DP told me her consultant said

it's hardly first hand knowledge then.

Of course we don't refuse referrals if a patient is stroppy or unpleasant, but it is likely to get in the way of the GP being able to make a proper assessment and direct the referral to the right place, with the right urgency.

Depending on the area where you live, there may be various different hospitals/consultants that may be best placed to deal with this e.g. medical versus surgical, and different routes to refer - some areas have a day unit where tests can be accessed more quickly than via outpatients. There are important decisions to be made within the GP consultation, it isn't just a matter of writing a letter.

Has she had a faecal calprotectin test?

Sorry, a consultant takes a brief medical history from a random third party during the third partys own appointment then says "tell her to tell her GP to refer her to me" and starts spouting the legalities of this.I don't know where to begin with how unprofessional this is, if it's true.

Precisely

[electionfatigue]

Don't get me wrong. I'm not saying that she shouldn't be referred, if the story as you give it is correct and there is nothing else that you don't know. But it will get sorted more quickly if you, her and the GP can work together than if you are at each other's throats.