GP letter about DD’s missed hospital appointment

[MindatWork]

I was originally going to post this in AIBU but am too scared so just wanted to get others opinions on whether I’m being a bit precious. Apologies for length .

My 6 month old DD has been receiving outpatient treatment at the children’s orthopaedic clinic at our local hospital for the last couple of months. The administration of the clinic has been a nightmare with very poor communication between the reception staff and consultants’ secretary re appointment dates/times, regular 1 hour waits at clinic etc.

Her final appt was originally booked for the wrong date by the receptionist (a week after it should have been as she also needed an ultrasound booked for the same day), so I duly called when we received the letter and asked for it to be cancelled and moved to the correct date. All fine, we had the last appt and we’re now waiting for her check up next month.

This week we received a letter stating we had missed an appointment at the clinic (the wrong one which I’d asked the secretary AND the reception staff at hospital to cancel) and they had rebooked her for the next available date. This was copied to our GP.

We’ve now received a bit of a threatening/scolding letter from our GP advising that they’ve been made aware we missed a hospital appointment for our daughter and though there could be a reasonable explanation, they need to flag it because of the “possibility of neglect” !

I called them straightaway and politely explained it was a cock up at the clinic, but could/should I ask for this letter to be removed from her record? I know it’s probably an automatically generated letter and it’s good that they keep an eye on potentially vulnerable children but I find it weirdly upsetting that the word ‘neglect’ is now on my DD’s medical record.

Her treatment was upsetting enough after a difficult birth including a scbu stay and a very tough first 3 months, and we were meticulous in following every direction from the consultant.

Is it possible to ask for it to be removed or should I just leave it?

[KateyKube]

I’d definitely ask for it to be removed. You don’t want to be flagged for neglect when it’s an admin error!

[sackrifice]

Yes get it removed.

[MrsGrannyWeatherwax]

I don’t think that it can be removed but annotated as an error? Someone posted about this somewhere else

[endofthelinefinally]

Put everything in writing to your Gp. That way it will be scanned into your records. You could copy it to PALS.
I could fill several pages with appointment cock ups. They write accusing me of either cancelling or not attending, when they have cancelled my appointment.
My consultant expresses shock that I have not been seen in a timely fashion, but it is the hospital that cancels the appointments. Nightmare.

[MindatWork]

Thank you for the responses - glad to know I’m not BU .

@endofthelinefinally good idea to write to the GP thank you, I’ll do that tomorrow.

[CherryPavlova]

No the letter won’t be removed. Child safeguarding takes precedence over your indignation.
Non attendance at hospital appointments is a ‘red flag’, a potential warning. If there were several such letters you might receive contact from a health visitor or social worker.
There are far too many children dead because agencies failed to spot warning signs. Serious Case review shows failings to spot warning signs.A child a week dies. A letter rather pales into insignificance.

[TroysMammy]

If they can't/won't remove the letter off her records they should at least add an admin note stating the true reason for the missed appointment.

However there are people who are not like you OP. I work in a small GP surgery (6,000 patients) and the GP's never mention missed hospital appointments to the patients even though we see the same patients not attending, especially children, time and time again.

It's such a waste of everyone's time from the Receptionist who made the initial GP appointment, the GP to send a referral typed by the Secretary, the courier who picks up the letter, the person in the hospital who forwards on the letter to the Consultant, etc , etc, etc back to the GP's receptionist who scans the did not attend letter onto the timewaster's record.

[Helspopje]

On the one hand I do see that it must be horrifying to see such a thing on a letter with your child’s name on, particularly when it was due to an admin error
BUT
Good on your trust for actually doing something when kids aren’t brought to hospital appointments!
It isn’t like adults when they DNA as a child doesn’t have the capacity to decide if it will it won’t attend. I always worry when a child is repeatedly ‘was not brought’. It isn’t just the wasted slot or the PITA to rearrange, there could be a child being denied access to healthcare it really needs to get or stay well or a parent trying to keep a difficult situation away from prying eyes.

I’d send a brief note to say I understand the reason for concern being raised but actually there had been an administrative issue in this case and there was no need for worry and leave it at that.

[ShortyShortLegs]

I had the same thing last month...
my 16 year old had a referral to Gastroenterologist,
appointment made,
got called in for an endoscopy before clinic appointment,
clinic appointment cancelled and got referred to dietician for Coeliacs Clinic,
got letter requesting me to book appointment for follow-up gastro clinic.

I phoned and tried to book but told no, no need to book gastro before seeing dietician as she has diagnosis now. I phoned back a few days later to check that was correct.

Then I got a snotty letter from GP asking why I hadn't booked appointment. I asked the receptionist to make a note on daughter's screen explaining why I hadn't been able to make the appointment despite trying to.

Last November we had a letter from GP asking me to explain her high number of A&E admissions....A&E doctor wrote and said what did they expect from a teenager with a syndrome that causes weak bones and dislocations plus Epilepsy!! He said not to worry about any letters as every time she's been (26 to that hospital) in it was for a legitimate reason. I've never been asked again and she has multiple constants and a social worker.

[MindatWork]

Cherry If you read my op I said I think it’s a good thing that they keep track of children who might be vulnerable - however in this case my GP also has a letter on file from the same consultant sent after her last appt (a week before the ‘missed’ one), explaining that her treatment has been successfully concluded and she’s now just waiting for her follow up on X date. If anyone had bothered to look they would have seen that it was a mistake.

[slipperywhensparticus]

There are many reasons why a child misses an appointment neglect is one yes but it's more likely to be an accident or illness threats like that letter are reasons why people dont engage with services in the first place

[MindatWork]

I agree it’s good that the trust are following up and I also have real issues with people who fail to turn up for appointments as I know they cost the NHS a huge amount of money. We’ve just had so many issues with this clinic and I’ve spent literally hours on the phone and cheerfully waiting for appointments, it’s just a bit of a kick in the teeth. I’m v nervous about her follow up appt so that’s probably not helping.

[florence11]

I work for the NHS. The reason this happens is because there are concerns when children don't attend appointments that it's a 'was not brought' situation, not a 'could not attend'. It's being used as a marker in cases of neglect. Sadly very often it is due to neglect. By all means try to get confirmation it was a clinic cock up and the letter removed.

[MrsEricBana]

I wouldn't like that at all and would definitely want the facts noted on my daughter's records for future reference.

[Petalflowers]

Put your request to have her notes amended in writing and address it to the practice manager. If they can’t remove it, they will record the reason for the letter.

[CripsSandwiches]

I would. I missed a hospital appointment once. (The GP had referred me and I'd had a letter with my appointment date. I later got a letter saying it had been changed to a different date. Fine. After the original date I got an angry letter saying I'd missed the appointment. When I enquired it turned out the original appointment had been a double appointment and only half of it was cancelled - there was no indication of this in either letter I received. I'd just had one letter saying to be at the hospital at a certain date and time). I was warned that there was a record of is and if I missed an appointment again there was some risk of action (can't remember what) - I explained and did manage to have it removed.

[Dontstepinthecowpat]

I’ve had similar with my 11 year old. In my case I was mortified that they would think I would not bring my child to such an important appointment, in his case to a clinic that takes months to organise due to the nature of his condition and the various specialities involved. They had created his appointment but did not send a letter so we had no idea till we received the DNA letter from consultant to GP. I wrote back to the consultant and copied the GP in, I received a letter back from the consultant apologising for the administrative error.

[CripsSandwiches]

I do also agree with PP that particularly for DC it's good they follow up missed appointments. Obviously your case was not your fault but in general not showing up for a hospital appointment for your child would be concerning.

[AnyFucker]

So you didn't show for your child's appointment.

Yes it was a cock up. Yes you are one of the "good" families that don't neglect your kids. No you are not an abuser of the NHS.

Unfortunately, the staff that generate these communications only have the information provided to them and not the resources to investigate any further which category you fall into

Safeguarding vulnerable childten on shoestring budgets has to use a broad brush I am afraid. Some genuine "mistakes" will be "punished" in this way. My advice is to get over it, carry on doing your best for your child and not use further precious resources trying to right the wrong that you perceive has been done to you, because it really hasn't. Unless this is a pattern of repeated incidences, nobody is interested, believe me.

[stayclosetoyourself]

Hi Op . I think most people would find this a bit unfair and irritating. Sadly clinics and appointments systems have a lot of admin errors. Then when people eventually get to their delayed appt they are' told off'.
I think get the GP surgery to put a pop up note on their screen to say you have not cancelled any of your baby's appts.
I don't understand the Pps holier than thou attitude - tbf it's bloody annoying to be blamed for another 's mistake and accused of neglect when you are a caring and concientious parent. And I also work in the NHS so know exactly how daft it is sometimes.

[MindatWork]

I certainly don’t think I’ve been ‘wronged’ in any way and I’ve no intention of wasting resources or going storming in anywhere having a go at anyone .

I tried to be quite measured in my op and just asked a simple question about what others would do but that doesn’t seem to have come across.

I’ve repeatedly said that I understand they’re checking for a reason and I think it’s a good thing to protect vulnerable children. I’m well aware this wasn’t aimed at me personally but as a first time mum of a long waited-for baby who’s been quite poorly it just upset me a bit, that’s all.

[MindatWork]

@stayclosetoyourself thank you x

[KittyMcKitty]

I feel for the OP here I think people are being harsh! She didn’t miss an appointment - the clinic had booked the appointment incorrectly, the OP asked for it to be corrected to a week earlier- she attended that appointment but the clinic neglected to remove the incorrectly booked appointment from the system. And they’ve now rebooked her for an appointment she’s already had.

I would put it all in writing to the clinic, GP and consultant. The sad thing is that due to their incompetence they’ve prevented another child from having the appointments freed up by the OP.

[Tolleshunt]

I had similar, OP, and got a phone call from my GP, enquiring about it.

Luckily I know she is a good GP, so I was able to rein the narkiness in, but I was quite clear that it was an admin error, that the medical issue in question had been raised by me, rather than spotted by a HCP, so I was unlikely to be deliberately depriving my DD of medical treatment. I did ask her if she had actually had any experience of hospital admin, and she said she quite understood, and would make a note on the system. It was annoying, though.

Separately, I do wish that somebody with a few brain cells would take a hold of hospital admin, and give it a good shake up. It doesn't seem to matter which hospital, it seems to be utterly, shockingly shite the length and breadth of the land. I dread to think how much the epic levels of error and incompetence must cost. Shame, as the clinical staff are usually very good, once you actually get to see them.

[AnyFucker]

It's not about a lack of "brain cells" but about a lack of resources