Why do you have to beg doctors sometimes to do tests? Or is my experience unusual?

My neurologist is an arsehole. He would never initiate medication, but write to my G.P, stating that it can come out of their budget, disgusting. I’ve since found out he isn’t following protocol, if he needs to prescribe anything in the future I’ll mention to him that it’s his job to do it, he’s a cheeky bastard, anyone would think it’s his personal budget 😳

And that is the patient's fault how? Patients should not suffer because of the politics of business.

Why should the GP have to pay from their own pockets for a test that secondary care should be responsible for?? Quick way to put every GP practice in the UK out of business…

Neither did your GP. That's the problem.

Whatever the politics of the situation, it is not OP'S fault and should not have been made her problem. Why does the patient have to suffer?!

I assume (perhaps wrongly) that the OP would have gone to her GP initially triggering the referral to neurology.

If so wouldn't her symptoms warrant bloods to be ordered at that initial contact?

That would seem a basic sensible first step for the unexplained issues to me.

@ReenaGee

What level was your b12?

It’s utter laziness that a speciality team
want bloods and fob it off
onto primary care. They want them and should therefore do them. Who is then checking for the results? Who actions them? Who determines if there’s an issue? Who lets the speciality team know? What if you’re on medication only initiated by a specialist that needs altering due to the results. There’s a lot
more than GP’s being difficult (don’t get me wrong I know there are some out there).

It's a shame it's not possible for the OP to cover the £6 then rather than have to pay £100 privately.

This is the problem with the NHS now. It's a free service but that often means no service.

I'm so glad you could afford to pay for the tests you needed OP. It's a terrible state of affairs when you are left deteriorating for want of a simple blood test.

In my case my son was referred to a paediatrician due to mouth ulcers, nausea/stomach & bowel pain and raised platelets levels, low weight etc etc.

The paediatrician refused to any tests (I now know a simple stoole calprotectin test would have got us a long way - showing inflammation). They said his symptoms were "non specific" despite me saying exactly what my concerns were - which my concerns turned out to be the case. Asked to come back in 3 months (for another chat no doubt). I was told "he can't just go referring everybody". GP said they "see people with gastro problems every day". That left me wondering- surely there is a well trodden protocol to help them then?

No further help or tests from my GP despite phoning them and crying while asking how low my son's weight has to get before he is at risk of cardiac arrest/death.

2 visits to A&E later and he was referred for appropriate tests by gastroenterologist at the hospital with heads up that he expected a diagnosis of Chron's or Ulcerative colitis.

My son now has a diagnosis of Chron's and his symptoms are well managed with treatment.

We are asked to use GPs etc and stay away from A&E as a GPs visit is a fraction of the cost but it's impossible if they can't/won't refer for the tests that are needed.

These medical staff are on big wages (GP/paediatrician) but can't order simple tests so you go round the merry go round of seeing them time and again wasting far more money than the simple tests needed for diagnosis would cost.

I hope you get the help you need quickly OP and your symptoms reverse.

I think we should move from a model of GPs to treatment centres where the primary focus for an unwell person is "What tests/help do you need - right now". It felt to me like the GP/Paediatrician was on a performance target for getting people to clear off without any help or a referral. The less they do the better they seem to feel they have performed because the person has gone away without costing the NHS any money. Except they will be back time and time again and then present at A&E.

I apologise for the rant. I think I have PTSD from seeing my son so ill.

This is correct . Also a hospital consultant. This was cheeky of your neurologist . They needed to arrange for you to have the bloods by requesting them so that you can make an appointment at the phlebotomy clinic. The test comes out of the secondary care budget.

Sometimes if a patient lives a long way from the hospital I will write a letter to the patient and GP, saying that I have requested the bloods and could the practice nurse take them. That way the GP funds the blood taking appointment but my service pays for the test to be processed and I am responsible for managing the result.

It’s about time and expertise not just about money .

It's all about funding. My GP surgery loses £5 / £6 for every test. They do c. 15,000 a year.

But if you didn’t the GP practice would be £100 out of pocket instead. I know it’s frustrating but it’s a funding issue rather than a lazy GP issue

@ReenaGee unfortunately many hospital consultants push their work back to GPs. If a hospital doctor requests blood tests, then they should be doing and reviewing those bloods.

Technically GPs aren’t contracted to do most secondary care work. We often do it anyway to benefit the patient, but really the consultant should be requesting the bloods, directing you to hospital phlebotomy services, and reviewing the results.

That’s not exactly what the NICE guidelines say.

It depends on the reason for the deficiency,

Hi I have just read this thread and how you have right sided weakness, I have right sided weakness for the past 3 years as a seizure, I have been passed from pillar to post, I have seen neurologist twice and been discharged now. I am currently under rheumatology as I also have joint pain and swelling going on but they aren't proving much help 😔.

Can anyone explain about B12 for me and what should the level be and what issues it can cause if too low

Many thanks

There’s been recent push back from GPs about doing blood tests ordered by specialists. Specialists are supposed to order the tests themselves. This is less than practical for me as a community psychiatrist who does not operate out of a hospital where a blood test could be done but those are the rules. GPs have been carrying out ‘work to rule’ type industrial action recently and have stopped doing anything above and beyond their contract. I now have to ask confused frail elderly people to attend an unfamiliar clinic a long way from home if they need bloods or an ECG. So much for devolving medicine into the community…

As I was reading the beginning of your post I was thinking b12 deficiency.

I’m glad they’ve identified it.

Just to make you aware, if you’re not already, many GPs don’t stick to the NICE guidelines. You need injections every other day until symptoms disappear. I have heard of several instances where the GP
does EOD injections for 2 weeks and then send you on your merry way, with a view to inject once every 12w.

Good luck. It’s completely exhausting having to battle for adequate care.

I'm a hospital consultant. If your neurologist thinks you need blood tests, then they should organise them i.e. send you a form and follow up the results. That's what I do, and that's what is supposed to happen.

The neurologist is not someone special.

It's terrible op! The communication is so bad between the services. When my folate was extremely low I had all sorts of weird symptoms, felt so much better when the level got back up to normal so fingers crossed it'll be the same for you.

I’m sorry this has happened to you op. Something similar happened to me and I’m now permanently disabled due to it.

the lack of communication between hospitals and gp are dreadful