GP complaint would you bother?

[eosmum]

DD has been feeling awful for the past couple of days with a very sore throat. White spots, swollen red throat, and raging fever. Got a telephone appointment this morning with GP, requested a picture, diagnosed with a "sore throat", get a throat spray. She was in such pain I sent the money for her to get a private consult, and she has Quinsy, the abscess is in the picture she sent earlier and she did mention the oozing spots. Would you bother saying anything to the GP?

Absolutely. Especially when you have the correct diagnosis from the private GP.

Yes. With the white spots I’d think tonsillitis straight away.

I would certainly wish to make her GP aware and express concern about the difference in diagnoses yes, especially as she was in so much pain.

As far as a complaint goes, put it in writing to the practice manager if you do action one. In all honesty I can't imagine a great deal will happen but it can't hurt.

Hope DD feels better soon.

Yes absolutely. They were wrong and it could have turned really nasty without antibiotics. Who did you use for the private consult? I think it’s useful to know as most of the time I can’t even get through to our Doctors let alone get a consultation. Hope your DD feels better soon.

Um yes. I’m baffled a GP could diagnose a “sore throat” when white spots are visible! Every HCP knows white spots are a sign of infection and would need antibiotic treatment.

I would be speaking to the practice manager.

Thanks guys, I'll get her to send an email when she's home. Private GP sent her to hospital for IV antibiotics I think. Her phone died unfortunately so no update from her since this morning. I'm not even in the UK so just googled a private GP near where she lives.

Yes definitely
It should be updated on her medical records, and the GP practice can learn from their error

NHS guidance states a pharmacist can help They can give advice and suggest treatments, like:

•	lozenges
•	throat sprays
•	antiseptic solutions

See the GP if

•	you have white pus-filled spots on your tonsils
•	the sore throat is so painful it's difficult to eat or drink
•	the symptoms do not go away within 4 days

No. GP was correct. Most sore throats resolve on their own, even with white spots. Antibiotics are not appropriate for sore throats, white spots or not.
There is no way the GP could have known this would develop into a quinsy. By the time your child saw the private GP things would have developed further so quinsy was diagnosed - had the first GP seen the quinsy at this stage they would also have treated. Had the private GP seen the sore throat at the earlier stage they also would not (or should not) have treated.
Antibiotic resistance is a really serious issue. GPs quite rightly do not prescribe antibiotics for sore throat because it creates antibiotic resistance - pretty much all sore throats and tonsillitis get better on their own.
Your child was unlucky that it developed into a quinsy but GPs cannot give everyone antibiotics just incase sore throat turns into quinsy. People with quinsy get worse, they go back to the GP and are then treated - just what happened in this case except your child went back to a private GP.

Nightlightcomfort It sounds as though there was only a couple of hours so seems unlikely would go from sore throat that will get better with no antibiotics to hospital IV and quinsy. Sounds like the GP missed this

I'm a GP. A sore throat with white spots alone does not necessarily always require antibiotics (it depends on other factors such as whether you have a cough or swollen lymph glands), but if as you say there was an abscess clearly visible in the picture which was missed then it absolutely is worth feeding that back to the practice as where I work we would do a Significant Event Analysis to work out what training/ change in protocols could ensure something like this is not missed in future.

Hope your DD feels better soon.

Incorrect

GP should have used FeverPAIN assessment. Not sure if patient had a cough or not so she would have scored a 3 or 4. Therefore, GP should have either given her a backup prescription for antibiotics if the sore throat didn’t clear within a few days, or a course of antibiotics to take immediately.

www.nice.org.uk/guidance/ng84/resources/visual-summary-pdf-4723226606

it depends on other factors such as whether you have a cough or swollen lymph glands)

A gp wouldn't be able to necessarily diagnose swollen lymph glands from a photo.
GPs need to start seeing more patients in person.

No, and I certainly would have offered a face to face appointment for this patient. I was really just addressing a previous post saying that white spots on the throat always needs antibiotics.

I didn’t say always and I should have worded it different to “every HCP knows white spots are a sign of infection and COULD need antibiotics”

Regardless this GP let the patient down. As mentioned to a PP the FeverPAIN assessment should have been carried out as you would know.

Yeah complain, its a miss-diagnosis.

Yes I would complain. Resistance to prescribing antibiotics just a misguided attempt to save money. I am abroad and went to my GP with a very sore throat and fever after 48 hours. She did an instant swab for strep throat, it was positive, she prescribed antibiotics. A week later I was much better. In the U.K. I'd have had to join a phone queue at 8am 27 times to get through to GP, wait 3 weeks to see if it resolved on its own and then take the same antibiotics. People should not have to suffer because the NHS won't prescribe a drug that costs less than the prescription fee.

A quinsy is a peritonsillar absess

Abscesses often do not respond to antibiotics as the infection does not have a blood supply to it as it's all inside the abscess

Surgical drainage is often needed by ENT in hospital

Private GP was not correct either

Why not just let the gp know rather than make a complaint. He won't just have used the photo he will have taken into account what other symptoms were reported.

Presuming your daughter is an adult, she will have to make the complaint herself (if she wants to). The practice can only deal with complaints from the patients (unless they're a child or don't have the capacity to make a complaint).

Absolutely! This is a misdiagnosis - and if this dr is prone to misdiagnosis, they need to be called out on it before it’s too late. I’m so pleased you sought a diagnosis elsewhere.

My friend went to the dr and fobbed off. Turns out it was TB, left untreated, she went into a coma and has been a complete cabbage ever since, unable to walk, talk, move, or live at all. Won a huge multimillion pound compensation case against the dr.

Absolutely your experience needs to go on record.