Advice on GP complaint - is this normal ?

[Orangemintcream]

Hello

I wanted some thoughts on a complaint I submitted to my GPs surgery about the behaviour of a practice nurse when I attended for mental health issues.

They have sent me a letter - it appears they handed the complaint to the person I complained about who has sent me a non apology which basically ignores the issues I raised and says “sorry you felt that way”.

Is there any point taking it further or will they find ways to be even more unpleasant now I have dared to raise a complaint ?

For context the complaint is that I was only able to say I was there for mental health issues and said I knew I needed help (I was suicidal).

I said I didn’t think raising my anti depressants would help as I had been on them years and this was new.

She then kept shouting at me “What do you want what do you want” as though I knew.

She also told me there was “Nothing else because it’s the NHS” other than a referal for therapy that was an 8-9 month wait when I said I needed help now.

She asked me no questions and didn’t even attempt to do my scores or ask me if I was a danger to myself or others. I was - I was both in all honesty.

I now know a bit more about secondary care and that it does indeed exist on the NHS.

I made a complaint about this and her awful rude unkind attitude towards me. This is the response I have had.

I think you need to decide what outcome it is you want to figure out if it’s worth taking it further

Well I would like a real apology for a start.

Ideally I’d like her to actually experience consequences for lying about their being no other help available except a waiting list for therapy - whatever the disciplinary process is.

Obviously I never need to interact with her again which won’t happen anyway as it is a larger enough practice I can avoid her.

There are far better ways of accessing immediate mental health support than going via your GP. Do you have telephone numbers for your local 24hr MH support line locally? Alternatively you can call 111 and choose option 2 for mental health.

I hope you're feeling better now

In your shoes i'd want an acknowledgement from the practice manager as well as the nurse that the way this was handled was unprofessional and wrong and that the staff have now had training in what to do and what services are available.

That seems to be the most important thing. But also you might want to discuss the non-apology and how that should have been handled too, but only if you think that will be helpful.

No. To be clear I only found out about all of this later when I finally reached the end of the months long waiting list and they spoke to me about it. In fact when I did reach the end of the wait list I was in such a state that they
wanted to refer me to secondary care.

I did not know about scoring systems, risk level or any type of secondary care other than A and E.

I was in such a bad way I was not able to articulate anything and she was so rude and unkind trying and obviously to get rid of me I was so upset I want able to stop her and say “well I am suicidal”

And no I wanted to hurt someone specific who had done something to harm me.

I don’t think you will get any useful resolution to this and you will just make yourself feel worse by continuing to push the point.
She sounds awful though.

I suppose that depends on what the practice guidelines on this are though? As a practice nurse in a GP surgery her only options really are your medication or a therapy waiting list, she’s not inherently wrong about that although she could have provided that information in a better way it sounds like. There are other options but the GP isn’t really the place to get that if you are in crisis.

Did you tell her that you were a threat to yourself and others? Did you ask her to do your scores?

I am feeling better now - hence being in a position to make a complaint. I know and understand a lot more than I did then.

I was given no info on this but I do know about it now via the therapy service. I am now also having therapy although I was actually put on the wrong wait list and the type of therapy offered may not be quite the right fit but after everything that had happened I felt that even being able to talk about it might be helpful - then I could see if I wanted to go back on the waiting list for something more specialist.

No it’s pretty clear that by handing the complaint directly to her (surely a conflict of interest) it won’t go anywhere.

To be honest I thought I might get some sort of closure submitting as it was part of the ensure saga of me being let down by various people including professionals. I also hoped it might given them pause for thought about being so unpleasant.

I clearly thought wrong.

Are you feeling better now OP? I don’t think it will do you any good to obsess over this to be honest but I’m sorry that you didn’t get the response from the NHS that you wanted or needed.

Sort of. Better than before yes. Therapy ongoing. No longer suicidal but still find things difficult. But looking back I have come a long way. Alone and without help for most of it but I have still succeeded.

I thought it might be helpful as part of the ..process that I made a complaint as part of accepting it happened and wasn’t ok.

I doubt that people like that are capable of self-reflection. It is just awful that she is dealing with people with such lack of compassion when they are most in need of kindness and understanding.

You could ask the Practice Manager for a copy of their complaints procedure/ policy. There will be a "next step", a way to escalate a complaint in the situation where a complainer is not satisfied with the response they have had. You could try that?

I thunk it might be better to put it behind you and make a plan for if this happens again, for example could you ask the surgery if there is a GP with an interest in mental health you can see in future

This is what I was wondering about - if it’s really worth it or if I should just I’ve up and pot it behind me as best I can.

I see a pp has suggested that I put it behind me and they are probably right.

Well no but I would have expected a neutral party to be the one looking into it at least.

I think some of the issue is is your expecting a practice nurse to act as a fully qualified mental health nurse who has trained in mental health when the reality is she probably has a vague overview of mental health as she works in general practice covering everything from babies to elderly and then refers into the specialist services. The same as GPs have a basic knowledge and then refer onto specialists in secondary care.

Hence suggesting upping your meds or putting you on the referral list - prehaps she should of offered you the local crisis teams number however expecting her to complete a full scoring and comphrehensive assessment is probably unrealistic of her skill set.

With regards to how she liaised with you no one can comment. From your version it doesn’t sound great however if you were feeling very vulnerable at the time could she of come across in a different manner, where as another take is if you didn’t want your meds changing and were unsatisfied with a long waiting list maybe she was trying to see if you had a suggestion of what you wanted however due to feeling vulnerable mistook her for being defensive towards you - just playing devils advocate and offering another perspective- she may well of just been abrupt.

I think in any complaint its often passed to the person to do some sort of reflection, regardless of being in healthcare or any other discipline.

I would say that the problem here is that the nurse doesn't have the clinical skills to do the job she is being asked to do.
OP said she was suicidal - I'm surprised the nurse didn't ask her if she felt she might harm herself, or others.That as far as I remember was part of the PND questionnaire I was given after DC 2 was born - and the health visitor was assessing that, not a specialist mental health nurse.

The GP surgery should have training/ procedures/ whatever in place to make sure that people with that level of mental health concern are not missed,and the complaint might not need to be about the nurse as an individual but that OP attended her GP with mental health concerns, aware she felt a risk to herself and to someone else, but was not asked about this or given an opportunity to volunteer it.
If the first line person seeing patients like OP is a general practice nurse they still need the tools and the training to know when they can't help that person appropriately and where to pass them on to.
The GPsurgery might not be the place to be when you are in crisis but they should definitely be able to pass you on to the appropriate serice.

She absolutely should have offered the local crisis team number and also discussed it with a practice GP and try to get them to see the OP. It’s not always the case that GPs aren’t the place to go in a crisis, as a PP suggested, they can be excellent and many practices will have a member of staff who is more specialised in mental health.

OP if you have the energy to further the complaint it may help the practice to get better protocols in place. That’s not to say I think you should.

Ask them what retraining has been put in place to ensure she offers professional knowledgable care and advice to service users