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!!

Butterfly I initially presented with vomiting. I put off seeking help because I thought it was a stomach bug. I think digesting food was so difficult for my body due to the intestinal ulcers, I was vomiting the food back up. Either that, or it was a reaction to the extreme pain.

Call the practice manager and ask about nice guidelines for gastro referrals

Butterfly, my brothers DP had vomiting so severe her teeth are rotten and she's saving up to get them capped since the crohns is under control with recent surgery.

She's a volunteer for the Crohns & Colitis UK charity and see's it quite a lot from people who contact her for help.

I have to say I really don't get this named referral thing. So I could get the name of a consultant from a friend / hospital website and because I know their name I can demand a referral to them? Seems very unlikely.

I do think your friend should see the practice manager or a different GP though, and take a full list of symptoms with her.

I'm quite aware of how difficult Crohns is to diagnose, our dad had it, and 35yrs ago it took nearly 2 years to get to the bottom of it and it and my dad nearly died twice once before surgery, and once after it.

I also know what my brothers DP has been through on her journey to diagnosis and treatment.

Apparently the speed of diagnosis and the state patients get into before someone actually does something constructive hasn't altered much in 35yrs, which is disgusting.

OP - what electionfatigue said, really.

You weren't in the room when your brother's DP asked about the consultant referral. DP might have said, 'Can she asked to be referred to you?' Consultant may have given a non-committal 'Mmm.' which DP has since fedback to you as 'The consultant said...' when that was nothing of the sort. I'm a clinician in the NHS - this kind of misrepresentation of what has been said to patients happens ALL the time.

I don't think you know the full story of what's happening with your friend, sorry. I think, in this case, the GPs may know something you don't and are trying to avoid unnecessary and invasive investigations.

I can think of several of my patients who regularly tell their friends/relatives how terrible we are, how their health is being neglected etc. etc.

A look at the notes often tells a very different story.

I'm not saying this is necessarily the case with your friend, sorcerer but I would be wary of relying on second/third hand information too much.

Couldn't those symptoms mean a lot of things? If she's as ill as she sounds isn't it better to run tests now to eliminate things like HIV, cancer etc rather than refer her to another doctor who won't see her for several weeks. And I would presume that they want to know they are referring her to the right person before making the referral. If she's worried she should get another opinion.

Since she's seen 2 doctors who seem to be agreeing with each other personally I wouldn't complain, but she could if she wanted to.

At any rate, I think there's a danger of listening to the opinion of a doctor friend who hasn't seen the patient or her files and doesn't know what tests are being run sounds like a great idea.. If you're a specialist then it's quite likely you're going to see every problem through the lens of your specialism, but a GP has to investigate every option.

Is there another GP in the practice that she could see? I think that should perhaps be the next move, if she is not happy with her treatment, and you could go with her to provide support if you can. It might make sense to get the colonoscopy done first in any case though.
The information you have about a named referral doesn't sound right to be honest.

no general gp bashing going on here. Just this one, because i'm watching my best friend disappearing to nothing and watching her feeling more and more helpless while getting sicker and sicker.

So she's been referred for investigations? What's to complain about?! It's better than she the results from a 'scope before seeing a consultant.

Well, this one and the one before that...

I asked before, but are you sure there is nothing else going on? You have said that 2 GPs and an A+E have treated her badly. I am not saying that never happens, but it is as likely that you don't know the whole story.

And you do sound so very certain of her eventual diagnosis. This may be colouring your view.

She's also had the non-invasive tests first which is the correct protocol. Sorry but YABU.

The referral thing is probably a conflict of interest.

I'd go back to the GP and insist the things GP wants done first are done immediately so she can get the referral

where on earth did i say the GP before refused to refer her? I said they were messing her around, which they were.

The practise is quite badly run.. its a nightmare to get an appt with, you could never see the same dr twice and it was usually a locum and each one had a different idea of what to do, kept changing her medication or she had to go through EVERYTHING all over again every single time, which gets exhausting.

The few times she got to see one of the actual practise GPs, they referred her for the tests.

Having got fed up of locums and her medication being changed and not being able to get appt when she needed them, she took the decision to change GP to the recently opened one on the local hospital grounds.

Having been with new GP for a month, she today, for the first time, asked to be referred to a Consultant on the basis of what we were told and advice given and she was refused on the grounds they've decided she needs yet more tests and they want her to have counselling for her anxiety first.. which she has had all her adult life, and as i pointed out, the rate she is losing weight, she can't afford to wait for NHS counselling. She doesn't understand why they can't refer her, as requested ALONGSIDE the counselling being sorted out.

She's fed up of the whole thing, she wants to be seen by someone who specialises in Gastric issues who can look at everything she has going on and be able to get her the right care and a diagnosis, be it crohns or whatever else that might be, rather than a 'general' practioner keep making stabs in the dark as something they clearly can't diagnose themselves (or they would have by now)

I dont think thats too much to ask.

She's fed up of the whole thing, she wants to be seen by someone who specialises in Gastric issues who can look at everything she has going on and be able to get her the right care and a diagnosis, be it crohns or whatever else that might be, rather than a 'general' practioner keep making stabs in the dark as something they clearly can't diagnose themselves (or they would have by now)

You're still able to come out with that after so many people have said how pointless it is to see a specialist before the colonoscopy results are back, and so many people have pointed out that the GP has referred for all the appropriate tests, which have been being done this whole time?

YABVVVU.

Maybe they have diagnosed OP and you just aren't party to that information and it's not something your friend has imparted to you because it's not a response that she wants to hear.

where on earth did i say the GP before refused to refer her?

No one has said you did, have they? If you think I did, re-read my post, I did not! You said you were not generally bashing GPs, I said, except for the current one and the one before that...

no Owen, 'general gp bashing' would be me sitting here saying every GP in the whole of the UK is clearly a useless bag of shit, which i haven't

I've said i'm annoyed that her GP is refusing to refer her.

Yes Elpheba, because my friend regularly phones me in absolute floods of tears, begging me to help her because she doesn't know what to do because she already HAS a diagnosis she's choosing to ignore!

Of course, why didnt i think of that?

Two doctors have doubted she has Crohns disease. If you're not a doctor you can't be sure she has got it. And also A & E sent her away. I know you want the best for your friend. I think she'll have to find the money for a private consultation somehow if this is to be resolved.

Do you actually know the referrals criteria for crohns? It may be that the hospital will reject the referral until the go has carried out all the other tests. I doubt the go is actually refusing to refer - just completing their job before they refer.