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!!

Yes, that's my point exactly. A know it all has taken upon herself to discuss your friend's case with her own consultant and relay misinformation back to your friend via you. I hope she doesn't usually use her status as a 'volunteer for Chrons UK' to dish out bad advice willy nilly.

As plenty of posters have pointed out - a gastro consultant will simply say - go away and come back when you've had the colonoscopy.

I'm sorry but I just blatantly don't believe this... The fact is, the consultant wants to see her and TOLD HER to ask for a 'named referral' straight to her ASAP... I absolutely don't believe the consultant has said this to your brother's partner, that a consultant would have a quick chat about a third party and decide the third party must be referred to her immediately.

Where was I unpleasant about people with MH issues OP?

I work every day with people with very real physical symptoms (INCLUDING diarrhoea, vomiting and weight loss) with an entirely psychiatric cause. The symptoms are just as real and unfabricated as they would be if there was an organic basis to them. If you don't believe me, Google 'conversion disorder' or 'functional illness'.

I'm not discounting Crohn's at all, and many on here have given very good examples as to how winding the road to this diagnosis is, but her mental health history and GP advice to seek counselling sounds familiar to me.

Okay... so in between tests the OP's friend continues to lose weight very severely and is unable to eat and in pain.. at what point does it become something in urgent need of attention? What's an adequate timescale for this, all compassion fatigue/NHS resource weariness aside e.g. if you were a wealthy patient in the US, what would happen now?

And Elphaba, don't you usually need a full medical and psych work up before you can confirm a conversion disorder?

yanbu op. If you need a biopsy to diagnose chrohns presumably you also need one to rule it out.

I dunno if most of the people on this thread are either bonkers or smugly thinking 'I can afford to go private'. And yes you can choose who to be referred to in so far as you can choose where to go and GP requests their clinic.

Mumsnet gets more and more crazy and accepting of utter shite from those in authority.

I hope your friend is ok op

duplodon To get a confirmed diagnosis of conversion disorder - yes. To get a suspicion of one - no. An experienced medical professional can spot a likely functional diagnosis pretty quick and request as few invasive tests as possible.

I have the worst of the worst crohns, short bowel, numerous other problems. I have had nothing but superb help from the nhs (I am under st marks, have stoma etc) and sometimes I have to wait for tests. I imagine if bloods showed no issues either inflammation, vitamin etc then that's why she isn't being fast tracked. I get your worried but she may not have the disease.
For example I have a suspected GIST and stoma nurse got me CT next week, I see gastro surgeon end of July. You sometimes need to wait.
If it's an issue due to weight or lack of fluids she needs to be assessed in hospital, but they may find she is ok.
Sometimes too much knowledge is no good thing. Crohns is a life time illness. They have to get it right.

I too have crohns. Diagnosis took lots of tests and lots of waiting. Was referred for an investigation 12 weeks ago and have just been to check why I hadn't heard from the hospital- only to find that the doctor had forgotten to write the letter- so you could check that paper work is up to date.

I wonder if they are confused with 'choose and book'. My doctor does it- I actually had a hernia repair done privately under choose and book with my normal surgeon BUT some surgeries don't do it.

what happens to those of us on the waiting list for tests when people go to A&E to get treatment faster

what happens is that they get told by A&E to go back to their GP and they don't get treatment faster. If you get a scan/endoscopy etc directly from A&E then you are generally very ill.

I dont agree Owen, anything to do with the nhs results in a load of mindless trilling about resources being stretched . OK we'll all just accept 3rd world treatments, live our lives in misery and die needlessly then...

This isn't about a waiting list she hasn't been referred .

Referred for what exactly?! It's been repeated over and over that a gastro referral without a colonoscopy is a waste of time. She will be having a scope.

^^ this. She won't get anywhere near a gastro specialist without having a colonoscopy as they don't know there is anything wrong with Her?
Also third world treatment and living in misery ?? Exaggeration much? Maybe try comparing too, I don't know, the actual third world. We are bloody lucky.

Elphaba, I'm pretty sure we were just taught that a functional disorder is quite explicitly not the same as a psychosomatic disorder. As in, a functional disorder is without known organic cause, or where the organic cause is irrelevant anyway and symptom treatment rather than further investigation is needed... right? It's not supposed to be due to a psychiatric cause. I'm thinking of examples like IBS here.

Obviously this is not relevant to the thread though so don't let me derail here!

Third world treatment?

She's had bloods, endoscopy, ultrasound and is waiting for a colonoscopy. I would imagine the results from previous tests are largely normal because if there was anything sinister she would be seen very quickly.

She is obviously unwell but given that she seems to be seeing a GP regularly and they haven't fast tracked her anywhere but are following a series of investigations, I think to say they are doing nothing is unfair.

I'm sure she will get referred to a consultant once they know which specialty she needs referring under - it could be anything from surgical, gastro, hepatic, medicine or psych.

I understand you must be worried about your friend OP but you're getting second hand information off the back of a relatives girlfriends "diagnosis" based on her own health experiences. Surely you can see that's counterproductive?

I don't understand why the 'friend's GP is being slagged off here or why the OP is so emotionally invested in her friends medical problems. The GP has referred her for a colonoscopy which is the op propriety investigation. If there is a waiting list for this the 'friend' should complain to the hospital not the GP as the delay is with the hospital. Named consultant referrals no longer exist in much of th N H S where referrals go electronically to a central referral unit

Appropriate I hate typing on my ipod

Elephaba, it is pretty dangerous for a GP to proceed on the basis something is a conversion disorder based on short consultations, no?
I had an adult neuro client once whose stammer was judged by GP as a conversion disorder. He was bloody lucky that didn't kill him. Conversion disorder symptoms are usually defined as being short lived, too, aren't they? Recurrent but short-lived.

Elphaba, thank you for your clear and sensible comments.

I can see both sides. Your friend is obviously ill but the consultant can't do much without the endoscopy results, which will be written by or at least overseen by a consultant. It may also be that the GP suspects something else, I had a lot of the symptoms you describe and it took referrals to three different departments (Gynae, gastro, general surgery) and three hospital admissions before a large ovarian cyst was found (the cysts had probably been growing and bursting so not showing up on US).

I was sent to gastro first as that was most likely due to vomiting, wind, diarrhea.

I'm also thinking the conversation with your brother's partner was more along the lines of

A friend of a friend has similar symptoms to me how would she get to see you quickly?
Oh the quickest way to see me is by a named referral, tell her to go to her GP

I didn't realise ordinary people used wording like 'triaged at A&E'