to think that this GP should be struck off

[atheistmantis]

www.bbc.co.uk/news/uk-wales-south-east-wales-39095656

A five-year-old girl died of an asthma attack after being turned away by a GP because she arrived minutes late for her appointment.

This is the daily mail which usually MN dislikes hmmm this will not be accurate reporting.
It is tragic for one so young to die but we do not know the true circumstances and I would never trust the daily hate.

The article says that the doctor had a history of sending people away, even emergency appointments, if they were at all late, and that the reception staff found her volatile and intimidating. Quite worrying really - the receptionist should have made it plain to the mother that A&E was recommended, if she didn't know already though the article says she'd had hospital treatment for it five times already.

It sounds like as ever that this horrific situation has not just arisen because of what happened at the GP surgery, but also because how it was communicated.
The poor girl died 5 hours after she had presented to her GP surgery.
As she had been critically ill previously with her asthma, it surprises me that there was not a better asthma management plan in place, or if there was that it was not actioned.

For the record, asthma kills. Many people, every year. Many, many of them because they are under-treated with their preventer inhaler, and overrated with reliever. Primary Care is not equipped to deal with severe and brittle asthma. I have not sweated so much as recently waiting for over 1 hour for a 999 ambulance with a brittle (adult) asthmatic - as we were at a GP surgery, he was considered to be at 'a place of safety' so the ambulance request was downgraded.
A GP can help with managing asthma, can help with respiratory infections, can even nebulise or give O2 short-term.
In the midst of a severe asthma attack, call 999/make your way to A+E, multi dose with reliever.
And attend for your annual asthma checks - poorly controlled asthma is a killer.

Mum took the child home - she died some hours later

She should've know she needed A&E treatment - my own are asthmatic - we always go to A&E the doctors can't deal with it even if they have oxygen its the steroids and monitoring they need - I wouldn't make a doctors appoint - even an emergency one you have to wait.

The reception staff should've told the mum to go to A&E

Terrible uncaring behaviour by the GP. Very sad, poor family

I read another article about this which indicated that what is being reported is from the GMC report. The appointment was clearly an emergency appointment. The gp refused to see the child and did not offer any advice to the parent. Apparently another gp at the practice spoke to the gp and told her she should not have refused to see the child. The report also suggested that disciplinary hearings can be held in private if the doctor agrees to accept a 'proposed sanction'.
The nhs report appears to squarely place the blame for the child's death at the feet of the gp.
Very, very sad.

I'm assuming the child was in a relatively well condition seeing as the mother accepted the decision to take her home and bring her back the next morning, if the mom had serious concerns about her daughter then I imagine she would have gone to A&E.

I think the problem is that people, naturally, trust GPs unless the GP betrays that trust. If a GP says they will see a child tomorrow, wouldn't most people accept it? Not all parents have the character to stand up to a GP receptionist and say they are staying there until they are seen.

It's also not easy to make that decision whether or not you need an ambulance - it is easy with hindsight to say you should have called an ambulance (been there, done that) but in the midst of the situation when it's your own child it's nowhere near as clear cut because you are trying to care for them, trying to deal with your own emotions and I think you are likely to accept what the GP says unless you are as stubborn as I am.

The GP had a duty of care and she failed to fulfil the obligations of that duty of care.

@bugsylugs - the linked article is BBC, not the fail

There's a more balanced report on the BBC website. It does mention that the family were 8 minutes late (as the mother had to arrange childcare & transport) & that the GP told reception staff to send her away (even though she had no patients in).

The mother then took the child home but dialled 999 later that night.

So the GP is not entirely at fault, but clearly should have seen the child.

Wow wonder if it was the same GP I had who made 6 month old ds wait an hour in the lobby in the winter with no clothes on because we were 5 minutes late because ds vomited all over himself in the car on the way to the appointment and I stopped to make sure he wasn't choking and clean him up a little. I made a complaint to the practice manager and as a result we were kicked off the gp's register despite my being 6 months pregnant and in the middle of shared care with the hospital and gp. By the way, turns out ds had a genetic disease which was causing all the vomiting (and a whole lot of other terrible symptoms).

astro I have two with asthma. I have no idea when to go and when not to because of the way I have been treated by health professionals.

I have been told off for taking my DS4 to A&E and I have been shrieked at by a nurse 'CHILDREN DIE OF ASTHMA' when she thought I had waited too long to take DS2 to the GP practice. At the same incident I was told by the (nice) GP that she didn't think he was having an attack after she listened to his chest. I swing from feeling I am too complacent through to being way too anxious.

I am thoroughly confused by asthma and I have cared for a child with cancer so not exactly squeamish.

I have also seen a shed load of threads on MN excusing this GP's type of behaviour. Insist or be pushing and you will be labeled as an ungrateful, abusive time waster who think they know better than a medic.

Its no bloody wonder parents don't know what the hell to do.

I am so sorry for this poor family.

OP - if my child had serious asthma and had been in a High Dependency Unit five times because of it then no, I wouldn't just accept a "bring her back tomorrow morning" decision and would instead go straight to A&E. I imagine the mother involved in this article but probably have done exactly the same if she she felt her daughter needed hospital treatment?

BTW: I am in no way blaming the mother, I just mean that if the child was that ill that it required immediate medical treatment then I imagine the mother would know her child well enough to recognise that considering she'd been admitted t hospital five times in the past.

I absolutely agree the doctor should have seen the child, no question, but at the same time we don't know how ill this little girl was when she presented at the GP surgery in light of the mom not feeling that further medical attention was needed I.e she was happy to take her home and not to A&E.

Given that she'd just been turned away from the GP, perhaps the mother felt no-one would take her seriously at A&E either? It's easy to speculate after the fact.

But I hate GPs with rigid rules. Exceptions should be made for emergencies. It's not like GP appointments run on time very often anyway! My old GP had a rule that he would only discuss one ailment at a time, which eventually pretty much because one symptom. I once went in for the results of a blood test while jaundiced and in severe abdominal pain, and he didn't want to know. It turned out I was going through a 5 day long gallstone attack. I was glad when he retired...

Asthma is a straight to a&e do not pass go issue for us. I'm surprised the receptionists didn't stick up for the family.

Very tragic. I don't know if there's more to it or not but it sounds like the GP could have seen the girl but might have refused to see child on a point of principle because they were late. If so that's unacceptable even if the story hadn't had such a tragic ending.

This is why I never complain when I'm kept waiting at my GP surgery because they're running late.

If there is no more to this than what is reported, then a warning for the GP is a woeful under-reaction.

I've just had to be assertive with DD's High School about her Asthma, giving them a copy of her written plan has helped a great deal. All the teacher's are supposed to have training according to the school's medical conditions policy, but if they have it obviously hasn't stuck and anyway, I don't expect teachers to fully understand, but a doctor... .

Though actually, in this case it seems the school acted correctly.

play last time I was worried about one of my DS's the receptionists wouldn't let me bring him in at all. They said I could have an appointment in a few days.
When I asked what I should do they said 'take him to A&E'. When I went to A&E I was told I should have gone to my GP.

I am not trying to be confrontational, just giving my experience.

Gp is probably a partner in the surgery which is why she wasn't sacked.
Very very wrong!

Interesting that the GMC hearing was held in private, and hard to avoid wondering what it was that they didn't want making public

If the Serious Concern Report is correct in saying that "There is a consensus that Dr Rowe is unapproachable and volatile. Many staff reported being afraid to challenge her decisions or seek a second opinion from one of the other doctors" it surely raises the question of whether the GP will have learned anything at all from this

That woman is not fit to call herself a doctor. She is an absolute disgrace. I'm not going to go with the "there's more to this" line either. Some doctors are shit. This woman was known to be agressive and was known to turn people away.

The practice had had notice from Ellie-May's consultant that she was at risk of a life threatening asthma attack, yet this woman still sent her away. There is no excuse for that. If Ellie-May's mum had pitched up with her in these circumstances they should have bloody well fitted her in even without an appointment.

I've got a DS with severe asthma. It's really hard when they are ill. Our GP is great. I could ring and they would come here in the middle of surgery if it was the quickest route of getting him seen, because we're very rural.

I'm so angry for Ellie-May's family. I wonder if the doctor has changed her ways?

I'm confused. Why was she even at a doctors appt? She's seriously ill, having an asthma attack, can't breathe etc..you go to A&E or ring 999 - surely?!

Clearly lots more to this story than is being reported.

People don't genuinely need a receptionist to tell them that their child is actually seriously ill do they? Unless this was the child's first time? All very sad regardless. No blame just very very sad.

My GP's surgery is great for asthma, including having it's own asthma nurse and nebulisers. If I've ever had to take mine to A&E though (when following the care plan drawn up by our asthma nurse) , my experience has been similar to the one that MrsDV describes.

There is very much an attitude of "Well why on earth did you bring them here?" from the A&E triage person. In each case the child has ended up being hospitalised for several days, so it clearly wasn't a case of time-wasting.

I can understand why some parents feel unsure about what to do and why they might prefer to see the GP instead.

I'm confused. Why was she even at a doctors appt? She's seriously ill, having an asthma attack, can't breathe etc..you go to A&E or ring 999 - surely?!

She wasn't having an asthma attack. Her asthma had got worse. Her mother had done the right thing by taking her to the doctors to get her seen, to get her meds adjusted, or sent to the hospital she was under, in order to try to prevent an asthma attack.