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.

We've had the 'why did you bring them here' at A&E as well. We've also had the GP phone an ambulance and been blue lighted to the hospital (we live opposite the surgery so it's our first port of call when open - it's an excellent surgery).

Because sometimes a doctors appointment is the right place, Star. There could have been an action plan in place telling the parent what to do given the symptoms. It's not always a case of ringing 999 or going straight to A&E.

That does assume that the GP at the surgery is going to attempt to provide at least the basics of some medical care and not refuse to see a sick child just to make a point.

I've done the correct thing in the past and gone to the GP and OOH. After one visit to the latter, with an 8 month old unable to breathe properly and told to just give them 10 puffs of blue through a spacer I turned straight round and marched into A&E. from where they were admitted for 4 days, aghast at the advice I had been given.

This is appalling. That poor family.

Fully agree with you fairy. There is no excuse.

My experience has been similarly confusing. My DS has spent days in hospital and I would still hesitate in going straight to A and E. This is despite the fact that every time we have gone to A and E he has been admitted.

I get different advice from just about every health professional we have seen. It's scary.

Oh that's not good mrsdv we are lucky and whenever I ring about dc - either their asthma needs an urgent review as it's deteriorated or they have had an attack and need a review withing 48hrs - they've always fitted us in. A&E have also always been amazing and the only time we were chastised by them was for not calling an ambulance (we are a 10min drive away so round the corner really) because they have a neb on board

It's a shame there is such variance around the country.

10 puffs of blue is the current advice in a&e too. It's the equivalent to a nebuliser dose. Nothing wrong with that advice at all but they should escalate you if it doesn't work.

Parents are afraid to take children to a&e when unsure as they're so used to hearing the scorn and vitriol directed at people deemed to be time wasters who misuse a&e. It's generally directed at them by the same people who tell them off for taking very ill children to the GP as obviously they should have gone straight to a&e.

StarUtopia If the mother had a written asthma action plan and followed it, it might have directed her to A&E. However, it depends where exactly the child's symptoms were on the plan. Our's have a green, amber and red zone depending on peak flow readings and symptoms. If you are in amber and you are not responding as you should to relievers, then the plan directs you to get an urgent, same day GP's appointment (Our surgery has always told us to just come straight away and made time). In a world that tells us that we shouldn't waste A & E time you sometimes need the confidence to risk being seen as a precious fuss pot.

The child could have gone into the "red" zone for peak flow and symptoms very suddenly leading to the 999 call, if she'd been treated while in amber that might have been avoided.

This of course assumes that the parents had any sort of written action plan at all. Like I said, we only started getting them for DD 14 two years ago. Without it you are going on your gut, what you remember from the yearly asthma review ,if you know they exist, places like Asthma UK who have specialist nurses you can call.

I understood it that she'd had an asthma attack or exacerbation while at school and then was taken in asap thereafter to an emergency appointment. The problem seems to be Dr Rowe and also the reception system because she arrived at 4 minutes past the appointment time but the receptionists were busy for at least another 10 minutes after that.

Poor family and yes this sounds like very poor practice. It's very hard for parents to know when to escalate to A&E and also an element of not wanting to think a child is actually so severely unwell that they need it (for me, anyway, when I was in a similar position as a parent I should have gone straight to A&E but I'd already got an emergency appointment and hoped that I was worrying unduly +/- they could call an ambulance or transfer if required)

A plan is great (we have one) however you do still have to be guided by how the child presents as well and go with your gut.

I wonder if the doctor has changed her ways?

In the absence of any real sanction, and given he reports about her attitude, what possible reason is there to suggest she might?

Horrific. Yet without wanting to sound callous why the bloody hell didn't they go straight to A&E or phone 111 for another emergency appt the minute they were turned away?

I'd guess it was all held in private because the incident revealed a sick culture which posed a risk to every patient due to fear-based obstructed communication. Having been a witness in a couple of similar nursing hearings, the privacy is to ensure that people can speak without being inhibited by their own shame and embarrassment at not having raised concerns before.

I don't think anyone should judge the mother for not taking her to A&E. Firstly, we are constantly being told to avoid A&E at the moment and to go to your GP or a pharmacy, and secondly, many people would have trusted the GP and done as they were told rather than disregard what they were told to do and go to A&E instead.

Poor little girl, and her poor mother. It's so awful.

The full story is not going to come out until the inquest. The GP refused to see the child more than 5 hours before the 999 call was made, the coroner will look at exactly what happened in great detail.

It's the wrong advice for a child under 1 with uncontrolled asthma who has had previous emergency admission , PlayOnWurtz. According to the specialist asthma nurse we were assigned soon after.

Please read what a previous poster said (whileweare):

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.

The doctor should have seen her, but without knowing full details of the case it is hard to know if that would have made a difference sadly.

Ds is a severe asthmatic. He has been seen by the Gp and been given the "carry on what you are doing" and ended up being admitted hours later. We have had the same at A and E where we have ended up back there a few hours later because things have deteriatoated. Sadly asthma can turn very quickly.

Hopefully lessons are learnt all around and any parents of asthmatics don't hesitate to go to a and e if they are in doubt. Even if they have been seen hours before. Things changeZ

As a girl with brittle asthma her paediatrician should have made a written asthma plan which mum, the gp and the school all had access to. In it should have been clear advice on when to seek which level of medical care, and instructions of the gp about emergency medications escalation etc. The gp should have at least looked at and assessed a child with breathing difficulties it should be standard practice regardless of an appointment etc. There also should of been an asthma nurse, community nurse, someone that was supporting the mum making sure she felt confident in the signs and symptoms of an attack so she knew when to present, empowering her to seek help. (I'm in no way blaming her by the way). While Dr Rowe was wrong she wasn't alone in letting this poor child down in my opinion there were failings all round.

Until I got to the part about her not having anyone else to see until 5.20pm I disagreed. At my GP surgery it is common knowledge that unless you say it is an emergency you will get given an appointment in 2 weeks time. The receptionists at my surgery no longer ask what the reason is for making an appointment - them and the GP may not have known why they were there. If I had an actual emergency I wouldn't go to my GP, I'd go to A+E. There's a sign up in my drs saying if you're late for an appointment you may be asked to make an another appointment. I know she was only 4 minutes late but if everyone was 4 minutes late the surgery would be chaotic. The mother shouldn't have made an appointment for that time if she knew she couldn't be there in time. The fact that the dr didn't have another appointment for another 15 minutes though is a joke, she could've seen the girl. She's tried to prove a point about turning up on time which has resulted in disastrous consequences. If it was that important to see a GP that day there are plenty of out of hours options, if you call NHS direct they'll make you an appointment. I agree with the other posts that the girl can't have been having an attack in the surgery as the mother surely wouldn't have left it until the next day to see anyone. It's a very sad story but it is unbelievable that a little girl would be having an asthmatic attack in a drs surgery with no one recommending either A+E or out of hours options. She must have deteriorated suddenly on the evening.

many people would have trusted the GP and done as they were told rather than disregard what they were told to do and go to A&E instead.

But it's not like the GP assessed the child, said it was nothing serious so take her home and bring her back again in the morning for further assessment is it?

The article implies that the GP didn't see the child so there was no medical advice given for the mother "to trust,". The mom was happy to take her daughter home without anyone medical having assessed her which implies to me the child must have been relatively stable otherwise the mother would have gone to A&E to have her looked at by a professional.

If my asthmatic child was having breathing difficulties and had previously had 5 HDU admissions I wouldn't take her home simply because a GP receptionist told me the GP wouldn't see them - if I thought my child was in need of medical attention I would go somewhere else and get it.

There's already a shortage of GPs. I don't believe even a GP as bad tempered and volatile as this one would ever dare turn away a sick child from an emergency appointment again, after this experience. Even bad tempered doctors don't want to be responsible for killing people. Some kind of training in anger or people management should have been required, though, if people didn't dare stand up to her!

the coroner will look at exactly what happened in great detail

While extremely skilled, coroners are not psychic and are largely reliant on reports supplied by the medics; therefore a lot rests on the reports being honest and not seeking to cover things up ...

There must be more to it.

The Dr absolutely should have seen her. She was 4 mins late which of course is late but technically there were still 6 mins left of the slot so given the severity of asthma and the fact the girl had been hospitalised several times befire then turning her away was playing with fire tbh.

Also not their fault that people queuing etc and causing delays with checking in.

It was an emergency appointment I'm sure she did her absolute best to get down there asap. What was she supposed to do? Say no sorry can't take it just cos someone might take 15 mins filling a form out at reception tying up staff or receptionists being tied up on the phone?

I've sat and waited an hour to be seen at the docs befire having shown up 15 mins early. Sods law the Dr was actually on time that day and just being a dick