to wonder if the GP should do more?

[DorothyL]

My son has chronic health problems.
Today we were sent for him to receive 24 hour blood pressure monitoring- he had been referred by the consultant. Unfortunately this could not go ahead as no cuff would fit which is to do with his condition. The nurses told me to ask the GP for advice, so I spoke to the receptionist at the surgery once I got home and she said she'd pass it on.

I just received a phone call from the surgery - not sure what the person's role was, but was basically told they had no idea why the nurses would say that, they could not help at all and I should call the consultant's secretary.

Aibu to think is this it? I thought a GP's role was to oversee a patient's care, especially when there are chronic health conditions? Could they not have offered either to monitor his blood pressure in surgery or to contact the consultant?

And yes I know GP's are overstretched of course - but they didn't say we're so sorry we are too busy, they basically made me feel like I was a nuisance for asking.

We don't even do 24 hour BP monitoring anymore. Our (adult) machine packed up and we couldn't afford another. Our patients borrow/buy a sphyg, take their own BP at varying times over several days and drop in the results. Maybe that's an option?

Oh OP it's crap I know. You just want someone, anyone, to take a tiny bit of the burden off you. But your GP wouldn't have really put you and the enquiry together. They would have just been told a patient's mom has rung saying we need to sort his bp monitoring and would have thought like feck we do and told them to call you back saying no.

Also not sure why the cardiologist is getting flack. It was the nurses that said it. I overheard my clinic nurses telling a patient to go to their GP for a sick note to cover them for the operation that I did. Apparently they always do that. If I was a GP I'd be bloody pissed off with that but I'm not actually responsible (I now offer at the end of each appt just in case).

This must be really frustrating OP, sorry

Sadly, whenever secondary care can't/won't do something they dump it on a GP, and give the pt the expectation that it is the GP's remit to resolve.

This is incorrect.

If secondary care need your son to have something done THEY are duty bound to provide it whether it is a blood test for oncology, wound care post surgery, an onward referral they decide is required or 24hr BP monitoring. They are funded to do all of this but they dump it on GPs who are NOT funded for the work.

This is why GPs are under so much pressure, too. When a GP says no they are seen as the bad guys, when they are not.

Hope your son gets sorted

I realise that primary care is going to hell in a handbasket, and GPs are ridiculously overstretched. However, it’s the CCGs that commission hospitals to provide cardiology services, so really they should be taking reasponsibility when a patient doesn’t get the care they need.

OP - PALS are your next step. I’m so sorry the NHS is letting you down. It it mostly doing an amazing job, but stuff falls between the cracks more and more these days. 🙁

I really sorry that your son has chronic health problems but YABU and are directing your anger at totally the wrong person.

From what I understand a Consultant, presumably a Paediatrician referred your son to a ?Paediatric Cardiologist at the local hospital. You had an appointment during which they had inadequate equipment to perform a test for your son. This has absolutely nothing to do with the GP and it is ridiculous of the nurse to have suggested that you return to the GP to ask about this, no wonder they were annoyed. Equipment and services in the hospital are the hospital's responsibility and have nothing directly to do with the GP. If the hospital don't have the correct equipment they need to find it or purchase it and contact you.
Everything is being dumped on GPs, no wonder they are leaving in droves.

You need to call the Consultant's Secretary and explain what happened. I know it must be hard work and time consuming for you but you need to be your son's advocate here.

GPs may be responsible for commissioning services but they are not responsible for providing the correct size cuffs to a hospital department!

more- you are right, GPs are not supposed to be asked to provide a med cert post op. That is the hospital's responsibility and is in the contract but, yes, these things often get dumped with the GP.

Pigshavecurlytails the OP came here looking for advice, she is a client/customer/service user of the NHS and as such is not expected to know how the system works. She's worried about her son. Have a bit of empathy please, or is that someone else's job too? I'm glad you're not my GP.

However, it’s the CCGs that commission hospitals to provide cardiology services, so really they should be taking reasponsibility when a patient doesn’t get the care they need.

You don't believe that CCGs have real power do you? CCGs were set up by the government to take the flak for the slashing of budgets. They can move the money around, but they still have to commission care for an ever more demanding, older, fatter, iller, population from an ever shrinking pot of money.

How frustrating and not helping you or Your son at all. As other said, i would email PALS and let them sort it out, it is the cardiac dept responsibility,

missyB1 well said!

Jeez why are people giving the OP flack??

because the cardiologists have screwed up and instead of being cross with them she is trying to blame the GP. who has nothing to do with the test.

She doesn’t sound like she’s blaming the GP for the lack of the correct equipment, but she does sound pissed off at the lack of care or help from the GP. Basically the OP’s child is in danger of getting lost in the system here. The OP just wanted someone at the surgery to help smooth things along. Sure GPs are horrendously busy (as are all HCPs), but as I already pointed out we need to remember that’s not the patient’s fault. There’s a child with a chronic health problem here who needs a medical test.

I don't think most posters are giving flack. They are simply explaining how it should work so she is aware who to contact to resolve it. I feel for OP and any pt who gets caught up in politics.

The GP is more accessible than a consultant so easier for people to moan to them. It's better to educate people about the process than continue to see GPs at breaking point.

The OP asked if she was being unreasonable to wonder if the GP should do more. I didn't read anger in her post or subsequent explanation. I'm disappointed in some of the defensive and aggressive responses from members who are health care professionals to a woman who is confused about the system that is supposed to support her and her son. I bet a lot of you would expect better service in Costa!

I think OP started fine, but she did not win any friends when she posted, "The GP had enough time to tell the person who phoned me what to say. In that time he could have phoned me himself."

That said, I still empathise with her being caught in the middle and OP is not being unreasonable to expect a joined up service.

@s0uper you have the comparison wrong. It wouldn't be going into Costa and expecting good service. It would be going into Costa and expecting them to fix a mistake made by Starbucks.

OP isnt wrong in what she wants, but her AIBU was about expecting more from the GP, which is unreasonable in this regard.

The cardiac dept are responsible for setting up 24hr monitoring, the consultant or the cardiac dept should have checked they had the facility to do this on children and had the right equipment in working order. It is nothing to do with the GP, he could not set up the monitoring himself, that's why it was referred to the specialist. Poor communication and buck passing doesn't help anyone, the nurse was wrong, if anything she should have spoken to cardiac manager or doctor to sort it out. Hope your son gets this done soon, call Pals.

Souper and others the OP has asked if the GP should do more in this situation.
It has been explained by many posters that this is not within the GP's remit. Instead of understanding and accepting this, she has continued to complain about the GP. If she wanted the GP to review her son she needs to organise an appointment instead of complaining that the GP hasn't been in contact.
She is unreasonable to be blaming the GP for the lack of care when this error has nothing to do with the GP. See Costa/ Starbucks crude comparison.

I understand that what the OP was requesting is not how the system works (and I understand how the system works) However I was disappointed by the tone of some of the responses. At the end of the day the system is letting a child down and we are all part of that system regardless of whether we are in primary or secondary care and have a duty of care to support service users even if we think they are being unreasonable.

It's probably quicker to call the cardiac dept yourself anyway, otherwise you ring GP, they ring hospital, GP rings you back.

I do understand that the GP is not to blame personally but I still think the system is wrong, when it is now down to me to sort this out and an important test is delayed for who knows how long.

It will be a lot easier for you to call the Consultant than the GP. GPs and Consultants spend huge amounts of their time unavailable for a call because they're in clinic/on the 'phone.

I spend far more of my time playing ''phone tennis' as a senior HCP than actually managing to get the conversation done.

If should be the cardiology department liasing with the refering consultant to sort it.

Sadly it’s often those who shout loudest who get these things sorted quickest though.

Are their cuffs too big or too small? I’ve heard lots of healthcare professionals being quite disparaging about people’s arms being too fat for standard cuffs, very judgmental.

He has short limbed dwarfism.
Adult cuffs are long enough but too wide, child cuffs are narrow enough but too short.