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.

The adult cuffs come in various sizes, there is a very small one I've seen used. Hope it gets sorted out quickly for you.

I see. It sounds as if the hospital do not have a suitable sized cuff for your son because of his condition and will need to source and order one. The nurse had probably not encountered this particular situation so had no idea what to do. I understand that there is a lot of bureaucracy involved in ordering equipment in hospitals.

They should have explained the situation to you and told you that they would need to order the appropriate sized cuff and would get back to you when it was available. I guess they didn't for the reasons above.

The NHS is really struggling and I do think all of us (we are all patients or potential patients) need to understand this and be prepared to take some responsibility and initiative where possible and appropriate. I say this as a parent of a child who is very unwell at present. I am happy to do this to ensure that she gets the necessary care within the restrictions of the NHS.

I hope your son gets the test he needs soon.

I've just read a blog/site about achondroplasia, and they said that no cuff exists that is suitable, so they tend to use arterial lines in anaesthesia. However, when they use a cuff, they attempt to use the upper thigh. Have they attempted the upper thigh with your DS? Could you see if that would work?

Thank you lougle, that's really helpful!

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.

No, of course I don’t. But they do hold the purse strings and are accountable for the services they commission. Much as secondary care is accountable for the services that they commission from the private sector - which is working equally as well.

However, if the CCG won’t/can’t monitor the quality of the services they commission, who will?

Sorry, I’m really not meaning to have a go at GPs, who are clearly in between a rock and a hard place.