To expect a doctor's appointment when I ask for one?

[AstridPeth]

Ok so I know how overstretched our nhs is and how long it can take to get appointments but...

I took my dd (12) to the doctors last Mon, whilst there it was discovered that her oxygen levels were at 72% , she was ambulanced into the hospital and we spent until Friday evening in there with her on constant oxygen, regular nebs. Diagnosed with bilateral pneumonia. She was very poorly bless her and at one stage they almost put her in HDU.
She got discharged on Friday evening with the instructions that we are to book an appointment to get her seen at the doctors again this Friday.
My dh tried to make the appointment today and they said the earliest they could give him is the 10th Dec. Dh said this wouldn't be acceptable as the hospital specifically asked for an appointment on Friday and the receptionist informed him that he would have to ring up on the day to try and get an appointment.

AIBU to think that in these circumstances; where it has been specifically requested from the hospital that she should see a doctor that she should have been given an appointment? I know that they keep a certain number of appointments available for release on the day, so in theory she could have just been given one of those.

Hospital inpatient departments are a nightmare for this, they have totally unrealistic expectations of GP surgeries and outpatient departments abilities to slot patients in for follow up. Your DD is lucky to have you on the case as loads of patients miss out due to being fobbed off by both sides.

Unfortunately the receptionist probably was physically unable to make the appointment - where I work they do not have the access rights to override same day embargoes. I would just ring on the day but if you aren’t prepared to do this ask to speak to the GP’s secretary or ask if the receptionist can leave a message for the GP to see if they are willing to book an appointment now. Contacting the practice manager is OTT.

Playing devils advocate here but if the discharging doctors at the hospital feel she needs a review on a certain day they should arrange it themselves, i.e., in their clinic

I had exactly the same situation when I had pneumonia. Sent off by hospital with instructions to book follow up with gp in specific timeframe to check antibiotics working. I couldn't get one as not an emergency. I gave up in the end and just crossed my fingers - but I was far less sick that your daughter. Is there a local walk in clinic she could get reviewed at? It's a very frustrating system.

my hopsital does have a paediatric obs unit. But you have to be referred there from the docs. And of course I wouldn't expect anybodies appointment to be cancelled to benefit my dd. I would, however, expect one of the emergency appointments to be given over to her as this is what was requested.

Regarding her discharge notes. I was told verbally by the doctor discharging her to get her in this Friday. I have checked her discharge letter and it is written for an appointment 2 weeks from discharge. So do I go with what I was told verbally or what's in the notes. Even so the 10th falls outside the week window. But i would rather get her seen as per the doctors verbal as she was that poorly and she is still not coughing up her mucus (sorry to be gross) and I don't want that sitting in her chest for 2 weeks.

In the surgery I work as a receptionist we cannot book you in if there is no availability. We would recommend you have a telephone call with your gp who can arrange to add a slot for you meaning they can be a little more flexible.
The receptionists work for the Dr, they cannot schedule additional appointments that may mess up their bosses schedule but all of our gps would rather fit a poorly patient in than see them become more unwell - it's difficult as demand is far outstripping capacity.
I would do as the receptionist suggested, they know how their system works.

yes I feel your pain

my dd is badly asthmatic and we called on the day and the receptionist said 'sorry all the daily appointments have gone'. I said look she's asthmatic, she really needs one and they said 'call again tomorrow'.

Took 3 days and by the time we got one, the GP said 'why didn't you bring her sooner'. I said wasn't like we didn't bloody try.

I really do think in cases like these, there should be some leeway to let appointments be booked even if all the pre bookable slots have gone. Even if they could have said on the day I couldn't get one that they would give me one tomorrow, it would have been fine but they couldn't even do that.

It's incredibly stressful as a parent with a sick child

fingers crossed you get that appointment and I hope your dd gets better soon

The GP should get a copy of the discharge letter and at that point they may be more willing to give an urgent appointment.

hope this helps I work in a surgery the appointments on the day are blocked we are not allowed to take those without permission from doctor or managers but we can use a blocked appt the kind that they open up 48 hours before so I would have done that and made a note why. I would ring back and if the receptionist can't book anything just ask for the manager they will open the block or tell the receptionist to do. We get in trouble of we take the one the day ones but if we have permission we can do it

ask to speak to the GP’s secretary or ask if the receptionist can leave a message for the GP to see if they are willing to book an appointment now. Contacting the practice manager is OTT

Contacting the practice manager is correct procedure. GP's secretaries are not employed to sort out patient's appointments.

I think the response you got is fairly normal practice. Ie. If routine appointments weren’t available, then try to obtain an on-the -day appointment.

Did you go in with any discharge letter from the hospital specifically reauesting a Friday appointment? With evidence, you are more likely to get one.

As Sockqueen says, hospitals frequently request patients to book appointments with their gp, not realising it isn’t possible (and whyisn’t The consultant following it up a week later.)

Glad to hear your daughter is on the mend

btw GP friend of mine said in London, they are duty bound to try and find you an appointment somewhere if you need one (certainly in my borough). So they can look at something called 'hub' appointments which means there may be a spare one at another GP surgery. So it might be worth asking about that if you can't get one there.

Bad asthma is an emergency, go to a&me if you can't breathe.
If gp has no appointment ask for home visit, practice manager, doctor in charge. Someone will see her.

Honey is good for loosening phlegm, but not a substitute for antibiotics obvs

For those who are saying that the she should be given an appointment, no one is disputing that but where do you think the free appointment is going to come from when the appointments are already booked? My DH does a brilliant job at looking after his patients but can’t materialize up free appointments when there aren’t any. At his surgery the wait time for appointments is getting longer as there is such a shortage of GP’s.

Yes there is a walk in down the road from us. Would they be able to do the necessary checks or would they ask us to go back to our surgery as that's in the notes.
I wouldn't take her to A + E as I know how much pressure there is on the system. And it's not that I don't want to ring on the day to get an appointment. It's the what if. what if she isn't given an appointment on the day and she gets worse over the weekend and ends up back in hospital. She is doing so much better than she was in hospital but she is still sleeping during the day and gets tired very quickly. Walking up the stairs is hard work for her at the moment.
I am probably a little overprotective as when she first went into hospital she had pneumonia on her left lung. They started her on iv antibiotics and they seemed to be working but a couple of days later she got very much worse and it was discovered she had pneumonia in her other lung aswell. So they changed her antibiotics to another one. Both the initial case of Pneumonia and the secondary one came on extremely quickly and it would put my mind at ease knowing these antibiotics were still doing their job.

I had to do this a few times - was advised to just ring up and book an emergecy appontment for the day. Sometimes you just can't get through though and if possible it;s worth physically going to the surgery and waiting for it to open so you can collar the receptionist before/whilst all the phones start ringing.

I feel like common sense would dictate that they said "certainly, i understand that the consultant recommended that - we can definitely get you a Friday appointment just not sure what time - can we let you know on the day?" - the discharge notice will be available on the patient data system so they can see she's been in - and then write on a post it note to book you an appointment as soon as one became available on the Friday, or refer it to their practice manager who will have the appropriate system permissions.

The computer says no is not a good reason not to book a consultant recommended follow up appointment.

If you’re in London, ring up Friday for an on the day appointment and if you’ve missed them ring 111 and ask for a walk in GP appointment elsewhere. They will find you one. It’s important that she’s seen, clearly.

As a PP has mentioned, you may have to go through the hassle of a telephone appointment to actually get a face-to-face one. I had to do this when I was discharged from hospital a couple of years ago.

When the SPR handed me a letter I immediately said 'what if I can't get an appointment' and they said the GP had to see me. 'But what if they won't' and he still didn't seem to think it would be a problem.

My DH had to ring for me, he spoke to the GP when she rang back for the telephone appointment and then we were given a slot later that day. Obviously took a lot more of everbody's time than just booking the appointment in the first place!

"try to get an appointment on the day" means "throw your raffle ticket in the hat and see if it wins"

The phone lines are turned on at 8am and constantly engaged by all the other poor saps. By 8.15 all the slots have gone.

my dsis surgery is like this doesnt matter what it is u cant have an appt for when u choose u have to ring p on the day its rididculous

Not in London..We are in the depths of Cornwall. Although our surgery is part of a trust and they do usually allocate appointments at other surgeries within the trust if available. Will try her on some honey and see how that works. We have been giving her the steam treatment and following the excersises the Physiotherapist gave her whilst he was in the hospital. And she has started to cough more and i can hear all the gunk moving which we couldn't before but still nothing is coming up.

As they’re not able to give an appointment ahead of time, I’d suggest you phone on Friday and firmly insist she is seen in an emergency slot. It’s unacceptable but I can understand why they can’t book non-emergency patients in those slots. I do think ‘non-emergency’ is the wrong word, sorry, absolutely no offence intended, couldn’t think of what to say. The bottom line is that she needs to be seen. I wish her well.

Just ring up on the day for an appointment, I am sure they will see her. And hospitals routinely do this.