Particularly interested in people within the medical profession to answer this one?

[asdou]

AIBU to think that when consultants send letters to your GP, that they should review them and action them (as in maybe call you in for an appointment or something?)

As it is with my practice, there are 3 doctors. My GP is down as the senior doctor, though the GP I see the most is probably the female GP.

Anyway, today, it turns out, that though I've been cc'd on 2 letters from consultants re changes recommended to my meds etc., they are never read, or certainly never actioned.

Today I went because yet another consultant has referred me back to the GP as I need some general stuff done before they can do the specialist stuff. The GP seemed totally baffled and then annoyed/anxious. Whether she was annoyed at them firing me back at her, or annoyed at herself for not having read the letters or what, I don't know, but she seemed just annoyed is the only word I can think of. She then said she wasn't going to prescribe me anything until she spoke to the medical/clinical registrar (she used different terms). Why was she annoyed? Because it was outside her speciality of general practitioner?

But, AIBU to think that when a consultant sends a letter to your GP that they should at least read and action it? Not just file it onto your file?

Snowy why didn’t your consultant prescribe you the new medication 3 months previously? Any why didn’t she tell you she wanted you to have new medications?
It’s also quite likely the GP would need a shared care agreement from the consultant, as is the case with many psychiatric meds.

MintyChoc I know GPs are under enormous stress, but surely you realise that social care is in disarray? My in laws had paid carers, but if it had been left to them to action hospital letters, nothing would have happened. The family did it, which is fine if you have family that will do it.

While I'm literate, I'm not exactly 'mobile' for want of a better word. Just making phone calls is a massive deal to me that mostly I will sleep through rather than make.
I can't find the other letter. I don't have a filing system here. I'm not a business. I'm not a patient who should be deemed capable of instigating my own medical care.
I'm sorry that you worked 14 hours. But I could quite easily die if the GP doesn't adjust my meds. It's that simple.
So somebody is going to be held accountable in the event of my death. I'm under 3 consultants and a GP. I shouldn't be left to die because the GP doesn't read the letters.

@jack11

I have the hospital ringing me up every day to find out what the GP is doing, but I couldn't get an appointment until today. Then said GP didn't KNOW what to do. There was a lot of fuss at the time about whether I should be sent straight to A&E or referred to my GP. Referral to my GP it was. GP today had to call the hospital to know what to do.

I've a feeling I'm like a hot potato. Nobody wants to handle me. Meanwhile, I'm waiting and not being treated by anyone.

Thisiscrazy- depends ever you work, there are no CCG’s up here in Scotland and do direct consultant to consultant referrals can and should be done. I and my consultant colleagues do know it, but sometimes we forget (one or two colleagues just never do it).

The three disciplines I'm under are curiously interlinked in terms of my health problems. But there doesn't appear to be such a thing as a multi-disciplinary meeting or the likes.

So I'm attending each of them separately. Everything is being fed back to the GP who reads nothing.........................

And therein lies the problem. The one person who should be joining up the dots, or even just actioning the 3 recommendations separately, isn't.....

And I'm getting a bit pissed off!

OP if you’re capable of posting coherently on mumsnet then I’m sure you can take some responsibility for your health. GPs are doctors, not relatives or PAs.

@Mintychoc1 Not when it takes 54 calls to get through and one of the specialities I'm under is psychiatry!

I think I'll call and ask to speak to the practice manager tomorrow. I can't be making clinical decisions for myself based on letters I'm cc'd on.

@Mintychoc1
hence my post above.
I totally do not blame GPs you have far more to do than any one person is capable of BUT the result is that patients who are educated/bright and on the ball get more out of the NHS because they do chase this
The letter you get is cc'd to the patient which suggests they should wait for the GP response --- this would be an easy change for consultants/NHS. If the onus is on the patient then they need to be told this. The lower the education the less likely they are to infer this is their own responsibility

I follow things up, probably more would if the patient was the recipient and the surgery cc'd rather than the other way round

If you are so ill that you can’t read a letter (you clearly aren’t illiterate) then perhaps you need a carer to look after you. That is something you sort out with social services.

The majority on here are not incapable of this but there is a huge gap between those that automatically do this and those that need carers.

This is 100% not aimed at you @Mintychoc1 - just frustration at a service that was set up to help those that most need it and still serves advantaged people best; even though I know I have benefitted from my education and knowledge in accessing services

Asdou- If the hospital specialists are concerned enough to be calling you daily to check what the GP is doing then I would suggest that they should probably be doing more directly themselves TBH.

I cannot think of a patient I would be calling daily myself to find out what the GP had or had not done- if it were that urgent I would be either speaking to the GP myself to clarify what needed to be done/discuss any issues or I would be doing the script myself/seeing you in person or getting you admitted for treatment/investigation. Obviously, I am not sure which would be most appropriate as I don’t have any details and unlikely to be my area of expertise!

For e.g the letters are addressed like this:

Dear Dr.

I would like you to change Asdou's meds from X to Y.

Yours
Other Dr.
cc Asdou

Now call me thick but I'd expect my next repeat prescription to have Y med on it?

Other letters

Dear Dr.
Asdou is low in X. Could you please treat and repeat bloods.
Yours
Other Dr.

Then you have

Dear Dr.
Asdou needs X treatments but we can't treat until Y & Z are addressed.
Please address
Yours
Other doctor

And you think I'm supposed to be the one actioning all this shit?

@jacks11 Until the GP treats X, they can't do Y. They want to update their computer, that's the messages they leave..........

I genuinely don't know why they're ringing me - they even rang me on Saturday! The first message was 'I need to update my computer'.

So maybe they're getting a blinking message at them every day or something.

The didn't ring today coincidentally!

I'm hoping that means I'm ok now lol.

OP

Well, again I would say the consultant needs to contact the GP directly not keep on calling you as clearly your GP cannot or will not action what they have requested. It may be that there is an abnormal issue at fault- but from what you have posted I wonder if the GP either has concerns about what the consultant is asking them to do (May be on clinical grounds or perhaps they think it is not their role to fix X and would be more appropriately done by the specialist team). Or it may be that they aten’t clear about what they want or why.

Well maybe Y is a consultant-only drug. And maybe the consultant should be treating the problems he/she finds themselves, rather than treating the GP like a skivvy.

Your thread title says you’re interested in what medics have to say, but you’re not interested, you just want to moan about your GP.

I’m done here.

You say you are not capable op of chasing things up but you are certainly capable enough to list multiple messages on here and argue your case, this seems to be a contradiction on your part.

Sorry should read - admin issue at fault, not abnormal issue!

OP, as someone who has a long standing, on going medical problem and who is also under the care of Hospital Consultants, I can only advise what I do/have done in similar situations to the letters you provide as examples.
Meds changes - I wait approx 5 working days after receiving letter and if surgery have not contacted me about a prescription, then I contact them.
I never phone the surgery in the morning, when they are most likely to be inundated with calls.

Needing treatment for low X then repeat blood tests.
As above.
I would also establish at the time I am being given said treatment for my low X, how long after this treatment starts do I need the blood test.
On the day my low X treatment starts, I phone the surgery to book an appointment for the blood test in however many days/weeks I have been advised.
Y and Z need addressing - as per meds change - wait 5 days and if I've heard nothing, contact surgery.

You may find it helpful, for everyone, to get a folder to keep your own paperwork in, so that you always know where to look to find your medical info.

Does your surgery have a system where you can book a Dr.'s appointment on line rather than having to make 54 phone calls?

It is exhausting, I know this, but ultimately I feel, if I want to have the best health I can possibly have, within my limitations, then I need to be a partner in my care and not a passive recipient (I'm not suggesting you're passive - you sound anything but!).

Good luck.

I never get copied in to any letters except when going out of health board area, eg to the dental hospital. Our health board seems to do everything completely paperlessly so letters will be electronically sent from hospital doctor to GP, just as the referral was done the other way round. Then they actually need to check what comes in for their action.

Any letters that require action should go to a GP. Any that are for information only can be filed. I lead a team of admin staff who read all the letters and forward those that need action to a GP. Occasionally we do miss the odd one as we look at over 200 letters each day (large practice) but the system works really well.

It's just that the psychiatric end of my illnesses means that some days I actually want to die.

You REALLY need to want to live to get an appointment with this practice.
Most of the time, I'd quite happily die.
But even when I show up, the doctor is reading things that I direct her to. It's ridiculous. She has never seen them before and asks me for dates of blood tests and other exams etc. 'I don't fucking know what date it is today Doctor!'

Ideally GPs should action every letter promptly and consultants should write initial prescriptions. BUT GPs and consultants are a scarce resource.

EITHER they read and action every letter AND they limit the number of patients they see per day (so maybe you will have to call 100 times instead of 54) OR they try and see the acute problems each day and try to get through what they can of the paperwork.

Same with consultants. EITHER they see patients promptly within x weeks and make a plan to send to GP to action. OR they bring the patient back to clinic more often to perform their own monitoring AND the wait to see a specialist gets longer.

There are only so many hours you can work, many are getting burnt out which will reduce the workforce and cause further problems. I have sympathy with OP, and I hope changes are made. However in the current climate do be proactive - @wingedharpy has good suggestions.

Today for e.g. she asked.

When were you in the hospital with abdominal pain? It says here you left without being treated?

When was the date of your last period?

How many times a day do you vomit?

How many times a day do you have diarrhoea?

How long are you vomiting?

How long have you diarrhoea?

Listen Linda. STOP ASKING ME QUESTIONS HONEY. LISTEN LINDA! LINDA, LISTEN!!!!

I don't track my period, I don't track how many times I puke or shite.

I just make answers up when I don't know the answer!