To expect my doctor to see me.

[Vedaisawesome]

I have Lupus, lupus nephritis, arthritis and also suffer from avascular necrosis. I have been fairly stable medically wise for the past few years but recently things are starting to go wrong. I am losing my hair, in copious amounts, which in my case, is a trigger for a very serious flare. I cannot get to see my consultant due to isolating, but AIBU to at least expect my GP to see me somehow and adjust/ give new treatment with perhaps consulting my consultant by video. I can't get an appointment at all with anyone. I am very worried which isn't helping. Last time I had a major flare I almost died. It is not something I want to risk again but all I can do at present is try to self manage,which having had Lupus for over 35 years I'm pretty good at. But now I can just about manage pain and am using what drugs I have to control symptoms but I need professional help. Also if anyone knows anything to do to prevent hair loss, please share as nothing I'm doing is working.

I suspect there is actually a delay / bottleneck in hospital blood testing in some places (presumably some staff and capacity are being used for Covid tests?) and I wish some of the journalists would raise it in the articles where hospital specialists bemoan the fact that people aren’t being referred with potentially serious non-Covid conditions. I had a telephone consult a couple of weeks ago and the GP specifically told me that ordinarily he would order blood tests but the lab is swamped and they wouldn’t get done so there was no point - so I should “keep an eye on things” and get back in touch if symptoms worsen.... it wasn’t very comforting tbh

Have you telephoned the Consultant's Secretary? The problem being with blood test forms prepared at the surgery is that it has the GP's details are on it and they will get the results. Your GP I would imagine is not specialised in your condition but they are obliged to interpret the results and sort out medication. As the Consultant is specialised please ring them in the first instance, they are doing telephone and virtual consultations in hospitals.

If it's impossible to get anywhere on the phone could you write a letter?

You have three options

1. ring and ask for a telephone consultation with your GP, who may decide you need to be seen face to face.

1. Speak to your consultants secretary and see if you can have a phone consultaton with them.

1. Speak to the specialist nurse if you have one.

You need to speak to someone first so they can work out what is the next step and how to safely achieve that for you. Hope you get to speak to someone today

If theOP has lupus her care will be through a hospital consultant.

Would that be all her care though or is it actually shared with the GP doing the monitoring etc.

mrpumblechook All her care, there is little a GP can offer. I've only seen my GP about a lupus related symptom once to get a prescription for a particular steroid cream, and even that had previously been authorised by the consultant. Most of the treatments for lupus can only be prescribed by consultants and issued through hospital pharmacies. Even if the GP had blood tests done at the surgery, she would need to send them to a consultant for interpretation.

My recent consultant appointment was changed to a phone call, but it was sufficient for my needs. My mum is having fortnightly blood tests at the hospital, she's also having dressings changed there a few times a week, all the normal stuff she needs just at the hospital rather than the surgery. I'm in a borough of London with a lot of Covid cases.

Can't you just have the GP phone appointment and get a referral to the consultant who can then arrange the tests via phone?

Op, I have Lupus too. I'm sorry your GP surgery aren't helpful. It makes me incredibly sad as one thing my surgery is doing is rheumatology bloods as many of us are on dangerous drugs. The staff are in full PPE. As others have said, try the telephone conversation as it is a way in. Equally call the hospital and see if the secretaries for your rheumatologist are working. Mine hasn't got one currently, but there could be a rheumatology helpline. Alternatively the hospital switchboard should have an idea of what services are still operating. Either way, take a deep breath and logically work through each 'port of call' in turn.

My hair has thinned out a lot, so I can sympathise. I thought the alpecin caffeine shampoo slowed things down but that's just me and I don't know how well the caffeine shampoos work over long term.

You need to accept a phone appointment. If you won’t do that you’re not being reasonable.

The surgery I work for are booking phone consultations first, then the doctor will arrange an in person appt if they need to, including bloods etc. Make a phone appointment and go from there.

And hospitals are doing blood tests! Their courier comes to my surgery twice a day!

Bloods are still being done or my friend would be out of a job

Are the my refusing you a phone consultation or are you telling the receptionist there is no point and you need to come in? The receptionist can't override the process. Make your phone appointment, explain to the dr what you need and go from there.

I suspect that things vary between areas but my dad had routine bloods taken in the morning and got the results back by 3pm the same day. Apparently the labs are really quiet.

OP, your problem seems just to be an over zealous receptionist. Try contacting the practice manager. The NHS is still very much open for business and you need some help.

They will give you a phone consult if you say you need one and will do blood tests with PPE.

It’s like you have decided you can’t access anyone and won’t try.

If you phone the consultants secretary and explain you are having a flare I’m sure they will call you too or the specialist nurse advisor can.

OP if you mention underlying conditions by name and then talk about hair loss - like you did in this post - the receptionist won't give you an appointment.

If you state your lupus is flaring up and last time it happened you were told to get an appointment urgently, you will get an appointment.

There is absolutely no need to mention your hair loss to the receptionist.

I was told off years ago by a GP for not saying the correct thing to their receptionist.

The GP appointment will be telephone triage first. Again explain that your condition is flaring up and mention all the signs and symptoms of the flare not just the hair loss.

OP you haven’t clarified if you have tried to book a telephone consultation.

Most practices are offering telephone consultations with a GP in the first instance for triage where it will be decided if a face-to-face is needed, The receptionists cannot book anyone in at all now, that is down to the clinicians, you must book a call with a GP and go from there. They will more than likely book a blood test for you.

Thank you for all your replies. I will speak to the receptionist again and ask for a telephone appointment. My surgery is practically closed and whoever said the receptionist are o er zealous gatekeepers is correct. Even in normal times it's hard to get past them. Although they have an online system it is currently not in use so I can't book anything via that. Hopefully after the phone call I'll get a favourable result.
Many have said what's the difference in seeing GP as against consultant if I'm isolating... The difference is that my consultant is about 40 miles away and I'd have to go there by public transport, not ideal in current times. My GP does the day to day monitoring of my condition anyway and I travel to my consultant about 4 times a year unless more often is required, so the GP is well able to order the appropriate bloods to be taken and to speak with my consultant if necessary.

I work in a lab. Bloods are being processed. Some tests like ANA (which you'll need to monitor lupus) may take a bit longer as they are analysed in batches and there are fewer requests atm so they might not be run every day. Our lab is much quieter than usual because GPs are seeing fewer patients and OP clinics have been cancelled.

Your consultant would see you by phone.

I have had bloods done twice at the hospital during lockdown. They were necessary. I was in and out very quickly, and mess changed as a result of the bloods.

Don't phone your consultant secretary. Email. Phone calls aren't being picked up as readily as emails. Explain everything in your email. It may take a few days to be actioned, but someone from your specialist team will contact you directly and advise you, if you need any further assistance they will organise or they will contact your gp practice (if you have shared care, I don't due to the nature of the meds).

Be very clear, and outline all the issues.

Good luck

*meds not mess

I needed GP advice today. The phone goes straight to a message from one of the GPs that makes the situation sound dire and implies I should do anything except speak to them. I did hold and explained the problem to the receptionist. I was put on a triage list. About 30 minutes later one of the GPs called. They have functionality to do video calls and accept photos so using those methods we were able to get to a diagnosis. I know our local hospital are still doing blood tests and several of my shielding friends have been for essential hospital appointments. A relative has been seen at A&E plus a follow up check so there's every chance you can get this sorted.

I work in a big hospital and around 70% of the outpatient appointments are being conducted over the phone or by video call. Phone your consultants secretary for a chat. You might be able to speak to your consultant that way.

Even before all this our GPs had started with telephone triage in a lot of cases to make sure you were seen by the best person. So you would speak to the receptionist who would give you a times lot that the GP would call you back in then decisions would be made from there.