To think this response to a hospital complaint isn’t good enough ?

[famedThesaurusofTheforgotten]

Dd had been unwell for some months in 2019. Repeated trips to gp. Nothing found.
Stomach aches, cold all the time, not growing well feeling sick etc etc all those sorts of symptoms and worsening. Kept being told ‘viral’

One week she was so unwell we took her to a and e as I suspected anaemia maybe as she was sleeping a lot and had no energy?
I was very worried we were seen and a dr said she probably needs some bloods done which I agreed with and we went to wait for the emla cream etc.

Then we were called through by a diff dr and agressively questioned then said she actually didn’t actually think bloods were needed i said I wanted her to have them done she kept shouting at me in front of dd ‘why do you want me to hurt her by putting needles in her ?’ And ‘I won’t stick needles in a child for no reason ‘
She was absolutely horrible told us dd was ‘fine ‘ That she looked fine I tried to explain she looked so much healthier a year before and had now become paler and thinner but she said no she looked fine to her

She was aggressive and was telling me I wanted to have my child hurt for no reason with a needle ??

I decided to walk out and we then went private. Waited a couple of weeks had bloods and dd was anaemic and had coeliacs.
I complained to the hospital and this has taken months to investigate then again as they said nothing had been found the first time that the dr hasn’t done anything wrong so i said no look at this again and theybe come back with ‘sorry that you felt this way’ basically. No apology no admittance that dd had needed bloods nothing and I’m so cross we were treated like we wanted to hurt our child!
I don’t know what to do now all I’ve been able to do is leave an online review for this dr to warn others but she was abominable and I’m really upset that we don’t even get an apology

Sorry OP that you had to go through this. I cant believe no medical professional thought of coeliac earlier. As I read your post it screamed out to me but only because I've been through the process. I think any medical professional worth their salt should have spotted that and I'm infuriated you and your DD had to suffer needlessly.
You were right to bring her to A&E. If you suspected diabetes it could turn into a critical situation very quickly. And whereas coeliac disease isnt a blue light emergency situation it causes a huge amount of internal damage and pain if left untreated so your suspicion that your DD was seriously unwell was correct.
The A&E doctor was rude and that alone warrants a complaint. I know it's a stressful job but too often we have "white coat syndrome" and accept rude behaviour just because of their position. On more than one occasion I've had to ask a doctor to put away their phone whilst they were supposedly listening to a patient (through my work).
Well done for making a compliant and I would also consider making a complaint to the GPs you dealt with for totally missing a textbook case of coeliac disease.

I think the point here is that whether or not OP took the child to a&e or not isn't the issue. Lots of people go to a&e without clinical justification but they don't necessarily know that. OP was clearly worried and had tried to go via the GP multiple times.

The point is, the child was assessed by a doctor who felt there was no indication for urgent treatment via a&e or as an inpatient, and that the GP should manage this child. This was the correct decision, clearly, as the child was not unwell to levels which warrant a&e/inpatient treatment.

If OP feels that the doctor was rude, and wants an apology for that, then escalation via pals is correct. I'm not sure what more she wants to come from that. It's their word against the doctor and nothings going to happen to the doctor in terms of discipline just for an accusation of being rude. The ombudsman is going to have nothing to do with that.

If OP, however, is saying A&E acting incorrectly referring back to GP (and in not doing bloods/investigation), then YABU. It would not be appropriate for A&E to do bloods on a child they felt had no urgent need. Even if your GP is being rubbish.

Complaint to the GP practice would be reasonable.

It seems two fold. The go was fobbing yuu off and the Dr in A&E was rude. I think actually your main issue should be with the go for letting it get so bad without doing investigations.

The thing with the Dr being rude is it is hard to prove. I once had a go tell me in a very aggressive way that I couldn't have a sick not as they were not for people who had too much on their plate. I had completly untreated back pain and a manual job. As well mental health issues. I complained to the surgery and general medical council. I basically got a similar reply in I'm sorry you felt that way.

So I understand it is enraging. She shouldn't have been so rude. But Dr deal with a lot of shit, are highly paid and have good trade bodies. So often this is the comeback. I'm not sure what you can do.

@HoppingPavlova

She also has been left with a lot of issues as her gut was so damaged as was irritated for so long

Yes, no doubt. BUT, and the thing you fail to see or admit, is that it was not an emergency and you were not in the right place. That’s why you are getting the response you are to your complaint. The questions raised are why you were there, why you believed it was appropriate to demand a blood test, what qualifies you to do so in the context of the services A&E offers and the remit it operates under, and why you are not pursuing a complaint against your GP instead. Just as you are perplexed about the response, many others will be about the details of your complaint.

A&E would have assessed your child as not being in immediate clinical danger and acted accordingly. This is a long standing issue that requires routine general management. If that was inadequate then that’s where you direct the complaint. Then you will be taken seriously.

The initial kerfuffle re blood test would have been due to you being initially seen by a junior who needs to have things overseen/approved. It’s really like saying many people ‘could’ have an MRI, this would undoubtedly make a diagnosis easy in many instances but it’s generally not actually required to diagnose accurately and would result in budget and bed chaos. Juniors need to be reigned in and taught how to manage without unnecessary items.

This. I have rtft. You still waited to see a private doctor after you walked out of A & E. Had I been unwell for the period of time you say your daughter was, I’d have been questioning my care with the GP long before. The fact that you took her to see someone privately shows that it was not lack of finances, as for many, but lack of inclination. Yet it’s the A & E clinician on whom you take out your frustrations. That’s not on. If she raised her voice to you, it sounds like you did the same, and whilst in a doctor it might not be ideal, perhaps a bit of compassion in hindsight from you? You were in the wrong, the doctor was in the right, medically speaking. Why are you not hitting yourself over the head for not taking more appropriate actions earlier? And not just you, your OH.

I’d agree that flagging it with the GP practice is a sensible thing to to do as a learning point for them, but as other PPs have said, coeliac is incredibly difficult to diagnose, particularly in a young child with a plethora of symptoms. I’m very glad for you that she is now on the right track, but I feel you should accept some responsibility yourselves for the situation.

I think the OP and a few others have watched too many episodes of TV medical drama series, “Casualty”, “ER”, House, etc...where every week the stressed Emergency doctor is able to diagnose a rare illness within half an hour of the patient walking in.

Unfortunately, that’s not how A&E departments work at all.

If it’s neither an accident or a life and death emergency, you’re unlikely to get any useful diagnoses from A&E.

What you need to do in that case is to badger the GP to refer you to a specialist.

OP I can understand why you took your DD to A&E if you are scared and worried and you keep getting told it's viral then I get it .I have been in the same position with one of my DC's .They were very poorly gp would say go to A&E they would be admitted to peads who didn't know what it was so got sent home again. It turns out they had a rare condition, not life threatening but can make them really poorly when it flares up .We now have an amazing consultant at a children's hospital. But I have been in your position so i can understand why you did what you did. You just want an answer .

The dr said your dd looked fine, she presumably did look fine from an A&E perspective and the dr was quite right. Your DD didn't need bloods in ED. You even say yourself you took her to Ed with suspected aneamia

What did the GP say when you suggested bloods? I'm surprised they didn't pick up coeliacs disease as in my experience they have been quick to test for coeliac with those symptoms. Its the GP who was the problem

You say the dr was shouting at you, but I don't fully understand why they would just come in and shout rather than explain they thought your DD didn't need bloods. Theres 2 sides to every story, you admit you were pushing for bloods and the dr was right that they don't want to take unnecessary bloods on a 5 year old,.

I think you should just let it go. The dr was rude but medically right and you would be wasting everyone's time by taking the complaint further. What is it you are expecting to gain?

@Lorieandrews

Oh bless you!

My dd was very poorly. Over the space of 2 years I took her to the gp over 50 times. I took her to a and e. She was having fevers. Every single 10 days. Her teeth disintegrated. Because she vomited so much. She was screaming in agony

I was told it was viral. When I was at a and e. They said they’d give her morphine. Which helped. They said to get something stronger than calpol. (The a and e trip was a nightmare). They said they’d sent a report to my gp explains this the next day.

Great. So rang my gp. They told me they’d got the report. Great. Can I have an appointment. Yes. Fab

I get into the gp office. Which at this point all my child is doing is screaming hysterically in pain. She’s also not one who gets sick. So I said before her fevers. You’ll see. She was never sick. She agreed. I said about what the dr had said. About pain relief. Seeing as she’s just screaming snd crying saying mummy it hurts. Mummy is so bad. Mummy make the pain stop. The dr tells me they haven’t got the report and how bad a mother I was for asking for morphine for my child. First off. I didn’t ask for morphine. Not once. I didn’t even tell her she’d had it the night before. I said eh? Where did you get that from. She said it was obvious that’s what I was asking for.....I said ok right....I said you can see for yourself. She’s screaming. She’s been like this for a week....all I’m asking for is something better than calpol. She said she’s refusing to do so because the next step for a child would be morphine. I said so you’re telling me. There’s nothing pain relief wise in between calpol and morphine?!?? It’s one or the other? That’s it??? I don’t want her to have it. But what she’s having now isn’t working....which was both calpol and ibuprofen...

Long story short. I walked out of there crying. My daughter still in agony. I rang the private hospital when I got home and made an app the next day.

Turns out she had a really rare condition

I made an official complaint against that gp. Not for what she said to me. Or how she treated me. But for leaving a screaming little child in agony.....

I got the same as you. Sorry for that. Won’t happen again. That’s it.

That is awful .I was lucky in the respect my gp was brillant with my Gp they would refer us to local peads at hospital and they would shrug , send us home and it would happen again .This went on for a long time too .My gp did want me to complain because the treatment was so useless and my Dc suffered because of it .Now we are under an amazing consultant but my Dc was let down badly for a long time.

I would raise a complaint for the gp not the A&E doctor!

While the A&E doctor shouldnt of raised her voice, i would give them the benefit of doubt, you dont know the shit they had to deal with in there shift, truma, abusive patients!

YANBU
You said your child was unwell, sleeping whole days. Sorry that’s not normal, I’d be worried too.

‘ not a matter for A&E unless blood was pouring out of her’ - what a load of rubbish. I took DD to A&E as per 111 because she had a small cut on her head! The doctor rang me back and told me to go. Yes it minor, yes I felt silly, but she was only little and the advice was to go.

Sorry you are getting a hard time on here from all the medical professions , especially considering your child WAS actually misdiagnosed. The A&E doctor could have given your daughter a fear of needles for life! I wouldn’t be happy with that comment alone!

People do misuse A&E like all the people that go out, get drunk and break bones!

I hope your DD gets the specialist help needed and makes a full recovery.

I don't think that you were wrong to go to A+E - they can rule out serious conditions needing immediate treatment, or can admit/refer etc if necessary. It sounds like the doctor did not do a good job of explaining - she could have said that she'd ruled out anything needing immediate further investigation, and that you should return to your GP who could arrange blood tests in a better environment for taking blood from a child. I'm sorry you had a difficult experience that sounds confrontational rather than explanatory and supportive.

It has been useful to hear your account of how coeliac disease can present in children, as I think a lot of people would not have thought of it, so thank you for awareness-raising.

@Suzi888 a head injury is different from a mystery illness that had been going on for some time and should've been dealt with by a GP. That's who the op should be complaining about, not a A&E doctor who felt that bloods should be taken by a phlebotomist, or at the GP surgery. A&E is for accidents or emergencies, neither of what this was.

@saffire

If the GP was being useless then sometimes A&E is the only option.

You did what you thought was right at the time for your sick child.
Some people are so quick to criticise , perish the thought but if you had said she had been diagnosed with leukaemia etc at a&e you would have been praised for acting on your instincts .
Don't feel guilty for being scared for your child .
As for the doctor, i hope they had 2nd thoughts after you left and may be a bit more respectful in the future .

I think the OP had a seriously lethargic, sick child. We’ll have to agree to disagree as I don’t think anyone with a proper medical background has commented. (At least I certainly hope not!) My point was that you don’t have to have blood pouring out of you to attend A&E.

Your complaint regarding late diagnosis should be with GP.

What exactly are you wanting from going to the ombudsman re hospital care?
A+E was not the right place for diagnosis.

The doctor was rude but GP should have taken bloods and investigated, a chronic issue is not within A+E remit.

@Suzi888

YANBU You said your child was unwell, sleeping whole days. Sorry that’s not normal, I’d be worried too.

‘ not a matter for A&E unless blood was pouring out of her’ - what a load of rubbish. I took DD to A&E as per 111 because she had a small cut on her head! The doctor rang me back and told me to go. Yes it minor, yes I felt silly, but she was only little and the advice was to go.

Sorry you are getting a hard time on here from all the medical professions , especially considering your child WAS actually misdiagnosed. The A&E doctor could have given your daughter a fear of needles for life! I wouldn’t be happy with that comment alone!

People do misuse A&E like all the people that go out, get drunk and break bones!

I hope your DD gets the specialist help needed and makes a full recovery.

Broken bones are absolutely the correct use of a&e 🤔

Agree with this. I wasn’t diagnosed with coeliac until I was 27. Twice in my life I’ve been to A&E with severe symptoms before I was diagnosed. Both times on the advice of 111. Unless you’ve experienced it, you really have no idea.

I got to the first paragraph and thought coeliac.

I get it’s generally not the issue for a&e but the dr could have suggested you visit your GP for bloods. Actually Dd was diagnosed coeliac after we took her to hospital as so unwell, had gone downhill all week , fobbed off as usual at the GP and then one morning she was so unwell I took her to hospital. She was admitted, put on an IV drip, deranged bloods due to chronic malnutrition. Dr in hospital said she’d have been dead within days, possibly hours. So it can be very serious and an emergency.

OP, hopefully this dr has reflected on it and may think of coeliac quicker next time.

I think the average time for coeliacs from symptoms to diagnosis is something like 14 years. We saw so many GPs over a period of at least 7 years. Mumsnet diagnosed her in the end!

I don't think you needed to go to A&E but understand why you did.

But I don't think you can complain that they looked at your dd and decided that A&E was not the appropriate place to seek a diagnosis.

What do you want to achieve? You have complained. The doctor will have been made aware of your complaint. It's been over a year since it happened. That's the end of it.

People do misuse A&E like all the people that go out, get drunk and break bones!

This is not necessarily misuse of A&E. Fractures due to accidents, sporting injuries or indeed drunken idiocy are within scope. Unlike diagnosis of chronic conditions.

There are many chronic conditions that can need acute management at times which would be best initiated through A&E but this was not the case with OPs child. Instead of using an escalation process at community level A&E was used. It was determined the child didn’t have an immediate life-threatening issue or indeed any of the 101 things OP thought they may have (but seems to think can only be established with a blood test). I’m gathering this is essentially what the OP was told, they kicked off and were given short shrift. In all probability A&E acknowledged there was something amiss that required further investigation, but it did not need to be done there and then in that setting, it’s community management.

The OP has complained that A&E didn’t correctly diagnose or treat her child. None of that holds water which would be the feedback they were given and don’t like.

@MissBaskinIfYoureNasty

I think taking a child to A&E with suspected anaemia was way out of line. The doctor was probably a bit annoyed at the misuse of A&E but could have been more polite I guess.

This!

Guarantee that if there was a thread on here saying "my 5 year old has been in and out of GPs for last couple of months but we are getting nowhere, she's unwell, pale etc and now she's started sleeping during the day. She's so unwell today, I can barely rouse her. What can I do to get her help and get someone to listen to me?" I guarantee there would be lots of "why are you posting on here? A&E. Now" type replies.

I feel for you, it took months of doctors telling me she was fine until she was suddenly malnourished and she has coeliac. Whilst I don't agree with going to A&E for that, you have my sympothy as my daughter was in agony for months before someone listened.