To complain about GP's incorrect referral?

[shallwego]

Hi all.

Sorry it's going to be a long one!!!

So following from a discussion I've had on another thread.

I have been suffering with infertility for the past 3 years. My DH and I have been tracking everything we possible can, and it's just not happening for us.

Around 2 years ago now, I contacted the GP at my doctors surgery to ask for some help and guidance. I had some blood tests carried out, and they came back clear. At the time, I also had a pelvic scan done which was also okay, but they did advise they struggled to get a super clear image since I was a little overweight.

I was told I'd be placed on a waiting list for further help in the fertility department, and so I've waited patiently to be contacted by this department.

In the meantime, DH and I took care of ourselves as much as possible, continued trying but tried to relax a little to see if the 'relaxed' approach would help, but it didn't.
We decided to both have weight loss surgery to aid in our chances of conceiving, and also for personal benefits and reasons, and this has worked really well for us. We are 18st down between us now and so so much happier and healthier! We have been given the all clear from our surgical team to confirm TTC. They're extremely happy with our progress.

I got a call around a month ago from the NHS, and was told I was finally at the top of the fertility waiting list! I was so, so happy to finally be getting some guidance. I awaited my letter in the post for my appointment, and when it finally came through I attended the gynaecology department as per the letters request. I was due into the appointment at 3:30, but ended up waiting in the wait in room for over 2 hours before being seen.

I went into the dr's office at 6.40 and sat down to hear about my next steps. Confirmed my details, DOB etc etc and he began reading back through my medical notes and history. He began talking about some of the notes he had on file, and all was okay (blood work, scan etc)

He then began discussing my 'consecutive miscarriages' at 10-15 weeks pregnant' and began to apologise for the losses etc. I was shocked COMPLETELY.

This isn't me. These aren't my notes. I haven't ever been lucky enough to fall pregnant, so I was utterly confused. I told him that this was incorrect, and he looked completely confused too. He continued reading through these notes and the rest of the information was mine again... but these consecutive miscarriages weren't true.

He asked me how this happened, and I honestly have no idea. He then continued on to say that since this isn't my information, and we are not completely sure I'm even able to GET pregnant, I'm in the wrong department. I would need to go back to my GP for a re-referral to the infertility specialists. Completely cold and matter of fact.

I was so upset and frustrated at both the length of time I'd waited in his waiting room just to hear that, and the fact I've been on the waiting list for the wrong department for 2 YEARS. I was just a sobbing mess.

He dismissed me, but before leaving the room he also said 'also you need to cut back on the junk food. You're still obese. The infertility team wouldn't give you so much as a look-in when you're BMI is this high' I asked him what my BMI would need to be. He said it's currently 34, and needs to be 30 in order to be considered. I explained to him that I've had weight loss surgery and have been trying so hard to bring my weight down to help in conception.

When I left the room, I was in absolute floods of tears. I'm absolutely heartbroken that I've been referred for the wrong department and wasted SO much time waiting for this appointment, only to be referred back to the start again.

I contacted the GP reception and advised on the situation, and was called back by my current doctor (the one before who mid-referred me isn't looking after me anymore). She's taken all our info and put us back onto the correct waiting list, but couldn't advise me of how long this may be.

What are my options now? For all I know these past 2 years could have been critical for us - and we've waited for absolutely nothing.

My mental health is so low following this, I don't know how much more I can actually take.

Just to share my experience, I had TTC for over a year before being referred to gynae, waited a few months for that appointment but then once gynae had determined that I needed to be referred to fertility (I was diagnosed with PCOS and did 8 cycles of Clomid before that) I actually had no wait at all for fertility appointment, I was seen within a month and started IVF the month after. So it's not always as bad as you expect. (I'm in the South East). However I do think your BMI might delay things a little as I think most fertility clinics will only treat if it's under 30. The whole thing is just awful isn't it. I have ended up with 2 gorgeous DC from IVF though who were totally worth the wait!

YANBU to complain about the inaccurate notes and how it's affected your referral.

YABU to be on a fertility waiting list when you both had such a high BMI. If it's 34 currently, after weight loss and surgery, you weren't a little overweight. You were significantly overweight which would have been contributing to your issues and they can't spend thousands giving you medical interventions when your body isn't in a good condition to carry a baby. Equally, your partner's sperm would have suffered with him being so overweight too.

Well done for the weight loss, it sounds like you've done amazingly. As the doctor said, you do still have a way to go. That's ok, I'm sure it won't take too long to get under 30.

I'd be writing a complaint to PALS. Then contact your GP and ask for another referral, prioritised due to their cock up. Then concentrate on losing the additional weight. By the time you get seen, hopefully you're in prime condition and ready to go.

All the best of luck!

None of you understand. The OP has not been delayed one single minute by the mistake. The referral cannot be done until the BMI is below 30.

Am I only one thinking what about that poor person who had all those m/c, whose records got confused with OP's name. When will they get seen?

Thank you! I'm so glad you got help with your DC's situation. It's awful!!

I'm hoping to be under 30BMI in no time. I'm averaging around 3-5lbs loss a week currently! Xx

Has your DH had any tests?

GP can do bloods for PCOS, it doesn't need a pelvic USS for diagnosis though it's useful you're getting on via private health insurance.
Endometriosis is another concern and that diagnosed via surgery - which may require a lower BMI first too.
What are your cycles like? You said you tracked them? Do you ovulate and menstruate regularly? You said the GP did some blood tests a while ago - have you discussed the results with them?
Sperm analysis would be a good thing to do - it's answers half of the question pretty much, and isn't too expensive privately.

I am so sorry you are going through this. We have been going through infertility and private care for almost 4 years , going into 5th round.

Please get your partner checked, 30 percent of infertility is male factor as was ours.

We have been doing this for so long though there has been a marked decline in my egg quality so if you can afford to go private please consider it. Age is one of the biggest factors, every year over 37 the decline increases at a faster and faster rate.

Plenty of my friends have gotten pregnant and had beautiful babies. One who also had gastric band surgery got pregnant in her second try and has a beautiful almost 3 year old.

As others have suggested if doctor suspects a cyst you should be able to get a hysterscopy and endoscopy privately which are great exams for fertility issues.

Have a look on the infertility board here. There's a great thread of people all losing weight to try to qualify for NHS fertility treatment. Try not to think of this time as wasted - you'd have needed to lose the weight if you needed NHS IVF or similar treatment anyway.
But, if you want to speed things up, private clinics will often treat with a BMI below 35.

Thanks everyone.

I'm well aware that I'm going to need to loose the extra weight.
My weight for various reasons has always been a very sensitive topic for me.

I'm trying really hard

Also just want to add, BMI under 30 is required for referral, but remember 25 is the top of healthy, and the optimum for conceiving and having a healthy pregnancy

Have you made formal complaints to both the practice manager and the hospital?

I would want to see the referral letter, and ask for an investigation into how you were referred to the wrong department. I would not take waiting for another two years lying down.

@MytummydontjigglejiggleItfolds I’m sure OP knows what the ‘healthy’ weight range is. You don’t need to twist the knife.

Sorry the ppl I mentioned who got pregnant did through IVF , just wanted to give some good news and hope as it can sometimes feel so hopeless .

TBH I'd save your energy to try to achieve what you want- a baby.
Making a formal complaint won't get you anywhere fast and all it will do is create stress.

Use your private health care for some basic tests if you can. Or maybe use some savings for those if you aren't covered? You can get your egg reserve tested, your FSH and an u/s scan for not a huge amount of money. Your H needs his sperm testing too- get that done privately and it's not £s.

And yes, all fertility experts will stress that lifestyle and weight are a key factor, so carry on working on that too.

This is very confusing to me. OP you say you were contacted by the NHS to say you were on the top of the "fertility waiting list". So your GP must have referred to to the fertility department. But then your subsequent appointment was for gynecology so it might be a hospital mistake rather than a GP mistake?

And, the fact that the consultant was looking at the wrong notes is very odd also. Whenever I attend for a hospital appointment I have to repeat my name, DOB and address at least twice before seeing the consultant. So perhaps he just picked up the wrong notes (presumably from someone else who was seen that day). It's very odd.

In any case… PP has said that you wouldn't be treated by the fertility department until your BMI is under 30 so you haven't really lost any time — just use this "complaint" constructively to expedite your next appointment.

Good luck and well done on the weight loss.

I understand at this point you feel heartbroken as it feels like you've wasted so much time. I went to the fertility clinic and on the day I went so many people were turned away due to their bmi including myself. I wish the gp had been more upfront about it as it was such a waste of a waiting list and all those appts that took place that day alone. They did however get hubby's sperm tested which revealed where our issues were.

Having been here, you do need go make a complaint, the state of the NHS fertility service is appalling, different regions have different rules and requirements and the additional stress it causes women is perverse.
Even the BMI rule isn't that clear cut, yes there's a limit for "treatment" but not "investigations", it's all about how regions are implementing the rules. In some areas same sex couples gets access to the same treatment, in some they don't. I wasn't eligible for treatment because my partner has children, but if we move 15 miles down the road that would change. It's a postcode lottery.

Consider going private for some investigations, IVF is expensive but not always required and sometimes you just need medication to help you ovulate. On the other side you may also find out your chances are slim for other reasons which will be heartbreaking but at leave it will give you some knowledge. Investigations will be about £500 and you are under no obligation to spend anymore after

What a truly vile thing to say.

Thank you.
Yes it was strange - but there was plenty of my correct information being read back to me, too. So I'm really not sure what happened.

I'm focusing on loosing the rest of the weight I need.

Ah yes, the season of goodwill and giving out random kickings.

Did you overdo the sauce last night dear?

It sounds like that person was top of the list so hopefully there will be a trail back to them. 15 losses sounds absolutely heartbreaking.

Keep losing the weight OP and your DP! I say this as a woman who has topped 20 stone at her heaviest. It will help miles with both your fertility and pregnancy and weight loss is also recommended for PCOS so it's a win win situation. Don't give up 3 - 5lbs of loss a week is fucking AMAZING and you should be so proud.

Also just because you need to lose weight, your case was still mishandled and I completely empathise with how upsetting this must be for you. I honestly cannot imagine suffering years of infertility, then being told they're finally able to help, then being told that actually it's an admin error and you're not eligible yet...

The main bits I picked up were the hospital 2 hour wait and the consultant’s poor bedside manner. No wonder you felt a mess afterwards. The referral letter sounds like an admin mix up of sorts. Well done on the weight loss and good luck 🤞

i would go to pals
you need to have your correct referral back dated to the date of the original referral.
good luck op