To be really annoyed with GP in light of strep A concerns?

[PeppermintChoc]

My sons pre-school has had several instances of Scarlett fever. He came down with a rash, white things and temp, complained of a sore throat. I would usually just have thought it’s viral but after calling pre-school they said don’t forget about SF and encouraged me to see the GP. They’ve had some really poorly children and staff.

Rang GP and he didn’t want to see him. Had a phone appt. He actually said “don’t worry about Scarlett fever it’s really rare” I said he’d been in contact with it and that didn’t change his mind.

My son was fine, fortunately, but reading about all these really poorly children and can’t help but worry that if one of mine does come down with something it’s luck of the draw as to whether they’ll see them. Conversely on another occasion he had tonsillitis and the only reason the GP (diff GP) picked it up was because he examined him. GP was surprised he wasn’t more poorly as his tonsils were awful and covered in pus.

I’m terrified at the state of our NHS. I am always reluctant to call “just in case” but I wish we could - really we should be able to be seen just to put our minds at rest. I’d rather pay £50-100 and feel happier my children aren’t seriously unwell than wait until they get really poorly just to justify going.

I’ve read your posts

you clearly stated “I said in a post that parents should be able to see a medical professional for reassurance”

What do you think GP appts are if not finite resources?

@ReallyTiredAndHungry do you think parents shouldn't be able to get reassurance when they are worried about their children? Or are you saying they can't because it's not possible?

I wonder if you are coming from the same presumption that parents 'don't know what they are talking about' which unfortunately can result in deaths by strep a, sepsis etc as per some of the most recent cases have shown.

I think we need a system where parents can get reassurance when their gut is telling them something isn't right. I wish we had separate paediatric doctors in every doctors surgery.

Parents worry about a lot, you see it often on here.

Parents don’t often know best either, the NHS isn’t there to put parents minds at rest when it’s unnecessary.

Id be all for it if parents had to pay an additional tax levy for such a service.

Same happened to my DD , she was seen in 1 hour at a&e, she had a chest xray and antibiotics prescribed. The GP said it was viral but didn't.bother doing chest auscultation or peak flow. I'm a HCP and I know primary care sometimes fob patients off.

I think the OP us right to feel annoyed. My dd is currently showing symptoms of Strep A and we are up in the night.

I'm going to be annoyed if I can't get to see my GP tomorrow to have her checked out.

Id be all for it if parents had to pay an additional tax levy for such a service.

I acknowledged that.

Youre just being deliberately argumentative.

@ReallyTiredAndHungry I've tried to look for statistics on GP visits by age etc but can't seem to find anything. From my anecdotal experience GP surgeries tend to be full of much older patients, with A&E being much more mixed. Why should just parents of young kids pay a levy?

Because he might not have been. And when a little child is ill, they can get really ill, really fast.
My 11 month old has a runny nose, cough and two day fever and it’s probably a cold. But I asked our surgery for her to be seen just in case and they gave me an appointment the same day. Yes, there will be the worried well taking up valuable appointments-but it will
mean that the serious cases don’t get missed. Parental instinct should the dismissed. I’d have expected the OPs child to be seen.

My 11 month old has a runny nose, cough and two day fever and it’s probably a cold. But I asked our surgery for her to be seen just in case and they gave me an appointment the same day. Yes, there will be the worried well taking up valuable appointments-but it will
mean that the serious cases don’t get missed.

Well… no. Because there aren’t a limitless number of appointments. My GP surgery has always been amazing at fitting kids in but if everyone whose baby had a cold and 2 day fever took them in for an appointment then serious cases would most definitely be missed because the entire surgery would be full of babies with colds!
I’m not trying to give you a hard time for wanting your baby to be seen, you were obviously worried, but then you have to recognise that by default someone else is not getting seen - and that person might really need the appointment. (This is more of an issue with our healthcare service than with individual patients. The capacity is seriously limited. There’s a whole other thread going on about that at the moment… and surprise surprise I’ve just noticed the first private GP surgery open in my local city…)

Were they ok?

There probably needs to be some triage based on symptoms by GP or 111

Some clear messaging on which symptoms to react to would helpful as well. Is a rash or strawberry tongue always present etc

This may have happened already

If you are happy to pay, find a private practice near you.

I am with one, it saves the battling for an appointment for me and the children, we can be seen the same day.

We also have an video call dr though our health insurance.

I do think the drive to reduce antibiotic use is having a real impact. In principle I completely agree with it and it makes complete sense but you do need a functional primary healthcare service to make it work where people can be monitored and if needs be seen more than once to ensure that things are resolving and don't require further treatment. The current system just can't do that so it places everyone in an impossible position.

Repeatedly being told that your child's symptoms are "probably viral" without anyone actually examining your child is really challenging and results in parents ringing repeatedly for the same issue.

Last Christmas my younger DS (who was 2 at the time) had spent a week lying on the sofa with a temperature of over 40, barely eating and complaining of ear pain. I was told viral. My instinct was that he was really poorly, I told them this. It was the 23rd December and I was then faced with trying to get Ooo assistance for a young child over Christmas which would be a nightmare.

I paid privately, got antibiotics, DS had a blood test which showed very heightened infection markers (dr called me the next day to say if he didn't improve in 24 hours to take him to a&e). It cost me £150 which I could really have done without spending but I felt I had no choice. I'm also lucky that I have the option, it simply isn't there for lots of people.

On the other hand I had covid earlier this year and had a persistent cough afterwards which went on for 5 weeks. I felt ok, no temp, bit tired maybe. GP prescribed antibiotics over the phone straight away without seeing me which immediately resolved it. It all just feels very inconsistent.

The minimising and dismissive replies you're receiving, OP, are the reason why healthcare is so shit in this country. We basically have the healthcare and government we deserve.

Of course a poorly child should be examined. And a community pharmacist can only offer symptomatic treatment. They won't listen to chests or look in ears. At least they don't get paid to do this.

It is worth bearing in mind that if your child has a fever and cold symptoms the GP is only going to be able to tell if they have strep A if they have any tell tale symptoms- sandpaper rash, strawberry tongue, petechiae or impetigo skin infection. If you don't see any tell tale symptoms then they are unlikely to have strep and the NHS really can't do throat swabs on every single child with a fever.
So whilst I 100 percent think the GP should have seen the OP's child who had clear scarlet fever symptoms and had been in contact with it, in most cases they can't really help determine what the symptoms might be. Yes they can reassure you that it isn't strep but that is just based on the symptoms at the time of presentation. They can't miraculously diagnose all conditions from non-descript symptoms. So most of the time it probably is a waste of time to take your child to the GPs for cold like symptoms such as runny nose, mild fever or cough. Rashes, white spots in throat etc, ear infections, high uncontrolled fevers, floppiness, blueness, non responsiveness etc, bad chesty cough which is affecting breathing, on the other hand are probably symptoms which do require a GP visit (111 or A and E maybe for some of those symptoms).

When DS had scarlet fever it was obvious from google that it was scarlet fever. I had to fight hard to persuade the Assistant Nurse Practioner as she had never seen a case before and also had to look it up on google whilst we were there. She was really reluctant to prescribe antibiotics but did so eventually. DS then got strawberry tongue the next day so was definitely scarlet fever.

OP I completely agree with you. I think it's a national scandal that people can't access f2f appointments with their GP. And especially so for young children, who can go downhill REALLY quickly and who.may not be very good at explaining how they feel for their parent to relay on the phone. They often NEED to be seen where maybe for adults a phone consult in similar circumstances might be enough.
And for.the PP who said

Id be all for it if parents had to pay an additional tax levy for such a service

What an absolute load of nonsense. Elderly patients are the ones who take up most appointments at GP surgeries as far as I can see. That's not their fault of course, they're likely to have more health issues but its definitely not little kids taking all the GPs time up!

Good post agree re distinction between symptoms

Great post. And some of us have no problem getting seen face to face.

For those worried about strep here are some symptoms to look out for in addition to non specific temp, sore throat and swollen glands:

sandpaper rash
strawberry tongue
red spots at back of throat or on roof of mouth.

For invasive group A strep
The UK Health Security Agency advises: "Anyone with high fever, severe muscle aches, pain in one area of the body and unexplained vomiting or diarrhoea should call NHS 111 and seek medical help immediately."

Invasive group A strep is really rare though and the above symptoms from UKHSA encompasses a whole host of other diseases as well.

What an absolute load of nonsense. Elderly patients are the ones who take up most appointments at GP surgeries as far as I can see. That's not their fault of course, they're likely to have more health issues but its definitely not little kids taking all the GPs time up!

Coincidentally had a conversation with a HCP this morning who said the elderly often stretch the appointment time because it takes so long for them to sit down and take their coat off, then try and introduce several problems into one appt. They didn’t seem to be of the view that it was the children in their practice who take up all their appt time.

In the GP waiting room it tends to be children and elderly people.
Elderly people who struggle walking to the examination room, and who take longer to undress if needed for an examination, will mean longer appointments. And it is people who put off going to the GP who usually want to take about more than one health issue at appointments. My gran did this. Would not go to the GP until she really had to so would often have a few things wrong by that time.
I find younger adults go to the GP with things that most people my age and older would never go near a GP with.
The other issue is that hospitals know require patients to go to the GP for a lot of monitoring that used to be done in hospital outpatients. I have taken elderly relatives to the GP for blood tests and to get dressings removed, when once this would have been done at the hospital.

Well actually I was worried I was taking up their time unnecessarily. But we’ve been sent straight to a&e for observation and treatment. So, I hope things will be fine!

But the dr said and I quote ‘when things go downhill, they can go really, really fast. Please go to a&e right now’ So I’m pleased I did. I get that lots of snotty nosed but basically fine kids will now go to a&e/GP….but isn’t it worth it to save the disasters slipping through the cracks? I do think parental instinct is very strong and should be respected.

I do think the drive to reduce antibiotic use is having a real impact. In principle I completely agree with it and it makes complete sense

Sadly antibiotics were handed out so freely and worryingly, some people weren’t finishing the course, if bacteria become resistant to antibiotics, we will be in deep trouble.

Years ago I had a bad sinus infection, bad enough to make a GP appointment for.

He said he wanted me to use a Neil - Med saline rinse- ( where buffered saline solution is swooshed high into the nasal cavities)
I was skeptical, but it worked.

However, one couldn’t expect a young child to use a Neil Med, but anything that reduces antibiotic use is a good idea.

It’s frightening that allegedly in some countries antibiotics are freely available over the counter.

What a way to go for creating resistance in bacteria 🦠.

Oh I completely agree, antibiotic resistance is a massive issue and it does absolutely need to be addressed. We should definitely be trying to reduce antibiotic use.

I think the issue is that it's actually quite difficult to ascertain whether something is viral or bacterial and things can start off viral and then develop into a secondary bacterial infection.

The difficulty now is that there is such massive reluctance to prescribe antibiotics for pretty much anything that people are needing to repeatedly return to the gp when "viral" infections don't resolve for weeks on end.

If the system had more slack it would probably be fine as there could be more monitoring and review but there isn't the capacity as things stand so you end up with repeated calls and repeated triaging etc.

My youngest was hospitalised last year around this time with respiratory infection needing nebuliser treatment. He is unwell just now but GP said that he needs to be triaged down at A&E possibly nebs again. It's anxiety provoking especially if they were born very premature. The night time is the worst.

I do think your child should have been seen by a GP, OP going by the symptoms and your concerns as a parent.