GP appointment for child and not going with child.

[WhoSaidWhat123]

Not AIBU - but I need to know before tomorrow!

To summarise, I want to book an appointment for my child (5yo) so I can get a referral that I can take to a private specific paediatrician. But that last time I took her she reacted badly and would avoid going to the toilet for a poo, which led to me giving her (prescribed) lactulose, but that made her incontinent as she wasn’t constipated, just afraid of poo’ing.

So I want to book an appointment with a private specialist as I wasn’t impressed with the paediatricians we saw at the local hospital after being referred and waiting months for an appointment, because they only prescribed laxatives and put it down to constipation (when I know this isn’t true), but they wanted to just give it a try first. But I don’t want to put her through the fear again and then being incontinent.

Does anyone know if I can book an appointment and go without her? Or can I ask for a referral letter over the phone?

And I know the way of finding out is just me calling my GP tomorrow, but I just want to know if anyone has any experience of an appointment and turning up without the child. If it was an over the phone appointment you would call on their behalf anyway wouldn’t you so just wondering if I can do the same with face to face appointments.

Why don't you phone your GP surgery and ask them .Hope you get things sorted for your daughter

I think any doctor worth her/his salt would insist on examining your daughter before diagnosing and prescribing medicine.

My GP practice is happy to do private referrals off the back of telephone consultations for issues they are already aware of.

I’m confused.

the last time you took her to the GP she reacted badly, withheld her poo and you had to give her lactulose?

now you want a GP referral for a private paed because NHS wanted to trial lactulose as a first step? Which you didn’t give because of incontinence fear?

phone the GP, tell them you want a referral and ask if they can do that without needing to see the child. If they need to see her, you’ll
need to take her.

what will you do if the private paed suggests lactulose as a first step?

I work in a GP surgery. The GP would want to see your daughter before making a referral. Especially considering her age.

I would expect them to want to feel her abdomen for impaction before making the referral.

It doesn't sound as if there's anything they need to look at that's new, so I suspect it would be fine, but I would probably say at the point of booking that you'll come without her unless they tell you to do otherwise.

I hope you get it sorted. Mine used to keep her poo until she had a nappy on at night - it was with much trepidation that we dropped the night-time nappy, but she did conquer it at 5.

My kids are 1 and 5 and are registered at different GP practices. Face to face appointment is always offered when I've requested an appointment, precisely so they can see and assess the child. I can think of only one occasion where I specifically asked for telephone appointment in the first instance which was accepted. This was because I explained I'd happily bring them in later for a face to face and assumed I'd need to, but I felt my child would be anxious and embarrassed about the conversation I needed to have so I thought it would be best to do the details on the phone without them there. As it happens the GP in that case was not concerned at all and didn't feel the need to suggest another appointment anyway. But Im pretty sure every other time I've ever requested GP input for my kids they've wanted to do a face to face appointment to assess them.

I can't imagine them doing a referral without a face to face because they will want to check your child's abdomen (they can feel constipation for example), possibly weigh and measure them too.

I am a bit confused. I have taken DD to
a few private specialist consultants and never needed GP.
I just booked with the private hospital

Had a sickly teen all through covid and after, I've described many a symptom over the phone and via the online platform and they have issued prescriptions without seeing or speaking to him. So I don't see why not.

Right! I went through this with my daughter & it was horrible not knowing how to help her so you have my absolute sympathy.
my daughter was turning 4 at the time but were able to have a call in by hv, her tips honestly seemed so simple but really helped within the second try & we haven’t had the problem since although now 7 she’s picky about where she poos & it’s somehow a honour if she feels comfortable enough to take a dump at your house🥲 although still won’t at school.
So exactly 20 minutes after eating, take her to the toilet, sit with her, talk, read even tablet whatever will keep her happy for a few, & no word of a lie she managed. I just continued that after each meal really we had some interesting little bathroom meetings😂

Seems like nothing but honestly it was such a problem for her that it honestly could have been a party trick for the hv, it helped so much!
Hope something helps eventually though bless her💞💞

the last time you took her to the GP she reacted badly, withheld her poo and you had to give her lactulose? I thought she wasn’t going because she was constipated, but turns out she was keeping it in. I knew this after because she would say she needed a poo, I’d sit her down on the toilet and then she’d say she didn’t want to and then cry saying she didn’t want to see blood. And then not poo because she was so hysterical, and obviously the next time the urge came she would be a little incontinent.

now you want a GP referral for a private paed because NHS wanted to trial lactulose as a first step? Which you didn’t give because of incontinence fear? Her GP agreed in the appointment after this that the problem wasn’t caused by constipation so he made an urgent referral. A referral had already been sent at that point but because she was getting worse (blood from bottom), and she clearly wasn’t constipated he sent off for am urgent referral.

phone the GP, tell them you want a referral and ask if they can do that without needing to see the child. If they need to see her, you’ll
need to take her. I will be phoning them this morning.

what will you do if the private paed suggests lactulose as a first step? Hopefully they won’t since her poo’s are loose enough as it is and my husband made the mistake of saying her poo’s were mostly hard, when they’re not, and he doesn’t usually help her, only if I’m not home.

I would expect them to want to feel her abdomen for impaction before making the referral.

Her GP has felt her abdomen when I saw him twice, which he had made a referral for. Which 2 months later we saw the paediatrician who did examine her also but because my husband said her poo’s were mostly hard, when they’re not, he wanted to try laxatives daily first. But since that appointment her poo is loose, every day, so obviously haven’t given her it yet in case she became incontinent again.

You don't need a referral to see a private consultant, just book it.

When dd developed a phobia at 8 I saw the GP without her when she was at school and they referred her to CAMHs without seeing her

The loose stool sounds like leakage round a very impacted bowel. Don't dismiss trying movicol etc.

It’s Nuffield Hospital in Chester I made an enquiry with. Just re-checked their website and it mentions getting a referral letter from your GP. Which I’m happy to do because he’s already referred to the local hospital, so I’m sure he will no doubt make a referral letter because the problem still persists.

Just wanted to know if I could get this with having to take my daughter in with me so she doesn’t get scared and react again by keeping in her poos.

I’m going to pop in to my GP shortly when my youngest wakes from her nap and speak to the receptionist there about getting a referral letter off the GP.

If the doctor has already referred her to a hospital but you just want a new letter for a different hospital they won't need to see the child but likely to charge for a new letter

The reason I am concerned as I am, I can now see from my OP that I haven’t mentioned it, is because the issue is that she is bleeding when she is having a poo. When I first saw the GP the issue had been going on for about a month on and off, just a little blood, thought it might have just been a hard poo at the time, but then it got worse and it was after every poo, every day. The GP examined her abdomen and her bum, although there wasn’t a tear to be seen he told me to try and in the meantime make sure she drinks more water (not that she doesn’t drink well, because she does), and he made a referral. Two weeks later the blood was more red, and there was more of it, so I made another appointment and GP then made an urgent referral. After this appointment and after having been examined again she was then holding in her poo. But I thought she was constipated so gave her lactulose but then she was incontinent.

Saw the secretary of such and such name Dr at the local hospital, I take it he was also a Dr but the “first point of call perhaps” and he did examine her, asked a few questions, I did mention that she will fluctuate from loose to normal to maybe slightly hard, but not constipated as she goes every day. She drinks plenty of water, always has a bottle of water on hand, I always encourage drinking with every meal, and her diet is also good. He asked about the colour of her poo, I would say brown sometimes orange. He asked if there was blood in the poo, I said not that I can see, because I genuinely can’t and didn’t know how it should look with blood in it anyway really. Anyway a few days after the appointment, so last week, she had a poo and it didn’t go into the water, got caught on the side of the pan and there was some red bits in it, like blood, and she has loose stools daily, so this is when I decided that I wanted to see a private specialist because I don’t want to have to wait for the NHS referral after seeing the GP again so thought I would go straight to private.

@Bells3032

thanks. I though that might be the case, I was going to book an appointment for her to see the GP face to face to explain what’s happening now, but I was going to go without her. But I will go and speak to the receptionist’s later and ask for them to arrange a referral letter.

I am a bit confused. I have taken DD to
a few private specialist consultants and never needed GP.
I just booked with the private hospital

same. I thought I could just make an appointment directly with them. I have been given a contact number for the secretary of the specialist but can’t get through to her by phone and on the website for Nuffield Hospital Chester it does mention that a referral by the GP is required.

I think the referral letter is if you are intending to use private medical insurance to pay, BUPA or whoever will require a referral letter to uphold your claim. If you are intending to self pay, make this clear & no letter is required.

Or are you asking your GP for a referral letter to a specific private consultant who is also NHS? If so, no idea how that works.

Yes, this is how my insurance works (AXA). If I want to make a claim on my insurance I need a GP referral before I can book a private specialist.

I’ve seen quite a few consultants privately. Some have wanted GP referral (gastro), some not (dermatology)

So I went into the GP and spoke with the receptionist, who spoke with the Practice Manager who wanted to check the credentials of the Specialist first and then gave me a request form to sign, so I will have a referral letter made up in the next couple of days so I can book an appointment.

And to answer @Braveheart35, yes it’s for a specific private consultant (gastro paed).