Disappointed with GP

[PinkStarAtNight]

I am in need of a bit of advice around how to handle this situation with GP before I go to the face to face appointment. Any knowledge or help would be appreciated! :)

So there's two things actually. First, I called my GP surgery a few weeks ago to tell them I had a form which needed to be completed by a GP. Its to allow me to access help and support from my university (postgraduate course). In order for me to access these services they need my GP to complete to form and confirm that I do indeed have the three disorders I have told them about.

The first GP receptionist I spoke to said I wouldn't need an appointment as it was standard for doctors to fill in these forms based on the information in my medical records, so they told me to just bring the form in and they would have a doctor complete it and send it back to me.

A week after taking in the form I received a text message saying that X doctor had said they could not fill out the form without seeing me and I would need to book a routine appointment with any GP. I called reception again and second receptionist again said you really shouldn't need an appointment for this sort of thing. She said the first available appointment was a good few weeks away, as its classed as 'routine' rather than urgent so she literally isn't allowed to book a same day or next day etc...I pointed out that it had already been a week at this point since I requested the form to be completed and now they were telling me I'd have to wait a further few weeks to see GP and all the while I can't access help and support services without it.

The receptionist said she completely understood this and said she would send message to doctor asking for clarification. I have been told today that doctor has come back and said that yes I will need a face to face before he can even think about signing the form to confirm the disorders I have listed, as my medical records do not have enough info on them.

I can't believe this. Over the years I have had countless appointments in which I've had discussions with the various doctors about my long list of physical difficulties, I've had multiple tests done (blood tests, ECGs, scans, MRIs) and have been prescribed anxiety medication as well as medication for aura migraines. In my most recent appointment with a GP a few months ago he said his opinion was that I have chronic fatigue.

So the three things I am needing the GP to confirm on the form are 'anxiety/OCD, Aura migraine and chronic fatigue.' All of which have been diagnosed at some point by a GP at that practice. I am now thinking...if those things have not been recorded on my medical records, what have those GPs written down instead??

Surely each GP has to write notes after each appointment detailing what has been discussed? If so then OCD, aura migraine and chronic fatigue should be there in my records. In my last appointment, I had a particularly long and detailed conversation with that GP in which I listed my physical symptoms at length, going back to my adolescence (there should be appointment notes from my adolescence as well, detailing issues with severe aura migraines, chest pains, fatigue and GAD.) It was after listening to all this that the GP said it was his opinion that I have chronic fatigue as well as OCD. So why is that not in his notes?

The other thing that I'm upset about is that I've had my letter asking me to book cervical screening appointment. I've only ever had one screening before and I'm incredibly anxious about it. I've heard countless stories from friends, family and online about how absolutely horrific they can be, depending on who is doing it. The nurse who did my first one was actually lovely and really put me at ease and said she makes a special effort to ensure each screening she does is pain free as she wants people to come back. It was indeed pain free - but I've heard this is not the norm. Therefore when I called to book i asked if I could be booked in again with this same nurse - and that I was willing to wait/be flexible in order for it to be her. The receptionist said that because the screening I had was actually booked through the out of hours clinic, even though the nurse's name is on the appointment records its impossible to book me in with her because she is part of out of hours team and they have no way of knowing when they work.

These two things have just left me feeling really annoyed and upset, tbh I feel let down by the system and can't believe everything is so hard.

I suppose there is nothing I can do about the cervical screening appointment- I will just have to make a decision about whether I still want to go through with it not knowing who it will be. For the other issue with the form, I don't know what to expect from this face to face appointment next week...I have a feeling they are going to say they can't fill out the form because the doctors I have seen in the past haven't added in their notes what they have diagnosed me with. I have no idea what to say or how to handle this??

Any advice would be great, thank you :)

GP probably wants to make sure they don’t miss anything and include everything you need included. Going through your medical records will take a lot of time. Generally they charge for this but you haven’t mentioned it so it sounds like they’re doing it for free?

You’re overthinking this. It’s part of routine care to check in with you (for medication review, to offer support if this is affecting your course, which you are stating it is). GP likely wants to make sure they don’t write something on the form that would work against you. Just take the routine appointment (no it’s not urgent). Any issues about delays, just speak to your course admin or tutor and explain. It’s no big deal.

Just book your cervical screening. The nurses are generally very good. I’d certainly be more comfortable with a nurse who does them routinely rather than an OOH one who probably doesn’t.

They have said there will be a £30 charge.
Thing is I've spoken to 3 receptionists now who have all said it is standard practice for these forms to be filled out based on medical records and an appointment shouldn't be needed. I've just checked calendar and my last appointment was only in September and that was the one in which I had long conversation and gave details of all issues, both present and historic and doctor said chronic fatigue. So they really only need to look at notes from that one appointment, if notes have been written correctly. Its just that it will be backed up by historical appointments going back to adolescence if they really wanted to make sure.

Its annoying that this whole process is taking more than a month just to get a form filled in. A form which I WILL be paying for and I can't access the support until I have it.

If I had written a shorter version people would be asking questions and I'd be accused of 'drip feeding'. Can't win!

When I needed the gp to write a supporting statement for pip for my teen dc, I wrote a letter summarising all the health conditions which I thought were relevant.

He wrote the letter as requested but did not ask to see dc. I assume the letter I wrote helped as he put almost everything I suggested. (It cost £15 btw)

The receptionist is at fault, they should know its up to the GP at the end of the day as to what they're happy to sign and complete and what assurance they want. If they want to see you face to face that's their perogative. It is frustrating, but it is what it is; you could ask for a different GP to review it I guess but they might say the same.

Yes this is exactly what I did, following advice from receptionist. I wrote a cover letter, attached to the form, with all of my NHS info and a very detailed description of the conditions. I said in the letter that these should be clear from even just a basic look at my records.

The worrying thing is that the doctor has said the information isn't in the records, which suggests that the GPs I have seen haven't been adding these diagnoses to their notes. So what have they put instead?

Can't help with the form thing and I agree it's very frustrating but re: cervical screening- I've had about 8 now I think, not always the same nurse, and have never had pain. It certainly isn't a given. I'd be surprised if it's even 'the norm'.

Thanks for this- it's good to hear a positive experience because literally all I've heard is horror stories. And not just because I've googled 'smear test horror stories' 😂 I've spoken to real people who have all said that most of the times they've had it done its been awful. So to me it did start to look like the norm. But thank you for your alternative experience.

Have you actually been diagnosed with CFS/migraine/OCD? A doctor’s opinion is not sufficient. If not, that’s why they’re saying it’s not in your records.

Only diagnoses can go on the letter.

Same here. I find an eyebrow wax more painful.

i can access my GP Record vis the NHS app. Can’t remember if you have to formally request this from your surgery and you might not get it before you get a GP appt. Mine goes back to 2021. You can check what’s been recorded from any consultations and there should be a list of diagnosed conditions.
Go for your cervical smear. I’ve had about a dozen over the year a while they are not pleasant but can be uncomfortable for a few seconds. Tell the nurse you are anxious.

I don't know why you are stressing so much over this. The GP can hardly just fill the form without definite diagnoses. The receptionist will be guided by what the GP says.
Also a GP probably won't diagnose actual OCD and chronic fatigue isn't really a diagnosis per se

I'm not sure how else you get a 'diagnosis' if not by a qualified GP telling you that they think this is what you have. How else do you get diagnosed with things like OCD and CF - things that don't show up on blood tests or scans? It's based on the education opinion of a trained medical professional, surely.

OCD would be diagnosed by a specialist. Have you been referred to or seen by mental health services for this?

Well chronic fatigue is more symptom than diagnosis.
Migraine is a diagnosis so that should be ok.
As I said OCD has criteria so not sure they will be able to confirm that without psych input but anxiety they can confirm though again is more symptom than diagnosis per se.

It's a bit woolly surely you can see that ?
The migraine would really depend how frequently you get them as to whether they are interfering with work .

Some things a GP is not allowed to diagnose.

They can tell you that they think you have X but actually a specialist doctor is needed to diagnose.

The medical world is full of very specific things like this.

As filling in the form is private work not NHS (hence why you are pay by for it) the doctor can ask to see you.

It's not a given that they will do the form.

It’s a private form that they don’t have to do.
at £30 for a professionals private time it’s a bargain.

Take that to a private GP and see if you have change from £150!!!

Id be bloody grateful they are even doing it, not stomping my feet about a few weeks wait. Or should you get an urgent appt ahead of the chest infection, the breast cancer and the suicidal patient?

They might be able to fill in a form with an appointment if it’s straightforward, the likelihood is that disability services are asking for 20 odd opinions they can’t give without seeing you.
Or they could just write ‘unknown/don’t know’ to all the specific how is X affected by her chronic fatigue specific to her studies.
Result - probably no support.

I'm surprised you got a formal diagnosis of these conditions from GP appointments. They're normally done by referring to specialists. They're also better at dealing with complex conditions like CF. I think that's what the pp meant upthread.

Chronic Fatigue Syndrome is considered a diagnosis by the medical community, and is helpful/ necessary to access support. The fact the doctors don’t actually know what is wrong with the patient is neither here nor there when requesting support.

Being told different information by different staff members is sadly not that unusual.

Agree that you would generally need to be referred to specialists to get “official” diagnoses, and this will all take time.

GPs shouldn’t diagnose migraine. It should be a neurologist after a thorough neurological examination. I only got my migraine diagnosis after a referral. Are you on medication for migraine?

It may well be in his notes that he thinks that, however he cannot (or anyone else) sign to say you have it because it is one GP's opinion.
If he actually used "In my opinion you have", then I wouldn't have taken it as a diagnosis, to me that's an opinion not a definite diagnosis. If he'd said "You have..." then that's a different thing.
Did they suggest any further tests?