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 :)

100% this.

The form probably has questions on it about how your conditions affect your studies. GPs aren't qualified to say how things affect studies. It sounds like they're being really kind to just charge you £30 for this non-NHS service and actually would prefer to see you to be able to write supportive things on your form rather than 'I don't know' to these questions.

You sound really entitled. They are perfectly within their rights not to fill in the form if they don't want to, it's not part of the NHS contract.

@PinkStarAtNight i think you are incorrect in presuming you have a documented “diagnosis” of CFS or OCD, (unless the GP has some specialist knowledge and has carried out all exclusion tests). In my area I needed to be referred to the chronic fatigue service to be given a diagnosis….many people attending GP’s will be chronically fatigued due to a variety of conditions,it’s not the same as CFS, and if the GP has never needed to refer you on to any other services , how can they fill in a form to say you need extra support?. Also, making a diagnosis of OCD without having an assessment by a mental health professional would be unusual. Your best bet is to have a GP face to face to go over what you need from them .

At least you can book an appointment for a few weeks time! We get told to ring on the day at 8.30, which obviously you are caller number 84 when you ring on the dot. I’m sure they’re just being thorough though as a PP has said. Also I would have thought a charge was pretty standard, too as you are taking up their time with your form filling. Sort of like certifying a passport photo-wasn’t that chargeable years ago?

To be diagnosed with OCD you need be referred to a psychiatrist for assessment. To be diagnosed with CFS you need to be referred to a CFS unit.

To be honest the receptionists have no medical knowledge, they have no idea if you need to be assessed or not. Only listen to what the GP says

Just to clarify- this is not for work its for university. I am not wanting this form in order to claim for financial benefits or get out of working. Its so that I can access support services from university.

this might be private but what form is it and for what do you need it? All these things are common in many people without being considered massive illness

Thank you for all the replies. It seems I have been mistaken about how these things work. From what people have said, it sounds like I need to be referred to three different specialists; for OCD, Migraine and CF and get three different official diagnoses from said specialist consultants, in order to have a form filled in saying that I need support.

And I assume the NHS won't cover three specialist referrals. So, what do people in my position do? How do you get support? Not just for uni but I'm now thinking about all areas of life, such as future work. Is there just no support for these kinds of conditions?

Yes sorry I did see that afterwards though the principle is the same.

I think the GP would probably be able to confirm anxiety and migraine also fatigue but not CFS / OCD
Also they may want to know what you need help with

To get a diagnosis of aura migraine my friend had to have an MRI and see a neurologist which took almost a year to finally get the diagnosis. So I can see why this and the other conditions may not have been formally ‘diagnosed’

As for the cervical smear I’m not sure who you’ve been speaking to but I’ve had Lletz therapy twice and probably over 20 smears in my life and not one experience has been awful. A bikini wax is more painful

Don't worry, I think they will be able to confirm that difficulties exist and that you need support / - where I think you are over reaching is the definitive diagnosis part.
If you don't fit OCD criteria you wouldn't t really fit the criteria for secondary care referral.

Firstly the GP is not obliged to do this for you. It is not core NHS work or urgent.
Secondly a GP will not make a diagnosis or CFS or OCD . These are specialist diagnoses. They probably wish to speak to you regarding referrals.

Thirdly , you can’t be booked in for a routine procedure by someone who is now part of the out of hours team and does not do planned bookable work.

Sorry to say you are being unreasonable frustrating as it is .

I know that I definitely have OCD as I have been formally diagnosed by a private OCD therapist who went through the criteria.

The reason I had to go private was because my GP told me they don't actually refer to mental health services anymore and you have to do it yourself as a self referral. They gave me a number for the local NHS talking therapies in my area. When I went there, the person I saw had no understanding of OCD and certainly wasn't a specialist who could diagnose. So I went private with a certified OCD specialist and they did officially diagnose me. I never thought to ask them for this in writing though as I didn't need it back then.

I'm confused that everyone is saying I should be referred to all these specialists, as if its standard. In all the years I've been visiting my GP they have never said that referring me anywhere else is an option, despite them actually saying 'I think you have aura migraine' 'I think you have OCD' 'I think you have chronic fatigue'. All they've ever done is refer me to self help and said there's really nothing available apart from anti depressants. I'm confused as to how you get referred without paying a fortune to go private.

Can you just describe your symptoms at the interviews and request what you think you need support with? I am getting older and cannot move physically and get worried with pressure in work and my manager came and asked me what makes me worried and then physically showed me again and again how she does the work, with the hope I will overcome these issues

I don't think you need a referral to neurologist for migraine - it's largely a clinical diagnosis which GP can manage.
Fatigue is different t from an actual CF syndrome. But referral pathway for CF is as rare as hens a teeth.
Anxiety can be managed with Gp but it all depends how much it is affecting you.

I'm confused as to how you get referred without paying a fortune to go private

You ask to be referred to an NHS consultant/clinic.

The reason I had to go private was because my GP told me they don't actually refer to mental health services anymore and you have to do it yourself as a self referral.

That’s if you want therapy. If you want your OCD formerly diagnosed you need to ask to be referred to an NHS psychiatrist.

It will depend very much on the company you are going to go to work for and what kind of stretch they will have for your problems.

Yes it depends if the GP is saying she is chronically tired or that he/she thinks she has CFS.

In that case you should be able to get a letter from your private provider to confirm the diagnosis of OCD. They should have written to you following your appointment but if you didn’t receive anything then I would contact them and ask them to send/resend you a letter to confirm the diagnosis.

Sorry, a 'private ocd specialist' means nothing unless they are a medically qualified doctor (psychiatrist).

You sound a bit of a nightmare tbh.

Firstly your an adult, who has potentially birthed a child (you mention a DC). Don't be so wet about the cervical screening. You're not some teenage girl. Surely you can root out the scary stories? Even if it hurts it's only a bloody second and could save your life.

Secondly two your diagnoses are a bit wooly, and I'm not surprised the GP wants to see you. It's a previous GPs opinion you have CF. But it's a diagnosis of a syndrome made by default, not like confirming you have something like spina bifida. The OCD diagnosis is also tricky. Were you assessed by a psychiatrist?

I think you'll get the letter, but the GP is probably just double checking he agrees with previous GPs opinions.

I suspect it's because your 'OCD' isn't that bad to warrant a referral.
I was diagnosed by an NHS psychiatrist, and been re-referred by my GP when I've had significant flare ups. In all cases my GP rushed the referral and made me come in weekly to check on me whilst I was waiting, rushed counselling, sent mental health nurses round, etc.

I can only answer about mental health but yes there are horrendous delays in getting assessment & diagnosis. I know someone with a child currently out of school who can't get an autism/ADHD assessment that they need to access EHCP etc.
The GP can diagnose you with anxiety but something more complex like OCD would need a consultant psychiatrist.
If they have said they need to see you to do the form then they can probably do it but need to see you. That just means waiting for a routine appointment which is weeks rather than months/years. It's worth going to the appointment & paying the small charge if it's going to get you the support at uni.
A private assessment for psychiatric diagnosis local to me is about £400 so it's worth trying the GP first.

As far as I know, NHS GPs can refer you to NHS specialists for these issues, unless things have changed.

I am under six different specialities. It's probably easier for me because I have a physical life-limiting condition. If I ask for a referral I get it. I'm currently waiting on an appointment with an anaesthetist to help me sleep. I take a lot of strong meds so my GP can't prescribe. I see an NHS psychologist, the pain clinic and a nutritionist, over and above the consultants and surgeon you'd expect me to see for my illness.
The GP absolutely can make referrals to three different specialists.