Should I be scared to complain about GP?!

[1234Travellingmum]

So I’m thinking of complaining about my GP treatment recently but am scared that it will get me a ‘bad mark’ and achieve nothing. Should I or should I not bother?

I had been unwell with stomach / chest / back pain for a month. I try to avoid our GP surgery usually as getting help is very difficult and seeing an actual doctor almost impossible. After several attempts got seen twice at GPs by different doctors as that’s how it works at the surgery. Given anti reflux meds and told to wait a month for it to improve. Had known gallstones from years ago so I requested a scan and it was approved but not urgent. After two weeks was worse and in pain all day / night. Given different anti reflux meds but told to keep waiting. Went to A & E and had ambulance out on two occasions due to pain at night. Got a phone call with GP after ambulance who agrees to do some more bloods on the Thursday. Told because it was the bank holiday that there would definitely be some sort of contact to follow up if results were concerning. Go for blood tests but about 30 minutes after going home start to be repeatedly sick. Call GP again as not sure what to do - they didn’t know - could be the codine I’d taken that day. Sick again and hubby has enough and takes me to A & E again. They redo bloods at the hospital and found liver abnormal. Turns out need an emergency gallbladder removal. Done straight after the bank holiday and I am now recovering slowly. That’s a whole other story about ‘day surgery’ and lack of help.

I’m left feeling upset that GP surgery did not contact me at all about the blood tests they did (which on checking my NHS record say liver abnormal - no action). If I hadn’t gone to A and E I might well have had a burst gallbladder as apparently it was bad. Complaining now won’t help me but it might help others if it is a system issue. However, would it have implications for me?

long post - sorry. Brain fog still hanging on.

How long from bloods taken until going to hospital? You said you took unwell a short while after having the bloods taken. If it was the Easter weekend then the Friday would have been a holiday so the results would not have been seen.

The labs only phone back the results that are abnormal over certain critical levels so the lab may not have phoned them back.

Sorry you've had such a rough time. Hope you're feeling better.

If you had your bloods done on Thursday.before the Eatser BH.... there will have nobody in your practice on Friday through until Tuesday to process them.
Urgent abnormal results when GPs are closed are managed either by the lab calling you ( in an emergency) or the lab passes it on to the out of hours service to contact you.
If neither did that... I doubt the bloods were an emergency situation.

Agree with PP. Just to add..the bloods may well have been abnormal but not abnormal enough to trigger a phonecall to you or the out of hours.

Who would have called you over the bank holiday? There is no one in the office.

Definitely complain. This will be marked as a significant event. You will be helping the GP’s by doing this as it’s a learning curve for them

GPs can usually go into the hospital system to see the results. If you had an abnormal result but they can then see that you have had further bloods in A&E later that day, then the original bloods won't require action as you have done the action yourself by going to a&e.
So I wouldn't bother to complain.
That said, I wouldn't worry about complaining in general. It won't be held against you unless it is malicious eg making things up about a consultation.

You say the bloods were done on Thursday. The results aren’t instant. They need to be collected by the lab, taken to hospital, analysed and then the results sent back to the surgery. Someone then has to read the results and take any action if needed, so the gp may not have got the results before you went back to hospital.

Did the hospitals do any scans in the earlier hospital admissions?

Need to find out the facts before you complain though. The GP said to go to A&E when she phoned up feeling worse the same day so they wouldn't have had the results at that time so it looks like the correct course of action was followed.

Think we need OP to return and answer questions about the timeline before we jump in.

Thanks for the thinking. Both GP and hospital bloods done within about four hours (GP first). GP did not say go to A & E. I suppose my abnormal results were not abnormal ‘enough’ for the lab / 111 over the bank holiday to act if surgery was closed - although they were for the hospital to act and know what the problem probably was. No scans were done until the day after, ready for the operation. I guess it’s possible that somewhere someone knew that I had been to A & E and was in the system for action if they could access the hospital notes. I think this might be what I want clarity on - so future errors aren’t made.

Whilst you're right it certainly could have been an error, it's also entirely possible that there was no error - your presentation with the GP could have been entirely consistent with reflux and not warranted any urgent scans (the waiting list for urgent is typically a month but can often be several months).

Normally at the end of the consultation you should have got some safety netting i.e if the pain ever becomes persistently very severe despite analgesia, you become suddenly more unwell.... goto A&E/call 111 etc. i.e "i think this is reflux, but medicine isn't perfect and sometimes things that present 'minor illness' can progress so if it does so you need another review". It's not 'unusual' to see a patient in GP for a suspect minor illness - start a treatment but actually it develops into something more sinister. If everyone was treated as if it was the worst possible thing then there would be no point in GP everyone should just goto A&E but now the wait time to be seen is several days!! Unfortunately agree this probably isn;t much comfort when you're the one who worsens.

The 'normal' ranges for bloods are typically given as what they would be expected for a middle aged white male - so if you're not that then abnormal can be normal for you, if there's any doubt then often the practice is to repeat in x weeks time to see if there's a trend. Labs wouldn't normally refer a result to an out of hours Dr for review unless they indicated immediately life threatening.

But don't be put off writing into the practice. They'll probably have a form on their website. They're not going to treat you harshly in future because of it and you might get some clarity on why you were given/not given advice

I’m a bit confused as to why you needed an emergency gallbladder removal as they are normally do those once the inflammation has settled?
if there is a stone blocking the common bile duct and thus affecting the liver blood tests it would be ERCP rather than gallbladder removal
Why did they say they needed to remove the gallbladder? Maybe GP was of the same understanding as me and therefore didn’t flag the results as needing admission?

Though as caveat to above if there is a stone blocking CBD would usually be admitted!

You’d been suffering for a month and it could have ended much worse.

I’d look to sue. Plenty of firms take on “no win, no fee” cases. It’s the best way of also making sure the NHS pays attention to what happened. Hit them where it hurts - in the purse.

Bit extreme. And it doesn't work like that at all in the UK - in the event of compensation being agreed this is paid from NHS Resolution - essentially a taxpayer funded body which acts as the insurer for the NHS. It's a separate pot of money from the NHS. It doesn't really spur any change/clinicians involved in any such cases will often be completely unaware of these types of outcomes.

Payouts are meant to compensate for any loss/cover any additional care the patient may need in future. It does sound like from the info given so far that the patient was seen, got worse - now in A&E awaiting surgery. It doesn't sound like there's been any report of actual harm so wouldn't really be something the no win/no fee people would be interested in.

Contact PALS to complain, or at least discuss with you. Practice won't be improved otherwise. I'm also going to assume you're a woman, and your GP is a man? If so, once again women's medical problems minimised until they are deemed serious enough.

There won't be a black mark against you abd it won't affect your treatment at the doctors.

PALS are great, and will listen. If nothing else, you'll get it off your chest. Reporting it means the hp might not make such a mistake again.

Except PALS wouldn't be much use here seeing as op thinks the problem is with their GP. PALS is relating to hospital care and can't discipline staff or force change directly.

If you've got a concern about care received from GP surgery you would normally first complain/write to the surgery, if not a satisfactory response then escalate to the local ICB.

If you had your bloods done by the GP on the Thursday before good Friday then the GP would not have them back to look at. Sometimes they are back by the evening but often the next day. Also the results have to be downloaded by the reception staff then allocated to the patient record so that takes time and is usually only done once or twice a day.

It may be that the GP did get your results but then saw you were in hospital (I'm not sure how quickly admission details come through where you are)so they didn't need to do anything else. If the GP had been looking out for the results actively during the day on the hospital system then they would have seen your admission on the system and thought you were in the right place so no need for further action.
i honestly don't think there is much to be complaining about for what happened on the Thursday.