To expect to be able to request a different GP?

[JustAnotherWhinger]

Nearly 20 years ago a GP at our surgery was suspended by the GMC for three months for their negligent actions toward a patient - my child. It was a very serious incident and he himself apologised profusely after (although he did feel the suspension was harsh, but he didn't actually appeal it).

Where we live it's not as simple as just registering for another GP surgery. There is only one.

It was agreed at the time that when he returned to work it would be inappropriate for him to treat any of our household. So when getting appointments it's always been acceptable to request a different GP if he was suggested - as the on call GP for example.

The surgery now have an automated appointment system. You ring up, you get triaged by the receptionist and they put yon through to an auto system that gives you the next appointment. If you don't accept that appointment you have to call back the next day and try again.

The practise manager has decided that there is "enough water under the bridge" that there should be no exception to that for me or my children (I have younger children - the child involved is at a different GP now where she lives). If the appointment comes up for him then I either accept it or try again the next day until such times I get a different GP. She has also commented that it's "unfair" to hold a mistake against the Gp forever - she wasn't at the practise when it happened and it wasn't a mistake, it was a shitty attitude that led to the negligence.

I have put my objection to this in writing. I don't think it's appropriate, and I'd be very surprised if he felt comfortable dealing with us either.

I simply don't think it's appropriate or right. I know it's a long time ago, but i just don't want him near me or my kids. AIBU?

I think you are well within your rights and you and your family absolutely should be entitled to refuse care by a provider who has previously let you down so greviously. The practice manager - to give her her due - is managing a heavy caseload and trying to get everyone expedient care. I don't think she is being glib, she's being naive. I think your letter should cement things for her and if it doesn't then I would ask to meet her in person to explain why it's untenable for you or your family to be treated by this particular GP. Maintain your advocacy for you and your family.

Absolutely within your rights, the practice manager is being wholly unreasonable.

I think the practice manager is out of line telling you to get over medical negligence. So it's been 20 years.

He cannot be trusted to be unbiased where your family is concerned because of the previous negligence and suspension and that outweighs whatever has led the practice manager to tell you to get over it. I would say she's dead wrong with breaching the ethics involved here.

Is there anyone over her head you can go to? I'm in the US and I would be reporting this to my state licensing board if they refused to make accomodations where your family could see another physician, given that there's no other local practice.

I hope you kept a copy of the letter you sent.

There is not a cat in hell's chance I'd trust that doctor.

You had a very serious complaint upheld. The practice manager doesn't get to decide when you are ok with it or whether it's fair.

I'd be lodging a formal complaint. And then again if it wasn't taken seriously take it to the body above them.

It's absolutely not appropriate.

Your relationship with that particular Dr has obviously broken down irretrievably, so YANBU. They may also prefer this too perhaps - it sounds like it’s the PM insisting it’s ok rather than the GP. I suppose there’s always a chance that in the case of an emergency, they might be the only one available - I think you’d need to decide if this would be acceptable to you, and if not then you may have no choice but to register elsewhere.

The practice manager is also in breach of the prior agreement you had come to with the practice.

I think you absolutely have the right to request to see a different GP, however depending on the size of the practice that may not always be possible for short notice appointments. I would really think about registering elsewhere - are there really no other surgeries within a reasonable distance?

Was the agreement that he would not treat you or your family agreed between you & the surgery, or was it imposed by the GMC?. If the latter, were time limits imposed? If this is something which has been enforced by the GMC you've got a very strong case to go back to them. Even if it wasn't it might be worth seeking their advice. As far as I understand it suspensions aren't imposed lightly or for trivial reasons so it seems entirely fair enough that there is not "enough water under the bridge" for you to feel comfortable being treated by this Dr again. I can understand that in an emergency there might not be an alternative, but for routine appointments all it takes is a bit of flexibility in the practice systems. It's pretty poor practice in any case not to allow a choice of Dr for routine appointments. Continuity of care is important! In short no, YANBU, if you don't get anywhere with the surgery I would elevate to the GMC or the clinical lead for the primary care network.

I agree with you, the trust has been breached and I don't blame you for wanting nothing to do with this doctor. From the doctors point of view I would imagine they would be anxious about any perception of doubt or confidence in his judgement and clinical decision making. Another arrow into the practice managers butt!

There's always been an acceptance that in an emergency we may have to accept him and he may have to accept us. That's never happened in 20 years so far.

I'm hoping he will also kick back against it, as he was instantly in agreement at the time, and he also requested MIL not see him again when she moved in with us (my surname was different then) as she became part of our household, and that was only six years ago.

The nearest surgery in our nhs area is 50 minutes away. The next nearest one is 30 mins, but that's a different trust/board (I've gone mind blank on what you call that). Moving to a surgery in a different area would be a logistical nightmare (even if it is allowed) as our 9yo has ongoing health issues involving appointments with three separate consultants so just wouldn't work.

We've always been totally understanding that sometimes not being willing to see him means we can't have an on the day appointment. There's never been any issue with that.

The practise manager being so flippant has really pissed me off. Her tone was so dismissive.

Under the NHS constitution “You have the right to express a preference for using a particular doctor within your GP practice, and for the practice to try to comply.” That last bit can be used to say it is “not possible” but unless he is the only gp covering the clinic then it is not out of possibility. It also talks about bias and I would argue it is hard to not have that in this case based on history so would be better for all to not interact. If you asked for a female GP , would they be able to comply?

I know you said it's the only GP in the area, but in these circumstances couldn't you request to go to one in another town? Unless you have to see them quite often (and of course I know some people do have conditions meaning they need to go much more frequently than most), this might work for you?
Alternatively, won't all GPs soon be moving to a Patchs type system, in which case you could write that you want to see Dr X, Y or Z, not Dr W?

But surely the agreement hasn’t actually changed from what you’re saying? You’ve always been aware that if you wanted a short notice appointment then this GP may be the only one available and you’ve agreed to that (although never needed it)

Now, you try and book online for that day and the only appointment may be with that GP. You still have the option to decide whether to agree to that appointment or to wait a day or so and rebook when another GP is available

If you took the PMs comment out of it, what is different in practice from the previous situation?

It used to be that you could book on the day if urgent, or book for a later time if it wasn't urgent. For the later times you could book with a chosen GP at their next available slot.

Now you can only book on the day, and you can only attempt to book an appointment once a day, and there is no choice of GP.

So if I phone up and the auto system gives me an appointment with him the exact same could happen again when I try the next day, and the next.

I believe that you have an absolute right to request a particular GP if you can wait longer, so I think your practice is in breach of guidelines there as well.

It was put in after research showed that people treated by one doctor throughout have better outcomes.

That sounds an appalling system anyway. I generally don't care about a particular doctor, but do want a female doctor if they need to look at my private parts (yes, I know they're professionals and some people wouldn't be bothered, and that I can have a chaperone, but I'd still feel very uncomfortable with a man). Also for ongoing issues it was a lot easier to see the same doctor each time, even if it meant waiting a bit longer.

I don’t blame you in the slightest. A GP at my mum’s surgery misdiagnosed two very serious medical issues so it is now in her notes that she isn’t to see him. She also lives somewhere where there is only one surgery in walking distance so changing to another practice isn’t possible.

Mum did have to have one appointment with idiot GP so I went with her and took notes throughout the consultation. At the end I read them back to him and asked reception to take a photocopy and add them to mum’s medical records. Probably overkill but there is absolutely no trust there whatsoever.

When I hear back if they say it's not possible I'll be asking how a female patient goes about requesting a female GP under their new system.

Also it's ridiculous that there's no longer triage to certain GPs for certain issues. We have one who is excellent for menopause for example, and another who has done extra training in certain mental health areas. Absolute waste if people cannot access them.

It's a stupid system, even taking our specific issue out of the equation.

Yadnbu!!

You are perfecly right not to want to see him. But with the shitstorm the NHS is now, with patients being the last consideration, I’m not sure it will always work like that. 🤷‍♀️

That is crazy about the menopause / mental health issue also. Presumably the GPs also chose to get their extra in those areas because they are particularly interested in menopause / mental health and so would like to see patients with problems in these areas.

My closest friend is an academic GP and so spends most of the week teaching / lecturing / researching in a university and one day a week as an NHS GP. She has a particular area of interest that she researches in. In her practice anyone who has that issue is able (and encouraged) to see her (assuming it can wait until Friday but it generally can as it is a chronic thing). Seems such a sensible thing to do.

So, I have no idea yet how it is going to work, but the GP in question has said there is categorically no way he will be treating anyone in my household (other then in dire emergency as previously agreed) so apparently I'll be told in due course how we deal with the appointment situation.

Hopefully it'll be a sensible solution to this stupid situation.

You are definitely not being unreasonable. If they don’t come up with a solution that works for you, then become a problem / risk for them.

Write recorded delivery to advise that if you are forced to see a medical practitioner in whom you can have no faith and where there’s been an unfortunate history, then you will be obliged to record all appointments with him and/ or take an independent witness with you. You are also likely to be requesting another appointment with another doctor in the practice for a second opinion which seems a poor use of their time. They’re unlikely to find this a desirable prospect.

That sounds positive for you but sounds very unprofessional for you too have been told that they said that (I can understand then saying that you practice manger but it shouldn't have been repeated). Sounds like they need a new PM

That sounds like a shitty practice manager and a terrible appointments system. Definitely escalate!