To think that the NHS should phone you with a diagnosis before prescribing medication?

[illfallforward]

My mum has just been called to say that a prescription is ready for her. Turns out it’s a chemotherapy cream for skin cancer. Now fair enough it’s not the worst diagnosis to have, but surely someone should speak to her before she finds this out?! I’m just flabbergasted

That’s poor, the dermatologist should have contacted her to explain why they’d prescribed what they had and how to use, when to review etc.

But bear in mind some topical treatments such as Efudix are for precancerous changes too so she may not have a skin cancer.

@WhateverMate its not the GPs responsibility to give her results of the hospital appointment - that should be done by the hospital team. The GP will (eventually) be copied in.

@illfallforward I suspect there’s a letter on it’s way to her via snail mail - not all departments send electronic communications via the app.

* its not the GPs responsibility to give her results of the hospital appointment - that should be done by the hospital team. The GP will (eventually) be copied in.*

My hospital results are always given to me by my GP.

They'll contact me and tell me to make an appointment.

The entire hospital is on the electronic system. All previous communications came via the app.

Is it Efudix? I've used it and so has DF. It's the first line of treatment for minor skin cancers like basal cell carcinoma and sun damage (can't remember what that's called).

I wish they would get a proper diagnosis for musculoskeletal complaints, rather than have a physiotherapist working blind.

I don’t know, she’s in a bit of a flap now. Either way, she should be phoned.

I think in SOME cases it’s fine to just get the prescription (eg you went in for bloods because you’re tired all the time and then you get a call/text to say a prescription has been issued for iron tablets) - things like that I don’t think need an appointment given how stretched GP’s already are.

In your mums case though, she absolutely should have heard before getting that prescription. That’s a really horrible way to find out that sort of news - she must have so many questions. I saw a doctor last year due to a number of things going on, they told me they were going to do some bloods to check l iron levels etc. When the results came back, they hadn’t checked those at all - the test was a cancer blood test (Ovarian I think). Now the result was fine, but the doctor hasn’t even mentioned this was a concern to them, so it was a shock when I opened the app to check my iron levels and saw a completely different test. Imagine if that had been a bad result and I hadn’t even in my head been thinking that cancer was a possibility?

I know how stretched our NHS is right now, but they need to remember their patients are human beings too, sometimes frightened, and we just want to know what’s going on. The decent thing for them to have done would have been to call your mum first and talk through what they had found, what they were prescribing and why.

I would complain. This is unacceptable, not only because of the shock but as you say, side effects, what to do next etc. Your poor mum, that must've been such a nasty shock.

Hope all goes well going forward. I hope too that because the cream and lack of contact that they may not be too worried, rather than being just inept.

Yeah I work in this sort of field (non medical), and know that cream means it’s not urgent.

But when it’s you and your health, it’s so much worse isn’t it? She doesn’t know anything about what to look out for with the side effects etc., and can’t get through.

Yep, they absolutely should ring you. But sadly too many of us accept the deplorable treatment by the NHS and so we now have this cycle that perpetuates itself. It’s a disgusting lack of respect for patients as people and for the past 3 years all I’ve seen is things getting worse and I know now I am no more than a number to them. It’s terrible

There is no medication for autism 🙄 and NO ONE CALLS EITHER ADHD OR AUTISM DISEASE FFS. You are alone on that one

And no, the diagnosis has not increased because of ‘big pharma’. It’s because of awareness. And thank God for that.

That’s ridiculous, and your hospital should be ashamed of pushing all their follow up work to GPs. No wonder people struggle to get appointments.

The department/specialist that saw the patient should be the ones to inform them of results, treatment plans etc. Primary care should be used for continuing treatment.

OP
Creams can be used to treat early or superficial non-melanoma skin cancers, including superficial basal cell carcinoma (BCC) and squamous cell carcinoma in situ (Bowen's disease). They are also used for precancerous spots called actinic keratosis

Please reassure your mother than she can feel confident the issue is mild. Chemotherapy sounds terrifying but it just means it either boosts your body’s immune response and/or kills off bad cells

There is no medication for autism and most ADHD medication is now off patent. I’m not a particular lover of “big pharma” but this is conspiracy theory level.

The letter still needs typing to go on the app and there is often a massive backlog

I would guess the cream is Efudex which is used for precancerous skin lesions and small superficial basal cell cancers.

I had a similar experience, the dermatologist team in the hospital contacted my GP who prescribed the Eufadix cream. It was very hard to get hold of, had to try several pharmacies. Nobody mentioned cancer. It was pre cancerous cells. I read the leaflet and researched online. The hospital and GP surgeries communicate badly, and slowly. The app is improving things a little. Not much sense of urgency, which I took as a good sign, but you can never be sure.
Anyway, the cream did the trick. It makes the area sore for a while before it gets better.
I'm just relieved to get past the whole issue, tbh.

Your poor mum. I cannot fathom not contacting someone to say what the diagnosis is, what this means and there being an opportunity for questions. That is shockingly poor care. Might be worth contacting PALs for support.

All well and good but it’s been prescribed by the outpatients pharmacy at the hospital. Nothing to do with the GP.

@illfallforward the pharmacist or the leaflet in pack will be able to tell her all the side effects and how to use it . My husband has used it very effectively on a bcc .

What medication do you think exists for autism?

You have absolutely no idea.

Have you tried getting ADHD medication as an adult on the NHS? What makes you think people with neurological conditions are being diagnosed with no evidence? If anything it is the other way round. My sister has just been diagnosed with ADHD, she is 53. She has struggled all her life but for a decade she has been in a really bad place. Repeated visits to the doctor had them blame the menopause, or written it off as her having a stressful job or depression. She’s had so many different medications for those things and nothing has worked. By chance she met a NHS consultant psychologist at a work event and was explaining what her issues were and she was asked if she had ever been tested for ADHD. Her GP refused to refer her so the consultant offered to do the tests. It took 6 months of gathering data, going in to every aspect of her life, which included me answering a whole load of questions about her in childhood and how she is now. Finally she was diagnosed, GP still refused to accept it and now she is paying privately for medication which has made a massive difference to her. This is not a one off anecdote, it is widely the experience of adults. If we are actually paying attention to children with neurological conditions and treating them now, saving them from the lifetime of issues my sister faced, then that’s exactly what my tax money should be doing.

Some of those creams can be harsh. I would expected to have had a call prior to it being prescribed. Also a dx of cancer (albeit one with a very good prognosis) is alarming.
I’d be upset if I got “your chemo cream is ready for collection” out of the blue.
YANBU OP

Nobody would want to receive a diagnosis this way. I hope your mum is able to receive better explanations of her care and to feel better about the diagnosis.
If this was a potential outcome they should have warned her at her previous appointment.
The story makes a good headline so I imagine the media may pick up your post.

It sounds like such a ball up they might have two patients mixed up. It’s happened to me a few times although not about something as frightening. There could be another poor fecker out there trying to get the cream they need.

If she can go back to the hospital to query this it might be quicker than calling. I hope it goes well for her and is resolved soon

@illfallforward I understand your point about your mum. She should have been told in advance, and the upset it caused. I was a bit shocked to read it was chemotherapy cream myself at the time.
The hospitals app (think called My Chart) where they send you appt details and so on. I received a copy of the hospital letter sent to my GP about 6xweeks later. They have backlogs and staffing problems. So things don't happen in the order they should.
As PP said, I think your mum can be reassured that her issue is relatively minor.
I don't think complaining will help, tbh.

Usually you get a letter or a follow up appointment. I would ring up to find out if communications has been sent out. It could be an admin error.