What happens when GP sends ill child to hospital?

[JellySlice]

Dd has been ill for 2w. GP twice, 2 different antibiotics. Last visit we were told that if there's no improvement within 48h they want to see her again, and will probably send her to hospital for further investigation.

That 48h is up on Friday morning.

What does 'send her to hospital' mean? Does it mean we go to A&E with a letter from the GP?

What if GP says to give it another day? It's been two weeks - I don't want to delay any more. But would any non-life-or-death investigations happen over the weekend? Also, being a Friday, I'd rather turn up at A&E before the party-goers!

A good GP will discuss with the paediatric team and refer directly. Both A&E and GP are 'gate keepers' to services in hospital so both make referrals to specialist teams if required. This will mean you wouldn't be waiting to first be triaged through a&E as the GP has already done that.

A lazy GP will send you to a&e. I've worked in a&E and seen this happen. If that's suggested ask the GP to refer you directly to the paeds team, he/she is supposed to make that call not pass you off to the a&e docs.

He may ask you to meet the paeds team in a&e but the language in any letter should be along the lines of having already been "accepted" by the paediatric team

Yeah we were given a letter to take direct to the paeds team so didn’t just go into a&e. Hope she gets better soon x

Will probably just admit you to the paediatric ward. This happened to us once when my son had a very high temp when he was 1. GP phoned ahead and they had a bed ready for him.

I've had similar and the GP told us to go straight to the children's ward. Luckily we were only there the evening, and most of it was waiting for a prescription.

I work in a doctor's and have also had this with my little boy they ring and discuss what's going on then send you to the hospital which has a children's paediatric dept

When my son was 'sent to hospital' we went straight to children's assessment unit.
So bypassed a and e but not straight to a ward.

As it was he didn't need admitting as they did all tests etc in CAU.

This has happened to us twice and each time was different.

First time we were sent to the local hospital’s paediatric ward for observation. There was a bed ready for us, DC was monitored for a bit then they decided all was ok and we got sent home.

Second time we were referred to our regional children’s hospital by an out of hours GP. We were sent to their A&E but with a referral letter (and the GP had also called ahead) which basically fast-passed us through their triage straight to diagnosis and then onto a ward.

I had several trips to hospital with my youngest and wheezing /asthma as a toddler. Every time the GP would call the children's hospital, speak to the nurse who answered the phone and say she was sending us down. They'd also pass on details of the treatment the GP had already started.

Most times we got there the A&E team were expecting us.

When we've been we've gone straight to the children's ward. In our case it was just to be assessed and have treatment and then be sent home the same day. We basically hung out in a private room, had various people come in and do various things, then got sent on our way with open access to the ward for 24 hours after (can go straight back without having to go via GP)

@MinorChef. I’m a GP and I sometimes have to send patients to A&E because the speciality I am trying to refer to don’t answer the phone/bleep, or refuse to accept the referral (rare, but happens with a dick SHO/reg). In both of these cases I make this clear in the letter to A&E an advise A&E directly refer as I’ve already triaged. It’s not because I’m lazy, it’s because I have 10 minute appointments and a waiting room full of grumpy patients stacking up. Realistically by the time I’ve seen a patient and assessed them as needing admission, called the hospital, written a letter and called the ambulance service if necessary, I’m already 25-30 mins into a 10 minute appointment.

Thank you. It's a relief to know that we wouldn't need to go to A&E. Forgot to mention that dd is 16. Is she still paediatric?

In our area the children's hospital / A&E takes children up to the age of 14. After that, they're seen in teh adult hospital.

This has happened with my son and they gave a bed ready for him at CAU.

My local hospital sees 16 year olds in adults A&E.

Our hospital has a paediatric assessment day unit. You would be referred there rather than the ward directly, it’s up to 16 so after that it’s the adult wards.

@PlonkyPlink that's fair enough. I appreciate teams don't always answer bleeps etc. When I was in a&e we'd get patients that were repeatedly sent by the same GP or even letters from GPs assessed "To A&E dr", they were the ones I was talking about- that don't even make an effort to contact the hospital doctor. Not ones like yourself or the situations you've described.

Even if she's regarded as an adult she'd probably be referred to the medical assessment unit at the hospital who could admit or move to a more suitable ward if necessary.

You will go to the Paediatric Ward, sometimes they have their own A&A.

Ours goes to 18

When I've been as classes as an adult via GP - both times I've gone to SAU (surgical) or MAU (medical).

So either way I would think you'd bypass a and e who would only triage as GP anyway.

Update: GP did not refer dd to hospital, but sent her for blood tests and urgent ultrasound scan the following day. Senior radiologist sent us to A&E and dd was admitted there and then. Radiologists displayed mild annoyance at GP not doing things properly, so I suspect were actually more annoyed. Still, dd is getting the urgent treatment she needs, albeit starting 24h later than it would have done, had the GP referred us properly.

When I had that with ds (Gp nearly sent for an ambulance) I was sent with a letter for A&E. Thankfully he recovered before needing to be admitted, but he was seen fairly quickly in A&E.

Oh no jelly she doesn't sound good. Hope she gets support and treatment she needs and makes a swift recovery!