OP this is from ChatGPT
Here’s exactly what she should do next, in priority order.
1. She needs a
named consultant paediatrician
(not GP, not “waiting list”)
If she hasn’t already been seen by a hospital paediatric consultant, this is the block.
She should say (verbally and in writing):
“My child requires review by a consultant paediatrician. This cannot remain in primary care or administrative waiting lists.”
If she has seen one, she should:
- get the consultant’s full name
- confirm they are responsible clinician
This matters legally and administratively.
2. Force a
tertiary referral decision
(yes or no — documented)
She should email or write (copying PALS):
“I am formally requesting an urgent tertiary referral to Great Ormond Street Hospital for genetics/endocrine/metabolic assessment.
If this referral is not being made, I require the clinical rationale in writing.”
Doctors hate putting refusals in writing without good reason. This often flips the decision.
3. Ask for
Advice & Guidance to GOSH
(this is key)
Even if they won’t refer yet, they can and should do this.
Exact wording:
“If a full referral is delayed, I’m requesting Advice and Guidance from GOSH to determine urgency and interim management.”
Advice & Guidance:
- goes consultant-to-consultant
- often results in GOSH replying: “Please refer urgently”
- bypasses long waiting lists
4. Escalate beyond PALS →
Clinical Director
If PALS isn’t getting traction, she should ask PALS:
“Please escalate this to the Clinical Director for Paediatrics.”
This is the consultant’s boss. That gets attention.
5. Make a
formal written complaint
(not just PALS)
This is different from “raising concerns”.
She should submit a formal NHS complaint to the Trust stating:
- child is 2 years old
- weighs 5 stone
- poor intake
- 14+ weeks waiting
- no tertiary referral yet
- risk of harm due to delay
Formal complaints trigger:
- deadlines
- senior review
- written responses
6. Contact the
ICB (Integrated Care Board)
This is the body that commissions care.
She (or PALS) can say:
“I believe my child meets criteria for urgent tertiary referral and this is not being actioned. I’m requesting ICB involvement.”
ICBs can override delays.
7. Last-resort accelerators (they work)
If she’s still stuck:
a)
MP letter
A short email to her MP:
“My 2-year-old has extreme medical needs and NHS delays are preventing specialist care.”
Hospitals respond fast to MPs.
b)
A&E if deterioration
Not dramatic — appropriate.
Admissions force senior reviews and same-week referrals.