Outpatient appointments

[smilingartichoke]

I remember reading a thread on here a few months ago where a poster had mentioned handing over responsibility for outpatient hospital appointment care to their relative’s GP.

Is this a thing? I’m increasingly struggling to get DF to routine hospital appointments. He lives rurally so it’s a fair distance to the local hospitals. He has dementia, can no longer drive and requires a chaperone. I don’t live anywhere near him and don’t drive either.

He does qualify for free non-emergency ambulance transport however chaperone options are limited to another elderly non-driving friend who in turn has to be ferried some distance to his house either by taxi or another friend. It’s a logistical nightmare and the last 2 attempts to attend an outpatient appointment have fallen through at the last moment as the patient transport has been cancelled (always a risk with this free service).

If outpatient care can somehow be covered by his GP that would be a godsend at the surgery is fairly local.

Have I dreamt this?

I doubt it. My friend's husband was in a wheelchair, had parkinsons and dementia. He was in care home but she still had to book and pay for transport and accompany him to every single appointment. It was horrific for a woman in her 80s who is very unwell herself.

You can talk to GP about whether the hospital appointments are in his best interest.
Will they actually increase his wellbeing in the short to medium term or is it ( sorry to be blunt) trying to manage a long term condition that will likely be cause of death anyway.
It's absolutely fine to come to the agreement that he isn't getting the benefit of hospital appointments or keeping going to just a main one.
Some GPs might pick up some of the management for long term conditions.
I would ask the broad question is this best for him in short / medium term and is this best / will it make a difference in the long term.

Been a Dr for 10y and med student 5y before that. Never heard of such a thing. Some specialties do clinics from gp practices or smaller 'cottage' hospitals, but that depends on who he needs to see and why

Do you not think they have enough to do already? People need to take responsibility for themselves! If your parent isn’t able to manage to the point they can’t even get themselves organised to go to a hospital appointment then conversations need to be had about moving into a care home or sheltered housing which would
be more suitable and would be somewhere where they would help manage hospital visits etc

Sounds like its time to think about assisted living somewhere near a doctors/hospital or even a care home. Or nearer to you. His dementia is only going to get worse.

Or are you saying no longer having specialist appts and letting the gp manage care which is definitely done. Gps can send "advice and guidance" requests if want help with management. Depends ultimately what the appts are for

This tbh. We’ve cut back on the number of appointments an elderly relative was having as they were just to keep an eye on various ailments. It was painful/ stressful for her to travel and was dying (slowly) of something else. We also had a medication review with the GP and cut stuff there too.

I think with the NHS you get put on a conveyer belt of care for each seperate ailment especially when older. There’s no one really looking at the patient as a whole and deciding what’s in their best interest. It was quite straightforward a chat with Gp by relative with medical POA, with a follow up best interests meeting by phone with a nurse and hodpital social worker.

Some care companies will offer a chaperoned transport service but £££s.

When my Dad went into decline, I had a chat to his GP and we put a stop to all hospital appointments, with the GP taking over his full care. Truthfully, they'd been little help for years and involved me taking days off, 60 mile round trips and an exhausted irritable Dad at the end of them. And he often picked something up like a virus. It was very liberating and I only regret not doing it sooner.