GP Surgery being a nightmare.

[stressedandconfused1]

I posted this on chat earlier for traffic but I figured that this board was more likely to have people who see their GP regularly and may have had the same kind of problems.

I have recently received a letter from my GP surgery stating that my insistence on seeing my own GP and repeated attendances at the practice are causing problems for them - not that frequent, maybe every other week. Which considering that my most recent exacerbation nearly landed me in ITU doesn't seem that bad!

I just wondered if anyone could tell me what my rights were with regards to picking which GP I see and accessing appointments when I need them.

Just to add a bit of background, I have a chronic health condition that lands me in hospital on a relatively regular basis. I manage it at home as far as possible but when I really struggle I tend to see my GP several times when I'm going downhill before I eventually end up in hospital. The reason I choose to see my own GP is largely due to mistakes that have been made by other GPs in the past leading to me becoming unecessarily unwell. When I am well I'm barely ever there, I just cost them a small fortune in drugs!

Can anyone offer me any advice on what to do? I would be very grateful.

I was a Practice Manager for many years at numerous busy Surgery's in London and I cannot understand what the Surgery's issue is. We had patients such as yourself and accommodated them.

How many doctors are there at your Surgery? Who sent the letter was it the Practice Manager or your GP/ a GP? If was the Practice Manager I am wondering if the GP even knows the letter has been sent. Unfortunately some Surgery's employ Practice Manager's with no clinical or NHS background. So the Practice Manager may not be aware that it was an inappropriate letter to send.

I would make an appointment with your own GP to discuss the situation. If you cannot get an appoitnment put it in writing to them explaining the issue.

If it cannot be resolved I would register with another GP preferably with a small Practice or better still a single handed GP. A GP colleague offered to my GP using a friend's address he is single handed so I get continuity of care. I am an enormous huge fan of continuity of care :) If there is a a Practice you would like to be registered with that is just outside the area where you live there may be around this by kicking up a bit of a fuss and asking your CCG to allocate you.

I am happy to guide you through this but do contact your own GP first.

Hi Honeybee,

The letter was sent from the head GP (not sure what you call them?) and says to make an appointment with the practice manager and himself to discuss these "problems" that are being caused and that it is himself and his "partners" that have the concerns. The letter doesn't elaborate on what these problems are.

There are 5 doctors and a nurse practitioner at the surgery. 3 of them have made mistakes with my condition that have put me in hospital (including the head GP), 1 is the GP they are saying I cannot request to see and the other GP is lovely and competent but impossible to get an appointment with.

I may have been a pain in the backside for the last couple of weeks ringing and trying to make appointments with my own GP and may have got over emotional a few times but I was really quite poorly and none of the GPs I was seeing were listening to how poorly I was getting. A couple of days I rang twice as different receptionists often give different answers as to whether there are appointments available.

I am pretty sure my own GP doesn't have a problem with seeing me as she has asked before that I request her. She says it is easier to treat me first off than to pick up the pieces later when someone else has made me poorly.

However, it seems as though the receptionists have been told not to give me an appointment with her. I tried to make appointments twice last week and was refused. I'm worried that by writing to her directly and asking her to back me up I would be causing her trouble? I understand that it's her job and she has to pay a mortgage etc so cannot afford to upset her colleagues.

I am assuming that I don't have much choice at this point but to attend the meeting, but I'm not sure what to say once I'm there.

Sorry if this is a bit of a ramble. I'm just completely confused about where I go from here and if I'm going to cause my own GP more trouble by writing to her directly.

Very grateful to you for taking the time to reply.

x

Does your GP know about this letter?

Could you request a telephone appt with her to discuss this and how to manage appts with her in future? For example rather than dealing with the receptionists would your gp agree to you contact her by telephone and her arranging an appt ?

I doubt you would cause your GP any problems by contacted her by letter.

To be honest you should not be discussing clinical issues re your appointments with a Practice Manager. That is not good practice at all.

I would make a routine appointment with your own GP or ring her to discuss this. Depending on the outcome I would be tempted to say you need to make a formal complaint and possibly register with another Surgery. I suspect your GP is a salaried GP rather than Partner of the Practice? Salaried GP are employed by the GP Partners in the same way a Medical Secretary is. If this is case then she will not have much say in the running of the Practice and you may well need to register elsewhere. I would pick a small Practice preferably a 2/3 GP Doctors Surgery or even better a single handed GP. I can give advice on this later if necessary.

See or speak to own your GP on the phone. I personally do not think the appointment with the Practice Manager is appropriate this is primarily a clinical issue so I would avoid that and go straight to you GP. You can ask her if she Salaried or a Partner she will not mind.

Ok - I will try and do that next week. I have just come out of hospital so I need to see her anyway. (That's if they'll let me have an appointment with her!). I've had another look at the letter and it comes from the head GP partner but I have no idea who actually wrote it because the signature doesn't look like his and there are loads of typos in it.

I have also asked my consultant to write me a letter explaining his views on how important continuity of care is and what a good job my GP does. He's said it before so hopefully he won't mind putting it in writing. I thought this might make them think twice. I am assuming the more they land me in hospital the more it costs them to look after me?

I'm trying to avoid having to move practices because my actual GP is fab!

I may be back with a few more questions next week if I don't have any joy with my own GP. I think it might be difficult for her to go against the practice management if she is salaried and I don't want to put her in an awkward position.

Thank you again for your help.

My DH has a chronic condition and always goes to see the same GP (unless timing is a factor, in which case he obviously goes to see one of the other GPs in the practice - e.g. recently had to have a repeat blood test within hospital timescales and our GP was on leave).

Irrespective of whether the other GPs have made mistakes with your case (which I'm not disputing) you will receive better continuity of care with a GP who knows you and knows your history, rather than having to recite a complex history to a GP who's trying to read the bare bones of it off the computer at the same time. In fact this is my practice actually recommending you see the same doctor on each repeat visit, in order to ensure continuity of care and to minimise the time taken up in the appointment gathering the patient's history.

It sounds a bit like the reception staff may have complained about the frequency of your calls and the senior partner and practice manager have decided to respond in a way that is disproportionate based on what you've written here.

Given you are ill, upset and on the back foot due to this being their place of work and not yours, I think it would be extremely unwise to meet them on your own - you need someone who can advocate for you. I would suggest that you need to have someone with you in this meeting, if it goes ahead. But you should also:

• make contact with your Patient Advice and Liaison Service (PALS) at your CCG (have a look here for your one if you don't know which CCG covers your area)
• have a look at the CCG's complaints procedure (here's my one)
• make clear in writing that you are following the instructions of your GP, who has asked you to request her (noting reasons of continuity of care etc)
• note in the same written statement that as per the NHS Constitution 2013 (page 9) 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".

If your condition is such that you can wait a bit longer for a routine appointment if it's with the right GP (which of course it may not be when it's going downhill) I'd strong advise getting an online account to be able to book your own appointments.

Overall, however, I'd be looking to move surgery.

Feel free to get back to me any time. However I do think you need to talk to your GP to find out exactly what the situation is. It is an excellent idea getting your Consultant to write the letter.

My worry is this a clinical issue and if you cannot have continuity of care if you are hopping from GP to GP and are you are not going to be able to see your GP. Talking to the Practice Manager about a clinical issue is just not appropriate.

Changing GP is daunting, last year our small village Surgery was taken over by a 16 doctor Practice. Never in a million years was that going to work for me which is why a GP colleague who is single handed is now my GP. Yes I have been a similar situation to you changing GP is so very stressful but the best thing I ever did. I love having a colleague as my GP. I have to say its even better than my old GP. There is light at the end of the tunnel.

If you need me for any help urgently message me if goes to email on my phone.