Can a GP tell me please - this is 'standard' for my GP to have included in a Referral?

[54isanopendoor]

I am rural Scotland so not much choice of GP.
My GP for the last decade is the person who is Head of our small practice.
I've thought her good to date. However, last year she went on holiday & forgot to refer me on the 2W pathway for suspected breast cancer. She was later quite dismissive about it as 'it turned out you don't have cancer so no harm done'.
I recently asked for a re-referral for a long standing mobility issue which has now worsened. Again there was an long odd delay & the GP told me I'd been referred a whole month before the Consultants secretary confirmed I had. Therefore I asked for a copy of the referral letter as I'm losing confidence in my GP a bit.

The letter gives the reasons for referral & current meds. Alcohol units/tobacco/excercise is all blank but my BMI is listed as 10 points higher than it actually is.
'Past procedures' lists the operations I've had (all relevant to this referral) +IVF.

'Past medical history' is the bit that's upset me. It lists my attempted overdose. (80 aspirin + alcohol. There was no alcohol involved) This was in 1988 !!
Is this relevant to this referral & should this info have been floating around reception? I say 'floating' as I've previously told the GP that reception not appropriate with medical info & she laughed & said: 'it's a small village, people will talk anyway, what can I do?' Letter was loose (no envelope) & unsigned.

I appreciate that I am sensitive about this but could any GP / HCP tell me if this is standard or if I would be within my rights to ask the GP to be more sensitive too?

It's unlikely to have been actively/deliberately included in the referral by the GP, but rather the computer system just automatically populates the past medical history section with coded diagnoses. If it's information that you wish to be withheld on future referrals then you can tell the surgery this. They shouldn't be being so dismissive of your concerns with regards to privacy. It doesn't take much for them to simply put the letter into an envelope to be more discrete.

Any referral includes past medical history, basically anything that is coded onto your medical records

Most referral letters include a summary of what is on your medical record. The GP wouldn't have chosen to put that on that particular letter. It's just standard to include a medical summary. The BMI would just be worked out on the latest height and weight your records contain.
The overdose reference would have been coded and lifted directly from a hospital letter. The GP coders will accept what is written is accurate.
All practice staff have to abide by strict confidentiality rules and if they don't they risk dismissal. However I can see the difficulty of working and living in the same small community.

Lots of Referrals are just automatically populated by computer.

They tend to come with a long list of every problem you have ever had, some of which will be wrong and almost all will be irrelevant.

In Healthcare you get very good at skimreading.

Oh and anything from 1988 will have been transferred from paper notes so is even more likely to be wrong.

Nobody has the time to look at stuff that far back.

@pbdr @chocolatenutcase @Elephantino @AnnaMagnani

Thank you for responding.
I didn't mean to imply that the GP had particularly chosen to include information from 1988 (but I cannot see why it is relevant & even if 'selected by computer', someone is programming that computer to print certain info)

It is important that information on medical records is accurate, especially if it is repeated as gospel so the inaccuracies become entrenched.

I previously reported to my GP that I had overheard 2 receptionists gossiping about a medical procedure I'd had & that one had discussed it with the local chemist (it's a very small village & the chemist is the sister of the receptionist).
The GP just laughed. She thinks I'm a bit precious because I said No to a recent 'student' in my appointment. I never say No to med students as its how they learn but this student was a 6th former in my own Ds' class which was really inappropriate I thought. I will ask for medical info pre-1990 to be excluded & see what she says. I'll also ask for my BMI to be recorded accurately too.

@54isanopendoor I think I would decline having a class mate of my DS in on my appointment too! Completely inappropriate.
Your GP does sound rather blasé about confidentiality and sounds like the staff are too.

Hmm, the referrals I send only include relevant information for that problem, the referral itself and the consultation(s) had with the GP regarding the problem, never a medical summary unless specifically asked for by the specialist.
And you're GP sounds terrible and exceptionally unprofessional.

Your coded medical history is essentially a list on your file. When they include past medical history it would pick up everything in the list. No one would select which items to include unless it was a free typed letter.

What do you mean by floating around reception? If you're meaning should it be the case that staff other than the GP were allowed to see the letter then yes that's normal. No one should go out their way to look at your file, but unless it's a close relative anyone who works there could see it.

I recently had a referral and it listed every reason I had seen the GP since I was registered there. Loads of it was irrelevant! It was a new GP so maybe they are just doing it by the book.

I work in a service that receives referrals - and every one from a GP practice has the same layout of initial problem followed by every medical problem they have had in their lives and everything they have ever been prescribed in their lives.

Am not even sure the GPs know their computer systems always do this.

A 6th former sitting in on a private medical consultation is always going to be inappropriate, never mind one who knows you. The practice's attitude to privacy in general seems weird as well as wrong, even for a rural practice.

Inaccurate data on health records is also an issue. "Computer sez" isn't a justification or a reason for something being right, it should be questioned in the same way that a human action should be questioned where needed. The full history may be required but it should at least be accurate.

I'm only an HCA but we get yearly updates on confidentiality and to me it seems that your gp practice is too lax in its procedures.
Ask to speak to the practice manager.
Obviously, if the practice manager is your gp then you may have a bit of an issue.

@lookingforMolly The Pratice is way too lax on confidentiality yes.
Unfortunately my GP is Head of Practice.
I know of 2 other folk who have complained (about this & other matters) and both were then 'de-registered'.

This thread has helped me clarify that I have 3 concerns:
1: lack of confidentiality.
2: referrals are not made in a timely manner (later obfuscated & outright denied)
3: this recent referral includes an incident from 1988 but not my recent (2018) surgery & results (eg I need ongoing hospital iron infusions & B12 injections). It is helpful to know from other posters that the referral forms are populated by computer but I would like my GP to make sure recent relevant information IS included if it's supposed to be a 'catch all' of procedures & general health.

I will write to the practice manager outlining this & see if I can find another local practice but it is very difficult around here without moving house (tried 5 yr ago)

If I'm stuck with this practice does anyone know if there is a Body to advise?
(I'm in Scotland & don't know if the GMC etc covers whole UK?)

@C8H10N4O2 Yes. I'm in Scotland but previously worked in England briefly for the IAPT system. I was a lowly Psychological Wellbeing Practitioner but part of my job was to assess patients using a set NHS criteria, 'score' them & then write to their GP advising whether I considered they had Generalised Anxiety Disorder or were experiencing an Episode of Clinical Depression I was well aware that it was important to be accurate as once something is on your medical records it is hard to correct (& can also affect insurance / employment etc). The company I worked for did NHS contracted out work & were awful with GDPR (fined). I left as I didn't want to work somewhere so sloppy & disrespectful to patients.

I may be wrong but aren’t all referrals now done via closed internet system. We use a system called Rego which means no written referrals are necessary. We automatically send an email version to the patient if they have given permission. All interaction is now done via Rego. I know that in England it’s all done by internet and they have recently added the 2week referrals to the system.
If your GP uses this system then a paper referral would not have been floating around unless it was the copy you requested.
The system, although good, does have some issues. It can take a few weeks for some referrals to be processed by the hospital or clinic you are referred to. Unfortunately the NHS is under huge pressure ( a phrase we are encouraged to use) and urgent and 2 week referrals go to the top of the queue.
Check with your GP what system they use and their policy regarding confidentiality. Check CQC inspection to see if any issues were flagged. If it is something that is a well known problem then CQC is your first port of call rather than GMC. The GMC route is very slow. CQC will react quickly and can do short notice ( 15mins in some cases) inspections if they feel there is a need. The CQC provides a wake up call to all staff if confidentiality has become lax.