NHS Nightmare with GP surgery -- suggestions?

[Ippagoggy]

My 3 year old son was recently made a referral by our GP to a paediatrician. This has turned into an administrative nightmare of unbelievable proportions. I'm looking for constructive advice on any of the following:
(1) how to work the system / (2) how to complain / (3) how to make a change so other people don't suffer through this.

In short, our GP has attempted to make 3 referrals to a paediatrician and each time there has been something wrong with the referral. I have pasted in my latest correspondence below with the surgery so you can see how ridiculous this is. I truly cannot believe how broken the system is. (We live in South West London). For the time being I've redacted the surgery's name.

Hi <GP SURGERY>,

Can you please urgently help me sort out the below referral? As you can see, my 3-year-old son, <SON'S NAME> was referred to the Ham Clinic for a paediatric consultation. I got the attached response from them saying that they cannot accept the referral and that we should "urgently refer him to a hospital paediatrician". Can you assist? This is very distressing for us as this is the third time I have had to speak with <GP SURGERY> regarding the referral.

(1) The first time the referral was made to "Richmond Royal" (a hospital that no longer exists or has at least temporarily closed down and from the looks of it is a mental health hospital). I spoke to <MEDICAL SECRETARY 1> and she agreed to reissue the referral.
(2) The second time the referral was made to Centre House -- which when I called them to see if they had received my son's referral said there was no way that could be right as they do not handle paediatrics.
(3) The third time, I spoke to <MEDICAL SECRETARY 2> at <GP SURGERY> who was very helpful and said that the referral in (2) was indeed wrong, and she very quickly redirected the referral to the the Ham Clinic. Ham Clinic have now responded saying they won't accept the referral and we should urgently refer XX to a hospital paediatrician.

I am really at the end of my tether, can you please have a word with Dr. <NAME REDACTED> or one of the other doctors so that my son can be seen a hospital paediatrician as the letter indicates? I don't want to have to go through another 10 phone calls back and forth trying to get this sorted. Each phone call often involves no less than 20 minutes of queue time.

I would also like to lodge a complaint : I don't know who the fault lies with, but you must agree with me that it CANNOT require this much effort from worried parents to chase admin teams up and down the town to get their 3 year old son seen. That the referral should be wrong THREE times cannot make sense. You have to agree that the above sequence of events is extremely poor. I want a correct referral issued to hospital paediatrician, please.

Regards,

Given what I see and hear what is going on around me in the south west of the UK, I think the NHS is literally falling apart.

The person to complain to is the Practice Manager but I wonder if it less incompetence and more that the GP is wrestling with changes. Are these two links any use? I'd be phoning up the hospital direct. Good luck.
https://www.stgeorges.nhs.uk/gps-and-clinicians/referrals/urgent-referrals/
https://www.stgeorges.nhs.uk/service/childrens-services-2/

https://www.stgeorges.nhs.uk/service/childrens-services-2/

Second link.

NHS providers have always needed to reject some referrals, the key thing is they should reject quickly & your GP should be finding the right place to refer to quickly. OP shouldn't have to do this chasing at all.

How long ago was the first referral? Is it a routine urgency (status) referral?

If this is on the routine pathway then the wait might be so long that a week or 2 delay means little wrt total wait to see a pediatrician.

The initial GP appointment was about 7 weeks ago. I have no problem at all with the idea that a consultant may reject a referral (eg to demand more blood tests etc) or that it could take time to process / wait for an appointment. Our daughter has been waiting 9 months to see an ENT (for a non urgent issue) but that’s okay because I know it’s coming and it’s in the diary.

But what I cannot wrap my head around is that the first 2 referrals were just WRONG — that the first was sent to a defunct mental health hospital (all numbers disconnected both on the referral form provided and through googling) and the 2nd clinic had no paediatrics unit so my son wouldn’t even be eligible to see them.

How can my GP surgery or the system they are using be churning out these kinds of referrals? Bananas.

My son is “lucky” that he has parents who know how to use the internet / make calls to advocate for him and chase these things. But what if we were old with poor technical skills or differently-abled or vulnerable in some way? I fear he would never get seen at all…

This is why "restructuring" and "organisational reforms" are so bad for NHS. It literally leads to this kind of confusion (among other ills).

Practice manager is who you take complaint to, I imagine. At least I suspect they handle complaints and that it's in their remit to make sure that GPs on duty have the right information about referral pathways.

Have your son's needs progressed from routine status to urgent?

Is the GP handling your son's referral a locum ?

The more you see if the NHS, the more you see the positives and negatives. In 14 years of being a 'hospital mummy', we've had over 250 appointments and lots and lots of lovely consultants who have been brilliant. I've also made 2 formal complaints about dangerous procedural errors (one of which nearly put my son in a coma) and complained about 3 consultants who treated us very badly. I've found that as a parent it is key to keep on top of appointments and to know about the conditions your dc have. I have been interviewed by medical students on several occasions and hopefully passed on the importance of listening to parents to them at the start of their careers.

Do get in touch with the practice manager to help them resolve this quickly for you. Ask them to review their referral pathway list and speak to the GP involved. Then ring the hospital, ask for the consultant's secretary and tell them you will take a cancellation.