How to go about a private GP appointment.

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Would be grateful for any advice as I think my brain has glitched.

How do I go about booking a private GP face to face appointment ? It is for suspected stomach cancer. Is bupa better than Nuffield, do I need to find one that specialises in Gastric or pain relief? Or are they generalists? Google is giving me the impression that I need to book a face to face at a private hospital as opposed to a clinic based GP.

Dh has seen his Nhs GP and has been referred on the two week pathway, but is in pain and needs to know what he is facing. Nhs GP has refused pain relief other than paracetamol and has refused a sick note for his work. Apparently they are two separate issues and need two more appointments - the next available appointment is a month away. He only managed to get an emergency appointment after 2 weeks of daily phoning. Dh was prescribed antacids. He had been referred for blood tests, (2 weeks for results) stool tests (2 weeks for results) and endoscopy. Our local A and E has some of the worst wait times (18+ hours) and understandably Dh would rather be in pain at home rather than on the floor of an and e. The hospital wait for scans which are around 26 weeks.

@Newbutoldfather it has happened all very fast. Dh ticks every single risk factor and symptoms for oesophageal cancer. Scans and endoscopy show shadows in his stomach, enlarged lymph glands in his stomach and the tumour blocks his oesophageal opening and the camera. There are mets also notes in various nodes. (According to discharge notes) Add in two pulmonary embolisms and it’s a shit show. It’s a case of how far along now. The discharging dr who wrote Dh sick note, said it is immaterial now how long I give you as Dh isn’t ever going back to work. The biopsy results are rubber stamping what we all know. It’s not even worth arguing over wether stomach cancer is the primary or oesophageal cancer is the primary. All care is palliative not curative.

there is always hope of a miracle/ Dh will be one of the lucky few. I will fight hard to ensure Timmy the tumour is either evicted or at least kicked into a corner. But I will also bear in mind that quality is much better over prolonging Dh pain. Taking it in small steps - getting Dh through each day.

I have access to a private gp 24/7 courtesy of Dh work. (Oh the irony!).

So very sorry to read these updates.
❤️❤️❤️

When my Dad was diagnosed with liver cancer, he had several mets and they were very matter of fact saying it didn't matter what was the primary/secondaries. Effect of them combined was inevitable. I found it very cold and upsetting at the time but in hindsight it was the best advice to go with the Palliative team rather than chasing rainbows with Oncology. I hope your DH is at least comfortable, OP, and you're managing to stay upright just live in the moment.

Update. Dh is very tired. Lucid when awake but those times are rapidly diminishing from a few hours to half an hour here and there. He thinks he can walk down the street with a stick - reality is he struggles to walk through the house.
mdt meeting today.

I used the private gp - who was excellent. But recommended palliative care/ care at home team/dietician/Macmillan. All things we cannot access until the hospital decide in two to three weeks what happens next. Non of it is available through our nhs gp, the district nurse or by self referral.

The lovely district nurse comes twice per week to dress his pressure sore - something I do anyway as the dressing are not shower proof. Apparently Dh discharge has been flagged as unsafe - I don’t know what that means for him being able to stay at home or possible future hospitalisation. District nurse recommended a few drug changes but our Drs is closed for 24 hours for the monthly staff training! Also until the hospital make up their sodding minds as to what happens next - no palliative / controlled drugs can be arranged for the district nurse to administer which includes at home fluid drip.

we have a working shower now! a new air flow mattress is being delivered today.

I have no idea how the next few weeks are going to be endured by Dh on paracetamol and oramorph alone or even if we have that time. I am so angry which is futile and have so much stuff to sort - getting married invalidated our wills which have to be rewritten, pensions having to be double checked for beneficiaries etc. and I just can’t.

I'm so very sorry OP. You sound like an amazing couple. My thoughts are with you.

I hope the meeting today goes well - do you get to be there to be part of the decision making? Maybe you can push them for the referral to Macmillan etc even if they haven't decided on the rest of the steps yet, because then you could speak to advisers there to get help sorting the practical stuff like the wills etc, which would just give you one fewer thing to worry about.

And pain relief. It must make you so angry that they are just not doing humane things like sorting pain relief, regardless of what else needs to be decided on and however long that takes - pain relief needs to be immediate.

good luck getting the needs and priorities you have across at the meeting, if you are part of it

@BlossomToLeaves no, we are not allowed at the mdt meeting. We have to wait to hear by post in two to three weeks. Everything is literally on hold until we hear in two to three weeks. Our wishes, input, voices are not considered at the meeting.

I'm really sorry you are not getting the care you need. If you have the strength I would contact PALs at the hospital and complain about the unsafe discharge and lack of appropriate care plan for your DH. It is completely inappropriate for him to wait so long for follow up. When my mum was dying I had to phone the hospice and kick up a fuss to get her pain relief sorted. Once they were involved it was much better. I also hired a private nurse who lived in with us and helped us with her care.

The other thing that can be surprisingly effective is to get hold of the name of the NHS secretary of the consultant in charge of his care and phone them directly. Point out that you really can't afford to wait. They can be very helpful getting things moving.

@elastamum was the nurse helpful? I am thinking of phoning around for some private care/home care. We do not qualify for any social services provided help only signposting to other care agencies and diy it. District nurse has advised she would prefer private medical care in this area.

Are Marie Curie able to offer you support? Or maybe a local hospice can signpost you.

@LIZS qe have to be referred by the hospital
for absolutely everything except the district nurse. Hospital will not budge until after the mdt have sent us their decision in two to three weeks.

in the meantime we have to rely on our nhs gp (telephone only as we have cats!!) and district nurse (twice per week visit). They are both lovely and supportive but are also having to wait on the hospital to make a decision as to what next.

This is just crazy - there is an MDT meeting to discuss your OH's care, but you will not hear the decisions for two or three weeks by post? This cannot be real.

I have attended many similar MDT meetings as a medical social worker and someone would immediately afterwards speak with the patient and their loved-ones - it might be me, or a medic, depending on what might be most appropriate, but we certainly would not have been leaving someone in pain while the hospital bureaucracy ground slowly to produce a letter.

I do understand that at the moment the last thing you want to be doing is taking up the cudgels to fight for his rights, but this is all you can do. I did all this for my late OH - as well as dealing with the misery of his illness, I also had to battle on his behalf. It is so fundamentally wrong.

Speak to PALS, the practice manger - lodge a complaint - the local health trust, and your MP. Honestly there is no other way - been there, got the T-shirt. It makes me want to weep. My late OH was a doctor and would just not have let this happen to one of his patients.

So sorry you going through this.From my experience often they will contact you promptly after a mdt meeting if it is appropriate to start chemo/radiotherapy. Really hope you get some answers soon.

We had specialist palliative care nurses from Consultus Care and they were really good, but expensive. My mum wanted to stay at home and I had small children at school so couldn't stay 24/7. They stayed with us for about 8 weeks and lived in the house. Because they were qualified we managed all her care and drugs ourselves.

@Mischance
unfortunately it is very much true and feels like a horror movie. I wish it wasn’t. The GP thinks part of our problem is that we ‘look’ young and able and we are just under 60 (by mere months). If you put us up against two 85 years olds in the same situation with limited resources - who do you help? Then it us?

Everyone assumes we have family - we don’t. This is a consequence of being born to ‘old‘ parents - parents are all dead as are their siblings, and you either have no siblings yourself or they are also dead. We couldn’t have children of our own. No family to help. Healthcare officials are shocked when they realise it is literally just dh and me.

yes I should put in complaints. But Dh doesn’t have long as he currently is. I’ve spent days sorting out finances, pensions, wills, getting married, medications, new allergies that he has, laundry, moving furniture, cancelling buying a home, work sick notes, cars, household bills, getting a shower installed. That’s taken me everyday to deal with since he’s been home. I do not want to waste anymore time that I could use to just sit with Dh and cuddle him and just be in the moment with him. It’s taken me from 6am till now just to get him showered and dressed in day clothes downstairs. He’s now asleep and I’m having a sit down before I tackle the Gp pharmacy for a change in the anti acids that he’s now allergic to….

@elastamum oh thank you and I’m sorry if I’ve brought back memories that I shouldn’t have.

I will add them to my list. Sounds very good and appropriate for us.

Hope I can be of help. It's a few years ago now, but my mum had the best ending she could. She went peacefully at home surrounded by her children. We were very lucky that we were able to buy in the help we needed to keep her comfortable.

@elastamum i admit I’m having a shaky day whilst Dh is having a good one for him. You are fab and a great help. In fact everyone her is just by allowing me to vent and write it down. It helps get me stable again. I can deal with practical stuff. Emotional stuff not so much. And this is emotional.

I know it's really difficult getting the help you need and time consuming but you could ask the district nurse to speak with the palliative team and the gp, your dh does have a say in his plans, he may also qualify for fast track chc funding which the district nurse or MacMillan team can arrange, that way you would get carer help. Whoever is saying it was an unsafe discharge could be for several reasons, if the hospital and discharge letter say he is for palliative care then the hospital palliative care nursing team should have been involved, so sorry you are both going through this at a time when you just need support.

@TraitorsGate i asked all this from the district nurse yesterday. The answer was it all has to be from the hospital. The hospital have to refer us to which ever services they see fit, we cannot ask for what we think we need. No one else and do it. The hospital will let us know in two to three weeks from the mdt meeting today. And we just have to suck it up.
The district nurse said Dh discharge had been discussed as unsafe. Wether that was just a discussion between them or someone else I don’t know.

Really sorry to hear that, it sounds really unhelpful and not what you need to be fighting against. It's disappointing that his nhs gp or even the private gp can't get more involved and at least prescribe medication if he needs it, do a home visit or refer him to the community teams.

@TraitorsGate it feels very ‘1950 consultant knows best,’ in our health care trust.
silly me for thinking we lived in 2024 and we were less class/gender orientated.

two phone calls to gp pharmacy so far today. They are adamant he’s on famotidine, when his notes clearly say it’s been stopped by the consult and he’s been prescribed lanzaprazole which the district nurse says he’s definitely allergic too and needs replacing with another anti acid, the pharmacy even read his notes back to me, yet still insist he’s on famotidine and I am giving him non prescribed drugs!!!
It’s utterly wierd and all a bit twilight zone?

I'd be phoning the ward/ oncology secretary - we always got a phone call within 2 days after the MDT meeting. Have you phoned your hospice direct and spoken to them ? They might be able to push the hospital

@notapizzaeater yes and the same answer.