post operative duty of care ?

[hobbgoblin]

My father has been discharged following a hernia operation and was, as usual, given the number of the ward to call if he experienced any problems post operatively. Well, he seems to have some reappearance of one of the hernia so we encouraged him to call the ward. He was extremely reluctant to do so and possibly trouble the staff so we had to do a bit of convincing that it would be fine.

Anyway, he has phoned and been told to contact his GP. He was discharged on Saturday. He is very worried but also really lacking in assertion. The GP failed to diagnose the second hernia apparently so my father has little faith in contacting him about something so surgery specific yet every faith in him as his GP.

Who should be the port of call for such a symptom, or indeed any post operative difficulty given that the GP surgery has only been open today since surgery took place and my father was discharged? What does NICE say? I have Googled but none the wiser.

It is the usual procedure AFAIK, they do say to call the ward if any concerns (they may give advice over the phone for simple queries) but in reality the GP would need to refer back to the surgeons if a complication seems to have developed.

The Out of Hours GP could refer back if the surgery is closed.

ok thanks

sorry for delay but my home internet has disappeared! am just hopping on sneakily at work

You should be able to ask to speak to the duty doctor (at GP) over the phone, who will tell you where to go and tell them you are on your way in (if he cannot wait to be seen). If the hospital he was treated at has a minor injuries clinic then that would be an option as well. The GP will err on the side of caution this time, and almost definitely send him to be looked at.

To the more general question - I think a lot depends on what operation has been done. Quite a lot of surgeries are done as part of treatment for a larger condition and therefore there is a care team/ nurse practitioner you can call. If there are serious side effects possible then you also get a support team, phone numbers and GP bypassing. However, for minor ops like hernias where it is not connected to another condition and even if recurs is not life threatening, then he will have to go through the GP channel. It isn't a one size fits all solution so I would be surprised if NICE have a policy (for example, even minor ops in vulnerable people will probably be treated differently than in those able to assess their own health).

You did the right things ringing the ward cos you are given a number to call but I don't see the point of the ward giving you a follow up number if they just tell you to go to GP.

All the wards I've nursed on have told patients that once they are discharged to ring GP or go to A&E if necessary. Problem with ringing ward is that the nurses would be limited what advice they could give you and it would be nearly impossible to get a ward dr to come on phone and talk to you.

Hope you get things sorted...