very angry at GP practice

[Purplecatti]

I found out I was pregnant about a month ago, after being sat in silent shock for a few hours I worked out I was about 9 weeks along.
I went to the GP, she didn't understand why I had booked an appointment when I should have gone to reception and booked a midwife. I've never been pregnant before and didn't know what the protocol was.
I did book a mw appointment and that was supposed to be yesterday. It wasn't at my practice it was at a health centre on the edge of town.
I turned up yesterday morning, the receptionist said the mw hadn't arrived yet and to take a seat, I did.
30 minutes after my appt was supposed to start I went back to reception to see what the delay was. The receptionist was surprised the mw wasn't there and rang to see what the problem was. She was told the clinic had been cancelled, the receptionist asked if I could book another appointment and they told her next week's clinic was full and the week after that had been cancelled. At this point I said I was almost fourteen weeks pregnant and I was going to have to see someone at some point. The receptionist repeated this (she was nothing but pleasant) and they told her there were no future dates available and hung up on her .
The receptionist was very sympathetic and luckily had a cancellation at their practice and booked me in as a temporary patient.
The thing is I'm fuming. How dare my GP practice treat me like this, I am complaining on the grounds I wasn't told my appt was cancelled, the health centre wasn't told and there was no alternative provision offered to me.

I'm also worried, how will this affect future appts? If I go to this appt at the nice place that's really hard to get to will that screw up future appts at my practice?
Of all the things I thought I would worry about, it wasn't this.

Write a letter of complaint and change GP practices. There should be more than one covering your postcode.

You have every reason to be angry. The way you have been treated is shit.

What on earth are you supposed to if you had a crisis with your pregnancy?

I think you need to make a formal complaint. A GP should be able to do a basic ante natal check. In many parts of the country GPs still do shared care.

I'm failing to see how this is the GPs fault. I agree wasn't great for the initial consultation to be so dismissive but hardly your GPs fault that the midwife had cancelled her clinic and not told anyone. You should have access to the local supervisor of midwives who can arrange an appt asap

Reallytired - I am a GP and all routine antenatal care is arranged via midwives, I have no access to the handheld notes and certainly not the time for the 1hr home visit that women get for a booking appoitment

I was under the impression from both my practice and the nice receptionist that the clinic was run and organised by my practice, apparently this isn't an isolated incident.
It is the practice I was going to complain to, I wasn't going to mention the GP, as yes, it wasn't their fault at all.

hello op, that sounds like a rubbish start for you, i'm sorry.

If i were you i would separate out the gp's initial rudeness from all that has followed, i don't think they are related. The GP shouldn't have been off with you, but has no control over the mw clinics...

My experience which is that the mw's messed me around too- cancelling apointments, not telling me about this, having no room for new appointments, never returning phonecalls etc. (I have a great GP & GP practice but made no difference at all).

In the end i decided the only way forward was a formal complaint to the head of midwifery- who then told me that they knew this particular team was poor, said there had been a lot of changes and new appointments within the team and 'lots of training needed to be reinforced' etc so they had just appointed someone to go in and try and get them up to speed.They also apologised and offered to place me within another team in a different area that were not struggling. If i hadn't complained i would never have found this out or been offered an alternative, would have struggled on.

Sadly my baby died at 20 weeks in the PG, so I never got to test out whether the new mw's were indeed more capable, but from what the head of midwifery told me they are well aware when teams are doing badly & will change you over if you ask.
Good luck with your PG , i hope things get better from here.

"Reallytired - I am a GP and all routine antenatal care is arranged via midwives, I have no access to the handheld notes and certainly not the time for the 1hr home visit that women get for a booking appoitment"

A GP has OVERALL responsiblity for health of their patient. A pregnant woman is far more than a baby incubator. Pregancy puts a strain on the physical and mental health of many women.

It is their DUTY to make sure that the woman has ante natal care. GPs are paid a hell of a lot of money because they are responsible. The GP should take up the matter with the supervisor of midwives. The primary team should see to it that between them the woman gets ante natal care she needs.

I do not expect a GP to do a booking appointment, but there is no reason that they cannot test urine, arrange bloods, measure blood pressure if it is really impossible to get hold of a midwife. Lots of areas do shared care. How on earth is a patient expected to know that ante natal care is only provided by midwives. If the GP doesn't want to do ante natal care then its up to the GP to create contact the supervisor of midwives and merry hell about all the cancelled clinics.

It is certainly out of order for a GP to be rude.

With DD1 my GP saw me first and congratulated me .

Then she explained the process and we went from there with me understanding what would happen next.

With DD2 i was more au fait with the system and went straight to the midwife.

Women who are pregnant for the first time are excited/scared/happy/impatient/worried and many other emotions. It would be nice if this were recognised rather than simply 'expecting' them to know what will happen.

As i said, i had a lovely GP and was very pleased and reassured to see her first (even though in essence she then just passed me over to the midwife)

Purplecatti like you I was unsure as to who to see, but due to my gp having a system where you need to ring up at 8.00 to make an appointment to see a doctor that day, I opted to see the nurse, who confirmed my pregnancy and then told me to make an appointment with the mw. I thought it was best I saw someone ASAP seeing as I was going to the USA two days later!! Upon returning, after I seemed to have seen ever midwife my local pct could offer, it was just never the same one twice, all ver nice, I know see a lovely midwife each week. Fngers crossed for you that you also find that yo have a lovely team of midwives around you. xx

Goes to show it varies from practice to practice. I tired to book into see the midwives directly but had to go via the GP who then referred me. I was told to contact the practice if they didn't contact me. GP has shared my care all the way, even thought midwives are great.

Sorry you've had a poor experience OP. Do make sure you complain & get it sorted ASAP. Sounds awful.

It is the clinic you need to complain to. No one else is at fault.

You should have access to the local supervisor of midwives who can arrange an appt asap

How the feck is the average Joe supposed to know this? FWIW, here you have to see a GP first and get a referral from them to a midwife, so it's not like protocol is obvious??

OP, I'm on your behalf, what a faff.

Oh my goodness, what a horrible way to be treated. All the things you read tell you to make a GP appointment with your first so they can refer you. Thats exactly what I did and the GP took time to explain the process, what happens and when. I expected this was just standard.

I would def complain. Is there another practice you can join instead (I know it's difficult if you live in a rural area but towns you should be able to find elsewhere)

It does vary from area to area, & each GP practice/maternity care provider seem to do it differently.

FWIW, with my first (DD) I went to the GP early-ish (5wks) & found out what to do thereafter from them. There was NO way I'd tell the rude receptionists why I was there in the first place. At 8wks I saw 1 MW at my practice, then saw another MW for the nxt few appointments, again all at the practice, then saw a 3rd & final midwife who saw me for various appts & at home after the birth. The booking in appt was maybe 30mins long & NOT at home. If my DD hadn't arrived on time, I would have seen the MW at the new sure start/childrens centre, where apparently all MW appts happen now.

This time I phoned & asked the receptionist (new & MUCH better GP practice) & I still have to see the Dr, I can't self refer to the MW. I believe that all MW/community care is now provided away from practices, although you may end up seeing the MW/consultant at the hospital if you are higher risk.

OP - In short - you weren't to know ANY of this before, esp if 1st pg, & as each area differs, & it can all change quickly too (my DD is only 23mo) and it was unacceptable for the clinics to be cancelled without notifying you or providing an alternative MW, even if it was a diff one to the one you see for the rest of your pg. The GP practice should be providing you with information/support, even if they literally cannot provide the care themselves. I think you've been treated v poorly. I personally would be concerned that no referral for the growth/NT scan had been made & the 'window' would have been missed.

I hope it works out better soon.

what a complete usless system!!!
if you wanted nuchal fold at your scan etc you would run out of time if the midwife dosent see you until after 14 weeks!!
I would be complaining too about the whole incident weather you should or shouldnt see gp at your partiqular practice theres no need to be rude to you they would be out of a job if the aversge jo bloggs knew all the answers!!
I hope you are getting somwhere with it all!!????

Well I have an appointment with the friendly practice on tuesday. It was the only thing I think I could have done really. I just hope everything is progressing normally. I'm addressing my letter of complaint to my preactice manager saying if it isn't them who organises the clinic can they let me know and I will redirect my letter.

Sorry you've been sent around the houses a bit Purplecatti, I feel your pain! Like you say, nobody knows the protocol for first babies and it's so frustrated being treated in this way. I found there has been a total disconnect between the GP and my team of midwives all the way along - they have no idea how each other operates.

Other than the 1 pager of appointments at various weeks in the maternity notes, there is no obvious place to start with 'here's how your care is organised and what you need to know, and what you have to do at each appointment'.

When I asked things about how to contact the midwife at my GPs, he had absolutely no idea. I also assumed (wrongly, I found out this week at 35w) that the team of 6 midwives I was assigned to meant that one of them would be delivering my baby. It seems that the midwives that work in the clinic or visit you at home are very rarely at the hospital and the baby will more than likely be delivered by someone outside of this group that I've never met.

I don't understand how it can be so difficult to produce a simple guide to maternity care / pregnancy online according to your area/trust. It SO doesn't need to be this complicated and all it does is cause frustration and anger in ladies who just need to stay calm!!!

Purplecatti I would just go to your next appointment (be it GP or midwife) with a list of questions like:

• when do I make each of my appointments (mostly the next one will be made as you go along)
• exactly what happens in each appointment (I was told off for not bringing a sample, apparently you must bring one to every appt)
• how and when do I get results for any tests carried out in my appointments (blood, urine, glucose)
• how do I contact the midwife for various inquiries, changing appointments, booking onto antenatal classes (recommend you do these even if you are also doing NCT) (that's a whole other rant, but figure out how to get through to someone before you need them in an emergency)

Good luck with your pregnancy!

p.s. lastly photocopy your notes at your last appointment, they keep these after you give birth which I'm very pleased I've found out before the day!! If you later want a copy it s a faff and they'll charge you a fortune.

p.p.s check what they are writing down with them before you leave the room. Make sure you understand what they have written and ask them to explain EVERYTHING. They've recorded conversations in my notes that we never had!!

Depending on where you live I think its a bit of a shock with first pregnancies how you are literally left to your own devices in the early stages of pregnancy. My experience is that on finding out you are pregnant you book in to see your GP (no tests done) who then refers you to midwife at the hospital for your 10-12 week booking in appointment. All my midwife appointments have run late or I have been phoned up to say that it has been cancelled and could I come another day.

I am now pregnant with my second child and the midwife services seem to have been cut even more in that there is no receptionist so you have to leave a message on an answering service and hope someone phones you back. Appointments are only 9-2 on a Wednesday whereas they used to be all day Wednesdays in first pregnancy. And you don't get a choice of appointments anymore, you take what you are offered regardless of how inconvenient it is because they are fully booked all the time. At your appointment midwife does all the admin side of things as well such as booking next appointment etc as no receptionist/admin person anymore.

im the same thery only do clinics on a friday am and it has to be at whatever time they can do not anything to suit you! but im lucky as my team of midwives,are very nice and very helpfull unlike most of my gp's!!

Meant to say my midwife appts have all been at the local clinic rather than the hospital. No midwife appts at all at the hospital apart from the tour I self booked on (which I only found out about through my yoga class!!) I'm in Hammersmith & Fulham (Chelsea & Westminster). The 12 week scan at the hospital was arranged by my GP and confirmed by a letter from the hospital in the mail.

No receptionist at the clinic for the midwife appointments either but at least those have been on time. GP has never been on time for anything, ever!

There seem to be a few GPs on here so can you please make note that first time mums are not always aware of the protocol of who to go to for a booking appointment and when etc. in their practice and this information is not easily available (I know, like everyone else I researched it first). Just putting this on the web or something would make it much easier for everyone; speed up the process and avoid a lot of stress for pregnant ladies. Have to say my GP was nice and gave some preliminary advice on what not to eat and couple of other snippets and explained what to do next a little. Have since experienced over worked MWs in my area too; tough to get appts and haven't seen the same one twice.

Good luck everyone ;)

OP, that is shocking treatment. If I were you I would phone the mw at your hospital who will do the scan (most hospital's websites will have contact no's for the mw team on their maternity/ante-natal page) and explain to them that you really need a scan asap and the GPs are messing you around. When I saw my GP I thought I was already 10w pregnant and so needed a scan quickly, and so I called and explained everything to them.