Can you change consultants (nhs)

[babysoon3]

I’m thinking of requesting this-but will it be allowed.
I’ve had 2 appts with mine and really fee there’s a personality clash and also not happy at all with some of the recommendations/things suggested.

Can I ask to be under a different team ? Has anyone done this?

Hi,

You're within your rights to do this but I'd also ensure that you're not going to compromise your care by doing so. For example, at my (London) hospital there was only one consultant who specialised in the reason why I was consultant led (epilepsy) so whilst I could have asked for another consultant, the new one wouldn't have been as "good" as the one I was originally seeing. If you're consultant led and they're part of a team where their specialism is duplicated then that's less of an issue.

You don't have to go with everything they're suggesting. I'd maybe start with asking more questions about how they feel it would be of benefit etc and asking if you can see someone else - for example, as my pain relief options were limited due to my epilepsy my consultant advised I should have an appointment with an anaesthetist consultant to discuss this in more detail. Is this an option for you?

Also, they're not going to be at your birth unless they happen to be on call and you require intervention (or at least they're not if you're NHS) so I'm not sure what you feel a new consultant is going to achieve in the long run?

I just found the last appt so traumatic and I was worried they would be at the birth I’ll have to check I’ll be having a c section I wasn’t sure if it would be my consultant doing it

I’m high risk and tbh despite me making it clear this was a planned and wanted baby I keep getting offered TOP and I just don’t want to discuss it anymore it upsets me each time and I make it clear I don’t want to yet it’s mentioned and the anticipation for next appt is stressful. Baby is totally healthy and fine ! So far my checks have all been good too so it feels like the very suggestion is really not appropriate and i don’t think I can manage another appt like the others have been

I'm sorry you found the appointment stressful, must be even more so at the moment given you can't have anyone with you for support. I assume that there is another member of staff in the room though, such as a midwife?

I'm not sure about c sections as I didn't have one, but what I do know is that there will be LOTS of people in the room (10-15) so even if the consultant does happen to be there, you won't be "alone" in the room, if that makes sense. From speaking to friends who have had planned c sections, it seems that you just get whoever is on "c section duty" on the day but this is something that you should definitely ask about and may likely be told anyway.

I don't know what TOP is, sorry, although from the context I assume it must be a form of counselling or support? (Google hasn't been very helpful, sorry!) If you don't want it then you just need to be clear at the next appointment - perhaps as soon as you enter the room you just state "I don't want TOP, thank you very much for the offer and I won't be discussing this again" or have it written at the top of your notes.

It's good to hear that your baby is healthy, how many weeks are you? Is your consultant related to the high risk or the c section? As I don't think my consultant performed c sections (she originally proposed that I have a planned one, which I didn't want) which is why she said I should have an appointment with someone else to discuss pain relief, so maybe it's a similar thing here?

TOP (termination of pregnancy) and I really really think it’s not something to repeatedly offer. The first time I sort of thought ok maybe they have to offer ? Although I found it a bit strange as I was 12+ w at that point and baby and me both fine it was based on a ‘what if’ rather than a likely outcome
I have a genetic conditioning that can cause complications in me (aneurysms and ruptures or uterine rupture) but I was told that what if something does happen further on surely I’d wish I had stopped the pregnancy when I could (that’s not how I’d feel at all)

I think I’m now stressing anticipating it being mentioned time and time again and not feeling fully supported if that makes sense
I really want to go to appts and feel ‘normal’ and happy and not stressed having to say no I don’t want that each time and ending up crying

There's clearly a significant factor you haven't mentioned wrt the baby having a chromosomal abnormality or congenital defect. Nobody would be raising the idea of TOP with you in a planned pregnancy of a completely developmentally normal baby.

No there’s absolutely nothing else except for the condition i have making the pregnancy potentially high risk
The baby is 100% fine on all scans and tests so far
I have been fine on all tests (I have a yearly heart scan and brain mri) amd has extra checks sooner than the year was up in early pregnancy after 12 w

You can request a change.

I wish I had after a bad consultants experience. Fortunately for me after a disastrous appt I saw different registrars for my other appts and she wasn’t on duty on my csec day anyway.

I think I will as it’s clouding things and making me stressed which doesn’t help me

I can well understand your distress and upset, op.
I'd ask your GP is he could help arrange for you to see
a different consultant. I had a similar thing happen - nothing to do
with pregnancy but a spinal operation. I spoke to my GP about
changing consultants and I don't know how he did it but I got a letter arranging an appointment with a different consultant.

Maybe another route anyway regardless of who is your consultant would be to enquire how you could get a request [in red capitals] on the front of your Hosp notes that you do not want to discuss TOP any further.

HauntedGoat.
Nobody would be raising the idea of TOP with you in a planned pregnancy of a completely developmentally normal baby.

Cleary your information I wrong.

If the pregnancy has a significant risk of a very bad outcome for you, such as severe stroke or death, they have to have a serious conversation about TOP with you and be certain that you understand the risks of continuing the pregnancy. If the worst happens, they will have to explain these conversations to the coroner.

You can request a change of consultant, I’m just a bit concerned that if you do that the new consultant will also have to be satisfied that you understand the risks and need to have that conversation with you as well. Especially if you have changed consultant because the first one brought it up, it might look to them like you are trying to bury your head in the sand.

It’s in my notes though so I assume they’ll see it’s been discussed in depth twice already. I know the risks but i really really just want to enjoy the rest of my pregnancy and not have to talk about more than I have already

could you ask to see a catholic consultant or lead doctor.
there are plenty of them in hospitals, and maybe they will understand and respect your decision and your right, having made an informed choice, not to be distressed by having to go over it again and again.
this extra stress they are imposing on you is not treating you in a holistic way, it is adding to your stress levels which impacts negatively on your health, both physical and psychological.
you are an individual person and ought to be treated as such, not part of an algorithm or flowchart.

I'm sorry that you've been made to feel this way about your baby, that can't be a nice feeling. I like the idea that the poster above me had about involving the Catholic chaplain or other senior doctor, and focusing on the fact it's making you distressed.

Unfortunately part and parcel of having other health issues is when you're pregnant they're discussed time and time again even when you know as the patient that they're not relevant or you've already accounted for them in your decision to get pregnant. My epilepsy is due to a brain tumour. I had an operation before getting pregnant and was having radio and chemo after. This had absolutely no barring on my pregnancy other than it meant I was automatically high risk and kept having to repeatedly have the same conversations. I ended up crying to one midwife because I really wanted a water birth and I'd been told no due to the epilepsy, when the reality was as it was secondary epilepsy I was no less likely to have a seizure than any other woman. But they have to have these conversations with you because if they don't then they could get in trouble with the coroner later down the line if anything does happen to you or the baby. The midwife then said she could see it was causing me a lot of distress so she'd speak to the senior midwife about my particular circumstances. Perhaps you need someone to advocate for you in the same way?

(Also never assume that someone has read your notes. That would make it far too easy )

@HauntedGoatFart they would if there was a significant risk to the health of the mother. It’s not just about the baby.

OP I’m sorry you’re finding things so hard. There is a certain amount of requirement on doctors to be clear about what the medical advice is so that there’s no risk of the patient not understanding and not being able to make a clear informed choice. However you are perfectly within your rights to request a different consultant if you wish. Why not have a chat with your midwife, explain how you feel and see what her advice is?

Could you ask to have it clarified by another doctor? A sort of second opinion?

Sometimes if I feel a patient doesn't understand my concerns, I book them I. With another clinician so I am satisfied that they have made the right decision, and they feel reassured too. Maybe ask for that.