Is it normal...

[kallia]

...for GPs not to be seeing anyone in person (still)?

I'm 30 weeks with my first baby (first pregnancy) and my midwife said last week that I needed to book a GP appointment at 31 weeks and to get my whooping cough jab at the same time. Rang the GP today to book but the receptionist said they were only doing telephone appointments, and that they wouldn't see me in person. I asked if I would be getting my jab at this appointment, and she said that I might be invited in "if the GP considers it necessary". She also said this would probably be another day as the GP won't be ringing me until 9pm.

I thought all pregnant women were offered the jab, and had to be seen in person by their GP at 31 weeks to do bump measurements, blood pressure etc.?

So far in my pregnancy I've only had one in-person appointment with the midwife - at 24 weeks - everything else has been over the phone. I'm a low risk pregnancy so not especially worried, but just thought it was odd?

I work at a doctor’s surgery and that doesn’t sound right at all. You’re right, you should be being seen for blood pressure, urine etc.

Where I am working, we have to give telephone appointments and then once the doctor has had the appointment, they can decide if they want to see someone in person. This is for more complex or uncertain issues.
But all midwife appointments have gone on as normal face to face and we don’t book phone appointments at all for those

Just rereading back, i don’t understand why it’s the GP the midwife says you need to see (unless it’s trust policy where you are?).
It’s the midwife’s job, not the GP’s for that sort of standard thing. It doesn’t make sense for you to need to see the doctor

I'm surprised you've only had one face to face appointment with the midwife. They should be seeing you every few weeks to check on the heartbeat, check your urine and a bunch of other things. My midwife was even happy to have my partner at a couple of my appointments (hearing heartbeat for the first time, making a birth plan)

With regards to the whooping cough, my midwife said they don't do that and I had to go through the GP, but never had a problem making an appointment.
It's crazy that it's deemed acceptable for you to miss out on what is essentially crucial care.

@Troyhelena Most appts are with the midwife, but apparently the 31 week appt is done at the GP as that's when I have the whooping cough vaccine. Looking at the NHS website it seems that some trusts do it under the midwife team and some with the GP. I did explain to the receptionist on the phone that it would definitely need to be in person as I'd be having the jab, but she said they weren't seeing anyone in person. (She even went away and checked with the doctor, who was apparently happy for this to go ahead over the phone.)

Glad it's not just me... I don't know if I should be worried. I know I'm low risk but I do want to make sure the baby is growing okay. I saw the midwife in person for the first time a couple of weeks ago and she seemed happy, so I'm sure everything's fine, but I won't be seeing her again now until 36 weeks and that seems a long time away!

That seems different to my treatment. I’m 31 weeks and have seen midwife face to face maybe 5 times. I’ve never heard of the GP doing bump measurements etc. At my practice injections are done by the nurse and it was no issue. Just in and out for vaccine. It seems a waste of time for you to go through a telephone appointment to ask about whooping cough vaccine.

Agree with others, it’s a nurse you need to see for the jab. Not sure what will be done over the phone?
You should be being seen by the midwife you need bloods done etc

You should be seeing your midwife defo. Don’t think you need to see Gp tho, the nurse can do ur whooping cough and check ur observations. At my GPs it’s a telephone appt Initially then if the Gp thinks it needs to be in person after that they’ll bring u in later in the day x

Not sure why the receptionist thinks the whooping cough can be done over the phone tho 😂

I'm not sure if it's something that varies where you are but I've never heard of the GP getting involved in routine pregnancy appointments. Only if you're having any issues that needs a doctor.

I'm in Scotland but I had phone appointments with the midwife at booking and 16 weeks. After this they were all in person at 22 weeks, 28 weeks, 34 weeks and I'll have another at 38 weeks. It has been the midwife taking my bump measurements, listening to heartbeat etc. I had my whooping cough vaccine done at the hospital at my 20 week scan which is routine where I am, again I've never heard of a GP doing this.

It may be worth speaking to your midwife again and telling her that the GP won't see you, see if there's anything she can do? All pregnant women are entitled to the whooping couch vaccine and (I think) it needs to be done by 32 weeks so definitely worth pushing. Could you ask to speak to another GP?

@kallia my whooping cough jab is booked along with my 20 week scan. My flu jab was booked along with my 12 week scan x

That is not an acceptable level of care! You should see the midwife in person at your booking appointment to get bloods (has anyone even checked your iron levels, blood type, HIV, etc), a baseline blood pressure, height and weight and urine.

You should then be getting 4 weekly checks from 24 weeks (latest but mine started at 16 weeks when I got my whooping cough vaccine) where they should be checking blood pressure & urine at every appointment. From 28 weeks they should be measuring fundal height and checking babys heartbeat as well.

You are ENTITLED to your whooping cough vaccine, so do not let them fob you off. It could keep your baby alive before they are old enough to get their own vaccinations.

For reference I am on 3rd baby, low risk pregnancies (low BMI, no dodgy history, 32, etc) and I am still receiving the above in person care.

Please start kicking up a fuss. Waiting til you are 36 weeks to check on babys (approx size) and heartrate is not acceptable.

www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-care/

In previous pregnancies I've booked my whooping cough vaccine through my GP but this time they said they could potentially do it at the hospital when I had my 20 week scan (which I did manage to get) if there wasn't staff available at the hospital at that time and date then I would have to book with my GP.
I would call your GP practice again and if it is the same response then speak to your midwife (don't wait for your next appointment, just call them).

In my previous 3 pregnancies and with this one I never once saw a GP.

Only a midwife. Even this time around with COVID all my appointments with her have been face to face so she could do blood pressure and urine checks, and my 16 week one she listened to the heartbeat.

At the end of that appointment she told me to book an appointment at reception in my way out to see the nurse for my whooping cough jab at some point after my 20 week scan.

I think it’s odd you’ve only had one face to face appointment but really don’t see why it’s a GP you need to see. The midwife us the one to do all the checks and fundal measurements etc.

My 24th and 31st-week appointment was with GP as well (On my folder it says only for first pregnancies). In my trust GP is doing it face to face, because they need to look at blood pressure, urine and measure the fundal height, etc.

However, I had my whooping cough vaccine at my 20th-week appointment. I was planning to get it on my 24th-week appointment with GP, but when I was at the hospital for the scan, they set up a corner for the Whooping cough vaccine, and apparently, it was kind of walk-in, so I did not need to book anything. Maybe you can check if it is available at your hospital by phoning them and drop in to have it.

Seems very strange your 31 week appointment is with the GP.

I got my whooping cough jab at my GP with the practice nurse - is that possible?

In my area whooping cough vaccine is done at GP surgery not with midwife. I made the receptionist aware I needed my whooping cough vaccine and she booked me in with the nurse. This was the same pre-covid. They are really stretched at the moment so it is taking a few weeks to get a face to face appointment even with nurses.

GPs ARE seeing patients, when necessary.

You need to be seen by your midwife for BP/Urine/Doppler/SFH measurements unless there are specific medical concerns where you need a doctor's input. If you need a doctor's input then in lots of cases you can do this without a face to face appointment.

My whooping cough jab was given by the practice Nurse, which I had to book myself and come in on a specific day.

I'm a doctor myself and I have found the process a little confusing, but I guess that's the way it is.

I was told every hospital trust has different procedures. Might be specific to my area. Took a photo from my folder. 24th week, 31st week and 38th week are with GP, and so far I attended 24th and 31st and both times she did BP/Urine/Doppler and SFH measurements and wrote it on my folder. I do not have any medical concerns.

The only difference is I had my whooping cough vaccine when I had 20th-week Anomaly scan, not on the 24th week GP Appointment.

Thanks all!

I've spent all morning phoning round the different teams, doing my head in...!

It does seem the 31 week (and 38 week) appts are with the GP - must be specific to my area. That's what's in my notes (same as @Mlsweetpea) and the midwife and GP confirmed. But the receptionist says they can't book any in-person appointments and they're not giving any jabs apart from COVID.

Midwife suggested I buy my own blood pressure cuff and check my own blood pressure, but I have no medical training and I'm not confident doing my own checks. Plus surely I need fundal checks/urine/blood tests etc. to check the baby's okay? I'm probably fretting unnecessarily, but it really annoys me that I'm not getting the appropriate medical care.

@kallia yeah I wouldn't be happy with that care either OP! You shouldn't be having to take your own measurements/stats, that's something they should be doing for you! And as said above, you are entitled to the whooping couch vaccine before 32 weeks so it's not up to them to tell you they're not doing it!

I'm not sure who you would raise a complaint with in this situation but I'm sure somebody could advise. I wouldn't be leaving that though, I would be raising a complaint that you're not getting the care you should be!

Cough not couch*

I get the time we’re in at the minute but the fact you aren’t seeing a midwife just blows my mind.
Like you say you need measurements, bloods, urine done. I just don’t understand it.
The above are really important factors whilst pregnant even more now your 30 weeks.

@kallia I am so frustrated on your behalf. That is not acceptable! Complain to the surgery, they will have a process in place. Please quote the fact that it was suggested you buy your own blood pressure machine (ridiculous) and refer to the NHS guidance that I sent you.

As our Chief Medical Officer and co have continuously told us, the pandemic does not mean that critical care stops. Making sure you and your baby are not in danger is critical care.

Pre-Eclampsia does not necessarily have any symptoms at all and could have a terrible terrible outcome for both of you. They don't check your urine for fun!

I am angry typing now so shall step away but please do escalate past the flipping receptionists!

Thanks ladies. So glad to know I'm not overreacting.

I've now managed to get a whooping cough jab booked in with the nurse although she can't do the other measurements/tests.

I do want to escalate/make a complaint but tbh I'm more concerned with making sure I get my medical care than getting an apology or assigning blame. I'll email the surgery in the first instance as phone is getting me nowhere, but does anyone know if PALS would be the right people to escalate to if I need? Or do they only deal with hospital care?