GP Retests

Sometimes it seems like the luck of the draw Bazdil. I am very fortunate in that my current and previous GP's are both excellent practitioners; professional, well informed, conscientious and warm. If they were my only experience of GP's I would say we have an excellent health service.
However, my mother has had a succession of GP's that seem to be cast in the same mold as you have described. Several times I have had to intervene to get her basic care. Once she visited the doctor with a back problem and he didn't even examine her, just sent her home to take ibuprofen. After a telephone call from me he did a very reluctant home visit to examine her back and then had to call an ambulance when he discovered a very serious problem (that needed immediate surgery).
I do think that you have been very, very unfortunate though Bazdil and that most GP's are competent and caring. (But mine's the best.)

You must have the same GP practice as myself Grannyactivist. Mine too are all of the above and have wonderful 'bedside' manner. After finding blood in my urine I visited GP immediately, was referred straight away to Urology Dept at local Hospital, was booked in for a CT scan and cystoscopy the same week. Had CT scan was phoned that day to say not to go for cystoscopy but to come to see the consultant the next day. Saw consultant who said that it was a TCC to the kidney (cancer) - a biopsy booked for the following week and operation to remove the kidney two weeks later. All in all the whole process took just 4 weeks. My consultants at the hospital were on the ball and to the point. Very kind and caring and I have never felt like someone on a conveyor belt. The same with my DDH when he had his cardiac arrest.

The problem is that a lot of patients will not go and see another doctor in a practice for a second opinion, thinking it might cause problems. I've always said if you're not happy with a diagnosis see another doctor.

My mother, like Grannyactivist's, also had very bad back problems but her doctor told her it was osteoporosis, arthritis, and 'what do you expect at your age?'. After suffering considerable pain for over nine months, she was finally sent for tests which revealed cancer in her lung. It was a secondary cancer but, due to her age, no investigations were done to find the primary site, and she was offered no treatment. She died two months after being diagnosed and I miss her so much.

I used to be a member of the Patients Association.
I left when they sent me an email to tell me how pleased they were to have joined forces with Bupa. Novartis and Pfizer are corporate members now.

I wonder where they stand on the AllTrials campaign. I will look into it...

Bazdil - that's a sorry tale. I don't want to appear unsympathetic, but i'm with others in having nothing but praise for my young GP, who is great. I'm with a teaching practice, there is a good choice of GP's and I've no complaints at all. I have chronic health problems, as a result of which I am on various medications with potentially unpleasant/dangerous side effects. I feel very lucky to have such good care from the nhs generally. My mum's practice wasn't great, until the arrival of a new GP (middle aged, not newly qualified) who was just wonderful throughout the 5 years he cared for mum.

Yes they have signed up to Alltrials
This is the admirable campaign started by ben Goldacre to pressure pharma companies to be transparent about their clinical trials (and stop hiding some of the evidence from doctors and patients)
Sign the petition please.
www.alltrials.net

My doctor now is excellent and supportive but this has not always been the case. Where I have major concerns is the communication between Consultant/patient. On several occasions recently I have been told by the consultant that I would receive copies of his letter to my doctor and throughout two and a half years following my hip operation many letters have been sent out but only one registrar got it to me.

This has culminated in one specialist getting cross when I asked 'you will send me a copy won't you?'. He replied and I quote: 'I have said I will and I will!'. I didn't receive it but eventually obtained a copy which had CC and my name. The specialist had done his bit but the office had not done theirs. Exactly the same thing has happened with a letter I collected on Saturday. If they want me to do this then I should be told and not charged for the priviledge.

My surgeon got extremely angry with me recently because he felt I was not following his instructions. Since the operation I have not received a single piece of directive correspondence or results to the various tests.

My health centre are not good at reading notes and I have pointed this out to them. After leaving hospital following my operation I was told to book an appointment to have my stitches checked, which I did making sure they knew why I wanted my appointment. When I arrived complete with walking stick the nurse looked at me, looked at the computer screen and said: 'I see you haven't had your BP taken for a while' and proceeded to take my BP. Did she not realise that I had been carefully monitored for the entire 5 days of my holiday in hospital?

Oh dear, sorry to go on. You will see Bazdil that I am not happy with the NHS but my doctor is terrific and I suspect that Galen would have been my type of doctor too

I think you've spoken for a lot of us LizG, on the communication problems within the nhs. Your experience mirrors mine when one of my adult children had investigations for epilepsy/brain tumour/heart problems. I confess I took her privately after a number of worrying delays. I've been very lucky with my specialist in a small local unit with close links to local GP's. Inevitably, it's being closed, and we're all being sent to the centre of excellence. It is excellent, but I left there because of delays, poor communication and the fact they seemed to be overloaded with patient to doctor/nurse ration. It's 20 miles away, public transport links are very poor. I could go on about the number of friends who have found the communication between their specialist hospital consultant, gp and other health professionals dire. I suspect I'm 'old fashioned' as whilst I appreciate the need for centres of excellence, I believe we need smaller, local units for most treatments, with the expertise of the centre of excellence readily available should it be needed. I had some treatment recently, I went to the local unit 3 times a week, for 12 weeks, for brief treatments. The closure means I'd need that 40 mile round trip with no proper public transport links, when our local unit closes. I can drive currently, but not everyone is so fortunate. Rant over

Iam64 You have highlighted a real problem within the NHS - centres of excellence vs local units.
Tragedies such as the Bristol Children's Heart Unit have pointed to consultants needing to see a critical number of cases of a condition, or surgeons perform a critical number of operations, to be able to do that operation or treat that condition, not just competently, but proficiently, so that patients get the best outcome.
For example, a few years ago it was decided that there were too many centres in the North-east where children were being treated for cleft lip and palate - not life-threatening, but very distressing even so. At the time, children were being treated at the Maxillo-facial units in both Newcastle and Sunderland. But the Department of Health wanted one centre of excellence for the whole of the northern region - either Leeds or Newcastle. Had Leeds been chosen, it would have meant that children from Berwick-on-Tweed would have had to travel all the way to Leeds for their surgery and follow-up care.
In the end a compromise was reached with a 'One team, two centres' concept which meant that the team of surgeons and nurses would spend half their time in each centre.
Not ideal at all, and at the time there was great concern that the training opportunities for young surgeons would be badly affected too.
Of course we all want the best outcomes in terms of survival and function, but the cost to the patients of concentrating all the treatment of a particular condition in one centre is the disruption and difficulty of access that you mention.
And of course, there is always the sneaking suspicion that the real motivation on the part of the Department of Health is cost-cutting.

No doubt jane costs are cut - but the argument for having centres of excellence is supported by the evidence in many areas I think. e.g. survival of serious injuries arriving in A and E - much better if you are taken to a centre of excellence.
When I was in NZ there was a classic case - it was only possible to have one children's oncologist for the whole of N Island and that was in Auckland. Tough on parents in the Wellington region but they had tried and tried to recruit a consultant and failed - there was just not enough work to attract anyone. It was not the money - there were just not enough cases of child cancer to keep them occupied.

Jess and Jane, the same thing is happening with children's heart surgery in the North East. A review was undertaken with the Freeman being chosen. Leeds Hospital objected so it has now gone to review again. As Jane said, if Leeds is now chosen children from Berwick on Tweed will have to travel to Leeds, whereas if Newcastle/ Freeman is chosen, children from Yorkshire will have to travel to Newcastle. However, there are also paediatric heart surgery units in Birmingham, Liverpool and Manchester, which are quite close to Yorkshire. The Freeman is one of only two in the country to perform paediatric heart transplants. That expertise will be dispersed if the Freeman is closed.
Although I now live in the North East, I am originally from Yorkshire, and can see the problem from both perspectives. I know how difficult transport of patients can be from north Northumberland as I quite often travel up the A1.
JessM, the consultants are at the Freeman. That is not the problem.

My husband was diagnosed with brain cancer in Durham Hospital. Except he was not told it was brain cancer, he was told it was a mass lesion.
We were told that when patients are told that, they often panic, but it might not be anything to panic about. We did not understand what the doctor meant.
My husband was referred to the RVI the next week and was then told it was cancer. He was operated on two days later.
Then he was sent to the Freeman for radiotherapy.
So which hospital was the centre of excellence? Certainly the Freeman has all the bells and whistles with the Bobby Robson Centre. But he never got that far as there was no point in him being part of the trials, as he was too far gone before he got there. Worst possible scenario.

jen I nearly wrote about the Safe and Sustainable Review (about Paediatric Cardiac Services)yesterday, googled it to find out the latest, and came up with nothing after the outcome of the Judicial Review.
It seems that all the surgeons and the Royal Colleges are united in their support to reduce the number of centres, so that excellence can be concentrated.
But the seeking of the Judicial Review by Leeds, and the subsequent temporary shutting down of its services when the outcome statistics were questioned, is the stuff of Machiavelli.
It seems tragic to me that money is wasted, and patient care is compromised, when self-interest of a particular unit and group of individuals comes before working for the common good.
Sadly, competition is now more important in the NHS than co-operation.

I have been referred to a centre of excellence for orthopaedics after a year of local faffing about and failing to diagnose the problem. It is a pain having to make a 3 hour journey, but at least I have confidence that they know what they are doing.

It must be even more difficult for parents having to travel a long way with little ones, especially for visits if the child is an inpatient - but, short of having an NHS with limitless funds and the ability to have expert staff everywhere, I can see no alternative.

The communication is no better in this centre however - I was seen on 4th September and received my copy of the GP letter on 20th October, it having been typed on 25th September!

I had to go for an ECG yesterday, and had a choice of going to Durham Hospital or Shotley Bridge. I chose Shotley Bridge as I knew the parking was free and it was usually easy to get a space. I was seen on time and out within fifteen minutes. That is a small local hospital, but it does not have an A&E, just a minor injuries unit.
I had to walk down a long corridor with clinics either side and many waiting areas. It appeared that the ECG unit was the only one working, but I bet that Durham outpatients was heaving at the same time.
Anyone who lives in the area, choose Shotley Bridge, or we will definitely lose it.

That brings back memories to me. in 1966 my dad had a lung removed at Shotley Bridge hospital, I am pleased they are still open

Just thought I'd resurrect this. The new head of NHS England started at Shotley Bridge Hospital, and was there yesterday to say what he was going to do with our NHS, privatise as much of it as he can, I think, by the reaction he got on the news. I bet Shotley Bridge will not be a hospital for much longer.
However, what is more important at the moment is that many of the brain cancer centres are being closed if NHS England gets its way.
There needs to be some sort of petition about this.
www.mirror.co.uk/news/uk-news/top-cancer-doctors-damning-letter-3320345

Shotley Bridge is the nearest hospital to DS and family but when he required treatment recently he was sent to Darlington.