Gransnet forums


GP doesn’t act on hospital advice without prompting

(33 Posts)
PenelopeB Mon 13-Jan-20 10:32:56

Recently, X-ray department and consultants requests to GP to prescribe medication for me have been ignored unless I make a surgery appointment and alert them to the request. In the past the doc would phone me. The hospital letters are to the GP not patient. Why doesn’t the surgery act? Am I doing something wrong?

Hetty58 Mon 13-Jan-20 10:43:56

Maybe your GP admin system has changed (for the worse)? I'd go in and ask about it at reception. We seem to have to prompt or shout for attention these days!

dragonfly46 Mon 13-Jan-20 10:45:48

I always follow mine up by popping into the surgery just to make sure. Hospital letters are always copied to me so I take a copy with me.

annsixty Mon 13-Jan-20 10:52:05

That reminds me (old age) that I had a DEXA scan on November 7th , I have osteoporosis, and not heard a word.
I will ring this afternoon, we can’t ring about results until after 2 p.m.
Thankyou for the reminder, it is getting a case of DIY.

Sussexborn Mon 13-Jan-20 11:02:52

You do need to be proactive and, even if you are lucky enough to have a decent GP, ask for copies of all correspondence to be sent to you so you know exactly what is being suggested. It also stops doctors giving rather ill formed assessments of your character and disposition after a 10 minute appointment when you may well be stressed and nervous.

cornergran Mon 13-Jan-20 11:02:56

Theres a notice in our surgery saying it is the patient's responsibility to follow up tests and any actions required from hospital visits. Irritates me but at least it's clear.

Charleygirl5 Mon 13-Jan-20 11:13:16

cornergran I find that unbelievable because not everybody is capable of doing that, but as you say, at least you know.

Sussexborn Mon 13-Jan-20 11:13:52

I do wonder what happens to the people who don’t have reason to visit the surgery. Even twenty years ago some doctors expected patients to know the surgery “rules” by some kind of osmosis. Until I worked there I didn’t know that home visits should be requested between 9.30 and 11.00! I also had no idea that the surgery opened on a Saturday for urgent cases only! I suppose websites might help but ours has pages of info to wade through.

jaylucy Mon 13-Jan-20 11:26:58

Several years ago, I had a fall and dislocated my left elbow. I hand delivered a letter to my GP at the surgery - in fact I actually followed him through the door into the place and also had several conversations with him while my arm was in a sling.
The letter from the hospital requested that he check on my elbow in between hospital appointments for assistance with pain control and also future physio treatment.
At no point was I contacted by the surgery asking me to go in (despite being told by the hospital that I would be) and several years later, when I saw him for something unrelated, I mentioned about my elbow - he checked my records (still paper files) the letter I had taken from the hospital wasn't there! He also told me that very often, the GP never sees the records from the hospital unless you make a point of booking an appointment to discuss the treatment,
Thankfully more recently, the hospital sends one copy of reports to me and one to the GP.

Doodledog Mon 13-Jan-20 11:35:13

I get copies of letters from the hospital, but they often arrive six weeks after the tests have been run. The date of dictation and date of typing are weeks apart, and then they must sit in an out tray waiting to be posted.

I assume that if the tests showed a serious problem they would be fast-tracked, but it is not reassuring. It's all very well trying to be proactive, but the GP and hospital systems are not in synch. If my GP requests a test, I see the results the next day, as I have signed up for online access, but if they are done at the request of a consultant they never appear on there. The system here is that hospital appointments can be at one of several hospitals, depending on when the next one is available, so there isn't even continuity of care in that system.

Getting a GP appointment to discuss anything is virtually impossible, too. Everything is now same day access, and is triaged by a telephone call.

I honestly don't know how anyone with additional needs is expected to cope with all of this, and I can only see it getting worse.

Liz46 Mon 13-Jan-20 11:43:12

I have had a long term illness and keep copies of the hospital letters to my GP in a file. My husband came with me to appointments with the consultant and we made notes afterwards.

Callistemon Mon 13-Jan-20 11:56:05

Our GPs request patients to make a further appointment with them to discuss results of X-rays etc, if they have sent the patient for the investigation.
It's up to the patient to be pro-active.

Why did the consultant not prescribe the medication required? Do you have follow-up appointments with the hospital?

In fact, the answer to your question about medication could be that the GP may be reluctant to prescribe medication that a hospital consultant has recommended, particularly if it is expensive, because it will come out of the GP's budget not the hospital's.
Perhaps the consultant should be prescribing it.

Callistemon Mon 13-Jan-20 12:01:30

jaylucy I had an injury last year and a letter was sent to my GP; he may have read the letter and noted it or not.

I went to A&E in one area, they wrote to the hospital in my home area, I got prompt follow-up appointments at the Fracture Clinic sent to me (by letter, text and email!) and also excellent physiotherapy follow-up.
I've not seen the GP about this at all.

EllanVannin Mon 13-Jan-20 12:20:10

I have no faith in my GP at all which is why I've struggled on with what I can only call, a chronic chest infection for the past 2 weeks.

2 weeks ago I was requested to go and see a GP after a hospital admission a week before Christmas and she said she'd increased my medication, which was already 5mg daily( via the hospital )----to 1.25mg !! Erm…………….is that really an increase ? What a waste ,as I hadn't noticed until the pharmacy had delivered it.

I haven't been back since and that was only the first time for nearly 3 years. The hospital had already done extensive tests, bloods, etc. and found no underlying cause for my A/fib.

Callistemon Mon 13-Jan-20 12:28:51

You do really need to see your GP asap if you think you have a chest infection.
Have you had the pneumonia vaccine yet?

Sorry if that sounds bossy.

annodomini Mon 13-Jan-20 12:44:47

An admin at our local practice (recently merged with three others) sent me an email asking me to contact the GP to discuss my blood results. I made a phone booking and the doctor said there was nothing to discuss and he didn't know why I'd been notified. He was as irritated as I was.
If I've had an appointment with a consultant or specialist nurse, I'm always sent a copy of the GP letter.

Sussexborn Mon 13-Jan-20 13:01:10

Does your surgery run a same day appointments for urgent cases? A chest infection would be classed as urgent.

It might also be worth asking the pharmacist or surgery what was on the original prescription. Mistakes can come from several sources. The pharmacy may even query it on your behalf.

In the 90s everything was gearing towards a national database for records and prescriptions but after millions was spent on it, the question of confidentiality was brought up and it was abandoned.

I attend Coventry hospital and recently they have become very efficient with appointments. Text reminders are sent twice and the written follow up appointment I received 2 days later. They also seem to be prepared to prescribe items that can be collected an hour or so later rather than getting the GP to do it.

I don’t know if it’s still done but letters used to be sent to India for typing. One GP commented that their grammar and spelling was far superior. He did get one letter that had all the punctuation written out! Dear Dr Bloggs comma. Etc.

Alexa Mon 13-Jan-20 13:07:25

I am shocked by the carelessness in administrative procedures that fail on ordinary communications which when I was a nurse would be taken for granted.

Many patients are not mentally , emotionally, or physically able to be as pro-active in their after care needs.

There is no excuse for such shoddiness, as such inter-service communications are properly a clerical assistant's remit and cost very little.

Alexa Mon 13-Jan-20 13:15:44

EllanVannin, would it be a good idea to ring the pharmacist either where you get the meds from or the practice pharmacist that some surgeries now employ?

I ask because I wondered if the doc mean that she had increased your dosage from 5mgs by 1.25 mgms to up your total dose to 6.5mgms.

In addition you should get a medical opinion on your chest symptoms. Unless you have breathing difficulty it's probably not urgent. But at least see the practice nurse to have your chest listened to.

PenelopeB Mon 13-Jan-20 13:16:25

The consultant didn’t prescribe the medication direct because I had a test at hospital and was matched with a specific antibiotic, which the consultant wanted me to complete before next appointment with her. I saw the copy letter and made appt at surgery. Locum was very surprised I hadn’t been contacted By surgery and said I should have been.

Callistemon Mon 13-Jan-20 14:32:32

The consultant wanted you to take a certain medication and wanted to see you again and check the results after you had taken this medication.
The consultant should have prescribed the medicine for you to pick up either at the hospital pharmacy or an 'outside' prescription for a chemist.

She was shifting the cost, therefore, on to the GP.

Hetty58 Mon 13-Jan-20 14:48:57

Doctors in our health centre vary a lot in their approach - and even openly disagree with each other. I don't see any particular one.

Following up is usually my responsibility.

One female GP, though, kept phoning me on my mobile about my side effects and asking if I was lowering doses of BP pills and/or not taking them.

I was usually out and about, walking the dog or shopping when she phoned and I found it too intrusive and inappropriate. I had to tell her to stop!

endlessstrife Mon 13-Jan-20 14:51:24

One of the receptionists at my surgery told me a few years ago, that patients have to be responsible for themselves now, as the surgery has so many patients, it simply can’t keep up with all of them. A product of a failing NHS was her reasoning, and the fact that GP’s are totally overwhelmed.

annsixty Mon 13-Jan-20 15:44:47

I rang my GP surgery, after being reminded on here, about my DEXA scan result, after checking, the girl in the office said they are waiting for the results.
Over 2months, I know things are slow but that is surprising.
If this has somehow been overlooked I wonder whose responsibility it is to chase them up.
I suppose it is mine as the surgery are not really aware until asked by the patient.

SalsaQueen Mon 13-Jan-20 17:10:42

annsixty..........I've just been for a bone density scan (today), although I've got no Osteoporosis or any other medical concern. I've only ever had 1 broken bone, 2 years ago (I had a bone density scan then and was fine). Told that results will be sent to my GP, in 15-16 WEEKS, due to a backlog of work at the department!