GP doesn’t act on hospital advice without prompting

gmarie The problem is that the whole system is underfunded. The government keeps on interfering with systems, but doesn't provide the resources for training and adjustment. GPs are doctors, not administrators and can't really be expected to develop systems.

Meanwhile, many GPs increasingly see the job as unsatisfying and not what they signed up to. They're as frustrated with ten minute appointments and little opportunity for continuity of care as the patients are. There's a chronic shortage of GPs, which just exacerbates the problems.

The onus is very much on the patient to chase up drugs and test results. The raised eyebrows by receptionist because I don't know the surgery routine.
I needed anticoagulants aftera PE but there was no communication between hospital and surgery, when I did eventually get them it was a one off prescription and had to keep returning to get it repeated.
Doctors surgeries are not for the old and sick, you could expire sitting waiting in ours. It is not unusual for a timed appointment to run 1.5 to 2 hours late.

When DH was ill and in excruciating pain, and GP would do nothing, we asked for a referral for a private consultation.

When the consultant saw DH, he said he was on the wrong medication and turning to his computer he immediately sent a request to the surgery asking for a change. We were able to go the surgery the next day, refer to the email and get the new medication. We were copied into the email.

If the private sector can do this why can't the NHS? It wouldn't cost any money to do it, in fact it would save money and would be so much quicker and easier.

I think it is partly down to the actual doctor's surgery.
Although I have been praising my surgery for their quick response to hospital communications, there have been a lot of admin problems concerning repeat prescriptions and phone messages not being passed on.
That is very stressful, when you are battling chronic illnesses.
In our town, the population is steadily growing, but the medical infrastructure is not developing to keep pace with it.

Are these problems the rule with healthcare in the UK? I've been a staunch proponent of universal/single payer healthcare here in the US but I'm starting to wonder.

In my practice the receptionists (or whatever their new-fangled job title is) deal with all hospital correspondence. They also deal with repeat prescription reviews. Allegedly they've been trained to deal with their new role, but I'm not reassured. I've had endless problems with hospital letters not being followed up and my repeat prescription being stopped in error. I've also had "needs telephone call" written on my blood test results, but have hardly ever received a call. The hospital always sends me a follow-up letter and I've learnt from experience that I have to follow anything up myself. Like many others, there's a four week waiting time for non-urgent appointments.

I agree that it may have been inappropriate procedure on the hospital’s part. Managing personal medical info online is essential but I don’t know what percentage of the population actually does.

I had a phone call from the heart clinic last week advising me that my medication needed changed.
A couple of hours later, I received a phone call from the surgery, advising me that my new prescrption was waiting!
The letter had been sent electronically immediately after the hospital phone call and was picked up right away by the surgery.
Now that's service!

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!

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.

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.

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!

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.

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.

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.

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.

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.

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.

EllanVannin
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.

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.

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.

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.

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.

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.

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.