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Naming and shaming GPs

(49 Posts)
GrannyTwice Sun 29-Jun-14 10:46:50

www.dailymail.co.uk/news/article-2673477/EXCLUSIVE-GPs-fail-spot-cancer-named-shamed-Health-Secretary-tells-Mail-Sunday-radical-new-policy-crack-doctors-miss-vital-diagnosis.html

I find myself quite concerned about this. The aim of course should be that GPs are generally competent at identifying cancer symptoms and referring in a timely fashion. However, as Sarah Wollaston said on BH this morning ( she's chair of the health select committee and a GP herself) the data on this is not very robust. What would make me feel safer would be if I thought that greater learning went on in GP practices when errors and near misses occur. There are systems in place that should be gone through for this to happen but I'm not confident that they are as honoured as they should be. If it becomes clear that a cancer diagnosis has been missed, surely the practice should get together and learn from that? Sometimes, there may be little, if anything, to learn but I expect often there is and I would guess that sometimes it's around issues of communication and understanding - on both sides. If we go down the JH routes, as SW said, GPs could refer far too quickly, the system would get snarled up and everyone would have to wait longer.

durhamjen Fri 04-Jul-14 15:08:00

nhap.org/1-2-billion-cancer-care-contracts-going-private-companies-shows-just-threadbare-government-promise-nhs-privatisation-become/

durhamjen Fri 04-Jul-14 14:57:02

Not just cancer care, Jane, but end of life care is to be outsourced, and with the complicity of Macmillan.
Completely wrong.
Tegan I stopped going to see one GP because of the way he spoke to both my husband and myself. Unfortunately he happens to be on the board of the CCG, and therefore responsible for overseeing the contracts in the local area.
I am sure that both Care UK and Virgin Care have handed back contracts when they became unable to make profit out of them. So how can they be considered fit and proper companies to be considered for cancer care and end-of-life care in Staffordshire?
It stinks.

Tegan Fri 04-Jul-14 11:41:56

When I worked for the NHS I was fed up of seeing the same GP's doing their job badly and constantly getting away with it; no one ever seemed to make formal complaints [probably because they're worried of being struck off if they make a fuss]. What then happens is that people start avoiding certain doctors and the workload of the better doctors increases, even though they are all paid the same. I know everyone makes mistakes and doctors are only human; if everyone with a problem was referred to a specialist the NHS would grind to a halt but if anyone else did their job badly they'd be sacked [unless they worked for a bank].

Mishap Thu 03-Jul-14 17:41:51

I have had cause to make complaints twice - on both occasions the medics lied when asked what had happened.

In one case an NHS hospital dentist was extremely rude to my teenage DD and I whilst her complicated dental problem was investigated. He took offense when I asked whether there were any other treatment options to the highly painful and complex one he was suggesting. Another dentist in the room witnessed this. I had to send my DD out of the room as she was reduced to tears. When I made a complaint, BOTH of them denied it ever happened.

When I complained about the misdiagnoses over my recent foot fractures, the consultant in question told the powers that be that he had properly diagnosed it and that his only error was not to have explained to me that the rare and complicated fracture might require surgery at a later date. This is lie - he told me that he did not think there was any fracture at all and he discharged me! The proper diagnosis was made at a specialist hospital later.

What is the point of complaining?!

HollyDaze Thu 03-Jul-14 16:11:00

I should add here that we've been on the receiving end of GP error as well as getting it 'right'. Sadly, some mistakes are inevitable.

I would imagine most of us fall into that bracket. It would help if they didn't close ranks the moment a patient tries to highlight a 'repeat offender'. We all make mistakes but with other people's health, the medical profession must learn that their mistakes can cost people their lives so those that protect their less able colleagues are doing no-one any favours really.

thatbags Thu 03-Jul-14 08:08:31

Well said, rowantree.

janeainsworth Thu 03-Jul-14 05:47:01

I agree Rowantree

This doesn't exactly inspire confidence either.

www.theguardian.com/uk-news/2014/jul/02/cancer-care-nhs-outsourcing-ccgs-unison-virgin?CMP=EMCNEWEML6619I2

Rowantree Wed 02-Jul-14 13:08:28

I should add here that we've been on the receiving end of GP error as well as getting it 'right'. Sadly, some mistakes are inevitable.

Rowantree Wed 02-Jul-14 13:06:28

I don't think the Daily Hate style of accountability helps anybody and I'm very against the idea of 'naming and shaming'. It leads to witch-hunts. As has been said, GPs are fallible and human -they make mistakes. Most are only to aware of the need to get a correct diagnosis. There are horror stories, it is true, and glaring inadequacies, but it wouldn't be right to assume that all doctors will perform better with the threat of 'name and shame' any more than a teacher would. It's insulting to assume otherwise.
They have a deep sense of commitment and responsibility towards their patients and most do their very best for themAnd I agree with Paula8 - it's easier to talk about the mistakes than the millions of times they get it right.

janeainsworth Wed 02-Jul-14 11:55:18

tegan A third of all cancer cases are in the over 75s, so that is probably the reason.

Tegan Wed 02-Jul-14 11:49:55

I find the one in 10,000 figure hard to believe given the number of cases of cancer we dealt with when I worked for the NHS albeit dealing with mainly elderly patients.

janeainsworth Wed 02-Jul-14 11:41:08

Of course I have great sympathy for anyone who has lost a loved one to cancer.
But cancer diagnosis is not simple, and GPs have to bear in mind the potential harm from investigations eg colonoscopy, as well as the financial costs of investigations which prove to have been unnecessary.
Here's a link to a blog explaining the difficulties of cancer diagnosis.
It also states that the average GP will see only one case of cancer per year, out of 10,000 consultations a year.
juniordoctorblog.wordpress.com/2014/06/29/named-and-shamed-gps-who-miss-cancer-diagnoses/

Aka Tue 01-Jul-14 22:56:16

Dragonfly that is so sad flowers

DebnCreme Tue 01-Jul-14 22:19:05

Oh Dragonfly that is dreadful flowers xx

Paula8 Tue 01-Jul-14 22:16:04

I am so sorry for your lossdragon I don't know how you get over something like that.

My Mum and Dad lost their son/my brother, when he was 4yrs old, my Dad never liked celebrating Christmas because my brother died 24 December.

A doctor once told me I had a tummy bug when I was in fact pregnant!! and a doctor once told my sister she would be un able to have children and she went on to have to daughters!! Also a doctor told my Mum she has a chest infection when she had Lung Cancer and it killed her because it was diagnosed too late.

I always tell my family not to ever just rely on what the Doctor says.

But all that said Doctors do obvioulsy do do good..

Dragonfly1 Tue 01-Jul-14 10:33:09

All I will add to this thread is that my late daughter's cancer went undiagnosed by a succession of RAF doctors and an ENT consultant for over two years. She died within twelve months of final diagnosis.

DebnCreme Tue 01-Jul-14 09:47:35

I have not mentioned this before because I felt my father's doctor was basically good and also my father had a habit of making light of his problems but -

My father had been complaining about a pain in his leg and eventally he was persuaded to visit his doctor. The doctor, who was going on holiday that day, arranged for an X-Ray and they arranged for another appointment when he got back. Although I was not happy with this my parents were and as they were of sound mind there was not much I could say.

Not long afterwards my father was sat at the kitchen table admiring the spring flowers. He stood up and immediately collapsed and died. A DVT. A wonderful way for him to go but devastating to the family, he was just 68

ayse Tue 01-Jul-14 09:14:00

Thank you for your comments Annodomini, durham jen and Paula 8. My DGD is unable to eat dairy, gluten and eggs and her gut flora has an imbalance to bad bacteria, thus the possible need for faecal implant in a couple of years time. She eats plenty of fruit and veg. and very little rubbish - dark chocolate on chocolate Friday. Her problem has been exacerbated by her tendency to catch anything going, being given too many antibiotics etc. She regularly takes child vitamins as encouraged by the medical profession and has non-lactose probiotics when she is poorly. I don't know if my DD has heard of Hirschprung's disease so I'll mention it to her.

The point I'm making is that all health services can fail to be pro-active and thus the patient suffers. I think nevertheless that we are so fortunate to have an NHS and that all can receive treatment free at the point of delivery, unlike many other countries where only those who can afford it receive care.

durhamjen Mon 30-Jun-14 23:28:21

Ayse, has your daughter tried giving her daughter vitamin C tablets? We can all tolerate so much before it gives us diarrhoea. It's a gentle way of finding out our tolerance level of vitamin C and getting rid of constipation.

annodomini Mon 30-Jun-14 22:53:15

When I was a child, my mother was constantly dosing me with laxatives and shoving All Bran down my throat. I am convinced that my constipation was a result of all this fuss. Since I left home to go to University, I have never been constipated. However, your GD sounds like a more severe case. My DS2 was born with a bowel problem which made him a very constipated baby and toddler, and eventually he seized up completely. His condition was Hirschprung's disease in which part of the bowel is without nerve endings. Since an operation at the age of two, he has never looked back and he's 41 now. I'm sure they must have considered such things in your GD's case and there must be a much simpler solution. Good luck to them in finding it.

Deedaa Mon 30-Jun-14 22:47:03

I think our GP feels quite guilty about not instantly diagnosing DH. He's always very prompt returning phone calls and gets very worried if DH is having a bad week. But really we don't blame him at all, if it's a rare disease it makes sense to have eliminated all the more likely causes first.

When DH had an enlarged parathyroid nearly 20 years ago it took a year to diagnose and the doctor we had then apologised to me for nearly killing him.(It was only the second case he'd ever seen in 30 years) I told him not to be stupid; there were so many weird symptoms and none of them really pointed to anything. In fact the doctor was the only person who was convinced that there was something physical wrong with him, even I was beginning to think it was all in his mind.

Paula8 Mon 30-Jun-14 22:08:27

ayse I presume she has tried all the usual, figs, prunes,fresh orange juice--also there is such a thing called emotional constipation which have something to do with not wanting people to hear you going to the toilet. Also learning how to relax your muscles when going to the toilet helps, also making sure that you are well hydrated is a great help..I am speaking from experience....

ayse Mon 30-Jun-14 10:29:15

When I heard this news I thought what a waste of money - more league tables! This is such a negative way of dealing with problems of non-diagnosis. Of course, as in any profession there are good and not so good medical practitioners.
My DD in Oz has spent 7 1/2 years trying to help my DGD, now 8 to sort out a diet that would not make her constipated. There was a distinct lack of interest by both GP and specialists and the difficulties are still continuing. Whilst this is not at present a life threatening degree it certainly compromises her immune system. My daughter in desperation persuaded a private clinic to take a look although they only deal with adults. They will eventually do a faecal transplant to alleviate the problem.
Surely there must be a better way to improve diagnosis. Money spent on league tables and black marks could be much better spent by more support for GP's, hospitals etc.
I'm so fed up with the blame game - it really doesn't resolve any problem

Paula8 Sun 29-Jun-14 22:52:07

I can understand all the un happines, if you have been wrongly diagnosed or not diagnosed, I appreciate that there is not enough sorry's in the world to make up for that, but just wanted to add that my two Doctor friends are very hard working caring Doctors that sometimes can not sleep due to concerns for patients they are seeing, Yes they do get it wrong, they are only human at the end of the day and that is why my attitude has always been do not totaly rely on anyone other than yourself for your health--what I mean by that is, in a way you have to be your own Doctor, if you feel something is wrong and you are not happy with a Doctor, then go to another.

We never talk about all the hours Doctors put in, we never talk about the near miracles they perform and how clever some Doctors are, we never talk about the millions of lives Doctors save every year..but are very quick to judge them and criticise them.

Mishap Sun 29-Jun-14 22:22:47

Those examples that you give susie are so common - I could quote a whole list too. It is very worrying, but I am not sure what the answer is.