Being honest with you sick.as.a.chip other than the mis-directed email to ENT rather than urology (and maybe delay in GP arranging) I don't see anything too unusual in your mum's treatment. Let me recap and maybe offer explanations (but I am a nurse and not in cardiology): Pre-op assessment - irregular pulse found. ECG and examination carried out showing possible left axis deviation but with no worrying symptoms and anaesthetist happy for operation to proceed with plan for echo. Echo undertaken and the sonographer sends an email (to the wrong department) requesting cardiology review ENT sends the email back to urology Urology sends a letter to the GP to arrange cardiology review GP phones mum/makes referral Sadly mum dies before appointment You say in your original post that there was no worrying signs and your mum never had any issues with her heart. The irregular heartbeat was noted and acted approrpriately in my opinion. The anaesthetist wouldn't request specialist blood tests to diagnose heart failure as mentioned by Sali. It is outwith his specialist knowledge and he was unaware of the fragility of your mum's heart which only became apparent from the echo. Even more important is that an left axos deviation does not necessarily mean there is heart failure. There were no adverse signs of decompensated heart failure and he was happy to proceed with the op. An echo was requested which took 4 weeks - again that seems appropriate. Our routine outpatient scans are within 6 weeks. The sonographer quite rightly flagged up the result to the referrer (or so she thought). The email can be put down to human error. From my view this is the only criticism that could be made but doubt it would have had any effect on the result. Urology got the mis-sent email and let the GP know about the need for cardiology referral. In my health board (Scotland) we would be the ones that do that however I understand England's system is different and the GP is asked to do this. The urologist will likely have dictated a letter, time it is typed by the secretary and then approved and posted out this could account for the apparent delay for the GP being made aware. It could be argued I suppose that if it was classed as priority then he should have phoned but that is conjecture based on the information available to him and indeed when he received it (could have been on annual leave/ ENT delayed in sending it to him etc). The GP received the letter and contacted your mum to say she was being referred urgently to cardiology. The letter was dated the 19th but that certainly didn't mean the GP received it then and the delay in posting, then the secretary receiving it and then the doctor reviewing it etc could account for this apparent delay. GPs - from my experience - have very limited time for paperwork/correspondence duties. The GP referred to cardiology and an urgent appointment was generated. In my speciality urgent appointments are within 6 weeks. Please don't think I am getting at you or criticising you in any way. Just thought my impartial views from someone in the health service would be useful. If I have got anything wrong please let me know.

Sorry to hear about your accident. I doubt very much that any surgeon would amputate such a short while after a accident. Conservative measures would be first to be tried then radical options considered next. Do you have follow up? You might end up with a middle finger you can't feel but amputation can lead to other issues as mentioned above - you say you are right-handed. You may need to learn to write again which could be even more frustrating!

Sorry your original post is a bit confusing. Who diagnosed the fractures and how did they diagnose them if the CT and MRI showed nothing. Who ordered these in any case? I had a bad sprain playing hockey at High School and still to this day have issues with that ankle. I have a valgus deformity (turns in) and excruciating plantar fasciitis. What do you hope to achieve?

I'm a rheumatology nurse specialist and today I completed 3 medical supports for ESA. They give you 5 working days to get the info back to them so had to stay late to type these myself as a dictated letter takes at least a week to be typed. All three of these patients had very different systemic rheumatic disease. The burden of ESA (and soon to come PIP) on these patients (and their specialists) is ridiculous. I fear there may come a time where I have to say "sorry, I can't help on this occasion" which is not why I became a nurse! Re: OP. Sorry to hear of your wife's problems with her PsA (and treatment!). MTX is a good drug but like many DMARDs has side effects some find intolerable! I would not call it chemotherapy in the oncology sense as technically all drugs are 'chemotherapies' but it should be recognised that there are well known and common side effects (nausea, diarrhoea especially) of MTX. Interestingly you say her PsA has been getting worse over the past few months? Has this been looked at? She may need changes to treatment. Do you have a local CNS you/your wife could contact for advice? My advice to any patients filling out the form or attending a medical is to make it your worst day and lose the proud stoic-ness! If you can only comb your hair 5 days out of 7 then you can't comb your hair! If you can't lift a box every day then you can't lift a box. Best of luck!!

Well from the stuff I've read they have no right to withhold these notes without valid reason. A complaint to the practice manager/senior partner. It would be useful if he copied the relevant parts of the legislation. Then through the complaints process. A letter from a solicitor however might be more forceful and require them to act.

Having a quick Internet search it would seem he has the right to see the medical records but the GP surgery will have to make sure it is appropriate eg an abusive partner trying to get the address of their ex via their child's records etc An honest letter about his concerns describing his request should do. If not then a solicitor's letter might have more persuasion!

Having a quick Internet search it would seem he has the right to see the medical records but the GP surgery will have to make sure it is appropriate eg an abusive partner trying to get the address of their ex via their child's records etc An honest letter about his concerns describing his request should do. If not then a solicitor's letter might have more persuasion!

Sorry didn't explain myself. If his visits were cancelled because of a hospital admission is he barred from visiting the child by the mother or is it such a short admission that visiting would be pointless. The reason would be is that if he could visit he could ask medical staff the situation. M Regarding medical records I'm not sure about that one. Having parental responsibility and being named on birth certificate is obviously in his favour but I assume the mother Is the primary care giver and I'm not sure about the law in that regard. He should try and get access to the records and then if that fails to seek legal advice.

So he doesn't get to visit the kid in hospital or is it just a short admission? I assume he lives close by as he is registered at the same GP.

"my teeth are in a bad way" Is that entirely due to the dental treatment or lack of care over the 40+ years? I think you would be laughed out if they were expected to pay for your treatment. Understandable it put you off dentists (im not a big fan myself) but I assume you needed the fillings as you had caries? Experimenting on people without informed consent was outlawed long ago. I had root canal treatment in primary school (and the tip of the instrument snapped off in my tooth aswell) so probably not that unusual. Best if luck with whatever you do!

Congratulations!!

I hope you get the answers you're looking for. I'm on the 'other side' and find the system just as frustrating as a clinician. I assume the echo showed some problems that ultimately led to your mums death. Sadly it would seem your mum's heart was so fragile I doubt that any review by cardiology would have helped. But of course that's conjecture and leaves the 'what if' questions unanswered - and they are the toughest as they will never been answered. And, of course, I don't know your mum or her health condition(s). The irregular heartbeat was picked up by accident. If it hadn't then the outcome would have been the same most likely and you and your family would have likely accepted it. Of course that's not the case and I am certainly not criticising you in any way. If questions need asked then good on you for fighting on your mums behalf. Re: the PM - I assume that the coroner would have the report or at least a summary of it - as I also assume they are the ones who provided the death certificate? The PM report should go into the medical notes (hospital and GP) however I do emphasise *should*. Most systems are computer-based these days and the report should be easily obtainable from the hospitals system. Send a letter to the health records manager of the hospital requesting this information - state that the coroner and GP have no note of it. Even if paper-based the secretary should have a copy or at least sent it to filing. If you get no where with the health records department then try the pathology service manager. Best of luck in your quest for answers. I hope you get what you're looking for. PS The practice manager should be au fait with the legal aspects of running a practice. As it seems this doesn't seem to be the case!! But then the legal advice seems to be a hit and miss too so not entirely their fault I suppose. As I said, frustrating!!!

Most doctors who are registered to practise with a licence aren't specialists or GPs. When a doctor qualifies they have provisional registration (foundation year 1) and enter FY2 and full registration thereafter. Most doctors will then undertake their specialist training - whether medicine, surgery, GP etc. only upon completion of the certificate of completion oif training is a doctor added to the specialist/GP registers. They are fully qualified doctors but unable to call themselves a consultant or GP.

That is a hefty amount of anti-hypertensives! Is there a possibility that white coat syndrome could be a part of it? Do you monitor it at home?

I am a rheumatology nurse specialist and obviously understand scleroderma and its effects on patients and of course their families. I totally empathise with you and your son around DLA. I have had patients in tears frightened that they will lose their DLA - which they use to make their trips to hospital for treatment which keeps them in employment/functional members of society. It is so frustrating when expert specialist professional opinion is disregarded and some paper shifter makes a decision on a person they know nothing about. I'd like to see them trying to button a shirt when they have no finger movement/digital ulcers or indeed no fingers or can only walk at a snail's pace in extreme pain or so breathless as a result of their lung and heart involvement all secondary to their systemic sclerosis. I get many letters/request for information from the DWP about a patient of mine and their condition. This takes an immense amount of time. With the introduction of PIP this is only going to get worse. Rheumatology as a whole is affected quite badly by the changes to the disability benefits due to the nature of rheumatic disease. This is beginning to add a burden to already stretched services. Anyway, back to the original topic - best of luck for your son at his court date!

First of all, if we had to admit everyone with a BP of 185/100mmHg or above, the whole NHS would collapse. Also a 'normal' resting heart rate is 60-100. One BP measurement is pretty useless anyway and your BP can be affected by a whole host of factors (you thought about white coat sydrome?). This situation might have been caused however due to poor communication from your consultant - GPs are very good generalists but they are led (quite rightly) by the specialists and if the consultant said prescribe only on basis of BP less than X then he is quite right to withhold. A good GP of course would understand that these are recommendations and their clinical judgement of the patient and their situation should be included in their decision-making. GP blames the consultant and vice versa which leaves the patient frustrated. Your gripe is probably more directed at the consultant than the GP who is taking the Nuremberg defence!

Just to clarify, epileptic seizures are not only where there is unconscious uncontrollable body jerking (tonic-clonic). Seizures might not even be noticeable to the sufferer or a bystander, e.g. absence seizures. If you are concerned about what the actual diagnosis is, then make an (double) appointment with your GP who will have the discharge letter and might explain the reasons for your wife's symptoms. Some of your wife's current symptoms appear more drug related however, this might be a good idea to discuss with the GP also. Hope she feels better soon.

Just for clarity. Old GP refers to PCT to state needs cosmetic procedure on NHS as seriously affecting your mental health. Old GP left but got a response from PCT saying no. Your new GP refuses to refer you again and to a different person this time? You are of course entitled to a second opinion. Is the GP part of a practice with a few doctors or is he/she a single doctor? Can I ask, who is the 'appropriate person' if you have already heard back from someone I assume who has the authority to make a decision like this? Why are they not the best person - because you didn't get the answer you wanted? Is the other person more likely to say yes? Is there any appeal process? You can of course continue with your current GP to show the impact your condition has on your mental health or seek the second opinion as above. Has your GP (old or new) diagnosed clinical depression? You can't actually take legal action to force a GP to do something AFAIK. If you have a complaint, you have to go through the appropriate channels first. This will first be a complaint to the GP practice (usually the senior partner if a multi-partner practice). They should then reply and give you the information to escalate the complaint if so desired.

"I want what I want" Therein lies the problem. You are not medically qualified (I assume). You have taken SEVEN doctors opinions and basically rubbished every one of them until you wore one down enough to get what you want. You are frightened and from your PM (which I won't disclose here) you have had a sh!t time but berating, shouting, stamping your feet like a petulant child is not going to get you anywhere. You say you have heart problems...stress and high blood pressure won't help. You can rant and rave all you like but I would not get my hopes up about you getting anywhere with your referral. Consultants are usually not as nice as GPs and will likely tell you straight what the diagnosis is and what the treatment is. Although, I fear that to avoid confrontation, aggravation and aggression you will undoubtedly bring they will simply agree to your demands and an unnecessary and expensive test will be carried out which provides no diagnostic value. You are quite right that I don't know you, your situation or your medical problems but you ignore the ones that do (your GPs). I don't feel there is anything else I can contribute or say that will change your mind. I really do wish you the best for your appointment with the specialist and you get what you want.

Thanks Kitten, she is actually ok at being off over Xmas and New Year. She was rather worried that this could lead to a slippery slope of being basically told throughout the year when to take her annual leave.

I'm a nurse not a doctor and my usual stance for anyone looking for health advice on forums is to see their GP. Now obviously you have done that and come to this stage where you feel you have to post on this forum and feel the need for a formal complaint. You do seem to have a fixation on MRI scans and the perceived benefits that you think/hope they will provide to your treatment - if any. "and have told me they can stick a needle in it and drain it off...not on their nelly I WANT to see what it is via an MIR scan before they fiddle with it" A needle aspirate would be appropriate in my opinion. An MRI would not. The tissue/fluid could be taken and sent to the pathology lab for analysis to determine its nature. An MRI might tell if it is a solid mass or a fluid filled one - possibly might be able to determine its nature but not likely. An MRI will likely tell us the location and size of these growths but ultimately a biopsy would be required. In any case, I am sure a HRCT (High Resolution CT) scan is the standard imaging investigation here. I may be wrong and will stand to be corrected. "also to check my shoulders and arms due I wrenched the right one when I fell over a raised pavement outside my house 'The last doctor told me that they do NOT do referals for shoulder strains' from the surgery....whats that all about and I also need to have them check my forehead when my head hit the path as i fell and it has left a small crater to the top left sdie of my forehead" How long ago did this happen? Did you go to casualty after this trip over the kerb? Are you still having issues with your arm and shoulders? An MRI might be of use here then again could provide no diagnostic information. A skull depression? Where exactly is this? I am sure in an adult would likely be a fracture - even a hair line one - and I assume you don't exhibit symptoms of a skull fracture? Your rather dramatic description of a 'crater' would seem to suggest it's pretty serious. From my days in casualty, I think the gold standard is a CT scan rather than MRI in any case. I think the GPs have all acted reasonably. These advanced imaging techniques - if used in the way you propose - would bankrupt the NHS pretty quickly and cause patients with complaints that can be sorted in primary care to cause lengthy waits at radiology departments up and down the country. It would be great if everyone who came to their GP with a headache for instance could be offered a CT. 99.9% of them will show nothing. From your posts it is obvious you are worried that these growths are malignant (cancer). From the little information you have posted, to me it wouldn't seem that way. I know that's not going to alleviate your worry for you and your sons. But you do come across as quite aggressive and your GPs seem to have had immense patience with you. I know many GPs who would remove you from your list for much less. Rather than you 'winning' by getting your referral, it is probably so the GPs can get you out of their hair for a wee while at least. Good luck with your onward referral to whatever speciality your GP has referred you to.

You are obviously worried about your diagnosis and your inability to get the answers you need or want from your GP. This is very understandable and not a criticism in any way. If you feel you are writing things on this forum in the "wrong place" then I'd take honeybee's advice and start a new thread about the matter. Even if you post these in the wrong forums, the moderators wil - I am sure - move them for you. Although the OP's poster was about formal complaints she was really looking for support or advice on her issue not as a invitation to other users to post their particular issues. Of course anyone is allowed to post but yours is on a different issue entirely but I am certainly here to help hence my questions. My questions are specific as I think they will help you get the answers you are seeking. You might not have answers to some e.g. the MRI and GP referral question but surely one of the seven doctors has told you what it is and why the aren't referring you on? Your diagnosis? Surely you can check with the receptionist if they have the correct number rather than assuming they lied when they said they tried to contact you? As I said, I can understand your frustration but going in and shouting and arguing with your GP or his/her partners is not going to get you anywhere except booted off of their list and you will be back to square one. My questions were posted to try to get a better understanding of your situation and to provide you with advice and support. Making a complaint is entirely up to you and I sure the users of this forum will help your formulate one which can address your concerns about your health and wellbeing.

burlyb - you really should start a new thread but I feel the need to comment. 1. Have any of the seven doctors given you a diagnosis or an explanation for your 'lumps'? 2. Which specialty are they going to refer you on to? 3. Why do you want a MRI specifically? A CT scan +/- contrast is usually used in detection/classification of tumours affecting the chest, abdomen and pelvis. 4. Are your GPs allowed to refer for MRIs? AFAIK I think it is not commonplace. There is a trial going on in my health board at the minute for GP MRI referrals. 5. Why do you feel "it's too late"? You say you noticed the first one three years ago. Is your general health deteriorating? 6. Do the practice have the right telephone number for you?

Thanks for that very helpful response Becky. I didn't even think to look at the WTRs prior to posting. She has annual leave but felt it was unfair to impose it.

Posting on behalf of a colleague. Works on a standard 37.5 hour contract under Agenda for Change which means 27 days annual leave and 8 public holiday days. She works on a ward which is mainly elective surgery and is therefore going to close over the Xmas and New Year holidays and has been told to take annual leave. My concern is that there is no contractual stipulation that annual leave must be take over this period or indeed any condition which talks about 'forced' annual leave. I assume I am correct in saying an employer cannot force employees to take annual leave at a particular time unless a condition of contract? Also as I understand it, an employer has an equal obligation to fulfil a contract and therefore should be offered her full 37.5 hours or paid leave if they are unable to give work. Thanks in advance.