Cancer diagnosis after gp took 3 months to send referral to specialist

[think about it]

Gem77, firstly I'm so very sorry to read of your OH's diagnosis.

 

I am, what some people on here would call 'one of them' and work as a GP practice manager. You absolutely should complain. If, for whatever reason your OH's referral took months to be sent then there's a serious breakdown somewhere.

 

You can initiate the complaint and handle it on your OH behalf, all I would ask in the circumstances is that he sign a consent form to signify that he is happy for us to deal with you in respect of his confidentiality.

 

If this were me, knowing the way things work as I do, I'd first ask for a copy of his medical records, you want a brief summary with all computer held attachments. They can only charge £10 for this and again, as a PM, I'd waive that in the circumstances. There is no set format that your complaint must follow but do address it to the PM and, in these circumstances I'd be minded to copy in your local health board concerns team too.

 

I'm trying to type this on a mobile so please bear with me, I'll get onto my PC in the morning and do what I can to help.

[think about it]

Gem77,

 

 

 

Apologies for the delay in getting back to you. You’ve already been given some excellent advice in respect of writing to the PM and, for the time being at least, concentrating on you and your OH.

 

With regards to his COPD / Pre Operative assessment I can’t begin to think of a reason why the PM wouldn’t agree to bringing that forward besides perhaps the equipment not working or something similar.

 

When you go in today ask to speak with the PM and, if they’re not already offering (and they should) ask to go somewhere private. Now, it’s possible that the PM may not be there, I work part time andso do lots of my colleagues, so in that case it’ll be worth asking for a callback. I think the world of my receptionists but would ask that they leave things like this to me.

 

I’d explain to the PM briefly what’s happened, there’s every chance that they aren’t aware of your OH’s diagnosis and the issues around the referral. It’s a good opportunity to start the process and to get things in your favour.

 

I have to be honest, I have a sliding scale of dealing with people who might get angry. If someone walks through the door shouting then they’ll politely be ushered back out. However, it’s perfectly reasonable for someone in a situation such as yours to not be perfectly calm.

 

Each surgery may handle referrals differently in terms of how they’re actually sent. We have the GP’s do their own, electronically, through the ‘gateway’ provided by the health board. That means we can track their progress and see ones that haven’t been viewed by the hospital. However, in a neighbouring surgery the GP’s dictate their referrals and a secretary sends them via the gateway. It’s a matter of preference but I honestly can’t see why it would take so long to send your OH’s. Our system allows us to categorise referrals in three ways;

 

Routine – join the back of the queue and wait your turn

 

Urgent – A polite request to the consultant to review the case ahead of the routine referrals and make their own, informed decision about how soon to treat.

 

Urgent Suspected Cancer – review referral almost immediately, if indicated put patient at the top (or as close as possible) of the list and expedite treatment.

 

If this were me, I’d ask for the following:

 

A sit down with the PM and GP concerned to review the notes and referral and sight of all letters to and from the hospital, if you’re especially concerned or worried about dates being amended, you can ask to see the audit trail – no action on the clinical system goes without being logged, this log cannot be edited, in fact, even viewing the audit trail is logged on the audit trail...

 

If as a result of this meeting you decide you’d like copies then please ask for them. Once you’ve seen these you may be in a position to make a decision on what you’d like to do next. I would complain, I think that it’s only right to.

 

There’s some value in at least having a think about what your preferred outcome of the complaint will be, as a GP practice we’re able to investigate and when needed change things to prevent a re-occurrence and offer an apology. That may not be sufficient and it’s a decision for you both to make. Someone has already offered some detail about the litigation side of things so it’s not my place to guide you one way or another on this.

 

You can get any number of agencies involved to help you though the process if you feel it would be of any use, specifically PALS (links further up), your local health board, local patient participation groups, Citizens Advice Bureau and Macmillian, there are probably many more but again, it’s an option, not a necessity.

 

Complaining directly to the practice initially does not prevent you from taking other action later on.

 

I’ll happily help however I can. Good luck and I hope all goes as well as it can in the circumstances.

Edited October 20, 2014 by think about it
spacing all over the place after pasting in from MS Word

[think about it]

Well that wasn't too bad not as much of a fight as I thought. I kept my cool moved it forward to 31st October. Amazing how they go from no appointments to suddenly oh there is one as soon as you show a little bit of persistence think when we said the word cancer that helped she seemed to go a bit panicky.

 

In all honesty, if there wasn't an appointment, I'd have made one.

 

There really is no need for a fight, believe me we're never immune to hearing that people are unwell. We do get better at dealing with it but hearing that someone is ill or worse always has an effect on us all. It wouldn't be the first time for me to go home feeling upset or shocked at learning of someone's diagnosis.

[think about it]

Am I the only one a little perturbed (maybe I didn't read the posts thoroughly) that the OP is organising an earlier COPD test. There was I hoping that the patient's GP and consultant (and their team) would have thoroughly reviewed the patient's notes prior to him appearing on the operating table and ensured that this test was scheduled in beforehand. What happened to pathways of care - or was this just political spin?

 

Sali / Gem77, the OP's OH will most definitely have a full pre-operative assessment before anything is done, the anaesthetists will need to know exactly how well the patient can tolerate the surgery before he/she would dream of proceeding, likewise the operating consultant.

 

The COPD review from a GP / Primary Care perspective is just that, a review into the patient and how well they're doing and a chance to discuss medication / lifestyle etc.

 

Only under the most extreme circumstances such as trauma would an operation be carried out without a thorough pre-op. I last had some 'work' done in 2008 and that required twilight sedation and even then I was put through the Pre-Op mill by the consultant, happily I might add as he said should something not go to plan I don't want to have to worry about giving you a general without a/ asking you first and b/ checking you over. Fair point really.

 

I guess Labour's promises belong on another thread, but I know that testing science has a long way to go before everyone gets a definitive answer within a week.