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


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Hi I wonder if some one can help advise me on what I should do about this.

 

Six months ago my OH went to our GP as he was suffering from stomach pains, weight loss and passing blood.

The GP told him to have a blood test and do a stool sample and that he wanted to referrer him to the specialist as soon as possible. He gave him some medication to help settle the stomach.

 

My OH had the blood test and stool sample and took the medication. His stomach seemed to calm down and we heard nothing back so presumed the tests came back fine.

 

4 months later we receive a letter from the hospital with an appointment to see the specialist so my OH attends.

 

The specialist was very concerned and urgently booked him in for a endoscopy and gastroscopy.

When the specialist asked how long he had been experiencing these symptoms my OH told him he went to the gp 4 months ago. The specialist was shocked as they had only recieved the referral 3 weeks prior to this appointment and he said he should have seen him no later than 3 weeks after the GP appointment.

 

The endoscopy showed a large stomach ulcer and my OH was given more medication for it but they had also taken biopsies.

 

On Monday my Husband received a call from the hospital giving him an appointment to see the specialist which was today (yesterday actually now)

The biopsies have shown that he does have stomach cancer and now has to have his whole stomach removed.

 

The original GP appointment was around 6 months ago.

I really feel that had he been referred immediatly like he was supposed to the diagnosis wouldn't have been as severe.

To top it off my OH went to this same GP surgery not long ago with a chest infection only to find out that 3 years ago they diagnosed him with COPD which they failed to tell him of or to register it on his file.

 

I feel so let down by our GP. My OH has always been in fairly good health since we have been together 13 years. We don't often visit the doctor maybe once or twice a year have never needed to but this year when my OH's health took a sudden turn we needed them to be there to do their job and it would appear they did not, resulting in a devastating and life changing diagnosis.

 

Sorry if this is a bit of a rant, it has been a very emotional and stressful day. :sad:

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Hi gem

 

This isn't great, I hope your OH recovers fully. It sounds like your GP / surgery has made errors. You clearly need answers as to why it's taken so long for diagnosis to take place. You need to write to the surgery asking for an explanation as to why he was not referred sooner.

 

Send the letter Recorded Delivery. If they call you in for a face to face conversation, explain that is unacceptable and you prefer to communicate in writing. If they have been negligent then you have documented evidence to help your case.

 

http://www.nhs.uk/choiceintheNHS/Rightsandpledges/complaints/Pages/AboutNHScomplaints.aspx

 

http://www.nhs.uk/choiceintheNHS/Rightsandpledges/complaints/Pages/NHScomplaints.aspx

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Hi I wonder if some one can help advise me on what I should do about this.

 

Six months ago my OH went to our GP as he was suffering from stomach pains, weight loss and passing blood.

The GP told him to have a blood test and do a stool sample and that he wanted to referrer him to the specialist as soon as possible. He gave him some medication to help settle the stomach.

 

My OH had the blood test and stool sample and took the medication. His stomach seemed to calm down and we heard nothing back so presumed the tests came back fine.

 

4 months later we receive a letter from the hospital with an appointment to see the specialist so my OH attends.

 

The specialist was very concerned and urgently booked him in for a endoscopy and gastroscopy.

When the specialist asked how long he had been experiencing these symptoms my OH told him he went to the gp 4 months ago. The specialist was shocked as they had only recieved the referral 3 weeks prior to this appointment and he said he should have seen him no later than 3 weeks after the GP appointment.

 

The endoscopy showed a large stomach ulcer and my OH was given more medication for it but they had also taken biopsies.

 

On Monday my Husband received a call from the hospital giving him an appointment to see the specialist which was today (yesterday actually now)

The biopsies have shown that he does have stomach cancer and now has to have his whole stomach removed.

 

The original GP appointment was around 6 months ago.

I really feel that had he been referred immediatly like he was supposed to the diagnosis wouldn't have been as severe.

To top it off my OH went to this same GP surgery not long ago with a chest infection only to find out that 3 years ago they diagnosed him with COPD which they failed to tell him of or to register it on his file.

 

I feel so let down by our GP. My OH has always been in fairly good health since we have been together 13 years. We don't often visit the doctor maybe once or twice a year have never needed to but this year when my OH's health took a sudden turn we needed them to be there to do their job and it would appear they did not, resulting in a devastating and life changing diagnosis.

 

Sorry if this is a bit of a rant, it has been a very emotional and stressful day. :sad:

 

 

 

 

GOOD MORNING gem

 

 

I am so sorry to hear of you and your oh sufferings, like me and most other people we expect a certain level of care from our doctors, the thing I find most difficult to swallow is the way they treat us when we complain they try to deny defend and delay anything not showing them in a good light.

rebel11 has given you good advice the important thing is to act immediately and and tell your story on every website you can find the more the n.h.s is made to justify their mistakes the more they will have to change their attitude. my best wishes goes to both you and your other half.

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Thank you both for your replies and well wishes. I shall do as you suggest. Would it have to come from my OH or would they deal with me over it? Don't think he is really upto it right now and definatly won't be after the op.

 

How should I word the letter?

The consultant is also submitting a complaint against the surgery so I guess that will help back my complaint.

 

Thank you once again for you help at this very worrying time.

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GOOD MORNING gem

 

 

I am so sorry to hear of you and your oh sufferings, like me and most other people we expect a certain level of care from our doctors, the thing I find most difficult to swallow is the way they treat us when we complain they try to deny defend and delay anything not showing them in a good light.

rebel11 has given you good advice the important thing is to act immediately and and tell your story on every website you can find the more the n.h.s is made to justify their mistakes the more they will have to change their attitude. my best wishes goes to both you and your other half.

 

SHIRLI : your (self confessed) revenge mission against your perceived slights at the hands of the NHS might be blinding you .....

 

gem77 (the OP) ... Rather than " the important thing is to act immediately and and tell your story on every website you can find", I'd suggest that the likely most important things are:

1) Focusing on your OH's condition,

2) if need be use the situation with your GP as a "lever" to ensure you get best attention from your GP's from now on, and then

3) then try and find out what went wrong at the GP's, so they can explain to you how it happened, what they are doing about it for you and your OH, and what they are doing to prevent it recurring.

 

Which (or all!) of those are "most important" isn't my (or Shirli's!) choice ... It is your and your OH's choice.

Which is important to you now may also change as time goes on.

 

I suggest that "writing about it on every website" ought not be your current priority, so the only point I agree with Shirli on is that rebel's advice is good : write to the practice.

 

What do you want most from the GP's?

 

You certainly are owed an apology and an explanation.

In terms of compensation : that might be a long and difficult road (if they can claim the delay in diagnosis doesn't affect either the presence of the disease or its outcome, then they can claim the delay caused no new physical harm....)

 

So they might claim "he would have got stomach cancer anyway, it wasn't due to the delay".

Where you might want to ask the specialist is if the delay has caused any change to the treatment your OH needs now, or affected his chance of recovery ......

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Thank you both for your replies and well wishes. I shall do as you suggest. Would it have to come from my OH or would they deal with me over it? Don't think he is really upto it right now and definatly won't be after the op.

 

How should I word the letter?

The consultant is also submitting a complaint against the surgery so I guess that will help back my complaint.

 

Thank you once again for you help at this very worrying time.

 

The initial contact must come from him, as otherwise they can claim "we can't discuss it due to patient confidentiality".

 

The letter from him needs to include that he gives his consent for you to be given any details necessary regarding the complaint, and that you can both complain on his behalf and discuss it on his behalf.

He can, if he wishes, explain why, too (that he doesn't feel up to it now with the surgery looming, and won't feel up to it after the surgery, but it is sufficiently important [and urgent, so that it doesn't happen to anyone else!] that it needs raising now, which is why he is asking you to deal with it on his behalf).

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Hi gem

 

Thank you both for your replies and well wishes. I shall do as you suggest. Would it have to come from my OH or would they deal with me over it? Don't think he is really upto it right now and definatly won't be after the op.

 

You can write it, just get you HO to sign the letter.

 

How should I word the letter?

 

Mark it as, Formal Letter of Complaint. In your orginial post you have a very good understanding of what's happened, ask open ended questions, so you actually get proper answers. Keep it relevant and concise.

 

You could possibly start off with, 'I was diagnosed with stomach cancer on xx/xx/xxxx'.

 

Then the background with all the relevant facts including dates that led to the lengthy diagnosies, pretty much what's in your first post with more detail.

 

Then go on to ask the questions that you want answers to.

 

Then ask them to provide documents you want, i.e. reposts, results, admin notes etc. You will know what you want to see.

 

Thank them for their co-operation in this matter.

 

Send it Recorded Delivery. Also, at this stage you are not blaming them, but want the relevant facts from them in writing.

The consultant is also submitting a complaint against the surgery so I guess that will help back my complaint.

 

Ask him for a copy of it.

Thank you once again for you help at this very worrying time.

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Thank you all. Really don't know what I want at the moment. Firstly for them to accept some sort of negligence.

 

The main problem with the late diagnosis is the he will more than likely need chemo before surgery where as this could have been avoided if caught earlier meaning longer recovery etc.

We will know more next week when he has had a laparoscopy.

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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.

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Thank you So much Honeybee for sosing this to think about it. I really appreciate it.

 

Hello Think about it and thank you So much for your advice and help. Our GP used to be great. And slot of the Dr's were brilliant. I usually have the utmost respect for the nhs doctors and nurses. I am a crohns suffer and my consultant and nurse are brilliant. I can't fault the dr's and nurses that have been dealing with my OH. But over the last 3 years all the original Dr's have left our GP surgery and since then it has gone down hill fast I am not their only patient to say it.

 

I wonder if you don't mind me asking but my husband is due for a test for his copd it is booked in for beginning of December but now with this diagnosis we need it done like now so the hospital have the results for the op. We are going into the GP surgery tomorrow to sort this out but I know we will be in for a fight to bring it forward. Right now I can see me looking it with them if they don't give us an appointment pronto. Would it be best to talk to the PM to sort this out and if I was to loose it and start shouting the odds for the whole waiting room to hear would this damage my complaint. (I am not one to ever loose it and am a very shy reserved and quiet person usually) but right now I am feeling totally out of character and angry at them I'm not sure I could keep it together if they refuse to move the appointment.

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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.

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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.

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Well Done Gem.

 

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.
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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.

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Bazza comments that 'compensation: that might be a long and difficult road.' I would suggest most people are not seeking compensation, just honesty and (swift) remedy in whatever way possible when mistakes are made.

 

It's not good enough to say 'he would have got stomach cancer anyway, it wasn't due to the delay.' This is exactly the kind of thing that happens now. It's an excuse for poor training and/or incompetence and should not be tolerated. No person with two brain cells to rub together would expect a doctor to predict (at this time anyway) beyond any doubt that a person will develop this or that cancer. What we are rightly expecting is that they recognise the early symptoms and ensure that relevant tests and referrals are done in a timely mannner. This will effect the outcome - how long the patient suffers (physically and mentally), how severely the patient may be debilitated (temporarily or permanently), or indeed whether the patient lives or dies.

 

I agree with Think About It, before any letter of complaint I'd want a copy of my medical records. And from this point onwards I would keep a detailed record of who I spoke to, when and what was said. (Actually I would audio record whenever possible).

 

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?

 

When I read gem77's story, I wonder how the Labour party, if it gets into power, will ever achieve a one week cancer diagnosis. Dream on.

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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.

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