doctor refusing to refer to specialist

hi,

Brief summary as i don't want to continue my earlier post last month 'urgent advice needed' as urgent advice is not needed at present. My 3 year old son has had 4 lots of breathing attacks in the last 4 months - the last 3 requiring hospital admission overnight. On the first discharge he was told to reduce the salbutamol gradually until he was better. On the 2nd discharge they added two puffs of becotide continuesly. On 3rd discharge they doubled the dose of becotide and told me he needs to be referred to the respiratory clinic by my GP. Before the last attack i asked my gp to refer him to a specialist he refused saying that 10% of all children he sees suffer with asthma or related conditions and that the specialist cannot tell me anything more than he can. My GP received the letter recommending referal 2 weeks ago. I've been chasing it ever since. The gp rung asking to see my son in surgery.....i thought brilliant he'll then finally refer him. The gp asked me how he has been over the last week. I advised a runny nose 5 days ago - but has had coughs on and off. He asked if he was coughing at night, i replied no. He prescribed Salmeterol one puff at night if he starts coughing at night. I explained he doesn't suffer nighttime problems, only the night before an attack. He did not examine my son at all and said he looks well. He told me there was no need to refer him and gave me a leaflet about dustmite avoidance measures (which he gave me on my last visit when i asked for a referral) - he said the specialist cant tell me anything he cant - he did not request to see him again.

Sooooo......i'm angry that he did not refer me after the paediatric doctor requested it after his numerous attacks and admissions. So where do i go from here - my thoughts were to put a complaint to the practice manager as he doesn't seem to be taking it seriously, or ask for a second opinion from another GP at the practice. My colleague suggested contact MP if they still do nothing....any ideas and suggestions would be greatly appreciated. I just do not want him to get ill again, end up in hospital before they do anything about it.

Ndam x

10 Replies

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  • Hi im so sorry ur having problems but saddly im having the same sorts of trouble with my 8mth old son, i did a post a few days ago (if u want to read it it started 'hi im new here....') I decided to visit my health visitor whos at the surgery and she recommended i spoke with the asthma nurse at the surgery which my GP had told me wasnt at the surgery. I suggest u either contact the hospital directly and explain ur concerns otherwise see about changing GPs the problem i have with changing Gps is theres a waiting list but if theres more than one gp at the surgery maybe u could see another gp, hope that helps alittle but im new here so someone else maybe able to help more than me xxx

  • I am sorry that you are having trouble with your son and doctor and i hope that you get it sorted asap, i would say to keep persisting and asking him to do the referall and if he does not do it then do complain, I am having the same trouble with my doctor who wont refer me when i am really struggling with asthma and struggle to breath most of the time, I have asked him and written twice and still not got anywhere

  • It's so difficult when one has a doctor like this. I've been fortunate with the two GPs and lovely consultant who treat my son, although there are a couple of GPs at our surgery who havent been prepared to listen. I go to them as a last resort!

    The fact that the hospital has advised referral to a respiratory clinic should be good enough for your GP. If you havent got a copy of the hospital letter I would ask the surgery for one. I would then go to the practice manager, explain your concerns and say that you no longer have confidence in your GP and would like to change to another GP. At the very least, insist on the referral.

    It's all quite stressful I know, but I successfully changed my father in law's GP when we werent happy with the way he was treated, and father in law wished he'd done it years before. He put up with a frankly dreadful GP for over 20 yrs because he didnt want to make a fuss and didnt realise it was possible to change GPs.

    Good luck and let us know how you get on.

  • nadam

    u defo need to get copy of the letter from paed doctor who advised gp to refer ur son, then get a another gp at same or diff practice to refer u.

    i dont know whether its diff procedure or not, but where i used to work, if child kept getting readmitted with same prob - asthma- they would get automatic follow-up in clinic by asthma spec doctor (he is general consultant , but also asthma/allergy cons) so no referal from gpo ever needed.

    x x

  • Hello,

    I am sorry you are having problems with your GP. You could complain to your PCT, i had to do that when i was having problems with my sons GP. You will most likely have to do this in writing. You could contact a patient and liason service in your area to find out who to complain to.

    When i complained it took about four weeks to sort out, but I was successful in my complaint and my sons GP has been brilliant since (strangely!!)

    Good Luck and please feel free to PM me.

    Vicky

  • hi

    hi all,

    Just to keep you informed, i have put a lenghy letter of complaint to the practice manager today - according to guidelines they need to respond within 3 working days - if i get no satisfactory response i will escalate this - i'm doing this not only for my son, but also other patients at my practice that are treated soo poorly. As you may have read my GP prescribed Salmeterol for my son - the instructions he gave me were wrong - this is a preventer inhaler yet he instructed me to use it like a reliever. I more angry at the fact that it should not have been prescribed in the first place...NNOT RECOMMENDED FOR CHILDREN UNDER THE AGE OF 4. My son is 3. Lets see what the practice has to say for itself or i will be contacting the Primary Care Trust!

    Thankyou for all your replies.

    Ndamx

  • Ooo my little girl is on salmeterol too. She's 2!

    I don't know for sure but is the drug prescribed to children under 4 only when absolutely necessary? My daughter was also prescribed Seretide when she was 18 months and I think that's only allowed for children over 12 (I think!!) I have a hazy understanding that it's 'not recommended' as there hasn't been huge investigations into the long term effects etc.

    As for giving confusing advice as to how to use it....eeek!

    I so hope you get a reply to your letter. It can be exhausting fighting a case like this and trying to be taken seriously. It's terrible that even after admissions, it's still not being recognised.

    Good luck and let us know how you get on

    Emily.

  • Gosh I am beginning to wish I had not started reading all these as this is the 4th discussion on very similar lines (see my other posts). I am so sorry for your distress.

    As a specialist nurse who only deals with children with respiratory problems I do know some of what you are going through as I see it most days in our clinics.

    In fact the hospital doctor who suggest specialist managment could refer you child but you do have a right to ask for a specialist referal & you should not be put off if you do not feel you are getting anywhere with the GP. May be you could talk to one of the other partners explaining your fears. Yes maybe he does see children with asthma but the specialist even a paediatrician will see more complex or difficult cases but also will have the extra experience & knowledge to find the answers.

    Good Luck

    A

  • I completely understand what you are saying. I went through this my son when he was smaller. The first 18 months of his life we spent almost all of it in hospital. Sadly I ended up moving GP's before getting a referal done as when my son was 18 months I went to see the GP, told them he had a chest infection, they refused to examine and said it was a viral infection and nothing could be done except wait for him to battle it that night he ended up in hospital fighting to breath, turning blue. The ped at the hospital examined him and said he has a chest infection and sadly needed IV treatment and a 3 day stay in ICU. We have resently move again to another doctor as they took my son off one his inhalers because he hadn't had an attack for 2 months. New GP put him straight back on the inhaler and now 6 months down the line is under a consultant at the hospital has had yet anther treatment plan change but sadly it took my son being diagnosed with a heart condition that is worsened by a flare up of his asthma and for that consultant to say I am taking on his asthma care

    I would writ a letter of complaint to the surgery manager and move to a new surgery and inform the surgery manager in the complaint letter that are no longer going to allow your son to be medically neglected and as of the reseival of this letter you are no longer a patient of ther surgery. I would also name and shame th surgery by going to your local press

  • Hi....needs some advice....confused.

    Update - i wrote a complaint letter to the practice manager. Due to a technical error we got our refferal at the hospital....no thanks to my gp. I went to the hospital and they saw my son and told us to continue with becotide 2 puffs twice a day and this will be reviewed in 3 months. I explained the situation with my gp refusing to refer. She stated they did need the refferal and that she'd need to speak to one of her colleagues. She did ask who id prefer to handle his asthma to which i replied the hospital specialist - think they will review the whole refferal thing at his next appointment.

    My gp does not know yet that we have seen the specialist.

    My GP practice replied to my complaint...saying that they are still of the view that they can offer a more flexible service within the practice. Salmeterol is licensed for children over the age of 5...unfortunately insufficient clinical trial evidence produced to support use in younger children, however my gp states a single puff for my 3 year old is likely to be safe and effective for him.

    He then states that Becotide is not the ideal steriod inhaler for my son. He has prescribed FLUTICASONE one puff twice a day, until symptom free for 4 weeks, then one puff daily for 4 weeks, if he gets wheezy increase to 2 puffs twice daily. if this does not work he'll try something else.

    The gp will keep the question of refferal under review if his condition does not stabilise. I am entitled to a second opinion.

    So why am i confused...the specialist is saying stay on becotide whereas my gp has decided all of a sudden this is no good. He has decided this without seeing my son again and without asking me how he is doing. In fact he seems better...he was last in hospital 19th April. My instincts say ring the hospital and speak to the specialist and take their trusted advise. This is why it is important for one person to be managing it. Also is fluticasone okay for 3 year olds?

    In terms of my complaint the gp never justified why he did not listen to my sons chest.

    Nor still has he requested to see him in surgery.

    Just needed some advise before i put my reply together, all comments greatly appreciated.

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