Beeing referred questions please!

Hi, Wondered if I could get some advice/experience please.

I have an appointment with the GP to get my son, 2, referred to a consultant for his asthma. This shouldn't be a problem as in his asthma nurse's opinion he should have been referred already but we were hopeful to try and get things sorted with his community nurse.

My dilemma is whether to get referred to my local hospital (where he was born, in nicu, and has had all of his care so far. I also work there in another department) or a specialist children's allergy clinic in the next city.

If he were to go to our local I would ask the GP to refer us to specific consultants who have special intrest in respiratory, whether this is possible or not I don't know. They are general paediatric consultants who have a special interest and do clinics in those, as far as I know there is only 1 specialist paedatric respiratory nurse too. Working there I could probably have closer access to them/their secretaries if needed. I couldn't guarantee what they'd do in terms of allergy testing etc. It would mean all his care was kept in the same place also.

If we were to go to the hospital at the next city he would see a specialist paediatric consultant working in allergy and immunology including asthma in a specialist allergy and immunology clinic with quite a few nurse specialists. I'm confident they would do allergy tests (he is milk intolerant and takes daily antihistamines for airborne allergies. we are very very confident about him being allergic to cats but haven't had any tests for anything for definite) but I'm worried about them focussing mainly on his allergies rather than his asthma. I know they are linked but the asthma is the main problem, the allergies aren't as uncontrolled as his asthma. Also it would mean they would have to liase with our GP and our local if he was admitted etc and I know sometimes messages and plans don't always get there. Also would they be able to suggest open access to our local hospital CAU? I only want this as none of our OOH GPs seem to have any sats equipment for paeds which isn't helpful when he's bad but he's not wheezy. Would I be able to ask for a care plan to be written so I could show/explain to our local hospital everytime he has to go in so they know what is suggested by the consultant at the other hospital?

Sorry for such a long post but I'm sure you've all been in the same situation where you really just want someone to help and take it seriously. I just want someone to take charge and say this is what you need to do if he's bad, good, in hospital etc so everyone can follow it rather than the GP suggesting one thing, asthma nurse another, OOH GPs another! I just want to get it right for his sake.

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From personal experience of having deal with a general pediatrician then one who specialises in pediatric gastroenterology qnd allergies (my son hqs severe gerd and cows milk protein allergy as well as asthma), the difference in levels of knowledge and thinking outside the box we found with the second specialist was amazing but I can understand why you may want to go to people you know and trust.

Hope this makes sense!

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[yaf_user681_30355]

Is it the same for children's referrals that you can use the choose and book? And then you can take a few hours to decide. For my asthma, I was able to reduce a list to 3 choices at the surgery along with the nurse practitioner/asthma nurse who referred me and then decide once I was at home after looking at the hospital websites.

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Thanks. We can choose and book so these will be the choices. We see his community nurse next week so willhave a chat with her and GP and get their opinions. My main worry is that there may be communication issues being in different hospitals and trusts.