GP Surgery being a nightmare.

Hi everyone,

Some of you may remember me as I used to post regularly, however I've been lucky to be fairly well recently so haven't posted much. However, I am currently having some problems with my GP surgery and I wondered if anyone here had experienced the same or had any ideas as to how I address it.

I have pretty much always seen the same GP and as far as possible I will request to see her. There have never been any problems raised with this until now with other GPs commenting that my asthma is complex and that 1) they would rather I saw my own GP and 2) they don't actually know what to do when I am unwell.

However over the last couple of weeks it has become impossible to get an appointment with the GP that you choose. I have repeatedly requested an appointment with my own GP but told that this isn't possible. The GPs that I have seen in this period have both failed to recognise how unwell I was becoming and that I had a chest infection. This ended up with me being hospitalised quite unwell at the beginning of the week.

I got out of hospital on Thursday and found a letter from my GP surgery asking me to make an appointment with the head GP and the practice manager to discuss the problems that I was casing them by attending frequently - probably less than once a week which considering how unwell I was getting was nowhere near close enough monitoring according to my consultant - and insisting on seeing the same GP.

Has anyone else had any problems obtaining continuity of care at a GP surgery and does anyone know where I could find information regarding my right to continuity of care and to choose my doctor.

Any support / help welcome. I am a bit perplexed by their problem to be honest.

Em

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Welcome back, good to see you again, but I'm sorry to hear that you're unwell again.

I've not got much that's constructive to say, as I've not got much experience of dealing with an uncooperative surgery. I don't think you're being unreasonable in your expectations of better care from your surgery. I think you should make it clear at this meeting they've called you in for that the severity of your asthma and the chest infection had not been picked up when it should have and that had it been then you might have avoided an admission. Also give them the feedback from the consultant. I wonder if you contacted your cons, if they would write a letter re-iterating that you'd not been adequately monitored.

I consider myself to have a good surgery and attentive care which has helped me avoid hospital many times. I'll always be able to get a same day appointment (as long as I phone at the right time in the morning), I often won't get to see the GP that knows me the best, but I would consider all my GP's to be good listeners and if they're not sure what to do they'll ask me/ask another GP at the time, they'll also make a follow up appointment for me with the GP who knows me best (who has an interest in asthma). I have regular review appointments (frequncy depends on current control). I can turn up anytime I need a neb. My primary care is fab. Hopefully your GP surgery will follow this example.

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Wow Em, that letter sounds very upsetting.

How would you feel about quoting it? I'm wondering if there's any possibility that you've misinterpreted - I would hope that their concern is for *you* and not for their frequent-attender stats.

""Frequent attenders"" - as we are commonly known - fall into a number of categories. Some have health anxiety or mental health problems, but the majority simply have a chronic condition that requires a lot of medical intervention or advice. In addition, ""Frequent attendance"" is defined as being in the top x% of attenders at that practice - so by definition even if we all only went once a year, and a few people went twice a year, those attending twice would be ""Frequent attenders"".

I saw my GP 3 times in 1 week recently. On the Monday I had a routine appointment as we're still unravelling loads of stuff to do with my new diagnosis, then on the Monday night I became acutely unwell, so I got an emergency appt on the Tuesday morning and sure enough she packed me off to hospital, and on the Thursday I saw her to follow up on what had happened at the hospital and how we might spot that kind of incoming emergency in future. I've no doubt that I've had at least 20 appointments in 2013 - maybe as many as 30. I've also had six hospital admissions so it's not like I'm taking the mick. My GP surgery are absolutely brilliant about it, but I was briefly under CMHT after I had a flare up of PTSD following being attacked by a patient with dementia in hospital, and my CPN gave me a total complex about how frequently I saw my GP.

Do I feel weird about how often I see my GP? Of course I do! And with all the stuff in the news about how overstretched GPs are, it's hard not to feel guilty, but the fact is that a GP appt is a heck of a lot cheaper than a hospital admission. Your admission will have cost your GP practice money - much, much more money than your normal appts.

It's possible that actually they want to put something in place that makes it easier for them to support you - I would hope that this is the case. With complex, chronic conditions I absolutely stand by your need to see the same GP whenever possible. Personally I can look and sound quite 'well' when I'm really not, unless you know what I look and sound like normally... !

It might be that they want to agree some extra protocols with you - for example I had an arrangement where I kept 2-3 days of high dose pred at home, and then could ring and speak to any of the Drs or the asthma nurse and get a full course (including the back up surplus for next time) put straight through to the pharmacy for my partner to pick up within an hour or two. Or - they might feel that actually you need to refer yourself to A&E or MAU at a lower threshold.

I'm hopeful that it's not nearly as confrontational as it sounds - it would be extremely abnormal for them to be meeting with you to challenge your use of primary care, it's much more likely that they want to understand what's going right and wrong and find a system that works better for you. It might even be that they decide to 'green card' you so that you can always get an appointment with the GP that knows your asthma best. I now have a complex health condition where I can't leave even a minor infection until the next day - it either requires aggressive treatment or admission to hosp, and my surgery appreciate that symptoms might not always be present at 8am when you have to ring for on-the-day appointments - they'll always squeeze me in the same day, just as they do with people who've had accidents in our area (we're very rural).

However it turns out, they've obviously worded the letter extremely badly in order to cause you this level of anxiety. I hope it's a good meeting, but do let us know how it goes. If you would feel better knowing in advance what it's about then I wouldn't hesitate to ring the practice manager to ask them to explain it a bit more. It would also be a really good idea to take another person with you to witness, take notes and help support you if you get upset - personally I can get just as upset if people are being nice as if they're being difficult!

hth,

Cx