dreadful GP appointment - a locum

[Caradoc1a]

I've made some notes!! I will be contacting the practice manager with a view to them providing training in B12 treatment.

• ‘On the day’ appointment to replace a scheduled appointment the previous day, which had not been inputted into the system

• Did not read the notes I had provided. I had explained that I had a great deal of cognitive deficit from the B12 deficit, I offered to summarise but this was refused

• Did not ask about my neuropathic or other symptoms of b12 deficiency – I tried to volunteer these but was talked over

• Did not realise that my B12 levels had reduced by almost 50% in 12 months - just looked at the latest test from late November after I had take sublingual B12 for 3 weeks

• Did not ask about the history

• Said I needed coeliac test when I had already had a negative test for this

• Did not realise that I was awaiting the results of a H Pylori test

• A difficult consultation as I had to correct several mistakes. I encountered some resistance/hostility and was asked if I had a medical background as I had used medical terms and showed knowledge about this subject.

• GP made erroneous statements - ‘as you have a negative coeliac disease test, there won’t be another reason for malabsorption of B12 and oral B12 is fine to take’ & ‘as your serum B12 is now within range (624) there is no need for injections’

• When asked if he would arrange a test for Intrinsic Factor, he said there was no indication this could be Pernicious Anaemia. When I suggested it could be a type of atrophic gastritis which has led to malabsorption of B12, he said only a gastroenterologist would conform that and there is no need to refer. When I pointed out that this is one of the most common reasons for B12 malabsorption, this was ignored

• GP said that he would not follow Endocrinologist’s recommendation to give B12 injections (letter 3/12/24) When asked why, he said he did not know enough about the subject and as a GP he isn’t in a position to prescribe them.

• The GP said he did not feel comfortable to follow the NICE guidance and BNF guidance for when there are neurological symptoms with B12 deficiency.

• When I said that BNF and Shropshire Formulary give a green traffic light for GPs to prescribe these for B12 deficit, there was no response apart from he wanted to research it further and then he would make a decision. I asked when that decision is likely to be made and communicated to me and he said about a week

• He says he will refer me to neurologist and I asked about the timeframe and he said about a week (I really do not see this as a realistic timeframe)

• When I wanted to talk about the ongoing Left ear infection, GP made the point that the appointment was time limited and he was only paid for that amount of time. I would need to make another appointment.

[Nackapan]

Frustrating. At least t he is open to 'researching it further.He should read your notes . Last consult!!!

How can wd be heard without giving a potted history ?

As for the not following NICE guidelines I'm guessing he will now be reading them.

The time constraints are ridiculous.

I was told by one G.p to make s double appointment.

Receptionist opposed this of course.

Rebook .

The referral to a neurologist good .

It has a waiting list unless fast track/ urgent referral within 2 weeks .

One G.p just emailed an neurologist for advice on my B12 Injectikn regime .

I hate it theh ask if you are medical.

Irrelevant.

Arrogant even.

Didn't matter who you are . Everyone should be listened to the same.

[Jillymo]

Sounds as if your Gp was as arrogant as the swine of a neurolgist I was refered to.

*I would have asked if no neurological symptoms 'why the referal to a neurologist'.

*What are the guidlines there for 'if not to be followed'.

*He was prepared to send you for another coeliac test but not a gastrologist to investigate further ? ? ?

I would be furious.

[Caradoc1a in reply to Jillymo]

I was!!! I'll share my letter to the practice manager. My mate is checking it over, given my brain fog!!

[Sleepybunny]

Have you considered writing short letter to GP that outlines your concerns?

I think it's harder to ignore a letter.

Maybe you could include short quotes from NICE guidelines and your ICB's guidelines. Always keep your own copy. Maybe send a copy to practice manager.

Link below has letter templates for writing to GP about B12 deficiency.

b12info.com/writing-to-your...

You may have read these threads below already but putting them here in case you haven't and in case they help someone else reading this thread.

They have lots of links/info to help people struggling to get treatment in UK.

Patient Safety

healthunlocked.com/pasoc/po...

Is this the tip of the iceberg?

healthunlocked.com/pasoc/po....

I left detailed replies in this thread as well.

Help Needed! Have I got Pernicious Anaemia?

healthunlocked.com/pasoc/po...

I'm not a health professional.

Good luck with getting the treatment you need and with educating your GPs.

[Caradoc1a in reply to Sleepybunny]

Thank you. On my ICB website there is nothing about B12.

[Hockey_player]

You need a different doctor. The lines of communication are broken between you and this one. If you have neuro symptoms in spite of the sublingual B12, you need injections. Don't wait until you have permanent damage to get them.

[Caradoc1a in reply to Hockey_player]

Thanks. He is a locum. The B12 ampules arrive tomorrow so I'll be injecting from Sunday 🎉