What's normal with private consultations and NH... - Thyroid UK

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What's normal with private consultations and NHS records?

Puddleperson profile image
10 Replies

My question is:- If one sees a consultant doctor privately, who then prescribes medication and informs the patient's GP of what he has prescribed, is it usual for that information to be added to the patient's medical record?

I have been consulting a private endocrinologist who has been helping me to find the right dose of NDT and T3 to suit me. After each consultation the endo writes to my GP to advise what is being prescribed and what the new dosages are. He also asks for GP to conduct a blood test for TSH, FT3 and FT4 after 2 or three months. This, I thought, was working well, until this week. I presented myself for the blood test and the nurse knew nothing about it, said there was nothing on my record to show I was taking anything or seeing anybody and no record of a request for a blood test (I have copies of all the letters sent to my GP). She asked if I took thyroxine, I replied no, I take NDT and T3.

When I looked up the results I discovered that they have only done TSH and T4, which is a shame as it is the T3 that has been increased during the past 3 months. The accompanying comments were:- 'stated to be on thyroxine ' and TSH below reference range for patients on thyroxine. Also that T4 is below reference limit. They want me to make an appointment to discuss with my GP - that certainly won't be happening! I don't give a rats what the numbers are as I feel better than I have done for years but this is what they are:- TSH .25 (.35 - .4.5) FT4 3.6 (11.0 - 24.0)

I am incandescent that someone has seen fit to ignore information that a Professor of endocrinology deemed important enough to write to my GP about, which has now caused confusion, errors on my record and a missing result, but before I poop off loudly to my GP practice is this normal?

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10 Replies
SlowDragon profile image
SlowDragonAdministrator

Suggest you make copies of all the letters and either make an appointment with GP or practice manager to ensure these are added to your medical records

Puddleperson profile image
Puddleperson in reply to SlowDragon

Thanks - I certainly intend to do that. As far as I know, which can't be for certain, it's secretaries who open the post then decide if a GP gets to see it - or not.

SlowDragon profile image
SlowDragonAdministrator in reply to Puddleperson

I had to get endoscopy done privately, and gastroenterologist wrote to GP to say I was definitely gluten intolerant and same consultant also did DNA test for coeliac on NHS

There was zero mention of any of this on my medical records

Puddleperson profile image
Puddleperson in reply to SlowDragon

Ah - thanks, it seems I am not alone!

SlowDragon profile image
SlowDragonAdministrator in reply to Puddleperson

at my annual review with GP I take in copies of recent private test results to be added to medical records

I can’t get Ft3 tested on NHS, even though I get T3 prescribed on NHS 🤷‍♀️

Puddleperson profile image
Puddleperson in reply to SlowDragon

That is utterly ridiculous. They want us to believe that T3 is too dangerous to take and far too dangerous to buy over the counter yet they won’t measure how much is in us if they do prescribe it. Where’s the logic in that!

Jaydee1507 profile image
Jaydee1507Administrator

Expecting the NHS to test FT3 is not likely to work unfortunately. Most members of this group pay for private blood tests to ensure they can see the levels they need to. FT3 is barely on the NHS's radar even if requested and its the labs that veto it even when requested.

It's strange how the NHS link in with private healthcare and its not always in the way we might imagine. Medicines can also be difficult to understand. For instance I am prescribed 2 medicines by different NHS consultants that come direct to me from their NHS hospital pharmacy. They do appear on my NHS record summary but the Liothyronine prescribed by a private Endo doesn't.

In many ways when you are getting private treatment its a favour your consultant is asking of your NHS GP to do blood tests.

Puddleperson profile image
Puddleperson in reply to Jaydee1507

Seems like I was lucky to have had T3 tested by the NHS the previous 3 times. I guess all good things come to an end ☹️

Framboise profile image
Framboise

No, it seems GPs don't have to include private treatment in medical records if they don't want to. When my records appeared online they didn't mention that I'd been treated privately for hypothyroidism for 20+ years, despite having been referred to the first specialist by my GP, who then promptly refused to treat me but was always happy to arrange blood tests, including FT3, when I asked. All other private consultations I'd had for things my GPs did understand, were included.

The GPs who knew my history had all retired by the time I realised this, and although I talked to the new GPs and gave them copies of every letter I had, they wanted original letters from each of the specialists. Thankfully, my current private endocrinologist was happy to resend all his and those are now included, but I still had to insist and point out that one day someone might really need to know - accident, ICU, coma etc.. On the downside the new GPs won't arrange my blood tests now without a letter from the endocrinologist.

Puddleperson profile image
Puddleperson in reply to Framboise

Thank you Framboise, that's really helpful summary, if somewhat depressing. I am incredulous that a GP practice can choose to hide something that a far senior medical expert has deemed important enough to write to them. I can't decide whether it's arrogance, ignorance or simply fear that they will be seen to be acknowledging that a condition exists, that requires treatment, outside of the precious 'guidelines'.

Like you, I have always been very nervous of ending up in hospital with no evidence of the medication I need and being forced to go 'cold turkey' on top of whatever other condition may have landed me there. It would not be a good way to recover.

I shall write to my GP practice to get my record corrected and ask, (somewhat more politely than I would have, before seeing everyone here's very helpful replies) to place details of my prescribed medicine on my record along with details of the practitioner whose care I am under for this condition.

Thanks again everyone.

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