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"Urgent Care unsuitable for children"

About: Princess Royal University Hospital (Orpington)

12/4/13 Beckenham urgent care with 15 months old child wheezing and heavy breathing, waited 20 minutes, GP prescribes asthma aerosol and chlorpheniramine and says child might need antibiotics (amoxicillin) if not responding to chlorpheniramine, GP failed to check throat properly. 14/4/13 PRUH urgent care, child with high fever not responding to chlorpheniramine /ibuprofen/paracetamol and not eating, triage nurse fine, waited 20 minutes, nice GP who prescribed amoxicillin for possible chest infection but failed to properly check throat. 15/4/13 PRUH urgent care with child refusing to eat/drink and in pain despite ibuprofen/paracetamol, triage nurse fine, waited 20 minutes, GP diagnose tonsillitis and kept same prescription. 16/4/13 child develops mouth ulcers, Beckenham GP rules out chicken pox (outbreak at nursery), child in pain not eating and drinking little, no diagnosis for the mouth ulcers, send home. 17/4/13 mouth ulcers increases in number, child in pain not eating and drinking very little, Beckenham GP doesn't know what thmouth ulcers could be, change prescription for tonsillitis to penicillin V. 18/4/13 to PRUH urgent care with child not eating for 5 days and drinking 500ml a day in last 3 days, child wobbly on his feet, pale, dark circles, tearfull, constantly bringing hand to jaw and ear, triage nurse fine, waited 1 hour, GP diagnoses herpes stomatitis and says amoxicillin better than penicillin V for tonsillitis. We insist to a referral for pediatric, GP with poor english made referral over the phone in front of us giving wrong information and says paediatric refuses to see us. Made complain to nurse leader who listens and asks paediatric nurse to see us. Paediatric nurse in A&E sees us and administers Difflam spray to numb mouth and tonsils, 10 minutes later we are able to feed child a 200ml bottle! Paediatric nurse also informs us we can increase the dose of ibuprofen/paracetamol in line with child weight, also says penicillin V is an appropriate antibiotics for tonsillitis. Why none of the GPs has been able to prescribe Difflam spray and tell us we could increase ibuprofen/parcetamol dose to help our child drinking ? Background: a year ago after many visits to PRUH A&E we were taken urgently to the children ward with a severely dehydrated 6 weeks old baby needing to be on a drip and requiring urgent surgery for pyloric stenosis; for the previous two weeks we were told by several health visitors, GPs at Beckenham and by paediatricians at PRUH A&E that the baby was not dehydrated; the diagnosis only came after much insisting and complaining, it took 10 minutes for an A&E doctor to carry a blood test and confirm dehydration, next day the diagnosis was confirmed with a simple scan and the baby urgently referred to Kings Hospital. Children should be seen by paediatrician in the NHS, not GPs. Regarding PRUH, it's a disaster hospital in a bad location with poor transport links and too far from the borough most populated area

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