"Nurse Practitioners versus Doctors"

My  Grandson woke with a sore throat, therefore my Daughter provided some antiseptic throat lozenges assuming it would be a simple virus. Several days later his condition worsened, complaining and crying with chest pains and severe lethargy.

It was a Saturday evening when she called the NHS out of hours service and she was given an appointment to be seen at the Queen Margaret hospital, Dunfermline. He was seen by a Nurse Practitioner who examined him, finding a swollen membrane in his ear and a wheezy chest. They informed my Daughter they were also concerned about the amount of pain he was in.

Nevertheless, they prescribed an antibiotic and sent him home and said if he had not improved by the following Tuesday she was to call the GP. Indeed there was no improvement, he seemed worse, so she called the GP practice and asked to speak to a Dr. The receptionist asked her if it was "an emergency". When my Daughter was asked this question, she thought 999 life thrreatening, therefore didn't feel it was but she explained my grandson had been to the out of hours emergency and was specifically told to speak to her GP if she was concerned. The receptionist advised her to call the following morning at 8. 30am.

She did that and managed to get an appointment with the Dr, who on examining my Grandson heard a "dullness" in his lung. He sent him that day for a chest x-ray, and then called my Daughter with the results saying he had spoken to a Paediatric Dr at the Victoria Hospital, Kirkcaldy, and they wanted him admitted to their care for further investigation.

Initially, they informed us my Grandson was suffering from Pnuemonia, but then the CT Scan later revealed abcesses in his lung, and informed us he was being transferred to the Hospital for Sick Kids in Edinburgh. They performed ultrasound scans and diagnosed Plueral Effusion. That was two weeks ago and he been to theatre to have a chest drain inserted to drain fluid from around the lung and chest wall, as he was not responding to antibiotics alone.

Both hospitals have been extremely thorough and marvellous, but my concern is the Primary Care prior to my Grandson being diagnosed. If the Nurse Practitioner was concerned about my Grandson's chest pain and wheeziness, why was he not referred to be seen by a Dr straightaway? Instead, he was sent home with a course of  antibiotics and suffered for another 5 days before receiving medical intervention. My Daughter trusted the Nurse Practitioners advice saying it would take several days for the antibiotics to "kick in".

I think the primary care, especially where children are concerned failed on this occasion and we feel this child was neglected of a proper diagnosis and subsequent treatment which might have avoided his condition to become so serious.