"Misdiagnoisis, medication refusals, appalling..."

Dear pt – we take any comments / concerns made by our patients seriously. We would be more than happy to discuss these matters in person – either with the practice manager or Doctor of your choosing. As the comments were made anonymously – we cannot make reference to your specific concerns, however are more than happy to discuss in general your concerns and outline Alpine House policies.

Firstly with regards medication – Alpine House would never refuse to prescribe medication on basis of expense. Refusal to prescribe will be dependent on Leicestershire Medical

Strategy Group [LMSG] guidance, the clinician’s experience with specialised medicine and the clinical evidence available to support the use of medicines, in particular those of low clinical value. The reasons for not prescribing hence are in patient’s best interest. If we are unable to prescribe, this will be discussed with the patient and arrangements made for alternative route undertaken. The patient will never be left without medication.

Secondly, with regards itching – this is not a uncommon scenario and there can be lots of causes for this. Scabies is one of a list of differential diagnoses that can cause chronic widespread itching, in particular if there has been a possible source and other close contacts with similar symptoms. Treatment is to usually apply cream all over for 12 hrs and poss repeat 1 wk later.

With regards referral for fertility treatment as per secondary care, this is again a common issue dealt with in primary care – so am a little puzzled as to why the Dr was uncertain of what to do in this context. Prior to referral, there is a clear pathway that needs to be undertaken including various investigations for both parties. If these investigations have not been performed, the referral will be returned directly to primary care without pt being seen with a request to undertake said investigations.

With regards investigations performed by secondary care, unfortunately it is not unusual for primary care to be simply sent results without context or without knowing who requested them. Hence it is difficult to ascertain who has responsibility/ownership and therefore, if there are any concerns, it is in patients best interest to be contacted.

Finally, with regards asking pts to leave the practice – it is practice policy to do so only if they have moved out of practice area or if there has been any aggressive/abusive behaviour at the practice – for this we operate a zero tolerance policy