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Urgent GP Referral downgraded

Posted By teslamoose

"Urgent GP Referral downgraded"

About: General practices in Lanarkshire University Hospital Hairmyres / Trauma & Orthopaedics (Wards 1 & 5)

(as the patient),

Visited my GP regarding neck pain / instability / tingling sensations.  GP examined me then sought advice from Orthopaedic dept. of local hospital.  They advised that I need an Urgent MRI.  GP said he would do the referral and I'd get a letter within a couple of days.

A week went past but I didn't hear anything.  So I rang NHS Referral Management who told me they had received the urgent referral, but that it had been vetted and downgraded and as a result I am now on a waiting list to see an "Ortho Extended Scope Physio" which has an *18 week waiting list*.   (I was told if I wanted to see a proper Ortho Consultant, there's a 30-week waiting list.)
So, I'm now expected to wait until approximately December to get this problem sorted out.  With no explanation as to why.  And when December comes around and I finally see this person, I still won't necessarily get the MRI that my GP and the consultant he sought advice from, thought I needed.
Please, someone explain to me how my GP can get advice from someone in the Orthopaedic dept. who tells my GP I need an urgent referral and yet when the urgent referral is put through, it is downgraded by someone else?  And did whoever downgraded it, know that I have an underlying condition which may be relevant? 
What on earth is the point of my GP taking advice and putting through a referral if it is just going to be ignored?   
Surely tingling sensations throughout my body, which is likely related to my neck problems (according to my GP) is not something that should be treated lightly.
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Responses

Response from Gordon Bryan, Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres, NHS Lanarkshire 5 years ago
Gordon Bryan
Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres,
NHS Lanarkshire

Submitted on 10/07/2018 at 12:42
Published on Care Opinion at 15:49

picture of Gordon Bryan

Dear Teslamoose,

Can I ask you to contact our patient affairs team as we need some private details in order to look into your particular case regarding the timescales and appointments.

I sincerely hope we can help, please call and speak to Christine McNeill on 01355 585325 and I will ensure a review of the circumstances.

Kind Regards

Gordon.

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Response from Gordon Bryan, Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres, NHS Lanarkshire 5 years ago
Gordon Bryan
Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres,
NHS Lanarkshire

Submitted on 13/07/2018 at 11:54
Published on Care Opinion at 12:08

picture of Gordon Bryan

Dear Teslamoose,

Thank you for getting in touch with patient affairs and providing us with the additional details required.


I can advise that the team at University Hospital Wishaw are currently looking into your concerns and they shall be in touch with you directly.

If I can be of any further assistance please do not hesitate to contact Christine again.

Regards

Gordon

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Update posted by teslamoose (the patient)

It's now 10 days since the update above and so far I've heard nothing from Wishaw Hospital. Meanwhile, I still have just as much neck pain and instability as I had when I saw my GP.

Response from Gordon Bryan, Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres, NHS Lanarkshire 5 years ago
Gordon Bryan
Senior Nurse, Surgical & Critical Care, University Hospital Hairmyres,
NHS Lanarkshire

Submitted on 23/07/2018 at 16:23
Published on Care Opinion at 16:25

picture of Gordon Bryan

Dear Teslamoose,

I am sorry that we were not in contact sooner.

As discussed today I have spoken with the physiotherapy department and as soon as a date is available we shall confirm this with you.

Regards

Gordon

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Update posted by teslamoose (the patient)

Gordon,

After reading your comment above I felt I should reply lest any other NHS Lanarkshire patients are reading this story and think that my problem has been sorted satisfactorily. It hasn't.

So basically in a nutshell, what you told me was that what the referral process deems 'urgent' is not necessarily the same as what a second opinion from a specialist sees as urgent. Then, why do GPs bother getting a second opinion at all, if it is going to be overruled by the specialists who deal with the referrals? No amount of repetition from you that "the referral just goes by the information provided by the GP" is going to help my situation.

I'm not proud of ending your call so abruptly but as I was in tears it was getting increasingly difficult for me to talk to you and that should make you realise just how much this problem has affected me.

So at this point, I want to know that this issue has been investigated thoroughly; I don't want generalities. I want to know (and as the patient, I believe I have a right to know):

1. Has the person in the Orthopaedics dept whom my GP consulted, been made aware that their 'urgent' patient has been downgraded?

2. If so, are they able to challenge the decision (after all, they must have had a very good reason for deciding it was urgent at the time)

3. If they haven't been made aware as part of this investigation, why not?

4. Has the person who dealt with the referral been questioned as to why they thought they knew better and downgraded it?

5. If it turns out that my referral was missing crucial information such as "urgent, on advice from so-and-so", has my GP been questioned as to why he did not include this information?

6. Why was I specifically told by my GP that I would be getting a letter regarding an MRI, when I've subsequently been told that this isn't how the process works and that a patient always must see a consultant before getting an MRI?

7. Why is it the case that a total of three different people will ultimately decide whether or not I am worthy of an MRI? (Is this not a massive waste of resources? Why should a patient require three different opinions?

In regards to bringing my physio appointment forward, well I shall have to wait and see whether that will be any help or not - I hope that he/she will actually take my condition seriously and not just fob me off with exercises. I never asked to see a physio - I should be seeing a proper Orthopaedic consultant about this problem.

I've had nothing but poor service, misinformation and delays from NHS Lanarkshire over the past year regarding a different health problem (which is still ongoing, and still has delays). I'd really hoped that it was a one-off; but after this latest debacle it's clear to me that NHS Lanarkshire is failing me miserably; and what is worse, it's clear to me from both situations, that my complaining (at least to the NHS) achieves absolutely nothing of use.

I would appreciate a detailed response to each of the numbered points I have outlined above. Feel free to email me with this, as I would probably prefer that over another upsetting telephone conversation.

Response from Susan Friel, Director of Nursing, Acute Services, NHS Lanarkshire 5 years ago
Susan Friel
Director of Nursing, Acute Services,
NHS Lanarkshire

Submitted on 24/07/2018 at 18:10
Published on Care Opinion at 20:42

picture of Susan Friel

Dear teslamoose

Thanks so much for meeting with me today. It gave me an opportunity to understand fully your frustrations with our services and systems.

I hope things went well today and you got the information you needed. Please give me a call if you didn't and I'll try to help.

As discussed, I'm going to phone the physio tomorrow and I'll give you a call to update you on this. As I said we will respond to you via letter to the specific concerns and questions you asked above.

Take Care

Susan

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Update posted by teslamoose (the patient)

Thank you Susan for taking the time to speak with me today, I think it helped a little bit to speak to someone face-to-face. I am glad that this situation is going to be investigated as an official complaint.

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