GP changed medication that he shouldn't have. Serious repercussions.

Fake_Northerner

Quick background on my mum.

She's on a concoction of antidepressants and antipsychotic medication. GP never prescribed the antipsychotic medication himself as that was done by a Dr within that field when she was diagnosed with a form of psychosis and informed the GP to carry on prescribing it. This has all been carrying on for 12 years now. Nothing's happened apart from when she had a 'crisis' after she thought she would be okay without the tablets about 3 years in. She realised after that she needed them and takes them religiously.

Now what's been happening now has all been told to me through my dad as I now live in West Yorkshire and they live in Hampshire.

She visited the GP 2 weeks ago to get her usual prescription. Within a few days my dad started noticing changes in her to when she had her last 'crisis'. Looked at her tablets and she didn't get given one of her usual tablets and was replaced by another. My mum told him it was just new packaging as the GP never mentioned anything to her about changing it.

This Tuesday (by this time she's in full crisis mode here) my dad went with her to the GP. He told them that he changed her prescription as he 'thought she'd be okay' and just didn't tell her! For one, he should have told my mum that he was changing it and 2, I'm pretty sure he shouldn't be changing something like an antipsychotic drug when that specific one was prescribed by someone else? Correction:GP didn't change medication. He lowered the dosage. Everything else applies. He still shouldn't have done thisThe GP then filled out a prescription for her old tablets to get her back to normal and there would be a home visit on Friday to check on her.

So yesterday another GP came to visit and first thing he said was 'this is not my field at all.. But I've informed people who are and I'm going to refer you to them and I'm just going to let them know her physical state from my visit'. Of course GPs arent specialists in mental health(!) Few hours later 2 people from the mental health crisis team come and visit and advise that it would be best if she spent a few days in the mental health crisis unit for her to be in the best care to get herself back to normal. So my dad drove her there around 20:30 and stayed with her til 00:20 til she fell asleep.

When my mums having a crisis she doesn't trust anyone, thinks everyone else is out to get her (even her family), a major ordeal to her to take her tablets as she thinks you're trying to kill her, thinks there's bombs in the house, she thinks she's thousands of pounds in debt (she's not), keeps saying she's a terrible mum (used to be an alcoholic when we were growing up), can't physically leave the house, will just stand in one spot moving her leg up and down one at a time anywhere in the house, can't have a proper conversation with her, just zones out all the time, etc. It's a lot to deal with. She's also now missed 2 weeks of work so far (at 3 different jobs), my dads missed 2 days at work. Thankfully he's not had to take too many days off as we've had my uncle and brothers gf who's stayed with her throughout the day when my dad and brother haven't been able too.

I'm asking who on earth do we complain to about this because I feel just complaining to the GP practice manager just won't do much. The GP should never have changed her prescription especially without even telling her.

tomtontom

Your first step would be to speak to the practice manager - you need an explanation as to why the GP changed her meds. Do you know what he changed her from and to? If you're not happy with the explanation then you can escalate the complaint, more about the procedure on the link below:

http://www.nhs.uk/choiceintheNHS/Yourchoices/GPchoice/Pages/GPcomplaints.aspx

j.e.j.

Fake_Northerner wrote: »

This Tuesday (by this time she's in full crisis mode here) my dad went with her to the GP. He told them that he changed her prescription as he 'thought she'd be okay' and just didn't tell her! For one, he should have told my mum that he was changing it and 2, I'm pretty sure he shouldn't be changing something like an antipsychotic drug when that specific one was prescribed by someone else?

:eek::eek:

That is medical negligence!

Someone I know is taking meds similar to your mum and the GP prescribes only what the psychiatrist has said to prescribe. Serious mental health conditions such as schizophrenia and psychosis are beyond the level of General Practice, which is why the patient gets referred on to the relevant specialists.

Hopefully someone will be along who can better advise on the protocol for registering a comment about what has happened, but this might be a good place to start with.

Fake_Northerner

tomtontom wrote: »

Your first step would be to speak to the practice manager - you need an explanation as to why the GP changed her meds. Do you know what he changed her from and to? If you're not happy with the explanation then you can escalate the complaint, more about the procedure on the link below:

http://www.nhs.uk/choiceintheNHS/Yourchoices/GPchoice/Pages/GPcomplaints.aspx

The explanation he gave my dad was that he 'thought she'd be okay'. That was it. I don't know what they got changed from or too but I've just text my dad to see if he can find out (though her tablets got taken with her to the unit).

sinizterguy

j.e.j. wrote: »

:eek::eek:

That is medical negligence!


.

It isn't.. ...........

tomtontom

Fake_Northerner wrote: »

The explanation he gave my dad was that he 'thought she'd be okay'. That was it. I don't know what they got changed from or too but I've just text my dad to see if he can find out (though her tablets got taken with her to the unit).

You need a formal explanation - there will be clinical reasoning behind his decision and until you know this no one can decide whether it is negligence or not.

Secondary mental healthcare is woefully lacking, and whilst it would be ideal that all decisions are made by a specialist, there simply are not the resources for this to happen. Whether this decision was in the GP's remit or not - you'll need the explanation to establish.

j.e.j.

sinizterguy wrote: »

It isn't.. ...........

..isn't it??

Sneaking an 'alternative' medication to the patient without their (or their psychiatrist's) knowledge, resulting in harm to the patient to the extent that they have to be hospitalised sounds negligent to me, but then I don't work in the NHS.

tomtontom

j.e.j. wrote: »

..isn't it??

Sneaking an 'alternative' medication to the patient without their (or their psychiatrist's) knowledge, resulting in harm to the patient to the point that they have to be hospitalised sounds negligent to me, but then I don't work in the NHS.

And you don't have the first idea of how negligence is established. It may not have been the best decision, but that is a long way from the GP being negligent. The OP needs more information before any suggestion of negligence is made.

j.e.j.

tomtontom wrote: »

And you don't have the first idea of how negligence is established. It may not have been the best decision, but that is a long way from the GP being negligent. The OP needs more information before any suggestion of negligence is made.

negligent
ˈnɛɡlɪdʒənt/

adjective
failing to take proper care over something.




Now, the most likely reason for this change in meds would be the cost. The alternative drug, given by the GP was most probably cheaper than the one the patient was prescribed by the psychiatrist, and the GP wanted to see if he could get away with giving her the cheap one instead.

Of course they are not going to admit that, but that is the most likely reason.

It will be interesting to see what 'explanation' they actually give, OP.

theoretica

It could, for instance, have been a change from an expensive brand name medicine to a cheaper generic which works the same for nearly everyone, but a few people react differently because of the other ingredients in the tablets.

I hope your mother is stable again soon and it is possible to get warnings put on her notes against making changes in future.

Fake_Northerner

Having to make a correction. Spoke to my dad who told me that the GP didn't change the medication (as originally thought as it was different packaging) but actually lowered the dosage of it! Which again.. He's not the right person to be deciding that.