Who is higher in the medical field.

Own_Worst_Enermy

Hi,

I feel really dim asking this (accept it is definitely a school day for me) and appreciate my ask could be closed as medical so trying without giving the back story but I had noted a shift in GP’s saying we’re primary care and hospitals are the NHS.

If a GP puts you on an urgent pathway to be seen can the hospital involved downgrade this? and then get you an appointment in a clinic you’ve already been to before and cannot help. Unfortunately I had wanted to avoid PALS.

Are GP’s really overrode? 

Sarahspangles

Primary Care includes a whole range of medical services including GPs, pharmacists, opticians and dentists. Secondary Care is the specialised services that patients are referred to, in hospitals or some other settings. There’s also Tertiary Care which is more specialised (for example transplants) but you would still expect care to be delivered in a hospital.

If a GP uses an urgent pathway, that’s to fast track your case being considered by the specialist. They are just that, a specialist. Normally there’s one or more consultants who have a team including registrars, specialist nurses and other professionals. It’s the consultants decision as to which outpatient clinic you should attend, and the tests and treatments you are offered. 

maman

Without going into medical details, this can happen in my experience. 

My GP referred me for a specific test. This was downgraded by someone who'd read the referral forms but not met me. I was sent to what is called a treatment centre locally. This is a private company who deal with simple, routine tests. My case proved too complicated for them and I then had to go to the local hospital (after a long wait) for the test the GP recommended in the first place.

So, in my experience, the GP can be 'overuled'. 

I don't know if that applies to an urgent pathway. My experience of that (for a different issue than the above) was being seen in 2 weeks as the GP recommendation. 

The terminology is straightforward in that Primary Care just means who you see first (GP practice) and the hospital is more specialised. 

sheramber

Have you checked with the hospital that it was an urgent referral.?

It may hve been am admin error and sent as a routine referral.

beckstar1975

Yes - happened to me several times - you can tick enough GP boxes to be referred under urgent pathway but hospital consultants/specialists may use different criteria and move you from 2 week to 'important' or similar  meant  my skin cancer was missed for 6 months (thankfully no ill effects).

if you get a change or increase of symptoms your GP can re-refer (or add to the referral) and the hospital may then reconsider your priority.

Flugelhorn

as a retired GP I can assure that hospitals (usually someone with little experience ) decide that they will do something entirely different to that requested. Used to increase the GPs blood pressure somewhat.

The hospital just seem to look at the boxes ticked - they are fixated by pathways which, if you are on the wrong one, are very difficult to amend

A friend referred my daughter to a specific clinic for specific reasons - that was downgraded too 

Own_Worst_Enermy

sheramber said:

Have you checked with the hospital that it was an urgent referral.?

It may hve been am admin error and sent as a routine referral.

I can apparently chase as soon as tomorrow is over. 

I looked on my GP record and saw the suspected thing in full dated today - perhaps they are arguing behind the scenes.

The GP tested me at to early an allowed age? They want to bring the age down to 50 I think I’m actually early to mid 40’s
Could that have an effect.

gwynlas

If your GP knowing your history refers you for a specific intervention regardless of age they should be able to argue why they made that referral. The person making appointments might be adhering to guidelines and you are appearing as an anomaly. If you agree with your GP then you should certainly question what you have been told. Younger people can and do get undiagnosed because certain ilnesses usually manifests later in life. Do not be wary of using PALS they were set up to assist patients as a neutral intermediary. I beleive if people do not raise issues when it is justified it perpetuates potential failures in the service.

Own_Worst_Enermy

Thank you 🙏 this is incredibly helpful.

After a review chat yesterday with a hospital nurse they have agreed I can have a camera test. They seem to have taken umbrage that the gp hadn’t physically examined me.

Praying for it to be an old fissure problem that has returned they think 🙏

Thank you again so very much.

forgotmyname

Priority Urgent MRI scan....  Just over 6 months!!!

Trying to get an appointment with the Neurology Department = hours and hours of the phone ringing before it hangs up
or you get the message the department is closed today or after 5pm.

Struck lucky when the receptionist knew my name and used to work in that department, she said come back after
your other appointment.  She got me an appointment at the Neurology within 2 weeks.

I think a little bit of luck and being in the right place at the right time works wonders.

Own_Worst_Enermy

Ah sorry you waited so long. I’ve probably wasted a year paying into Benenden Health but fortunately on the old member terms so I feel reluctant to cancel and have paid for a private ultrasound not so long ago which was worth every penny.

Have to say seen 18 days later for colonoscopy at nhs property and cancer ruled out instantly 🙏 no fissure/no piles! they took some biopsies to check for other things which may explain all the drama over last 18 months. Very lucky I suppose inflammation problem showed on day as some others are saying they suffer 2 or 3 colonoscopies before even getting near to the heart of problem.