GP issue, can anyone advise please?

swingaloo

Bit of an odd subject but hoping someone may have some insight into this kind of situation. 
 
Daughter has had issues with her body image and confidence. She has a heart condition which is monitored annually. 

She wants to do some personal training but because she has health issues the trainer rightly needs a letter from her GP to cover himself training her. 
Now 2 years ago she was going to start training and asked her then heart specialist if it would be ok. The specialist said she could see no reason why not and that it would in fact do her good. She advised daughter to email her secretary and request the letter. 
However, daughter did not follow up and never asked for the letter or start training.

Now she has decided she does want to do it the original specialist has retired. When she requested a letter from the new one he told daughter that it was not something under his remit and that it was something the GP should do.

The GP says they do not provide letters and that the specialist should do it but they referred back to GP.

GP has now said that daughter will have to find a private doctor and ask to have a letter written. ??? 
Daughter has made clear she knows she will have to pay but GP wont budge and instead wants daughter to find another doctor (who will know nothing of her issue) to write the letter.

Is it normal that a GP can refuse?

LinLui

Yes the GP is entitled to refuse. 

To be fair,  they aren't a specialist and it would be questionable if they were to approve her doing this. Two years ago,  lots of things can change. They can't say it hasn't. I doubt their insurances would cover making an assessment when it isn't their specialist area.

elsien

Pretty sure there’s no obligation under Nhs contracts to write letters for people even if they are willing to pay. 

swingaloo

Thank you for the reply. I completely agree with what you say but the specialist is saying that the GP should be doing it which is what we cant understand.

swingaloo

elsien said:

Pretty sure there’s no obligation under Nhs contracts to write letters for people even if they are willing to pay. 

I understand that Elsien. Its just catch 22 though. The doctor has actually said that the training would be good for her as she has been struggling with depression and confidence issues. Yet she cant get the training without the letter to say it is ok.

LinLui

The specialist is incorrect. GP contracts do not include such letters, and so it is up to them individually whether they wish to,  or feel able to,  provide such letters. I other words - nobody can force them to write such a letter even if they feel capable of making such an assessment. Alternatively,  put it this way - if the specialist is clear that it's safe,  they can put their name to it. 

bouicca21

Is there a work around? Could specialist advise GP that training will be beneficial so that GP can then write a letter to the effect that they have been advised that training will be beneficial.  That way GP is let off the hook of potential liability ( which might be why they are reluctant).

AskAsk

the GP will not write a letter to state that they agree or disagree that your daughter can start training as that is not their specialism and they will not want to be making statements outside of their remit.

they will disclose your daughter's health conditions and that is all they will do.  if you want a medical opinion, you need to find a specialist that will agree to do it, but you will find this to be difficult as it is a tricky thing to be stating opinions that may come back and bite you if the patient becomes ill from the training and it was your fault that you had recommended it!

Skiddaw1

If it were me, I'd try a further (tactful) approach to the specialist (either by letter or email) explaining everything again and asking for his/her assistance. Has to be worth a shot.

swingaloo

Thank you all for the replies. She is due to see the cardiologist the week after next so she will try him again.

silvercar

In similar circumstances, its the heart specialist who needs to write the letter. Your daughter needs a consultation with him to discuss it and for him to assess what is appropriate. The new specialist isn't going to recommend anything without a full assessment. That will no doubt cost for the consultation and whatever tests he wants to run.