Summary

The jurisdiction of a General Practitioner (GP) is to treat a patient’s condition up to the point that they can, and when the problem is out of their remit, to refer the patient onto secondary care.  As soon as the patient is accepted onto the caseload of the Consultant in secondary care, the responsibility for the patient’s care is with the clinical department at the hospital. The British Medical Association’s ‘The Doctor Patient Relationship Toolkit’ states; ‘Legally, health professionals have a duty of care when they assume responsibility for a patient. In secondary care, it may be once a patient is accepted onto a caseload.’

I have been with eight GP practices through this medical crisis. Every one of my GP’s has fulfilled their clinical responsibility. They have prescribed antibiotics, pain relief and anti-inflammatory medication. They have referred me to Specialists in Ophthalmology, Ear Nose and Throat, Oral Maxillofacial Surgery and Infectious Diseases. Once their referral reaches the NHS Trust, the referral gets triaged by a consultant, who either refuses to see me, or they see me once, and then send the problem back to the GP. The Consultant sometimes sends the referral onto a different hospital, but the problem normally gets batted back to the GP, who cannot treat the problem.

The refusal by the secondary care world to take ownership of my medical problem has put an enormous strain on my relationship with all of my GPs. Each time that a referral gets sent back to the GP with no resolution, the GP rightly feels that they have fulfilled their responsibility, and that they can do no more for me. I am then left to carry the burden alone. I feel angry towards the GP, when it is not their failing. It then becomes a situation of Checkmate. The GP’s hands are tied. I have to then transfer GP surgeries, because our relationship breaks down.

My Current GP

My current GP is one of the most caring and committed GP’s around. He has sent out nine referrals since he took over my care in March 2022. We are none the wiser about my condition. His first referral, which was sent to Oral Maxillofacial surgery, was rejected because the problem was ‘too complex.’ He was advised to send it to a named consultant who specialises in parotid gland disease at a Teaching Hospital. He did this in a timely manner. We did not hear anything for four months. I telephoned the hospital. I was told that my case had been closed down- that I had been discharged without being seen. The hospital did not give me any reason why they had refused to see me. They did not bother to write to my GP to tell him that the referral had been rejected. He was ghosted.

My GP then referred me to an Ear Nose and Throat (ENT) specialist re my ear pain. He received a letter, telling him that he must insist that I am seen by Oral Maxillofacial Surgery. Three Oral Maxillofacial surgery departments had refused to see me. The ENT Consultant answered none of my GP’s questions. He commented that my sinuses were clear, even though there was nothing in my GPs referral about sinus problems. The ENT Consultant shifted the responsibility. He sent the problem to an Oral Maxillofacial department at a third hospital who sent the referral back to him. Nothing was actioned. My relationship with my GP started to fracture at this point, and has since crumbled.

I struggle to understand how a GP supposed to care for a patient, when Consultants will not answer any of their questions about their patient’s condition?

My Previous GP

My previous GP in Fife had been a GP for 36 years. He had been a lifeline for me, during two national lockdowns. This guy had it even worse than my current GP. He sent referrals to ENT departments at two NHS Trusts. Both referrals were sent back to him after I had been seen only once. The ENT Consultant advised that I was seen by Pain Management. Two pain management teams then refused to see me. They said that their service was not ‘appropriate for me.’ The Infectious Diseases department then discharged me after one appointment. My GP turned to me and said; Sorry, Felicia, there is nothing more that I can do for you. My relationship with that GP completely broke down.

The British Medical Association’s ‘The Doctor-Patient Relationship Toolkit states in the section, Communicating with Colleagues, how vital it is to the patient’s care, to share information in a timely manner with colleagues who are involved in the patient’s care. It states that ‘patients who receive good co-ordination have better health outcomes and higher satisfaction rates; communication between teams involved in the patient’s care is an important component in this.’

The General Practitioner is a vital part of the healthcare chain – without them, the health network could not function. I have felt saddened by how my GP’s have been ghosted by various Medical Consultants.  A GP does not send a referral out to secondary care unless they deem it necessary. Eight different GP practices would not have sent out this many referrals to specialists over the years, if there was no need. Consultants need to stop treating my GPs like pawns on a chessboard – kicking them down and taking them out. They need to start showing them respect, and start treating them as the esteemed colleagues that they are.

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