GP Complaint Meeting

Well - it's done.

Mummy and Gran went to the GP surgery to speak to meet the GP who handles the complaint (not the one we complained about, to clarify). She was very nice and, more to the point, very apologetic.

The GP opened the meeting by agreeing that there were - clearly - several valid points that required to be addressed.

She went through all of the points in Mummy's complaint letter, having grouped them into categories:

• Review of drug doses
• Messages via reception
• Messages via Health Visitor
• Omeprazole suspension availability
• Vitamin Drops
• Advice from Reception
• Breach of confidentiality
• Prescribing to breastfeeding mothers
• Callback from GP
• Callback from reception
• Midwife care

Review of drug doses

This category covered the several failures to review Matthew's dosage and to update his repeat prescription. The investigation that was carried out did show from the file that Matthew's dosage was not checked when I asked and that his record was not updated after his dosage was increased at the hospital. It was nice to see that the file backed Mummy up, because she half expected it to come down to her word being accepted, or not.

The action taken as a result of this section of the complaint is that a meeting took place to remind all GPs of the importance of reading letters from the hospital and taking action where required, and to insist that they be more vigilant when prescribing to children, or issuing repeat prescriptions. In this particular case, all they can really do is apologise because it's done now.

Messages via reception

This covered the messages requesting Matthew's dosages be checked. The record shows that Mummy asked for a review once but that the same dosage was issued anyway. For the other time Mummy asked for a review, there is no record. The additional action taken as a result of this discussion is that receptionists have been formally reminded that all encounters must be recorded.

Messages via Health Visitor

This one was a bit edgy. It sounded like the GP was trying to push some of the focus back to our Health Visitor because there was no record made of the conversations between her and the GP. There was no dispute that the conversations took place but the issue seemed to be that they were not documented. The action for this is that they are encouraging Health Visitors to attend a weekly team meeting where cases - like Matthew's - can be discussed and, as that meeting is minuted, a record would be held of the conversation. Mummy agrees that this would be good, but doesn't agree that this should be the only communication between Health Visitors and GPs. Mummy feels there is nothing wrong with a short conversation on an ad hoc basis if it means things can be dealt with faster - provided someone makes a note of what was discussed.

Omeprazole Suspension availability

The GP showed Mummy the September 2009 edition of the British Formulary, which doesn't list Omeprazole as being available in suspension form. Fair enough, but Mummy went on to explain that it wasn't so much the genuine error as the fact that nobody checked. The answer, when she asked about this, might have been, "It's not in the book," but that should have been followed with, "where did you hear about it?" and, "maybe it's a special order but we can't obtain that without a hospital referral," which is what Mummy was told today. It is interesting to note, however, that Losec Mups (nasty tablets) cost around £7 per month to prescribe; Omeprazole suspension costs around £130 per month. To be honest though, Mummy and Daddy couldn't give two hoots about how much it costs. It works and Matthew doesn't scream when he takes it. The action on this one is that a special request form has been completed so that Matthew can get this in future. Not fantastic, because this fixes things for Matthew but not necessarily for someone else in future.

Vitamin drops

Mummy thinks the GP got the wrong end of the stick with this one because the discussion seemed to be around why Mummy doesn't qualify for free vitamin drops. Mummy doesn't mind paying, provided she's given the explanation as to why she needs to pay. For clarity, Matthew should take vitamins. However, Mummy and Daddy need to buy them because they're not on benefits. Fair enough. If only someone had explained that way back in the beginning, instead of telling us they had been prescribed, sending us to Minor Ailments and then telling us they didn't know we needed them. The issue isn't the paying for them; it's the needless confusion around the whole issue. The action from this one is quite good though; training is to take place for all surgery staff and health visitors, with the Infant Feeding Advisor, who can clarify this so that other people are given the right advice.

"Advice" from reception

This was regarding the wonderful receptionist who thought she was a doctor. The GP was quite understanding and agreed that receptionists should not be providing medical advice. She felt that the comments were probably meant to be offhand, but Mummy stressed the point that people call a surgery for medical advice and do not necessarily know what they should disregard. Mummy knew that they were talking rubbish, but that isn't the point. The GP agreed. The action on this is that as part of the receptionists' training they will be reminded not to give medical advice or ask more questions than they need to. The only questions they should ask are to allow them to prioritise calls.

Breach of confidentiality

This was probably the one that set alarm bells ringing when the letter arrived. The GP agreed fully that this should never have happened. The receptionist concerned owned up when asked and was really sorry. She realised immediately that she should not have given Mummy's prescription to Gran. All staff have been reminded of their responsibilities to confidentiality. As expected, the receptionist thought, at the time, that she was doing Mummy a favour. To be fair, on this instance it didn't cause any harm and did save her picking up the script, but clearly this was not meant to happen and the GP agreed.

Prescibing to breastfeeding mothers

This one was interesting. The surgery has the option of recording a code on Mummy's (ANY Mummy's) file to show that she is breastfeeding, to prevent drugs being prescribed which shouldn't be. However, this code is not used, which is why Mummy was prescribed a drug she shouldn't have been. The reason given for this was that by the time Mummies are seen for their postnatal checkup, many of them have given up breastfeeding for a variety of reasons. Mummy thinks that's very sad but it isn't a good reason to not use the system that is already in place. Let's face it - we pay our contributions so that these computer systems can be purchased and we expect them to be used. Mummy told the GP that having fewer people breastfeed makes it even more - not less - important to check before prescribing. They agreed and the codes are to be used in future.

Mummy also pointed out that she should have had the opportunity to speak to a doctor to check that her medicine wouldn't react badly with Matthew's. The GP didn't seem to have thought about this before, agreed and noted the point.

Call back from GP

The GP couldn't really understand why Mummy couldn't get a telephone appointment when she called about her prescription between Christmas and New Year. It was marked in the system as a prescription request, rather than a telephone appointment. It seems that this was as a result of the receptionist misunderstanding Mummy's need to speak to a doctor as a simple request for a prescription. Fair enough - these things happen. However, in future, if the receptionists refrain from asking questions that are best left for a doctor, the difference will be clearer as a GP will need to speak to the patient to find out what is required. Mummy was advised that telephone appointments are available and that she can ask for one if she wants one in future.

Call back from reception

Mummy was advised that the receptionist asking Mummy to call back after saying she'd do it was a fail safe mechanism in place in case something came up that really would have prevented her from doing it. Mummy suggested that they don't offer to call back unless they really mean they'll do it, because she would rather just know that she should ring back herself. However, this wouldn't have been necessary at all if she'd been able to speak to a GP, because there would have been no need to pass messages back and forth.

Midwife care

Well, to be fair that one was chucked in just to set the ball rolling. Mummy knew the GP couldn't really answer for that one anyway and in itself wasn't too terrible. It was just a bad start.

So that's what happened. The letter to follow this all up will be in the post soon, I imagine.

No fireworks. Mummy was very polite and fair. Writing such a detailed letter in the first place helped because there wasn't a need to go into it all at the meeting, which was a good thing because it meant Mummy didn't get all wound up again.

Mummy didn't want heads to roll. Mummy just wanted someone to take notice and make sure it didn't happen again. Like Mummy told the GP, she'll never know if these points have actually been addressed or not, because there's no way the surgery will let it happen to her again, either way, after this. There will be no way for her to know if they do it to someone else.

Let's hope not.

The end?