Teething problems between GP and hospital

[Gilly_Bean80_]

Afternoon all

I joined the DCUK forum a while ago but this is my first post .

I'm having a problems with my GP as they are saying they are not being kept up-to-date by my consultant or via my pump nurse, even though I know they send copies of letters to thr GP after each appoinent I go to. Plus the GP wants my hba1c tighter controlled than what the hospital recommends.

It just frustrates me as they are not issuing things that I need such as ketones testing strips and also a lot of mixed messages.

Just wondering if other have had this issue and how do you deal with it.

Thanks

Gill

 

[Juicyj]

Hi @Gilly_Bean80_ Good to hear from you so a big welcome

It's pretty common to have issues with GP's communicating with your hospital team, mine are exactly the same, sadly they both work on different agendas and I find I have to communicate information such as my HbA1c to my GP if asked at all, however your GP shouldn't be dictating your HbA1C - this is a decision between you and your DSN/Consultant, your GP isn't a diabetes specialist and doesn't know your condition as well as your DSN who sets your targets and reviews you. Your GP's practice will have a HbA1c target for patients at the surgery as they are point scored on this. So please ignore your GP's HbA1c request and do not feel pressurised by them, this isn't fair on you.

If you are having any issues with medication being prescribed then write a letter of complaint to the practice manager advising them that you are a type 1 diabetic, insulin dependent and require your medication to help you manage your condition, you take insulin to stay alive and my thoughts are that they haven't understood this, your situation should change, I believe there is a standard letter you can send to your practice so will hunt around now for it (@noblehead - can you locate this ?), also speak to your DSN to advise them as to what is happening as they may also want to intervene on your behalf, please let us know how you get on ?

 

[donnellysdogs]

Get your consultant to send you a copy of letters that go to GP.

When you see GP take copy with you.

Your GP is not responsible for your diabetes your hospital is. They have no clue about pumps.

Apart from your prescriptions and 6 month or annual prescription reviews / checklist they have to do then they have no reason to interfere with what your hosputal say.

I would actually say to your GP Practice that unless they do the specialist training for pumps then you will continue to follow the guidance given by your secondary carers (hospital).

I have had similar over the years. This GP and this CCG like T1's to be cared for by GP's.... unless difficult to manage. I proved too much for primary (GP) and secondary (normal hospitals) and now tertiary care.... so i would just advise get basics from GP like your scripts etc and standard tick list that they have to do but listen to your specialists... however as somebody here said to me recently.. remember that you are the expert though in your care.....

 

[ickihun]

These posts just remind me how lucky I am to have good listening gps at my practice.
All the staff play their part and are very helpful in helping me improve my health.
I'm sure another gp practice wouldnt have time for me and my many health problems.
Can you not find a better gp practice @Gilly_Bean80_ ? What happens on a day you really need help if they cannot get the basics right?

Ps. I take a copy with me from consultants too. Just easier that way.

 

[mark4785]

If your diabetes is managed via the Hospital then you need to put in writing to your GP that you don't want any medical advice from the GP surgery. Alternatively, if they make diabetic appointments on your behalf or ask you to make an appointment just tell them that it is all managed by the hospital and you don't require any appointment services concerning your diabetes. This is usually enough to stop them from pursuing you.

 

[noblehead]

Plus the GP wants my hba1c tighter controlled than what the hospital recommends.

Go with what the hospital diabetes team recommend, they are more experienced and adapt at dealing with type 1 than your gp will be.

, I believe there is a standard letter you can send to your practice so will hunt around now for it (@noblehead - can you locate this ?

Sorry @Juicyj didn't get an alert to your tag, here is the letter @Gilly_Bean80_ which was sent from the Dept of Health in 2013 to all gp surgeries:

https://www.gov.uk/government/uploa.../Safe-care-of-people-with-type-1-diabetes.pdf

 

[Seacrow]

I think you're unlucky, and have got caught in between clashing bureaucracies.

I had something similar, and finally got fed up and went in for a meeting with the practices diabetic nurse. Turns out that if blood tests are done off-site (I.e. hospital) the GP is informed by letter. The nurse was expecting the results to be uploaded automatically onto her computer from the local lab (as happens for blood drawn at the GP). Nurse then complains to GP I've had no bloodwork done this year and no 'diabetic' appointments with her, GP panics that targets are not being met.

I sat down with the nurse and explained. She wrote a note on my file (it read "Ignore this one, the hospital does her", don't think I was supposed to see that). All has been fine since. I really do recommend sitting down with someone (admin or nurse) at the practice, and setting out what you do and don't need from them

 

[ann34+]

Afternoon all

I joined the DCUK forum a while ago but this is my first post .

I'm having a problems with my GP as they are saying they are not being kept up-to-date by my consultant or via my pump nurse, even though I know they send copies of letters to thr GP after each appoinent I go to. Plus the GP wants my hba1c tighter controlled than what the hospital recommends.

It just frustrates me as they are not issuing things that I need such as ketones testing strips and also a lot of mixed messages.

Just wondering if other have had this issue and how do you deal with it.

Thanks

Gill

it is possible your GP really does not understand Type 1D, in some areas of uk i have found this, the GPs mostly see Type 2 - it does take ages to get understanding, then something happens, and you realise there is still a problem.....over the last 5 years, at different GPs i have had a variety of problems, esp re testing understanding - and difficulties of dealing with infections .....this sorts, then i have found that other hospital depts do not understand, either. This makes the current proposals concerning - at local STP meetings here the plan appears to be all Type ones, other than those at Specialist clinics - eg pump clinics - will stop being cared for in hospital outpatients, but by the GP. not a good idea, as far as i can see.

 

[donnellysdogs]

it is possible your GP really does not understand Type 1D, in some areas of uk i have found this, the GPs mostly see Type 2 - it does take ages to get understanding, then something happens, and you realise there is still a problem.....over the last 5 years, at different GPs i have had a variety of problems, esp re testing understanding - and difficulties of dealing with infections .....this sorts, then i have found that other hospital depts do not understand, either. This makes the current proposals concerning - at local STP meetings here the plan appears to be all Type ones, other than those at Specialist clinics - eg pump clinics - will stop being cared for in hospital outpatients, but by the GP. not a good idea, as far as i can see.

Very good point!! I actually used to take pride in my pump and show it all to gp and nurses.... to educate them. I do it now with my cgm!! Show it on phone and bum all the time to all consultants, gps, and ambulance, a&e etc..

Agree with docs not treating T1's as they are heading for... my CCG already try to enforce this. Gp's 1st to treat T1's and they really do not know the soecialist knowledge needed.