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backdatedgp letter about removing me from practice if don't have blood test

brushcolours

Hello :-)
Got letter from gp surgery today saying if don't respond about blood test [regarding ibuprofen/please see below] will review registration with practice, on basis of breakdown in doctor/relationship.

Nearly posted earlier, but very recently had no option but to contact sheltered housing warden ... she recommended care needs assessment and kindly referred me. Very long-term severe disability/dissociation; housebound since 2019, nearly age 60. The care needs assessment has just been done, on the 4th. I've been allocated an apprentice social worker, although the lady is leaving in 3 weeks. Thought it might be sensible to email her about the gp letter earlier today. Note came back saying she is back in the office tomorrow. Just had to attach a further small email as have noticed the date on the gp letter is 4th February (the same date as I had my assessment), meaning that maybe tomorrow the gp surgery will remove me from their list. Shocked to notice that. Need pain relief ... have been left with no option but to take highest dose of ibuprofen possible due to historical abuses/no help with pain, except lanzaprazole alongside ibuprofen helps.

I did a search online and saw information saying if they drop me they need to continue eg medication while I try to find a new gp, but it is entirely unexpected, cruel and overwhelming that a letter back-dated by nearly 2 weeks has been sent like this, trying to force a blood test and likely change medication to things that don't help ... this has happened before, in a serious way, and needed to make complaint to have replaced medicine returned to original one. There have been other worrying issues too. At least with the baseline medication I've needed to survive on for many years, I know I get relief. I don't have reason to trust any gp decisions unfortunately. I wish I could say differently, as am more than willing to trust and work with anyone that is positive.

With having just met the social worker, and not knowing what may happen, plus very overwhelmed generally, thought had best ask here, as I can see rights and legal matters are covered here. I would be very grateful for any advice.

Thank you.

Cat

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brushcolours

Sorry, looked for edit button, but just need to add that 1st contact from gp about blood test required was around 21st January. Had been so busy with difficulties that lead to care needs assessment, hadn't thought needed to respond quickly. Had thought it was a standard message, and never dreamt would end up with this threat.

figraspberry41

#@Brushcolours,

Hello and welcome,

I am certainly not an expert on any of your issues but I would like to ask why you do not want a Blood Test?

That said, neither would I agree to a Blood Test without knowing the reason first, however, if you cannot be given a satisfactory answer then I'm not sure if you can be removed from you GP's list simply because they want you to have one. I have taken Ibrufren for years but now take Naproxen, however both these anti Inflammatory medications can cause stomach and intestinal ulcers, which is why you have the Lansoprazole (to reduce the anti- inflammatory medication causing more problems).

A suggestion may be to contact the GP surgery and explain your reason's for the delay in response but also you need to know the rational behind needing a Blood Test. Ask to have a telephone appointment with the

GP and ask them why you need the Blood Test failing that try going through PALS (Patient Advisory Liaison Service) and make a complain to them. The issue is unlikely managed immediately but you should get some advise from them. Hope this might be useful to you. Hope that a more knowledgeable person can explain to you your rights as an individual and support you through this crisis.

brushcolours

@figraspberry41 Thanks for responding. The concern was about being threatened with removal from surgery. I'd covered why I'd not been in a position to sort out having a blood test just yet, with having just begun care needs interaction. Also, housebound, and expected gp surgery of years to a) know that, and b) offer home visit. To go straight to threatening removal, and to backdate the letter to ensure that deadline was the day after receiving the letter, was the issue, and only adds to wariness about going ahead with a blood test and what may then happen regarding medication/pain relief.

Pain relief was suddenly reduced early 2020, and opiate given as only top-up option, which doesn't work well. Really don't want that happening again, so was wondering what to do. It wasn't about refusing a blood test, but that I have no reason to trust the surgery, and current actions made that more obvious. Systmonline records say letter is about medication monitoring, but to threaten removal from practice just is impossible to align with it being about checking wellbeing, thus am concerned what could happen regarding pain relief.

Not sure how a blood test monitors effects of ibuprofen on stomach, and never known a blood test to be insisted on before, regarding ibuprofen, but at least it now looks like I won't be removed from the practice. Literally just found the most awesome response from my new social worker. First time have needed to contact her out of the blue, and, having met once briefly plus a couple of emails, her sailing through with calling and emailing the surgery first thing today, and sharing what she wrote to them, is brilliant. She is waiting for further email contact with them, and has represented me really well, including saying that I need email contact and time to adjust/prepare. Her being so great with this also gives me confidence that, if eg unsuitable medication changes are pushed, I am not alone with that.

Apart from the sheltered housing warden having been great on a few occasions when needed to contact her, and getting on very well with the previous warden at reviews, haven't had a carer since 2013 [assigned to help me move to sheltered housing], so this is a very new feeling, a great relief, and something I really appreciate a lot. Hopefully others reading this who haven't had care can be encouraged.

brushcolours

Hi @willow1 ! 😀

Kimi87

I notice you mention previously having problems with your GP surgery, could these factor into the current position they are taking?

Contacting PALS is a great suggestion, I would say if you've had issues with GP surgery in past meaning you have zero trust in them, perhaps finding a new surgery is in your best interests going forward.

While I don't wish to give medical advice, blood tests can be offered with NSAID use due to potential impact on other organs such as liver & kidneys, and to check for any indication of gastric bleeding.

(I had to stop taking NSAIDS regularly after developing bleeding stomach ulcers, even though I always took the medication following Omeprazole AND had full meals immediately afterwards!)

I don't see how "and to backdate the letter to ensure that deadline was the day after receiving the letter" is actually possible. The Surgery had no way of knowing which day the letter would be put through your letterbox.

Much more likely it's Royal Mail who have failed to deliver the letter to you in a timely manner, this is entirely outside the GP Surgery's control and there are well documented issues with Royal Mail prioritising parcel delivery and allowing letters to build up at sorting offices before making any deliveries.

brushcolours

Thanks for responding @Kimi87 I've never caused them any problems or been hostile in any way; more a case of bad things happening and me just keeping away as much as possible, while being thankful at least can obtain pain relief and that chemist do deliveries. The gp surgery approach currently really took me by surprise.

I've thought about moving surgeries before, but wasn't well enough to deal with it. With the care needs process having just been started, that may possibly involve a move to a different area, which may naturally involve no longer being with this gp surgery. Just waiting to see what happens.

Great to understand more how a blood test may be relevant, so thanks for explaining that. Sorry to hear you developed ulcers and hope that's been remedied and there's no discomfort now from that.

Something positive to carry forward that the gp surgery could do, if it's common knowledge that royal mail now routinely deliver letters very late, is to use email as 1st point of contact, and also not threaten people, especially when someone is severely disabled, mental health issues, housebound. My social worker has suggested email contact to them, so having that established should thankfully avoid this kind of thing happening again.

WhatThe

Hi brushcolours, it sounds like you have things under control now. If you have a phone number then also provide that to the surgery. My surgery sends emails and texts to alert me.

FYI it is possible to be discharged without any notification at all! It happened to me while I was in temporary accommodation and expecting a prescription for my third subcutaneous hormonal implant. I was devastated at having to wait after being pain-free for two months.

It also happened to my daughter - again with no notice - as my current surgery mistakenly thought she was living at her dad's address.

However, I cannot complain about our NHS because they have saved my life many times.

brushcolours

Hi @WhatThe Yes, a big relief; really thankful for what the social worker is kindly doing. She's sent me further communications she's having with the gp surgery, and has asked that they contact me via email. I never have the phone on; not a very online person. Good that you get both emails and texts. Sorry to hear that both yourself and your daughter went through the surgeries removing you! That is shocking, and surely against your rights. A big contrast to experience that and yet they've saved your life many times too … that's really good news of course!

JennieWren

I have received letters for appointments at the hospital after the date of the appointment. The date of the letter and the date it was franked at the hospital were a week apart plus Royal Mail being very slow in my area. I explained this to the hospital staff but got the ‘computer says no’ answer and had to go back through my GPs as I’d wasted the appointment. My GP was brilliant and it’s obviously becoming an issue as they told me not to worry. Perhaps NHS needs to use email more or allow longer periods of time to allow for delays in posting?

WhatThe

https://forum.scope.org.uk/discussion/comment/1102842#Comment_1102842

I didn't know it was even possible! I lived a few doors down on the same street so there was no reason not to let me know - I turned up to be told I'd been deregistered. I later found out that my treatment was expensive and that's the only reason I can think of.

Lots of us are not IT savvy and I think service providers forget that.

Yes, I exceeded my own expectations and I'm enjoying old age more than I ever imagined! Thanks for your kind words 🤗

brushcolours

https://forum.scope.org.uk/discussion/comment/1102843#Comment_1102843

Hi @JennieWren That's a shame your appointments got messed up like that, and you had to go back through the process. Couldn't agree more that, with even GPs fully aware that royal mail are slow, email would be much easier all-round … I think there tends to be a push that patients mustn't be late or miss appointments, last time I looked anyway, so using e.g. email would guarantee that not happening, as well as patients able to get the help they very much need. Seems like a win-win to me! 😀

brushcolours

Hi @WhatThe No worries; glad to hear you're exceeding your expectations and enjoying things so much! That's awesome. 😀 🎉🏆️

Them having dropped you when you lived on the same street is just surreal; what on earth. I think you're right it was likely money-related. I also agree that IT being pushed everywhere isn't good. Keep things simple and accessible to everyone always works better, and less expensive, and it seems the more 'tech' everything's got that hasn't meant better healthcare necessarily … just more complexity and remoteness. Always good to keep things simple, positive and human.

JennieWren

Thanks. I get care for my back from the Royal National Orthopaedic Hospital in London and although I have had some cancelled appointments during my 35 years under their care. There’s a lot the rest of the NHS can learn from them. They just seem to apply common sense. I receive a letter confirming my next appointment then receive text reminders in the week and days before and if anything needs to be rescheduled etc and it’s within a couple of weeks then they phone so that the mail isn’t involved at all. Both of us get our answers asap and the cogs keep turning.

I know what you mean about technology - you’d think that repeat prescriptions would be so quick and easy now, but they seem to take longer than when I was a kid and it and your notes were written by hand by the GP. I’m showing my age now 😉