A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house. She rang the GP who, without making a house
call (do they ever, these days?) prescribed antibiotics for a supposed
chest infection. No examination of the patient, no listening to the chest.
I think the advice that was given was, if you feel really unwell go to
A&E at your nearest hospital. Which isn't a very palatable option for
someone feeling very unwell.
Does this sound like negligence or a breach of professional standards on
the part of the GP? Do we all now accept that house calls are not an
option except (based on my own experience) where the patient is dying
and in need of palliative care, in their home?
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com> wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house. She rang the GP who, without making a house
call (do they ever, these days?) prescribed antibiotics for a supposed
chest infection. No examination of the patient, no listening to the chest. >>
I think the advice that was given was, if you feel really unwell go to
A&E at your nearest hospital. Which isn't a very palatable option for
someone feeling very unwell.
Does this sound like negligence or a breach of professional standards on
the part of the GP? Do we all now accept that house calls are not an
option except (based on my own experience) where the patient is dying
and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and housebound (including age related disability) and end of life care, have been an unaffordable luxury for decades now. An acutely ill able-bodied person can either cope, with whatever level of support is available to them, or needs to go to A & E.
That does not mean the management of the patient you mention was wrong. It is possible to make a reasonable diagnosis of chest infection on symptoms, and examination adds surprisingly litle except excluding other problems, and trial
of antibiotics may be reasonable in case either these or the natural course of
the disease enables the patient to recover and avoid hospital. Ideally someone
could have taken her to the surgery, but that does not mean the doctor was wrong.
Home visits are generally not an option. You and I don't pay for them.
On 10/12/2024 18:32, Roger Hayter wrote:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com> wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house. She rang the GP who, without making a house
call (do they ever, these days?) prescribed antibiotics for a supposed
chest infection. No examination of the patient, no listening to the chest. >>>
I think the advice that was given was, if you feel really unwell go to
A&E at your nearest hospital. Which isn't a very palatable option for
someone feeling very unwell.
Does this sound like negligence or a breach of professional standards on >>> the part of the GP? Do we all now accept that house calls are not an
option except (based on my own experience) where the patient is dying
and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and housebound
(including age related disability) and end of life care, have been an
unaffordable luxury for decades now. An acutely ill able-bodied person can >> either cope, with whatever level of support is available to them, or needs to
go to A & E.
That does not mean the management of the patient you mention was wrong. It is
possible to make a reasonable diagnosis of chest infection on symptoms, and >> examination adds surprisingly litle except excluding other problems, and trial
of antibiotics may be reasonable in case either these or the natural course of
the disease enables the patient to recover and avoid hospital. Ideally someone
could have taken her to the surgery, but that does not mean the doctor was >> wrong.
Home visits are generally not an option. You and I don't pay for them.
Thanks. That's a very clear explanation and I suppose the GP acted as
most GPs would act in that situation.
On 10/12/2024 18:32, Roger Hayter wrote:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com> wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house. She rang the GP who, without making a house
call (do they ever, these days?) prescribed antibiotics for a supposed
chest infection. No examination of the patient, no listening to the chest. >>>
I think the advice that was given was, if you feel really unwell go to
A&E at your nearest hospital. Which isn't a very palatable option for
someone feeling very unwell.
Does this sound like negligence or a breach of professional standards on >>> the part of the GP? Do we all now accept that house calls are not an
option except (based on my own experience) where the patient is dying
and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and housebound
(including age related disability) and end of life care, have been an
unaffordable luxury for decades now. An acutely ill able-bodied person can >> either cope, with whatever level of support is available to them, or needs to
go to A & E.
That does not mean the management of the patient you mention was wrong. It is
possible to make a reasonable diagnosis of chest infection on symptoms, and >> examination adds surprisingly litle except excluding other problems, and trial
of antibiotics may be reasonable in case either these or the natural course of
the disease enables the patient to recover and avoid hospital. Ideally someone
could have taken her to the surgery, but that does not mean the doctor was >> wrong.
Home visits are generally not an option. You and I don't pay for them.
Thanks. That's a very clear explanation and I suppose the GP acted as
most GPs would act in that situation.
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
On 2024-12-11, GB <NOTsomeone@microsoft.invalid> wrote:
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
Both of those are "the patient is very deceased" ;-)
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
These days, I'm afraid, doctors dole out antibiotics rather freely. We
should all try not to live too long, because there are going to be an
awful lots of antibiotic-resistant bacterial illnesses going round in a decade or two.
Really, a throat swab needs to be taken and sent off to the lab for
culture. Depending on the results of that, an antibiotic may be
warranted. But, who, these days, wants to wait 3-4 days for treatment?
In your friend's case, it's probably a virus, but she will probably get better in a few days regardless of anything the doctor can do.
On 2024-12-11, GB <NOTsomeone@microsoft.invalid> wrote:
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
Both of those are "the patient is very deceased" ;-)
On 2024-12-11, GB <NOTsomeone@microsoft.invalid> wrote:
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
Both of those are "the patient is very deceased" ;-)
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making a
house call (do they ever, these days?) prescribed antibiotics for a
supposed chest infection. No examination of the patient, no listening
to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable option
for someone feeling very unwell.
Does this sound like negligence or a breach of professional standards
on the part of the GP? Do we all now accept that house calls are not
an option except (based on my own experience) where the patient is
dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support is available to them, or needs to go to A & E.
Roger Hayter <roger@hayter.org> wrote in news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making a
house call (do they ever, these days?) prescribed antibiotics for a
supposed chest infection. No examination of the patient, no listening
to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable option
for someone feeling very unwell.
Does this sound like negligence or a breach of professional standards
on the part of the GP? Do we all now accept that house calls are not
an option except (based on my own experience) where the patient is
dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support is
available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of Scotland. Within the last 5 years my elderly mother was visited semi regularly by a
GP or locum to manage her various conditions. She could have been
mobilised by local family members to attend the local surgery and was to attend hospital appointments. The surgery clinicians chose to visit her
to make sure she had the most appropriate care but she was neither
disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
On 11/12/2024 02:16, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house. She rang the GP who, without making a house
call (do they ever, these days?) prescribed antibiotics for a supposed
chest infection. No examination of the patient, no listening to the chest. >>
I think the advice that was given was, if you feel really unwell go to
A&E at your nearest hospital. Which isn't a very palatable option for
someone feeling very unwell.
Does this sound like negligence or a breach of professional standards on
the part of the GP? Do we all now accept that house calls are not an
option except (based on my own experience) where the patient is dying
and in need of palliative care, in their home?
The GMC guidelines for prescribing state that:
1. Doctors must have adequate information before prescribing medication.
2. Prescribing should be done in the patient's best interests, ensuring
the diagnosis is reasonable.
3. Where uncertainty exists, a physical examination or additional
diagnostics may be necessary.
If the GP prescribed antibiotics without sufficient information to
reasonably confirm a chest infection (e.g., without listening to the patient's chest), this may fall short of professional standards.
For a claim of negligence or breach of professional standards to be
valid, it must be shown that the GP’s actions fell below the standard expected of a reasonably competent GP. Prescribing antibiotics without a proper assessment (especially for a chest infection) might constitute a breach.
On 11 Dec 2024 at 15:59:54 GMT, "Peter Walker" <not@for.mail> wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making a
house call (do they ever, these days?) prescribed antibiotics for a
supposed chest infection. No examination of the patient, no listening
to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable option
for someone feeling very unwell.
Does this sound like negligence or a breach of professional standards
on the part of the GP? Do we all now accept that house calls are not
an option except (based on my own experience) where the patient is
dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support is
available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of Scotland.
Within the last 5 years my elderly mother was visited semi regularly by a
GP or locum to manage her various conditions. She could have been
mobilised by local family members to attend the local surgery and was to
attend hospital appointments. The surgery clinicians chose to visit her
to make sure she had the most appropriate care but she was neither
disabled nor housebound.
In all but the most rural areas of England and Wales doctors won't be able to visit. People with chronic conditions or nursing needs will be visited by nurses, but not primarily for the diagnosis of acute illnesses. "Clinicians" is one of those slippery words that some people think might mean doctors.
Roger Hayter <roger@hayter.org> wrote in news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making a
house call (do they ever, these days?) prescribed antibiotics for a
supposed chest infection. No examination of the patient, no listening
to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable option
for someone feeling very unwell.
Does this sound like negligence or a breach of professional standards
on the part of the GP? Do we all now accept that house calls are not
an option except (based on my own experience) where the patient is
dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support is
available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of Scotland. Within the last 5 years my elderly mother was visited semi regularly by a
GP or locum to manage her various conditions. She could have been
mobilised by local family members to attend the local surgery and was to attend hospital appointments. The surgery clinicians chose to visit her
to make sure she had the most appropriate care but she was neither
disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
On 11/12/2024 15:59, Peter Walker wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making
a house call (do they ever, these days?) prescribed antibiotics for
a supposed chest infection. No examination of the patient, no
listening to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable
option for someone feeling very unwell.
Does this sound like negligence or a breach of professional
standards on the part of the GP? Do we all now accept that house
calls are not an option except (based on my own experience) where
the patient is dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support
is available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of
Scotland. Within the last 5 years my elderly mother was visited semi
regularly by a GP or locum to manage her various conditions. She
could have been mobilised by local family members to attend the local
surgery and was to attend hospital appointments. The surgery
clinicians chose to visit her to make sure she had the most
appropriate care but she was neither disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
My friend does not live near me and is not registered with the same GP surgery that I use. She tells me she has been ill in bed for a month,
maybe longer. Only recently was she prescribed antibiotics, by phone
and without any examination. I don't know whether a person in her
position who developed sepsis would be examined in time. She has
mental health problems and a limited command of the English language.
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
These days, I'm afraid, doctors dole out antibiotics rather freely. We
should all try not to live too long, because there are going to be an
awful lots of antibiotic-resistant bacterial illnesses going round in a decade or two.
Really, a throat swab needs to be taken and sent off to the lab for
culture. Depending on the results of that, an antibiotic may be
warranted. But, who, these days, wants to wait 3-4 days for treatment?
In your friend's case, it's probably a virus, but she will probably get better in a few days regardless of anything the doctor can do.
On 11/12/2024 15:59, Peter Walker wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making a
house call (do they ever, these days?) prescribed antibiotics for a
supposed chest infection. No examination of the patient, no listening
to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable option
for someone feeling very unwell.
Does this sound like negligence or a breach of professional standards
on the part of the GP? Do we all now accept that house calls are not
an option except (based on my own experience) where the patient is
dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support is
available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of Scotland.
Within the last 5 years my elderly mother was visited semi regularly by a
GP or locum to manage her various conditions. She could have been
mobilised by local family members to attend the local surgery and was to
attend hospital appointments. The surgery clinicians chose to visit her
to make sure she had the most appropriate care but she was neither
disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
My friend does not live near me and is not registered with the same GP surgery that I use. She tells me she has been ill in bed for a month,
maybe longer. Only recently was she prescribed antibiotics, by phone and without any examination. I don't know whether a person in her position
who developed sepsis would be examined in time. She has mental health problems and a limited command of the English language.
There were complaints from some members of the audience that if you want
an appointment you have to log into the portal as early as possible
after 8am and sometimes it refuses to accept messages after just half an hour. The GP said that it is still possible to get appointments by
phoning the reception desk or by calling in person and queueing at the reception desk. She said that was a legal, contractual requirement. Some
of the audience said that when they tried that they were turned away by
the receptionist and told to persevere with the portal. She said she
will now ensure the receptionists get refresher training!
On 11:12 12 Dec 2024, The Todal said:
On 11/12/2024 15:59, Peter Walker wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes she
is too ill to leave the house. She rang the GP who, without making
a house call (do they ever, these days?) prescribed antibiotics for
a supposed chest infection. No examination of the patient, no
listening to the chest.
I think the advice that was given was, if you feel really unwell go
to A&E at your nearest hospital. Which isn't a very palatable
option for someone feeling very unwell.
Does this sound like negligence or a breach of professional
standards on the part of the GP? Do we all now accept that house
calls are not an option except (based on my own experience) where
the patient is dying and in need of palliative care, in their home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life care,
have been an unaffordable luxury for decades now. An acutely ill
able-bodied person can either cope, with whatever level of support
is available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of
Scotland. Within the last 5 years my elderly mother was visited semi
regularly by a GP or locum to manage her various conditions. She
could have been mobilised by local family members to attend the local
surgery and was to attend hospital appointments. The surgery
clinicians chose to visit her to make sure she had the most
appropriate care but she was neither disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
My friend does not live near me and is not registered with the same GP
surgery that I use. She tells me she has been ill in bed for a month,
maybe longer. Only recently was she prescribed antibiotics, by phone
and without any examination. I don't know whether a person in her
position who developed sepsis would be examined in time. She has
mental health problems and a limited command of the English language.
If your friend has been confined to bed for a month on account of
illness then I would think that justifies a house visit by her GP.
I wonder what her online medical record says about the practice's
assessment of her condition?
However if she has started antibiotics recently then it may be as well
to finish the course (assuming it's 5 to 7 days, rather than 14 days).
If her condition doesn't improve markedly by the end of the course, then
I would contact the GP again and specifically request a visit.
This is not really an A&E matter as it's neither an accident nor an
emergency (yet). Some areas provide an NHS "urgent care centre" for conditions which do not need A&E; however you still need to visit.
At a wild guess, this could be one of the respiratory conditions that
the press report are prevalent currently and there may be little to be
done if someone has already caught one. For what it's worth, the
symptoms charts in the press suggest fever is most likely from flu or
less likely from Covid, rather than norovirus or RSV.
On 12 Dec 2024 at 13:57:09 GMT, "Pamela"
<uklm@permabulator.33mail.com> wrote:
On 11:12 12 Dec 2024, The Todal said:
On 11/12/2024 15:59, Peter Walker wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com>
wrote:
A friend of mine has been ill in bed with a fever. She believes
she is too ill to leave the house. She rang the GP who, without
making a house call (do they ever, these days?) prescribed
antibiotics for a supposed chest infection. No examination of the
patient, no listening to the chest.
I think the advice that was given was, if you feel really unwell
go to A&E at your nearest hospital. Which isn't a very palatable
option for someone feeling very unwell.
Does this sound like negligence or a breach of professional
standards on the part of the GP? Do we all now accept that house
calls are not an option except (based on my own experience) where
the patient is dying and in need of palliative care, in their
home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life
care, have been an unaffordable luxury for decades now. An acutely
ill able-bodied person can either cope, with whatever level of
support is available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of
Scotland. Within the last 5 years my elderly mother was visited
semi regularly by a GP or locum to manage her various conditions.
She could have been mobilised by local family members to attend the
local surgery and was to attend hospital appointments. The surgery
clinicians chose to visit her to make sure she had the most
appropriate care but she was neither disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
My friend does not live near me and is not registered with the same
GP surgery that I use. She tells me she has been ill in bed for a
month, maybe longer. Only recently was she prescribed antibiotics,
by phone and without any examination. I don't know whether a person
in her position who developed sepsis would be examined in time. She
has mental health problems and a limited command of the English
language.
If your friend has been confined to bed for a month on account of
illness then I would think that justifies a house visit by her GP.
I wonder what her online medical record says about the practice's
assessment of her condition?
However if she has started antibiotics recently then it may be as
well to finish the course (assuming it's 5 to 7 days, rather than 14
days). If her condition doesn't improve markedly by the end of the
course, then I would contact the GP again and specifically request a
visit.
This is not really an A&E matter as it's neither an accident nor an
emergency (yet). Some areas provide an NHS "urgent care centre" for
conditions which do not need A&E; however you still need to visit.
That rather depends on whether she is able to eat and drink and keep
herself clean and bed sore free. There is a catch 22 here though, if
she can do the above it is really not impossible to bundle herself in
a taxi and get to the GP. It would be nice if the NHS funded home
visits for everyone, but it doesn't. If she really can't look after
herself then she belongs in hospital, whether you regard it as an
emergency or not. Unless there is a local scheme to look after acutely
ill people at home - but I have never seen such a scheme except for
old people. It might be worth asking the district nurses, but in most
places they wouldn't have the capacity to help.
At a wild guess, this could be one of the respiratory conditions that
the press report are prevalent currently and there may be little to
be done if someone has already caught one. For what it's worth, the
symptoms charts in the press suggest fever is most likely from flu or
less likely from Covid, rather than norovirus or RSV.
On 17:17 12 Dec 2024, Roger Hayter said:
On 12 Dec 2024 at 13:57:09 GMT, "Pamela"
<uklm@permabulator.33mail.com> wrote:
On 11:12 12 Dec 2024, The Todal said:
On 11/12/2024 15:59, Peter Walker wrote:
Roger Hayter <roger@hayter.org> wrote in
news:5553513126.915da2a5@uninhabited.net:
On 10 Dec 2024 at 18:16:52 GMT, "The Todal" <the_todal@icloud.com> >>>>>> wrote:
A friend of mine has been ill in bed with a fever. She believes
she is too ill to leave the house. She rang the GP who, without
making a house call (do they ever, these days?) prescribed
antibiotics for a supposed chest infection. No examination of the >>>>>>> patient, no listening to the chest.
I think the advice that was given was, if you feel really unwell >>>>>>> go to A&E at your nearest hospital. Which isn't a very palatable >>>>>>> option for someone feeling very unwell.
Does this sound like negligence or a breach of professional
standards on the part of the GP? Do we all now accept that house >>>>>>> calls are not an option except (based on my own experience) where >>>>>>> the patient is dying and in need of palliative care, in their
home?
House calls, except for the chronically severely disabled and
housebound (including age related disability) and end of life
care, have been an unaffordable luxury for decades now. An acutely >>>>>> ill able-bodied person can either cope, with whatever level of
support is available to them, or needs to go to A & E.
I do not agree that is the case, certainly in certain areas of
Scotland. Within the last 5 years my elderly mother was visited
semi regularly by a GP or locum to manage her various conditions.
She could have been mobilised by local family members to attend the
local surgery and was to attend hospital appointments. The surgery
clinicians chose to visit her to make sure she had the most
appropriate care but she was neither disabled nor housebound.
I hope the o/p's friend is not adversely affected by the failure to
properly assess their condition.
My friend does not live near me and is not registered with the same
GP surgery that I use. She tells me she has been ill in bed for a
month, maybe longer. Only recently was she prescribed antibiotics,
by phone and without any examination. I don't know whether a person
in her position who developed sepsis would be examined in time. She
has mental health problems and a limited command of the English
language.
If your friend has been confined to bed for a month on account of
illness then I would think that justifies a house visit by her GP.
I wonder what her online medical record says about the practice's
assessment of her condition?
However if she has started antibiotics recently then it may be as
well to finish the course (assuming it's 5 to 7 days, rather than 14
days). If her condition doesn't improve markedly by the end of the
course, then I would contact the GP again and specifically request a
visit.
This is not really an A&E matter as it's neither an accident nor an
emergency (yet). Some areas provide an NHS "urgent care centre" for
conditions which do not need A&E; however you still need to visit.
That rather depends on whether she is able to eat and drink and keep
herself clean and bed sore free. There is a catch 22 here though, if
she can do the above it is really not impossible to bundle herself in
a taxi and get to the GP. It would be nice if the NHS funded home
visits for everyone, but it doesn't. If she really can't look after
herself then she belongs in hospital, whether you regard it as an
emergency or not. Unless there is a local scheme to look after acutely
ill people at home - but I have never seen such a scheme except for
old people. It might be worth asking the district nurses, but in most
places they wouldn't have the capacity to help.
At a wild guess, this could be one of the respiratory conditions that
the press report are prevalent currently and there may be little to
be done if someone has already caught one. For what it's worth, the
symptoms charts in the press suggest fever is most likely from flu or
less likely from Covid, rather than norovirus or RSV.
The following article is interesting, although it's unlikely to help the situation being asked about.
"GP home visits: essential patient care or disposable relic?" (2020)
https://bjgp.org/content/70/695/306
My friend does not live near me and is not registered with the same GP surgery that I use. She tells me she has been ill in bed for a month,
maybe longer.
Only recently was she prescribed antibiotics, by phone and
without any examination. I don't know whether a person in her position
who developed sepsis would be examined in time. She has mental health problems and a limited command of the English language.
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP
surgery that I use. She tells me she has been ill in bed for a month,
maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living
on her own? Is she very isolated?
I have no idea what services are available for people with long term
mental health problems in her area?
Only recently was she prescribed antibiotics, by phone and without any
examination. I don't know whether a person in her position who
developed sepsis would be examined in time. She has mental health
problems and a limited command of the English language.
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP
surgery that I use. She tells me she has been ill in bed for a month,
maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living
on her own? Is she very isolated?
I have no idea what services are available for people with long term
mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a
GP is under any obligation to conduct a physical examination.
Only recently was she prescribed antibiotics, by phone and without any
examination. I don't know whether a person in her position who
developed sepsis would be examined in time. She has mental health
problems and a limited command of the English language.
On 12:41 11 Dec 2024, GB said:
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is
too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
You must mean Fahrenheit rather than Celsius.
On 12/12/2024 13:58, Pamela wrote:
On 12:41 11 Dec 2024, GB said:
On 10/12/2024 22:37, The Todal wrote:
A friend of mine has been ill in bed with a fever. She believes she is >>>> too ill to leave the house.
What you haven't mentioned is the temperature your friend has. 98C is
hardly a serious fever. 99C is more serious.
You must mean Fahrenheit rather than Celsius.
Mistakes like that are enough to make my blood boil!
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote:
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>> surgery that I use. She tells me she has been ill in bed for a month,
maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living >>> on her own? Is she very isolated?
I have no idea what services are available for people with long term
mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a
GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to practice medicine to the professional standards to be expected of a doctor in his position.
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote:
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>>> surgery that I use. She tells me she has been ill in bed for a month, >>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living >>>> on her own? Is she very isolated?
I have no idea what services are available for people with long term
mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a >>> GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to
practice medicine to the professional standards to be expected of a doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote:
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote: >>>
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>>>> surgery that I use. She tells me she has been ill in bed for a month, >>>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living >>>>> on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a >>>> GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in
tort to practice medicine to the professional standards to be
expected of a doctor in his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
I think you miss the point. The professional standards apply if the doctor >sees the patient. They don't say anything about having to go and see them at >home. That is purely an administrative arrangement about how the NHS works. >There was a time when GPs were responsible for the whole service to patients >on their list, but I am afraid successive governments from the 1970s took that >reponsibility away from them on the (laughable) grounds that they thought huge >numbers of NHS administrators could run the service better and cheaper.
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote:
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote: >>>
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>>>> surgery that I use. She tells me she has been ill in bed for a month, >>>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living >>>>> on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a >>>> GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to >>> practice medicine to the professional standards to be expected of a doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
I think you miss the point. The professional standards apply if the doctor sees the patient. They don't say anything about having to go and see them at home.
On 15/12/2024 14:39, Roger Hayter wrote:
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid>
wrote:
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com>
wrote:
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the
same GP
surgery that I use. She tells me she has been ill in bed for a
month,
maybe longer.
This sounds a lot more serious than appeared from your OP. Is she
living
on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of
whether a
GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in
tort to
practice medicine to the professional standards to be expected of a
doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
I think you miss the point. The professional standards apply if the
doctor
sees the patient. They don't say anything about having to go and see
them at
home.
If you are right, Todal's friend's GP, should simply have said that he refused to have anything to do with the patient unless said patient
attended the surgery. Is that your point?
On 15/12/2024 14:39, Roger Hayter wrote:
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote: >>
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote: >>>>
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>>>>> surgery that I use. She tells me she has been ill in bed for a month, >>>>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living >>>>>> on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a >>>>> GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to >>>> practice medicine to the professional standards to be expected of a doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
I think you miss the point. The professional standards apply if the doctor >> sees the patient. They don't say anything about having to go and see them at >> home.
If you are right, Todal's friend's GP, should simply have said that he refused to have anything to do with the patient unless said patient
attended the surgery. Is that your point?
On 16 Dec 2024 at 10:23:00 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote:
On 15/12/2024 14:39, Roger Hayter wrote:
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote: >>>
On 14/12/2024 14:34, Roger Hayter wrote:
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote: >>>>>
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP >>>>>>>> surgery that I use. She tells me she has been ill in bed for a month, >>>>>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living
on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular
individual - I was just interested in the general principle of whether a >>>>>> GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to >>>>> practice medicine to the professional standards to be expected of a doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays
doctors to see a certain number of patients a day in the surgery and
doesn't pay them to do house calls, how is all this supposed to work?
I think you miss the point. The professional standards apply if the doctor >>> sees the patient. They don't say anything about having to go and see them at
home.
If you are right, Todal's friend's GP, should simply have said that he
refused to have anything to do with the patient unless said patient
attended the surgery. Is that your point?
If they wanted to avoid responsibility, I suppose so. But they clearly felt their management was reasonable.
On 12/16/24 11:13, Roger Hayter wrote:
On 16 Dec 2024 at 10:23:00 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote: >>But surely there is a responsibility to patients, and that includes responsibility to offer some type of phone consultation. If the phone consultation indicates antibiotics, doesn't reasonable management
On 15/12/2024 14:39, Roger Hayter wrote:
On 15 Dec 2024 at 13:55:47 GMT, "GB" <NOTsomeone@microsoft.invalid> wrote: >>>>
On 14/12/2024 14:34, Roger Hayter wrote:I think you miss the point. The professional standards apply if the doctor >>>> sees the patient. They don't say anything about having to go and see them at
On 14 Dec 2024 at 13:37:22 GMT, "The Todal" <the_todal@icloud.com> wrote:
On 13/12/2024 13:42, GB wrote:
On 12/12/2024 11:12, The Todal wrote:
My friend does not live near me and is not registered with the same GP
surgery that I use. She tells me she has been ill in bed for a month, >>>>>>>>> maybe longer.
This sounds a lot more serious than appeared from your OP. Is she living
on her own? Is she very isolated?
I have no idea what services are available for people with long term >>>>>>>> mental health problems in her area?
I'm not looking for suggestions as to how to help this particular >>>>>>> individual - I was just interested in the general principle of whether a
GP is under any obligation to conduct a physical examination.
A GP is under an obligation, to the professional regulator and in tort to
practice medicine to the professional standards to be expected of a doctor in
his position.
But, there is a contractual element to this. If the NHS requires pays >>>>> doctors to see a certain number of patients a day in the surgery and >>>>> doesn't pay them to do house calls, how is all this supposed to work? >>>>
home.
If you are right, Todal's friend's GP, should simply have said that he
refused to have anything to do with the patient unless said patient
attended the surgery. Is that your point?
If they wanted to avoid responsibility, I suppose so. But they clearly felt >> their management was reasonable.
dictate that the doctor should prescribe them, if appropriate. The alternative being the patient is left untreated.
Basically, to borrow a motto from Google isn't their an overall responsibility "Don't be evil", so a GP should try to offer the best treatment available in the circumstances.
If the situation was critical, there was a paramedic, or ambulance.
Pancho wrote:
If the situation was critical, there was a paramedic, or ambulance.
I remember a few years ago, GP surgeries seemed to contract with some
type of service that provided doctors for overnight house calls ... is
that no longer common?
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