Mr S complained that his GP Practice would not allow him to book appointments with the GP he regarded as his family doctor when he needed them. He also said the Practice's systems for allocating appointments and home visits were not fit for purpose. Mr S also complained that the Practice made mistakes in his prescription and he then received the wrong type of insulin.
What happened
Mr S phoned the Practice on numerous occasions to request appointments with his family doctor. Sometimes the family doctor was available but on many occasions he was unavailable or Mr S was told he would have to wait weeks to see him but could see someone else in the meantime if his needs were urgent.
On one occasion Mr S phoned the Practice to request a home visit for his mother who was unwell and unable to attend the Practice. The customer services manager asked Mr S about his mother's condition and also asked if Mr S's mother could call at the surgery instead of having a home visit. Mr S's mother got a home visit.
Mr S had diabetes and had been taking insulin for some time but his treatment was not successful in controlling his blood sugar and he suffered other symptoms, including thrush, as a result. Mr S's specialist recommended a change in insulin regime and asked the Practice to implement this. The Practice changed Mr S's prescription as the specialist had requested, but then changed it back to his old prescription two weeks later without documenting why. As a result, Mr S continued to receive his old insulin rather than the new prescription recommended by the specialist.
What we found
We partly upheld this complaint. The Practice was reasonable in the way it dealt with Mr S's requests to see his 'family doctor'. The NHS constitution states that people can ask to see a doctor of their choice, but a GP practice is not obliged to agree to the requests. The Practice did not refuse to give Mr S an appointment when he needed one, but the appointments it offered were not always with the doctor Mr S had asked for.
The Practice dealt with Mr S's request for a home visit for his mother appropriately. The customer services manager gathered relevant information from Mr S about his mother's condition and passed this to a GP, who reached the clinical decision that a home visit was necessary.
The Practice changed Mr S's insulin back to his old regime against the advice of the specialist diabetologist and failed to record its rationale for doing so. There were also failures in record keeping at the Practice because the GP did not record the rationale for going against the advice of the diabetologist. Mr S was not harmed by the change back to his old insulin, but an opportunity to bring his diabetes under better control was lost. We noted that Mr S could have brought the prescription error to the attention of the Practice earlier than he did.
Putting it right
The Practice apologised to Mr S for not providing him with the prescription recommended by the diabetologist. It also put a procedure in place to make sure the reasons for prescription changes are clearly recorded.
A GP practice
Merseyside
Not applicable
Apology
Recommendation to learn lessons or draw up an action plan