To the GP that thought she was doing the right thing 

First things first, I want to make it clear that I have no end of admiration for Nurses, Doctors, Gp’s, Midwives etc and the massive amounts of work they do. I’m not one to complain on a whim, but only where I feel there is a serious need for something to be addressed. 

A few months ago, you will remember I was basically accused of harming Vivienne after the GP spotted a teeny bruise on her thigh. 

A few days after this happened, I wrote a strongly worded (and entirely justified) complaint to the head of my GP surgery. Below, you will find that letter. 

Please note, names of medical professionals have been changed for the purpose of this post. 

Dear Practice Manager 

Further to my appointment with Dr Dahlia at 11.30/11.40 am on Thursday the 26th of January 2017, I wish to make a complaint in relation to Dr Dahlia’s  handling of my appointment, and her lack of training in relation to a sensitive matter which has left me feeling distraught. 

On the 26th January I arrived at the surgery with both of my children (Sebastien and Vivienne ) for a double appointment for a cough that both children have suffered with for over a week. Sebastien was checked over and his cough listed as “viral” – no concerns there. 

When it came to Vivienne’s assessment Dr Dahlia  listened to her chest and back, whilst listening to her back, Dr Dahlia noticed a small rash on the upper quadrant of Vivienne’s back, and although the appearance of the rash was nothing of concern, I agreed that it would be pertinent to check for further rashes. It was as Vivienne was undressed that I made Dr Dahlia aware of a tiny (less than 2mm) bruise on Vivienne’s right thigh. After finishing the assessment of Vivienne’s cough, Dr  Dahlia advised that she wanted to refer to a colleague in relation to the bruise, as it may warrant a paediatric referral, but she wanted to check if the guidelines stated 6 months or 12 months (Vivienne is 44 weeks of age) 

It was upon her return to the consulting room that Dr Dahlia’s demeanour changed, and she told me that I would need to take Vivienne the hospital “as the guidelines state 12 months” I have checked the guidelines, and they do not mention age, they refer to NIM (non independently mobile- le not crawling, bum shuffling etc) babies but do not state an age limit. 

http://www.portsmouthccg.nhs.uk/Services/Bruising%20Protocol%20final%20version%20Jan%202016.pdf

Now at this point I feel it is important to reiterate that my complaint is not in relation to the above guidelines, but in relation to Dr Dahlia’s lack of training and understanding regarding these guidelines and her inability to address patients in a respectful and non demeaning tone during what can be a delicate and emotive time. 

I was not immediately aware of the significance of the referral to paediatrics, and advised that my husband was away in Germany (armed forces personnel) and that I had friends at home for a play date with the children, so that it wasn’t particularly convenient, but as my husband would be home at the weekend, I could pop up to the hospital with Vivienne upon his return. This is when Dr Dahlia advised that if I did not present Vivienne to the hospital that same day that she would be making an immediate call to child services. I was quite taken aback, and asked if she had any concerns about the bruise. She answered no. I asked if I should have any concerns in relation to the bruise- again, her answer was no. I asked if she could therefore please explain the reasons for the referral to paediatrics and she just stated that it’s because of Vivienne’s age and that the bruise was “unexplained” 

I had already told Her that Vivienne is an active child (cruising and crawling) and tries to keep up with her (very active) 2 year old brother. 

When I realised her assumptions were in relation to child protection, I became very upset, and I did at this point raise my voice. I asked that she give me a moment to arrange childcare for Sebastien, and whilst messaging my friend, Dr Dahlia proceeded to make a telephone call. 

It took a few moments for my friends to reply saying whether they could have Sebastien for me, and whilst waiting for them to reply, Dr Dahlia told me to “make a decision as she can’t keep the registrar on the phone all day” I asked her again to wait a moment, and again she reiterated that the appointment must be that same day, and I needed to accept an appointment time immediately. I was very flustered and accepted a time of 2pm. 

I left the GP feeling extremely upset and somewhat vilified. This made worse by another member of staff stood behind the consulting room door when I opened it to leave. (As though she was listening through the door- I expect the reasons for her presence to be explained in full) 

I believe that if Dr Dahlia understood (and implemented) both the NICe and the NHS guidelines correctly, and had employed a little common sense or asked a more experienced colleague for a second assessment/opinion as stated in the NICE guidelines (point 1.2; https://www.nice.org.uk/guidance/cg89/evidence/full-guideline-243694621 ) that the upset and distress caused could have been avoided for both myself and Vivienne. Let it also be noted that the consultant that attended to Vivienne has hinted at Dr Dahlia’s misuse/misunderstanding of the guidelines in her follow up letter.

It must also be noted that Dr Dahlia did not provide me with an information leaflet (please see section 4.3 of the first guide) 

The way in which Dr Dahlia handled the appointment has consumed me these past few days, and ruined what should have been a happy time with the return of my husband from Germany. I have spent every waking hour fretting about my children, scared to let them play as a child should. I would hesitate to seek future guidance from Dr Dahlia for both myself and Sebastien and Vivienne, as I unfortunately feel I could not trust Dr Dahlia’s judgement. Be it towards my care or her medical ability. 

I suggest that at the very least, Dr Dahlia undertakes training on the new Children’s act, and look forward to a full and detailed apology from both herself and the practice. 

In anticipation of your reply. 

Kindest regards 

Zoe <sn> 

It took way over the 10 days stated in the practice complaints procedures for the practice manager to reply, and this was not without (a lot) of prompting and chasing from myself. 

When I finally did receive a reply from the practice, I was happy that they took my complaint seriously.

 They (the practice) advised me that they have classed Dr Dahlia’s handling of my appointment as a Major Incident and informed me that the entire practice staff were to undergo training in the new children’s act, and on Baby bruising protocols. 
I still feel very sad that this had to happen, and a part of me feels sorry for Dr Dahlia- as far as she was concerned at the time, she was acting in Vivienne’s best interests. 

I hope however, that no Parent has to go through the rigmarole that I went through, because it was painful, discouraging and embarrassing. 

Until I received the reply from the GP surgery, I felt I had a question mark over my ability to parent. I felt like I was being judged, and didn’t dare return to the GP practice until my complaint was resolved. I’m normally a self assured (arrogant!) individual, but this nearly broke me. 

Just imagine if this happened to a Parent that was already on the edge?! 

Zx