Advice provided regarding attending walk in centre
16. Mr H complains when he asked to be seen by a GP in January, he was instead instructed to go to walk in centre, or take Nurofen for the pain.
17. In its response, the Practice explained it is everyday practice for all GP surgeries to signpost to the walk-in centre when they are at full capacity. Mr H contacted the Practice on 3 January and was offered a routine appointment. He wanted to be seen sooner, so was informed to contact the Practice the following day, or to attend the walk-in centre or contact NHS 111.
18. BMA guidance on safe working states:
• “Practices are obliged by their GMS contract to provide for the reasonable needs of their patients and for the assessment of urgent problems arising in their patients in their practice area. Emergency or urgent problems can be directed to emergency departments, 999, or 111. Patients that can wait should, following assessment, be placed on the waiting list if safe capacity for appointments is exceeded for the day.”
19. We consider the Practice acted in line with the above guidance. It was at capacity for same day appointments so offered Mr H a routine appointment. Mr H was unhappy with this, so in line with the guidance the Practice advised him he could attend the walk-in centre. In considering this, we have not found any indications of failings for this complaint component.
The Practice refused to accept a urine sample on 7 January
20. When Mr H presented at the Practice on 7 January, the Practice refused to accept a urine sample from him.
21. In its response, the Practice explained it was unable to ask for a urine sample and it needed to be requested from a doctor at the Practice. Mr H had been seen by a private online GP through his insurance.
22. The advice provided at the private GP consultation was for Mr H to book a face-to-face appointment at the Practice, not to drop a urine sample in. There is no impact here, as the following day Mr H had a telephone appointment with a GP, a urine sample was sent off, and the results came back normal.
23. GMC guidance states:
• “15 You must provide a good standard of practice and care. If you assess, diagnose or treat patients, you must :a adequately assess the patient’s conditions, taking account of their history (including the symptoms and psychological, spiritual, social and cultural factors), their views and values; where necessary, examine the patient promptly provide or arrange suitable advice, investigations or treatment where necessary refer a patient to another practitioner when this serves the patient’s needs”
24. The Practice acted in line with GMC guidance, it assessed Mr H’s condition and sent off a urine sample. Our adviser explained it would not be in line with the private GP assessment to just turn up at the GP practice with a urine sample with no assessment by the Practice.
25. In considering the above, we have not found any indications of failings for this complaint component.
Antibiotic prescription:
26. Mr H complains the Practice would not provide antibiotics on 5 February. In its response, the Practice explained when Mr H had attended the Practice on 5 February, his symptoms seemed better and he was advised to wait and see if his condition improved, as antibiotics can continue working a few days after a course is completed.
27. NICE guidance on prostatitis states: • “Review antibiotic treatment after 14 days and either stop treatment, or continue for an additional 14 days based on an assessment of history, symptoms, clinical examination, urine and blood tests. Treatment may be required for up to 6 weeks.”
28. This guidance highlights if someone is still showing symptoms, they may need a clinical assessment and a longer course of antibiotics. If they are no longer showing symptoms, they do not.
29. It is recorded in the records on 5 February Mr H spoke to a member of the reception team, this member of staff recorded that Mr H felt a lot better. The member of reception staff took advice from a clinician, who advised Mr H to wait and see how he felt (this clinician did not see him face to face or speak with him).
30. Our adviser explained if the clinician had assessed him, the outcome may have been different. Our adviser explained an adequate assessment did not take place in line with the above NICE guidance.
31. Mr H then had a private assessment through health hero, an online GP as he said he was not completely better (this was several hours after visiting the Practice). Health hero prescribed Mr H 14 days of Ciprofloxacin (antibiotics).
32. The Practice did not carry out an adequate assessment of Mr H’s symptoms on 5 February. Mr H says as a result of the GP not assessing him on 5 February, he experienced pain and discomfort, and and the Practice did not diagnose his condition properly. We cannot link this impact. The private GP prescribed Mr H the antibiotics the same day, so we cannot say the pain and discomfort he experienced was due to the Practice not assessing him adequately.
33. We cannot say that if the Practice had assessed Mr H on 5 February, it would have prescribed him antibiotics.
34. The injustice claimed by the Mr H cannot be linked to the indication of failing we have identified. For this reason, we will not consider this complaint component further.
35. We hope Mr H is reassured that we have taken his concerns seriously.