Being honest with you sick.as.a.chip other than the mis-directed email to ENT rather than urology (and maybe delay in GP arranging) I don't see anything too unusual in your mum's treatment. Let me recap and maybe offer explanations (but I am a nurse and not in cardiology): Pre-op assessment - irregular pulse found. ECG and examination carried out showing possible left axis deviation but with no worrying symptoms and anaesthetist happy for operation to proceed with plan for echo. Echo undertaken and the sonographer sends an email (to the wrong department) requesting cardiology review ENT sends the email back to urology Urology sends a letter to the GP to arrange cardiology review GP phones mum/makes referral Sadly mum dies before appointment You say in your original post that there was no worrying signs and your mum never had any issues with her heart. The irregular heartbeat was noted and acted approrpriately in my opinion. The anaesthetist wouldn't request specialist blood tests to diagnose heart failure as mentioned by Sali. It is outwith his specialist knowledge and he was unaware of the fragility of your mum's heart which only became apparent from the echo. Even more important is that an left axos deviation does not necessarily mean there is heart failure. There were no adverse signs of decompensated heart failure and he was happy to proceed with the op. An echo was requested which took 4 weeks - again that seems appropriate. Our routine outpatient scans are within 6 weeks. The sonographer quite rightly flagged up the result to the referrer (or so she thought). The email can be put down to human error. From my view this is the only criticism that could be made but doubt it would have had any effect on the result. Urology got the mis-sent email and let the GP know about the need for cardiology referral. In my health board (Scotland) we would be the ones that do that however I understand England's system is different and the GP is asked to do this. The urologist will likely have dictated a letter, time it is typed by the secretary and then approved and posted out this could account for the apparent delay for the GP being made aware. It could be argued I suppose that if it was classed as priority then he should have phoned but that is conjecture based on the information available to him and indeed when he received it (could have been on annual leave/ ENT delayed in sending it to him etc). The GP received the letter and contacted your mum to say she was being referred urgently to cardiology. The letter was dated the 19th but that certainly didn't mean the GP received it then and the delay in posting, then the secretary receiving it and then the doctor reviewing it etc could account for this apparent delay. GPs - from my experience - have very limited time for paperwork/correspondence duties. The GP referred to cardiology and an urgent appointment was generated. In my speciality urgent appointments are within 6 weeks. Please don't think I am getting at you or criticising you in any way. Just thought my impartial views from someone in the health service would be useful. If I have got anything wrong please let me know.

Sorry to hear about your accident. I doubt very much that any surgeon would amputate such a short while after a accident. Conservative measures would be first to be tried then radical options considered next. Do you have follow up? You might end up with a middle finger you can't feel but amputation can lead to other issues as mentioned above - you say you are right-handed. You may need to learn to write again which could be even more frustrating!

Sorry your original post is a bit confusing. Who diagnosed the fractures and how did they diagnose them if the CT and MRI showed nothing. Who ordered these in any case? I had a bad sprain playing hockey at High School and still to this day have issues with that ankle. I have a valgus deformity (turns in) and excruciating plantar fasciitis. What do you hope to achieve?

I'm a rheumatology nurse specialist and today I completed 3 medical supports for ESA. They give you 5 working days to get the info back to them so had to stay late to type these myself as a dictated letter takes at least a week to be typed. All three of these patients had very different systemic rheumatic disease. The burden of ESA (and soon to come PIP) on these patients (and their specialists) is ridiculous. I fear there may come a time where I have to say "sorry, I can't help on this occasion" which is not why I became a nurse! Re: OP. Sorry to hear of your wife's problems with her PsA (and treatment!). MTX is a good drug but like many DMARDs has side effects some find intolerable! I would not call it chemotherapy in the oncology sense as technically all drugs are 'chemotherapies' but it should be recognised that there are well known and common side effects (nausea, diarrhoea especially) of MTX. Interestingly you say her PsA has been getting worse over the past few months? Has this been looked at? She may need changes to treatment. Do you have a local CNS you/your wife could contact for advice? My advice to any patients filling out the form or attending a medical is to make it your worst day and lose the proud stoic-ness! If you can only comb your hair 5 days out of 7 then you can't comb your hair! If you can't lift a box every day then you can't lift a box. Best of luck!!

Well from the stuff I've read they have no right to withhold these notes without valid reason. A complaint to the practice manager/senior partner. It would be useful if he copied the relevant parts of the legislation. Then through the complaints process. A letter from a solicitor however might be more forceful and require them to act.

Having a quick Internet search it would seem he has the right to see the medical records but the GP surgery will have to make sure it is appropriate eg an abusive partner trying to get the address of their ex via their child's records etc An honest letter about his concerns describing his request should do. If not then a solicitor's letter might have more persuasion!

Having a quick Internet search it would seem he has the right to see the medical records but the GP surgery will have to make sure it is appropriate eg an abusive partner trying to get the address of their ex via their child's records etc An honest letter about his concerns describing his request should do. If not then a solicitor's letter might have more persuasion!

Sorry didn't explain myself. If his visits were cancelled because of a hospital admission is he barred from visiting the child by the mother or is it such a short admission that visiting would be pointless. The reason would be is that if he could visit he could ask medical staff the situation. M Regarding medical records I'm not sure about that one. Having parental responsibility and being named on birth certificate is obviously in his favour but I assume the mother Is the primary care giver and I'm not sure about the law in that regard. He should try and get access to the records and then if that fails to seek legal advice.

So he doesn't get to visit the kid in hospital or is it just a short admission? I assume he lives close by as he is registered at the same GP.

"my teeth are in a bad way" Is that entirely due to the dental treatment or lack of care over the 40+ years? I think you would be laughed out if they were expected to pay for your treatment. Understandable it put you off dentists (im not a big fan myself) but I assume you needed the fillings as you had caries? Experimenting on people without informed consent was outlawed long ago. I had root canal treatment in primary school (and the tip of the instrument snapped off in my tooth aswell) so probably not that unusual. Best if luck with whatever you do!

Congratulations!!

I hope you get the answers you're looking for. I'm on the 'other side' and find the system just as frustrating as a clinician. I assume the echo showed some problems that ultimately led to your mums death. Sadly it would seem your mum's heart was so fragile I doubt that any review by cardiology would have helped. But of course that's conjecture and leaves the 'what if' questions unanswered - and they are the toughest as they will never been answered. And, of course, I don't know your mum or her health condition(s). The irregular heartbeat was picked up by accident. If it hadn't then the outcome would have been the same most likely and you and your family would have likely accepted it. Of course that's not the case and I am certainly not criticising you in any way. If questions need asked then good on you for fighting on your mums behalf. Re: the PM - I assume that the coroner would have the report or at least a summary of it - as I also assume they are the ones who provided the death certificate? The PM report should go into the medical notes (hospital and GP) however I do emphasise *should*. Most systems are computer-based these days and the report should be easily obtainable from the hospitals system. Send a letter to the health records manager of the hospital requesting this information - state that the coroner and GP have no note of it. Even if paper-based the secretary should have a copy or at least sent it to filing. If you get no where with the health records department then try the pathology service manager. Best of luck in your quest for answers. I hope you get what you're looking for. PS The practice manager should be au fait with the legal aspects of running a practice. As it seems this doesn't seem to be the case!! But then the legal advice seems to be a hit and miss too so not entirely their fault I suppose. As I said, frustrating!!!

Most doctors who are registered to practise with a licence aren't specialists or GPs. When a doctor qualifies they have provisional registration (foundation year 1) and enter FY2 and full registration thereafter. Most doctors will then undertake their specialist training - whether medicine, surgery, GP etc. only upon completion of the certificate of completion oif training is a doctor added to the specialist/GP registers. They are fully qualified doctors but unable to call themselves a consultant or GP.

That is a hefty amount of anti-hypertensives! Is there a possibility that white coat syndrome could be a part of it? Do you monitor it at home?

I am a rheumatology nurse specialist and obviously understand scleroderma and its effects on patients and of course their families. I totally empathise with you and your son around DLA. I have had patients in tears frightened that they will lose their DLA - which they use to make their trips to hospital for treatment which keeps them in employment/functional members of society. It is so frustrating when expert specialist professional opinion is disregarded and some paper shifter makes a decision on a person they know nothing about. I'd like to see them trying to button a shirt when they have no finger movement/digital ulcers or indeed no fingers or can only walk at a snail's pace in extreme pain or so breathless as a result of their lung and heart involvement all secondary to their systemic sclerosis. I get many letters/request for information from the DWP about a patient of mine and their condition. This takes an immense amount of time. With the introduction of PIP this is only going to get worse. Rheumatology as a whole is affected quite badly by the changes to the disability benefits due to the nature of rheumatic disease. This is beginning to add a burden to already stretched services. Anyway, back to the original topic - best of luck for your son at his court date!