North Laine Medical Centre's Response

The email below, sent on 6 October 2009, was the first response from the North Laine Medical Centre to my email:

"Dear Steve and Helena Huckle,

I am sorry to learn that you were not happy with the service provided by this practice. I will look into the issues you have raised and give a response within the next 2 weeks.

Mike Stemp
Practice Manager, North Laine Medical Centre"

Below is the next letter, dated October 27, 2009:

"Dear Mr and Mrs Huckle,

I have now had an opportunity to look into the points you raised in your letter dated 4th October 2009 and reply on behalf of the practice.

We are very pleased that Tara was seen by the specialist Paediatricians at King's College Hospital and is healthy, has made a good recovery and is back in the family fold. Our thoughts are with you over the coming few months as Tara completes her tests and receives the appropriate care following her treatment in one of the UK centres of excellence for dealing with tumours in children.

The doctors at this practice have carefully examined the medical records for your daughter for the period. Both Dr Clarke and Dr Sharp have reviewed the symptoms that indicate the development of a tumour in young children. They are very sorry that you felt that the practice let you down in the run up to the diagnosis.

The medical records indicate that your daughter was initially seen for a squint on the 23rd June and referred to the Ophthalmologist for a routine assessment via the Brighton Integrated Care Service. She had a history of viral infections as well as being unsteady on her legs. The last contact at this practice was on 23rd August (*Note – that can't be correct as Tara was sat in a bed at King's waiting to be fitted with a shunt - we believe this was on 1st August), when the GP that saw her made an urgent referral to the paediatric unit for her neurological symptoms. It was the result of our initial referral that your daughter was seen at the Sussex Eye Hospital and subsequently diagnosed as having a tumour.

We do appreciate your deep concerns as reflected in your letter. We would like to explain that making a neurological assessment in young children is particularly difficult in Primary Care. Our doctors have many years of clinical training and experience. However, a doctor working in general practice would rarely if ever see this condition during their careers, whereas the clinical staff at King's would be very familiar with the symptoms presented by your daughter. They are sorry that the diagnosis took 6 weeks following your daughters initial visit to the practice, but believe that they took the appropriate actions to ensure that your daughter was referred to the clinical specialist within the hospital sector.

I can assure you that the practice recognises the importance of learning from your daughter's condition. We have now conducted a significant events analysis and will share the learning points. Also we will ensure that all the doctors who were involved in your daughters care while at the practice have a record of our discussions, and have the opportunity to learn from this experience. The analysis lists your daughter's clinical history. Our main conclusions are:

1. To reflect on the indicators and diagnosis of a brain tumour in children with all the GP's who saw Tara.
2. To review causes and symptoms of squint/6th Cranial Nerve Palsy in children.
3. To remind all clinicians of the referral pathways, particularly for urgent referrals.

I hope that you find this a satisfactory response relating to the care provided by this practice, if you need any more help or feel that you wish to discuss this issue further with myself and a doctor then you should contact me again within 2 months from the date you receive this letter. If you feel that you cannot resolve your complaint with us or you are dissatisfied with the result of our investigation then you should contact:

Health Service Ombudsman
The Parliamentary and Health Service Ombudsman
Millbank Tower
Millbank
London SW1P 4QP

web: www.ombudsman.org.uk
tel: 0345 015 4933

Yours Sincerely

Michael Stemp
Practie Manager"
 

*Note. You can read dad's thoughts at the letter on this blog entry.