AIBU to insist on meeting my consultant before c-section.

[time2deal]

Hi,

I'm an NHS patient with a high risk pregnancy (history of cervical cancer, need a C-section, high risk of early delivery, bedrest since 22 weeks) and I'm getting increasingly frustrated that I can't see my actual consultant.

He runs a weekly 'clinic' at the hospital, but never actually seems to be there. I see a different junior doctor each visit - and we have been told that the senior consultant is reviewing my case, and is interested in it, but as I'm now 33 weeks I'd really like to just meet him before we do the c-section. As my case is complex whenever I meet the doctors, which is almost weekly, they say something different (or something totally wrong as they haven't seen cases like mine) and also don't fully understand some of my concerns arising from the cancer surgeries. I just want to meet and talk to the senior guy and be confident that he id on top of the issues, and won't be reading my case as he scrubs in!

Now we are being told that perhaps he won't actually do the section, as he only does them on Thursdays, and perhaps it should be done by a gynae oncologist instead. But it's all just theories and maybes, but people who aren't in a position to make the real decision! Today we were given a specific appointment to see the senior consultant, checked twice over the last week to make sure it was ok, and then when we get there it turns out he isn't in today. My husband took a half days leave to join me, but a complete waste of time as all it was was another quick BP check, urine check and the usual 'you really need to speak to the lead consultant directly'. As far as I can tell there is no actual way for us to book an appointment with him.

Not sure what I'm posting for. Just frustration! I ended up in tears today over it, but nothing changes. I actually have private cover that I could have used but was told it wasn't necessary as the lead consultant would be looking after me. At this late stage I don't want to change things, or even change hospitals, but at the same time there is a real risk that I'll end up being opened up by someone who doesn't understand what is really a complex case, causing damage which means the slight chance I have of having a second baby could be ruined.

Do other people actually see their consultant, or are they always just leading a clinic where you see junior doctors? AIBU to keep pushing to meet him, although I'm not actually sure how to do this - other than perhaps booking a paying for a private appointment (is that even possible!). Or as an NHS patient do you just have to take what you get with senior staff.

[AnotherStitchInTime]

I was a very high risk case for my last pregnancy and saw my consultant twice in clinic and twice briefly on the antenatal ward. The rest of the time I saw registrars from their team. Despite this the delivery was meticulously planned and done by my consultant at 34 weeks. On the day there was my consultant plus a consultant gynae oncologist on call for my delivery should they be needed. I nearly delivered earlier and would have had the consultant on duty, but they have weekly meetings where they discuss the high risk cases so they were all aware should it have come to that.

My suggestion would be that you put your concerns to your consultant in writing via his secretary and request a face to face meeting. Do you have a date yet for your delivery?

[Bellyrub1980]

I work for the NHS and no, I don't think it's unreasonable to expect to see him and to push for it. The reality is, he's probably just incredibly busy, having to prioritise between several very complex cases or gets called away to emergencies. Unfortunately you've kept losing out. It also sounds like maybe he doesn't work full time (more than likely due to working privately a few days a week).

It's also the case that he summer is notoriously difficult to secure appointments with your own consultant. Many of them go on holiday which means they share the caseloads about and are spread more thinly, becoming more reliant on less senior staff to run clinics.

It's not fair for you to feel so in the dark about your own and your baby's health. You could pay for a private session (that would guarantee an appointment and is potentially less stressful to arrange) or you could phone his NHS secretary and tell her what you've just said here. I'm more accustomed to dealing with orthopaedic consultants, but the same thing often happens with their patients. And for the ones where they need to speak to the organ grinder (not the monkey!) the secretary can be a helpful way of getting in the right clinic at the right time.

Failing that, writing a letter with your concerns can be very effective.

[DPotter]

OP - if you are tempted to take the private appointment route - pls check with your insurer as most private medical insurance in the UK does not cover maternity care even if complicated by past medical history.

I don't think you are being un-reasonable to want to meet and discuss options with the consultant, however I think the best way would be to contact his / her secretary as the appointments clerks may not have all the info available on his / her availablity
Good luck

[time2deal]

Thanks, I'll try writing tomorrow. I don't have a date yet, and each doctor gives a different opinion on when is likely, but none give the impression that its based on my specific case, but more on the 'normal' case.

I'd be happy if I knew it was being discussed in mettings, but the wide eyed 'oh you're quite unique' look I get with every new doctor makes me think it isn't! Plus I'm sure everyone thinks they are special, so I don't want or expect all the docs to be aware, but just one who has an overall view would be nice.

If no luck I'm going to consider changing back to an old hospital. Its further away, but I know the doc there and would be much more confident he knows who I am.

[Annietheacrobat]

Another NHS worker and in your position I don't think it is at all unreasonable to want to confirm who will be doing your section and meet the consultant. I would send a letter to this effect.

Agree with earlier person - expect part of the problem is the school holidays.

[time2deal]

Thanks ladies. I've droppped him a polite email, and got an out of office until 28 August. Presumably he has a secretary who reads his emails too so perhaps I'll get an appointment. Hope I don't go into labour in the next week!

I do know my private insurance will cover it, as I have talked with them in the past. So long as the section is medically necessary (which it is) then they cover it. Although there is a fairly significant gap as they don't cover the full consultant fees. I'm happy to pay the gap, but in a way I believe in the NHS and feel it's unfair to jump the queue - but my principles may be wavering at the moment!

[squizita]

I have seen the senior consultant three times out of about 10 or 12 appointments ... But in my case its because my risks reduced over time.
Try contacting pals or supervisor of !midwives - when I had a dodgy appointment with a jnr Dr and wanted someone else, my som sorted it within a week!

[time2deal]

I just hate complaining! And I'm not even english.

Perhaps we don't need to see him, and perhaps I'm making a fuss over nothing, but surely they can see that we need some reassurance.

The most worrying thing is the occasional totally incorrect comment which frightens me. I am literally the only lady with my condition at the hospital at the moment, so I understand the lack of experience, but I just want a single person to have an overview when needed. I can imagine me being a bit ignored if it's an emergency, and the consultants just assuming I'm a hysterical woman and trying to do things as per normal - which will cause me problems later on.

I'll give it a day, and then call the secretary tomorrow.

[QueenCardigan]

No, yadnbu. I would want to meet someone that was cutting me open and even more so in your complex case.

Don't assume that the secretary is reading the consultants emails and s/he probably isn't due to password protection etc so I would definitely chase up the secretary.

It's very frustrating seeing different doctors all the time but unfortunately with the way on call rotas now work plus holiday/sick leave etc, doctors are around much less frequently that they used to be.

If you can't secure an nhs appointment with the consultant then I would definitely pay privately for your consultation. It doesn't mean that you still can't have the baby on the nhs ( and with access to intensive care for both you and baby if required then nhs is probably preferable to private hospital) but it will give you the time to discuss your concerns.