NHS waiting times - the flip side

[PashaandMe]

Just reading how massive the NHS backlog is, how long people are waiting etc etc

I manage a waiting list of over 2000 patients for my service. I have 2 booking clerks under me and a team of admin staff. Any one of them will tell you the hardest part of treating a patient is getting them in in the first place.

We call patients and offer surgery dates and around 50% of the time they are turned down. The best one I’ve heard so far is that someone was “going out to lunch” that day. We have people phone up the day before surgery to say they’re going on holiday or to ask if they can come in the next week instead. We have at least 3 people just not turn up for surgery every week.

We can’t just call the next patient because they have to be swabbed and isolate for 3 days before surgery.

We can’t discharge because they DNA - once a consultant has said they need treatment it is very difficult to discharge without it.

We can discharge if they turn down 2 consecutive dates. But they will accept them and then just cancel the day before which doesn’t count as turning a date down.

It’s an absolute shit show

Instead of phoning people, why don't you send them emails? I hate this idea that you always have to be available if someone calls you. Quite apart from the fact that you may be working - you know, like you are OP - people can be driving, on the loo, doing a nappy change, out walking the dog anything.

I have just had a lengthy discussion with the booking team for a clinic I've been attending regularly for several years - they have sent me through my next appointment for the end of November. I have rang them to say I am unlikely to be able to make that date as it's my due date. They offered me an appointment a week later - suggested to them that this may not work as obviously I can't guarantee when I will go into labour so can we please push it back by, say, a month? They got very stroppy with me for being so 'picky' and have suggested I might be discharged from the clinic. Doesn't leave me much room for manoeuver!

@Caramellatteplease There's a hell of a lot broken with our NHS and it ain't the patients.

I fully agree. But there's an entire ethos within the NHS of patient blaming and making people they should be grateful for the scraps of care they're deemed worthy of.

The absolute classic was when my son's surgery was nearly cancelled on the day because " the hospital he attends outpatients at hasn't sent his notes over". Except we had already had a discussion with the anaesthetist with the notes and I could see the notes on the desk. Would anyone listen to me? No, too busy insisting he couldn't have the fairly major surgery because "no notes". In the end I picked up the notes, banged them on the desk and said forcefully "here they are". Got told off for picking up the notes , for medical staff only to touch.

And I've forgotten the number of appointments were we turned up only to find a cancellation letter had been put in the post the previous day! We'd driven 50 miles and both taken the day off work for one of them as it was to discuss surgery options for our son.

@countrygirl99

And I've forgotten the number of appointments were we turned up only to find a cancellation letter had been put in the post the previous day! We'd driven 50 miles and both taken the day off work for one of them as it was to discuss surgery options for our son.

Similar to what we suffered with my OH. We had an appointment with a consultant and his transplant co-ordinator in a hospital a couple of hours' drive away for my OH's stem cell transplant.

We arrived in good time after a very early start (for 9.30 appt), and watched as the time passed and everyone around us went in to see the consultants. It got to 11 and we asked at reception, just to be curtly told "wait your turn". It got to 12, we asked at reception to be told the same, but we refused to be fobbed off and went to find the HCA down the corridor who was calling patients through. She said they were waiting for the transplant co-ordinator, who'd been paged a few times, but "must be busy with an emergency". At 1pm, we went back down the corridor, and asked the HCA again, to be told the same. At 2pm, we'd had enough and went down the corridor to find no-one there. Went back to reception to be glibly told the clinic finished and they'd all gone. No one bothered to tell us! The receptionist was as helpful/useful as a chocolate fireguard. We finally found out the same consultant was doing an afternoon clinic, so we waited outside the consulting rooms in the corridor and when the HCA re-appeared, we insisted on seeing the consultant first and literally refused to move from outside the consulting rooms. He finally saw us, no apologies, clearly annoyed that we were still there, and just glibly said, "turns out xxxx (transplant co-ordinator) doesn't work on Wednesdays (it was a Wednesday). So they'd had us sat there, whilst they were paging someone who wasn't there. A complete wasted day, all down to an appointments clerk making an appointment for a day that the transplant co-ordinator never works, made worse by the consultant and other staff not knowing that either!

We eventually got another appointment, a few weeks later (after lots of phoning and chasing). Finally got to meet the transplant co-ordinator who was full of apologies and said "it happens all the time". What a waste of everyone's time. But then again, the NHS doesn't give a toss about inconvenience to the patients - it's all run for the benefit of targets and box ticking!

I was DNA for DD's 6 week check - because the surgery sent out the letter two days before (according to the postmark), second class. For an appointment at 9:30. Our post arrives at lunchtime, so the letter arrived after the appointment time. I don't doubt some patients are just being careless or lazy or whatever, but not all.

Another vote for the be grateful it's free so patients have to suck it up mentality around admin. Schlepped up to London for my outpatient clinic to find it had been cancelled. No text or letter. Phoned up the booking line to discover (despite having attended the clinic for 15 years) that they couldn't book me a new appointment. Eventually done via my consultant's secretary. This is not an efficient use of her time or mine. And no hint of an apology for wasting 3 hours of my day. Mistakes happen but at least someone could say they're sorry.

I always book the first appointment of the clinic. In those 15 years, the clinic has never started less than 45 minutes late. Emergencies happen and consultants are called away but it's a non emergency specialism and it happens every single time. Consultant is great but the rest of it is so frustrating. Luckily I have private health insurance which I use for other medical issues. I know the NHS is under a lot of pressure but some staff's attitudes around patients wouldn't be acceptable in the private sector.

I will have a moan about CAMHS. They keep sending out appointments that DH can't attend because he'd lose his job. The great thing at the moment is that it's Zoom appointments only, and DH hasn't had to be there.

But sending a letter is so bloody old fashioned, and it can easily be true.

The hospital where DS2 has his appointments gives you the option to go paperless, which I love, as long my phone notifies me when I get an email. It's a bit hit and miss.

Ha, as I typed my last post, I received an email for a Zoom CAMHS appointment for myself and DH when he's at work.

I'm on a waiting list for surgery. I keep getting offered other people's cancellations (well three times now) but it's just too short notice. Once they wanted me in the next day!

I could make it work for my home life, but I'm the sole employee for my organisation and I need a bit more notice for that.

I wonder if there's a black mark against my name for turning down three short notice ops?

We are as flexible as we can be with appointments, especially when rebooking any subsequent ones needed.

For example if people need 8am or 4/5pm we will offer these, or a specific day if available.

But we can’t offer weekend or evening appointments as the department is not open or staffed for those hours.

The only letters l get are from the NHS.

Everything else comes by email.

There is no consistency in how quick/slow an appointment will be given so I'm not surprised a lot of people are saying it's difficult to attend. The level of complete chaos and disorganisation is ridiculous given there are now much more modern ways things could be done. In the last 12 months I've received communications by cloud, letter, text and phone call and timeframes have varied from 'can you come in the next day for a pre-op then self isolate for 3 days' to being told you'll hear from us within two weeks (and having to chase over a month later).

Also over the time I received an appointment I didn't need but when I rang up to say they were not required nobody seems to be able to actually be able to check/confirm this this. Instead I just got told if you don't turn up you will have to go back to your GP and be re-referred. Hence the path of least resistance is to turn up and waste everyones time.

I've also had follow up appointments booked way in advance. Which never happen as the letter/call will generally come through a week before saying it's needed to be moved.

with the current nhs waiting lists and delays - if people never paid privately to see a consulant or took out private health care what would the nhs list be like - the government should refund some of the peoples nhs money if they have to pay privately or take out private health insurance because of delays which are affecting their health.

lh

The “two offers and the discharged” thing is a bloody nightmare when you have a child with serious health issues that sees multiple departments.

I’m a constant go around with a clinic that only schedule 4 weeks in advance and for 1 week at a time. DD sees 5 different depts, two of which have to be co-ordinated. She has weekly physio. Regular transfusions. Yet that one dept think we should “just keep a whole week free” but that week can’t be in 6 weeks or 8 weeks. Has to be 4 weeks from when they call, and they can’t tell me when they’ll call as they depends on holidays and the likes.

In the last 12 months I’ve also received 8 appointment cancellation letters, from 3 different departments that were either sent the day before or the day of the appointment. Which apparently is just “one of those things” and “unfortunate”, but DD missing the 5 appointments that had letters sent in a similar timescales is my responsibility to keep track and check if I’m expecting an appointment…

The NHS is amazing in so many ways. But the appointments and admin side is beyond frustrating. And has got much much worse recently. Especially in terms of the attitude toward patients/families.

yes and how many times do patients turn up for a procedure or operation and it is cancelled that day due to issues with the hospital some after fasting and travelling.

lh