to think if a business operated like the NHS...

[hairytriangle]

then it would quickly go out of business

Just in terms of client communication and customer service.

Today I've been

1. kept waiting for one hour past my appointment time

1. had a snooty receptionist tell me I'll 'just have to wait' when I asked (nicely) whether I'd been forgotten about

1. Had to push for investigations that their own NICE guidelines say I 'should' be offered

1. Been given advice contrary to what another department of the same Trust gave, about a potentially life threatening action.

1. Been examined yet again when they could easily have got the results of the exams I had six weeks ago by lifting the phone.

I know if we treated our clients like this, then we'd quickly lose them.

Agaree scattered. In the outpatients I work it is up to the nurses to inform patients of how long a delay we have in clinic. We usually try and update every 15 -20 mins, so when we go to call a patient in, before we call the name we would say "sorry, there is a delay of whatever".

Not only happens in the NHS though. I was working at a private hospital when the Watford train crash happened. The surgeon who had a clinic at the private hospital abandoned his clinic to go to the NHS hospital to help out in theatre. I was given the job of informing patients that they would have to make another appointment.

Not going to write what was said to me - I will leave that to peoples imagination.

fair play for the private surgeon helping out after the Watford train crash.

and boo to the twunts who had a problem with that.

Thats shocking! People are so selfish sometimes!

I agree, but I can't seem to put into words what I feel about it!(but I'll try anyway)

I do think that there are a lot of time wasters who drain resources, (did anyone watch The Hospital last night? Young peoples diabetes clinics, where a very low percentage of patients actually turned up for their appointments, and the clinic was costing something daft like £10,000 a day for a handful of patients - please correct me if those figures are wrong!)

If the NHS could fine for missed appointments, I'm sure more people would keep them.

My neighbour is a paramedic, he's kept busy with loads of callouts that really aren't necessary at all. He has an old lady that regularly rings 999 because she can't find her glasses, or some other pointless reason, but gives an excuse like "I've fallen down stairs and can't get up", so they have to go, even though they're 99.9% certain that she's absolutely fine!

I think the NHS is a fantastic institution, but since it is not commercial it can lead to a more lax attitude to customer service by a very tiny minority of it's employees.

The last two appointments I have had, in different places, I was the first appointment of the day. In one the nurse was 10 minutes late getting to work. No apology, didn't seem bothered at all. For the second appointment the midwife got in 5 minutes late and then chatted to the receptionist about her shopping trip for 15 minutes. Then asked if her appointment i.e. me, had turned up. It was only then I realised she was the midwife otherwise I would have said something!

However, that is what happens whenever you separate payment from the point of delivery.

Hairy - often it is a life saving scenario to be booked in at 3 weeks once the CT scan, MRI scan, blood tests etc have been done.

I agree with you, I hate running an overbooked clinic. It stresses the patients (waiting for ages to be seen), stresses the medical staff (seeing too many patients).

I really don't know what the answer is. If we didn't overbook it would put peoples lives at risk - imagine if you had an ovarian cyst and a raised tumour marker. Would you be happy to wait 2 - 3 months? Or if we did not overbook and took someone off the clinic list how would you feel? You've waited months for your clinic appointment which has been cancelled because someone else needed the appointment more than you?

It's not fair either way.

But there is no reason for staff to be rude. That is a big no no. I would not tolerate anyone being rude to patients in the clinic's I run.

I see what you mean agedknees

But are clinics really that overbooked ie: full for entire weeks? would it not make sense to leave a number of slots per week free for just those types of scenarios?

I think it's general lack of resources that leads to this (more staff would mean better service), but I think there is also a bit of a lack of proper admin going on.

I wonder how it is that my current surgery manages to, in 9 out of 10 cases, see patients on time, but in other clinics I have waited over half an hour regularly?

Are there useable and practical guidelines for admin of appointments across the board?

It would make sense to have slots available, but due to gov targets people have to be seen within a certain time or trusts can be fined. (The 18 week pathway).

Clinics are fully booked up. Some general surgery clinics can be overbooked by 13 patients.

All clinics have a template, ie 20 follow up patients and 8 new patients (just using the figures for examples). The figures differ depending on how many medical staff you have for that clinic. So if someone (doctor) calls in sick generally the full clinic will just go ahead to save cancelling patients.

Then you have the 2 week wait patients (must be seen within 2 weeks).

Sometimes you may get only 3 2 week wait paitents, other times it can be 8, 9 or 10. These patients must be seen, and of course it is not fair to bump someone off the clinic because their need is not as great as someone else's.

Wish I knew the answer. When we have a really overbooked clinic, you just have to be honest with the patients, keep your cool, be kind and take the flak. Its the uniform they are shouting at, not the person (well, hopefully).

YANBU - I've generally been happy with the medical care I've had on the NHS (when I've finally got to see a doctor) but the administration is routinely bloody hopeless. Lost referrals more than once, 2 hour waits to be seen at a scheduled hospital appointment, lost results, I could go on.

There is no need to feel grateful for that. Put in a complaint, it's the only way to improve accountability with the NHS. There's no mechanism to make them raise their game otherwise.

I'm not sure it would make sense to have spare appointments though - not if it resulted in idle time.

I have no professional experience of the NHS, but when we organised restaurant bookings we'd keep one or two slots a night, just in case. But then it was our money we were risking, not the tax payers. I wonder if the NHS would even be allowed to manage their resources that way.

Aged - interesting to hear how the clinic is organised with government targets.

I had a friend booked at the Whittington hospital who had been waiting 90 minutes. When she complained she was told the consultant was still at his private clinic on Harley street. He never turned up until about 90 minutes after the NHS clinic opened. Nobody would stand up to him.

I understand your complaint but YAB a bit U in how you phrased the title...

If the NHS was run like the telecoms/gas companies they would say 'Yes, we can see you in four weeks time, but you'll have to come into the clinic and sit in the wating room all day. No, we can't tell you when you'll be seen. Or whether the doctor will turn up at all."

I had a (non-urgent)referral from GP and the consultant only did clinics one morning a week. As I couldn't make it for more than two weeks(on holiday) I was told to get re-referred neccesitating another GP visit as I had to be seen within 2 weeks.

It's not good if you have received unsatisfactory service, but I do get fed up with the attitude that private businesses are a shining beacon of wonderful customer service. Exhibit A: Ryanair. Not known for its accommodating attitude to their customers, yet still in business.

Feel free to add your own examples.

Patsy - I probably worded it wrongly. When a patient is referred to a consultant they have to be seen within a set number of weeks (government targets).

It's like the 4 hour wait in A&E. So a patient in A&E may go to an inappropriate ward because they have been sitting in A&E for 3 hours and fifty nine mins (ie a medical case may go to a surgical ward).

Its not good for the patient. Care should be about the patient, patient centred care.

What happened to your friend is appalling. I would have given that consultant my strongly worded viewpoint of keeping patients waiting (maybe that is why I have had sooo many jobs in my nursing career). Just cannot keep my big mouth shut.

PMSL at people who think their few pounds NI they pay in a life time ever even touch the sides of what you take out.
Does anyone have any idea how much the average non complicated pregnancy costs the NHS, I was gobsmacked.

I have been the person causing the delay and coming out of the surgery and having everyone glaring at me as I went back through the waiting room was pretty horrendous. Felt like yelling "Sorry everyone, the doctor has just signed me off work for 8 weeks and referred me to 2 consultants, I'm walking past you in floods of tears and you are glaring and muttering about time wasters."

Trouble with something like the NHS is that in their business they can't guaruntee how long an appointment will take.

Of course the NHS isn't run like a business, it it was, it would charge at the point of use, and the clinics etc would be less full!

If we want a businesslike NHS we should be willing to pay a token amount for GP appointments for a start.

The truth is, to many users, the NHS is 'free' and therefore not to be appreciated or respected.

mamatomany, well put.

NHS has its failings, but if you want them to treat you as a 'client', then pay them like one.

exhausted - just think of the one patient who you really helped, thats what keeps me going.

Take some time out for yourself tonight, nice glass of wine, can someone give you a foot massage?

I must be one of the lucky ones! I don't know if it makes any difference or not, but I live in Scotland. When I needed a CT scan recently, and rather urgently, the radiographer who did it actually came into work half an hour early to do it! In the last few months I've had many appointments (and many still to come) and the treatment I've had couldn't have been better, from the receptionists right through to the consultants. The odd thing is, I AM a member of BUPA, and they weren't able to give me the treatment I require, and so I've had to be referred to the NHS.

That's not to say that the way the receptionist treated HT is right - I'd be the first to complain if that happened to me.

exhausted - I have been front line NHS staff for 30 years (with the odd foray into private healthcare, which I hated).

If work is making you so stressed, you must do something about it. Can you cut your hours down? Even doing 4 days instead of 5 can make a difference. Can you move to another area that is not so stressful.

We need experienced, caring nurses. Who is going to care for us if everyone leaves???