To be annoyed with the NHS referral service

[slightlyconfused85]

I think maybe I am, but I'm having a bit of a crap time with them today. I went to the GP last Tuesday with a painful lump on my neck; she referred me to ENT and they have given me an appointment for next Monday when I am on holiday, which I discussed with the GP at the time and she noted. So, in going to rearrange this appointment it turns out that essentially I have to give this appointment away, and be re-referred by the GP and wait potentially another two weeks to be seen. I find it really frustrating that I have to join the back of the queue and can't just be moved into the next available appointment after my holiday.

Additionally, I saw a different GP two days later because it was very painful and I wanted some pain relief. He then called me back later in the day, and said he'd refer me to Head and Neck in the cancer part of the hospital, as this would be quicker. I've heard nothing about this one, so having tried to speak to several people about this I can only assume that this appointment (which is different to ENT) is floating around somewhere and I may hear about it soon. Or maybe it's been cancelled?!

AIBU to feel upset and annoyed? I am worried enough about this lump, and short of cancelling a 5 day break to Ireland which I've been looking forward to for months, I don't think I can do anything except wait.

What a horrid time for you. I would keep pushing via your GP, although if you're going to be on holiday next week there may be little they can do if the clinic is weekly.

The NHS appointment systems are not fit for purpose. Practically every company in the country has a better way of arranging appointments which suit their customers. It's not hard.

Last week I was referred by my Dr for ante-natal care. I received a Choose and Book letter and called the number to be told they would print out my letter and discuss with the midwife and then send me a letter with an appointment for a scan. So, a) not Choose and Book at all and b) why did they even bother sending me the first letter if my case had to be reviewed anyway? Why not just review first and then get in touch?!

The NHS is in severe trouble and this inefficiency is just a symptom.

Where I live referrals take around 6 weeks but sometimes longer! I had a lump in my neck a few years ago and had to wait around 6 weeks - I was told this was standard. In Wales so don't know if that makes a difference.

About the other referral, can you speak to the original gp and find out exactly which dept it was for.

It's so bloody annoying though isn't it. I'm currently waiting for a referral appointment to come through and it's been 7 weeks now but I'm still waiting and having a nightmare locating the right department so I feel your pain!

It's actually an 'urgent' referral so should only take 2 weeks. But apparently it's not urgent enough not to be put at the back of the queue!

I really hate to complain about the NHS as I think it's a good service, but I feel really stressed about this and I'm sure it could be better handled.

Not the same condition but I had to cancel an appointment. They tried to tell me to go back to my GP which I refused to do (as would be a waste of time as GP would refer straight back) so insisted on a new appointment which they eventually did.

I also had to agree that I was delaying my appointment (not that I had much choice)

It is a daft system I agree.

Do I have this right? They've offered you an appointment very quickly, for next week and you've turned it down as you're on holiday and now you're annoyed that they don't just rearrange their entire system to suit you? Surely if you're really worried and want to be seen quickly you should cancel your holiday?

"The NHS appointment systems are not fit for purpose. Practically every company in the country has a better way of arranging appointments which suit their customers. It's not hard."

If it isn't hard, I'd be grateful to know how you would arrange things so that the appropriate doctors, nurses and support staff are there. In our department, we have particular clinics for particular conditions to ensure that the best and most appropriate team are there for the patients' benefit, so this morning, I did a diabetes clinic, knowing that if anyone needed to see a diabetes specialist nurse or diabetes dietician, they could see them straight away.

I'm looking forward to knowing how we should be doing it!

I think this is another of these things that are different all over the country.

The appointments system where I am seems to have been overhauled in recent years and seems to work far better. So instead of getting sent and appointment you get sent a letter and you have ten days (or something around that length of time) from the date on that letter to contact them and arrange an appointment that actually suits you.

Its such a simple solution and presumably isn't any more time consuming than sending out dozens of letters to people who then perhaps can't make the appointment and end up having to get referred again.

Cailindana its not that, its just that I told the gp at the time that I would be on holiday for a few days and she said if she told them this, which she would, then they wouldny give an appointment in this time.frame. which they did. I am also a bit perplexed by the two different referrals and no one seems to know Much about this.

That sounds a bit more efficient treaclesoda. The re referral if you can't make the appointment does seem very admin heavy and possibly not most efficient

The NHS has loads of problems, and personally I think a 2 week wait is already too long for something that is supposed to be urgent.

But tbh, I don't really think you are in a position to complain if they gave you an appointment for something supposedly urgent but you feel that your holiday is more important. If it's important enough for you to be at the front of the queue after refusing an appointment, it's important enough for you to delay your holiday for.

I don't feel my holiday is more important, I think you are being a bit harsh. Simply that I have had a really difficult few years for lots of reasons including meningitis and the death of child, and me and my family just wanted a short break that we have looked forward to. If she hadn't said that it would be possible not to be given these dates if it was mentioned then I would have changed my flights last week, but now this will cost me 400 pounds.

"personally I think a 2 week wait is already too long for something that is supposed to be urgent."

There are degrees of urgency. Anything that should be seen that day or the next day will be, by referring someone in to be seen by the on call doctors. Lots of urgent things don't necessarily need to be seen the next day and can be seen in the next 2, 4, 6 weeks depending on what is going on.

There is limited staff, limited resources and limited time, so things need to be seen when clinically appropriate, not just when people would like to be seen.

Do you have travel insurance? Not sure of they'd pay out for something like this, but if you are going to be worrying when you're on holiday anyway it might be worth checking.

Or maybe if you don't want to wait any longer it would be cheaper and quicker to get a private appointment?

I'm not meaning to be harsh, I get that you must be feeling disappointed and frustrated, but there just aren't the resources to give everyone quick and convenient appointments on the NHS.

Sorry to hear of your loss.

In the region I work in, head and neck 2 week rule appointments are under the ENT dept. I don't know why they didn't just offer you the next available appt after your return, and I can't see why it would require a re-referral.

Regarding the urgency, they would point to your prioritisation - if it's not urgent enough for you to cancel your holiday, it's not that urgent.

I hope you get an appointment that suits you. It's always a horrible wait, I think.

Why not talk to your gp? See what they say - they might say its fine to be re reffered or advise you to wait. The problem is that the nhs are really stretched and have lots of people to see. Each appointment for the following two weeks will have been allocated.

I work in the NHS and ENT and Head & Neck are seperate departments in different buildings. Ring your hospitals main switchboard and ask for the Fast Track Office. This is where your 2ww referral should have gone. They have to get you in within the two weeks, either for an outpatient appointment or a relevant test (scans, ect).

I had this with a bladder problem. Told the GP when I was on holiday.
The hospital rang and offered me 2 dates, only a week apart. One date was during my holiday the other date I was working a 13 hour shift
(I work only 2-3 days a week so have plenty of spare days)

The hospital said if I didn't take one of those dates then I would have to go back to the GP and start the referral process again
This all seems abit time consuming, but seems the way it's done.

In the end I took a day off work unpaid ( i work for NHS and they won't pay you for hospital, dental, drs appointments)
It's a vicious circle, you have my sympathy OP

I think YABU but I do understand why you would feel like that.

If it's really urgent to you then you would cancel your holiday even at short notice. If you don't want to do that then you have to follow the system, I'm not saying it's a good one but everyone has to do it.

With the NHS you don't get to pick (unless you are lucky), if you want the option of picking and choosing then pay for private health care. I think two weeks is pretty quick for the NHS!

DinoSnores - To make booking appointments efficient for patients you would keep precisely the same set up - still have all the relevant clinicians booked to attend within a certain time frame. I think you have misunderstood - I'm not interested in the set up of the clinic, merely the way patients can book appointments.

What would change (at least if you book appointments in the same way my hospital does) would be you wouldn't send out a letter asking someone to book an appointment ("Choose and Book"), have them call up to make said appointment, tell them they can't because the clinician hasn't reviewed their case before sending out a letter, tell them they will get a letter with an appointment time, then if the patient can't make the appointment have them call back to rebook. That's inefficiency. And if it continues will be a contributor to the bankruptcy of the NHS.

Why can't we use online tools? Think about online supermarket shopping, British Gas appointment booking, even something as simple as the room booking system in my office. It's just number of slots available at a clinic (which, of course, is already scheduled to be staffed appropriately) shown to patients who can choose and book. If they have no internet access, they can call and someone can use the same system for them. My CTO DH says he could knock a solution up in a few days. What he couldn't do, is negotiate the behemoth of politics within the NHS which allows these inefficiencies to persist.

If your service already has a system which works efficiently, I suggest you outline it to Birmingham Women's Hospital so they can learn from you.

Sorry, OP and DinoSnores - that's a bit of a rant. I get hugely annoyed by organisations like the NHS, schools, councils not being more efficient. They have a lot to learn from private industry.

Where I live referrals take around 6 weeks but sometimes longer! I had a lump in my neck a few years ago and had to wait around 6 weeks - I was told this was standard. In Wales so don't know if that makes a difference.

About the other referral, can you speak to the original gp and find out exactly which dept it was for.

It's so bloody annoying though isn't it. I'm currently waiting for a referral appointment to come through and it's been 7 weeks now but I'm still waiting and having a nightmare locating the right department so I feel your pain!

This is gaming by the hospital trust. Deliberately sending an appt when they know the patient is away means they meet their targets and they know you won't come so they can double book the appointment. It is conspiracy rather than cockup. Complain very loudly.

really always? That is very interesting and unfortunately believable - I'm sure they are under a lot of pressure to meet targets.

I have spoken to my GP since, who says the Head&Neck referral was made (2 days late - last Thursday) because it would be guaranteed to come through quicker but I've not heard anything yet. Apparently this should still come through, so perhaps I will still get this appointment for a day I can do. If not, I have arranged for a re-referral for the ENT appointment anyway, but I have spent the day very confused.

I will not cancel my break for an appointment made at a time that I specifically outlined that I wouldn't be able to attend, and was assured by the GP wouldn't happen. My DD is looking forward to her first trip on a plane, DH has been working tirelessly, I have been ill and we are due to meet my brother's new little girl. A lump will not stop my family having a tiny holiday!

I reckon your original appointment was booked under the two week wait and you cancelling would earn them a fine because they didn't have a slot to get you into within the two weeks.

I would have a look on the nhs website, find out the name of the lead consultant and phone his secretary. Be nice but firm and keep in mind it is summer so there's a lot of staff off on their holidays too at the moment so fitting in appointments or getting authorisation from the clincian to overbook can delay things, but getting a secretary on side will mean you're less likely to get lost in the system.

Oh and there's every chance your gp has just over complicated things by sending another referral. If it's pretty much the same as the first (I've seen referrals used with exactly the same info, including dates ffs) it's possible the booking centre would pick it up as a duplicate.

It could be the consultant she's marked it for the attention of is on holiday - always mark it for the department clinicians!

Seriously, call the secretary.