About how hospitals time appointments?

[Moanyoldcow]

I'm pregnant, have a high risk pregnancy and have been referred to Haematology for a number of reasons.

I was asked to attend 30 mins early for bloods and then to wait for my appointment. So 13:00 appointment. Had bloods at 12:35 and was waiting for appointment by 12:45, all checked in.

I wasn't seen until 14:00 and spent maybe 10 mins in a rushed appointment. I was given a prescription with the wrong name and since then (30 mins ago) the pharmacy has been trying to track the doctor down to rectify the problem.

The HCA looking after the waiting room said the clinic is always late. Is it just me, or does that not mean they need to change the way the clinic is organised? They clearly don't allocate enough time per patient but they compound the problems by cramming everyone in. It's a shambles. I've been at the hospital for well over 2 hours and spent only 15 mins in actual appointments.

I love the NHS and I know there are staffing issues but this is not acute care - this is scheduling.

AIBU to think they could avoid this a lot of the time?

My guess would be they book more appointments than they have time for to take account of no shows (which I believe to be shockingly high). That way they don't have wasted appointments but risks running over, which is the lesser of the evils due to costs.

This is just a guess, no doubt someone In The know will be along.

If it's a anything like my local hospital they double book every appointment because so many people don't bother to turn up. Of course when they do all bother to turn up....

That makes sense. It's just so frustrating. But surely a balance can be found? If it's like that every single clinic then surely there's room for a tweak...

I go to haematology every 12 weeks
If appointment is at 10am, I have to arrive at 9am for bloods. Then I sod off to costa until just before 10am
Eventually got seen at 11.30am. Picked up my prescription which can only be dispensed by that pharmacy. They had a 45min wait. Eventually left the hospital at 1pm

I can't be mad though, even though it takes up half a day as my consultant could well be running over because he's telling someone they have cancer, or other life changing illnesses. I know he spent extra time with me when I was first diagnosed so I just suck it up and allow it's going to be a half day for a 15 min appointment

I understand the philosophy behind making appointments at the same time to cover no-shows, but what really gets my goat is when the clinic doesn't even start at the appointment times, i.e. when the doctor/consultant/clinician isn't even there and patients aren't started to be seen until an hour or more after the patients have been sat there.

Yes, I appreciate, there MAY have been an emergency, (weak excuse as lots of them aren't on emergency duty) but from what I've seen, it's more a matter of a "couldn't give a shit about patients' time" attitude, where the bloke/woman just saunters in, late, then gossips with reception, then has a brew, and finally when there's nothing left to waste time on, decides to start seeing patients.

Drs who work in clinics are often responsible for care on the wards as well and get called away to deal with emergencies. Also unexpected things can come up during clinics that mean people have to wait longer while it gets sorted.
I kept everyone waiting for over an hour when A&E referred me to the eye clinic with a retinal tear. The waiting room was packed, first Dr tried to repair with laser and couldn't do it, she called in a more experienced Dr who eventually managed to get it done.
Perhaps people should be given more explanations about why delays are happening, otherwise they're like to assume it's just bad organization.

Yes, I appreciate, there MAY have been an emergency, (weak excuse as lots of them aren't on emergency duty)
Drs don't have to be on "Emergency Duty" to get called away.

Yes I agree, every time I've gone for an appointment at my maternity hopsital, I've waited at least 45 minutes past my appointment time and I don't think they are managed very well. A lot of waiting round, not being told what specific waiting area to wait in and then sent back to wait again.

I'm the same as @Ollivander84, have regular clinic appointments & know I'm there for half the day. I used to have to be there every 3 weeks knowing my day was basically done & dusted (also 3 hour round trip to hospital so definitely all day outing!) but now luckily as stable they want to clear the clinics of ppl like me so I have arranged phone consultations instead. It's frustrating but with so many ppl being referred there are so many ppl coming through I know each slot is booked out twice so impossible to run to time even when ppl don't turn up for 10 min slots but I was once someone getting bad news asking lots of questions & taking 45mins. So I can't begrudge it. Just know I'm in it for the long haul & wish it was closer! But each time there are new patients complaining it's not good enough....but each day there is a different clinic so where does the extra time come from to take the extra patients...need more doctors I'm afraid

I think the frustrating thing for me is it's lifelong - and I can't do phone consults as they need to take my bloods, check the results and then do my prescription 😐 but hopefully I can drop to every 16 weeks at some point

They have to wait for the blood results to come back, can take a while! I work in haem, I know your story well!!

I absolutely understand about emergencies - I really do. And obviously, if I needed extra time I'd want it.

When I had my 12 week scan the radiographer was running late and was very apologetic and said she'd had problems before with a set of twins and I was emphatic in saying I understood, was not at all annoyed and would expect her to take the time she needed.

It's when you're told the clinic is ALWAYS running late. I hear that a lot - that surely means there is room for some adjustment to the schedule. And if I was told ahead of time that I should allow half a day, I would do so. I had to get back to work because I didn't realise I'd be gone for nearly 3 hours for a 15 min appointment.

Imagine if the appointment letter said:

'X Clinic is very busy and it is not unusual for you to spend over 2 hours in the department including dispensing of medication. Please ensure you arrive on time and allow 3 hours for your time here'

Then that's exactly what I'd expect, I'd turn up with a book and be pleasantly surprised when I left after 2 hours. I'd haved told work, booked annual leave etc. and wouldn't be left feeling so frustrated and rushed. I'm sure that if you're expectations are managed better it wouldn't lead to the way I feel now.

@Mo0517 - none of my bloods were expected back at the time of the appointment. She had none of the results.

It's a hard one. I know there are many pulls on the time of clinicians. But in my experience there can sometimes (by no means always) be an attitude prevailing that patient time has no value which is rather galling.

The NHS does not have enough money. Resources available are not enough to meet demand. At the hospital I attend it is fairly routine to 'overbook' appointments (eg, book in more patients than there are available appointments) and the poor doctors and nurses just have to work extra fast to keep up. Everyone is working very hard!

"Sauntering in late" - could easily be has been in all night or early that morning dealing with an emergency. They may even have the cheek to have a drink before starting a busy day of clinics.

When ds was critically ill he hit his worst at 8.30am. The consultant who saved his life was due in clinic at 9am, I am pretty happy he decided to stay until 11am when he was finally stable rather than "saunter" off to clinic.

Waiting is a pain, I am about to take ds to a clinic and I am fully expecting a wait, but it is highly unlikely to be due to the staff on the frontline not caring or working hard.

@LadyoftheLake123 - honestly - I really do know how hard NHS staff work and they have been taking amazing care of me.

But I do work hard too. Not in the NHS but my time is valuable for lots of reasons, just like everyone's is. Today, I happened to have the childminder to collect my son. If that appointment had been a different day, I would have expected that an appointment at 13.00 would still give me enough time to collect him at 15:15 which it wouldn't have been and I'd either had to have left (which is another waste) or been late to collect him from school.

My orthopaedics letters tell you to expect to be there for 2.5 hours and this seems about accurate for about 10-20 minutes time with an hcp. I pay for half a day's parking and take a book.

More annoying was midwife clinic appointments which were always delayed by her gossiping for ages.

At the hospital I used to work at clinics are booked three people' for every 15 minute slot. Because of all the no shows. Then they wonder why clinic is still going at 6 pm.

I waited an hour and a half for an appointment last week. Everyone apologised, but there was no real explanation. In the end, the appointment was so brief and pointless they probably could have had a 4 minute chat with me on the phone instead. I wish that had been offered up as an option when I arrived! Or even if I was told it was going to be 90 minutes late...I could have gone back to work and come back later. I get that things are stretched but it's really difficult when you have to fit work around lots of appointments and they all end up involving 4 times as much time out of the office as they should. I don't know what the answer is, but I feel your pain!

It's frustrating and maternity clinics are almost always like this. In ours, a 40 slot clinic will have up to 80 women booked, of whom 65-70 might attend. Overbooking happens because the demand has outstripped the services capacity by a huge margin. This is primarily a cost and staffing issue.

It was even worse when I was first a midwife, hundreds of low risk women had to come to hospital clinics for some of their care. This has improved a lot with community midwives providing low risk care. I pride myself on my clinics rarely running more than 10 minutes late.

So a consultant, registrar, sho and midwife will plough through this list.Tricky cases, might need to wait to see a more senior person. Unexpected problems crop up. People need other tests doing. And then senior doctors get called away to the phone or another department and it all slows down again.

The only place I have ever witnessed any sense of urgency in a hospital is in A&E.

I had the same last week, 2 hour wait and a saw a few people leave as they couldn't wait longer, so really it could have been even later. Then I was told to go to reception to make further appointments but by that point the reception had closed for the evening.

It's not a scheduling problem that can be fixed. There will only space for that particular haematology clinic to be run say, twice a week, and x number of patients that HAVE to be seen on that particular week and y number of doctors (never enough), all of which mean it overruns.
The only way to schedule it successfully would be to have fewer patients, which would be safe clinically- you would have had to wait several weeks,possibly even months for your appointment whsuch isn't acceptable is it?