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?

We are currently waiting for an appt for Fracture clinic. If it's not 9 am or close then I will be trying to change it (we've requested as early as possible).
DD missed too many hours of school, me too many hours of work and almost bankrupted with Parking charges. Thankfully the 3 hour delay was in the school holidays.
She shouldn't still be attending clinic but that's another story (but the main reason we are fed up waiting)
Normally I don't complain with waiting at the hospital but this has been ridiculous. I know they don't know in advance how many people will break bones but when you are delayed for hours each time then something is seriously wrong.

When I was expecting dc1 I had lots of problems I was booked into see the consultant, I waited 4 hours for him to talk down to me for 5 minutes (yes 5 fucking minutes) and book in again in 4 weeks.

Booked the earliest appointment I could which was 9am, turned up at 8.50 for my 9am appointment the consultant didn't arrived until 9.45 and they had double booked the 9am/9.15/9.30/9.45 appointments, I didn't get seen till nearly lunchtime. The system is broken.

Now if I need to see a consultant I pay privately either cough up for £120 fee or put it on DH work health insurance. Guess what I've never been kept waiting once.

Fruu 6 hours is obscene! I haven't had to wait quite that long (thank fuck), 90 minutes has been the worst so far, but I've also had the surprised reaction that I'm actually working. Every single time they ask if I'm off home afterwards and seem surprised when I say I have to get back to work and actually I should have been back an hour ago thanks very much. Are working pregnant women such a rarity?

I'm a high risk obstetrics case and my care is shared between my consultant at my regional hospital and a specialist consultant at our nearest centre of excellence.

What I've noticed is that the specialist's clinics always run on time. He handles his own case load, has his own private secretary, and nothing ever runs over. He also does his own scans.

By contrast, the consultant clinic at my regional hospital runs over by hours. the longest we've waited is five. But what I do notice is that the consultant seems very disempowered in her role, as though she's subject to administration and managerial dynamics she cannot control in a way the the specialist simply is not (due to reputation, experience, and a more commanding manner etc).

Sometimes, I do wonder whether a lot of this comes down to how able a consultant is to confront hospital administration and demand change to the way their clinics are managed and run.

Improvements must be possible. The antenatal clinics at the same hospital are so much better run and it's extremely busy.

I of course accept that there are more midwives and obstetricians than haematologists but there are also many many more patients.

From PP it seems clear there are clinics running mostly to time out there so I wonder what can be done.

"Hospital 1 booked everyone in for the clinic start time and hospital 2 actually gives me an appointment slot."

Interested that there are still places booking everyone in for the same arrival time - can anyone throw light on why this is done? I know a pp said that it was so the consultant will never have to wait - ok, but isn't it possible to devise a system which still ensures that but reduces waiting times, at least to some extent?

As a matter of interest, do out-patient clinics ever use queuing theory at all? Is it possible to build a basic system that would reduce, although not eliminate, really long waits - with the numbers of patients involved, isn't it possible to 'build in' to the schedule for the 'no-shows', unpredictable emergencies, longer appointments etc?

Agree that NHS care is not free!

'That's not over-booking. That's not a consultant busy elsewhere. That's not even a consultant arriving late, coffee in hand. That is a simple administrative cock-up.'

I'm a frequent attender, both myself and taking re!actives. This ^ is usually the case for huge delays ime. That and Drs poor time management. It isn't the 'emergencies', the over booked over worked staff it is constant cock ups. Staff wandering round constantly looking for colleagues, patients booked into the wrong clinics. The place is often a circus. Yes I am grateful the NHS is free but some of them couldn't organise a piss up in a brewery.

"Yes I am grateful the NHS is free"

it isn't though! Not for anyone who pays tax - ie everyone. Some may not pay the full cost in tax, others do - but we all pay something.

Many years ago, I was given an appointment (for a new type of eye-scan) on a Saturday.

I immediately called up, and was told "no, that's no mistake, we now run clinics on a Saturday".

Got to the hospital (other side of town), with appointment letter (following my own advice to never lose it). It was instantly apparent that this was not going to be a good day. Letter was checked, I was told to wait.

And wait.

And wait.

Two hours later, I was called into a consultants room. He said straight off that he had no idea why I was there. He hadn't got my notes. (Obviously) the department that issued the appointment was closed. So basically, there was all he could do. When I asked why it had taken two hours to tell me, he said that when the admin staff realised there had been a mistake, they decided to wait for the next consultant to "sort it out" when they started, which was him.

You could probably have powered a small country with the steam that came out of my ears. Especially as MrsLH and DS(8) had tagged alone, and so were bored out of their minds (this is pre-iPad days).

And yet, I did have an ultrasound scan on a Sunday morning a few years later

My orthopaedic consultant was running over 2.5 hours late when I last went to see him.

No-one got arsey about it. Receptionists and nurse clerking the clinic kept apologising, there were plenty of magazines, a coffee machine that produced surprisingly drinkable coffee, chilled water, tv to watch, comfy sofas, spotless toilets, it was air conditioned on a boiling hot day and about as pleasant as waiting for something can be.

I especially didn't mind when I found out from a friend who works at A&E in another of the trust hospitals that my consultant had been delayed because he was doing emergency surgery to save a motorcyclist from having his arm amputated, and it took a lot longer than expected.

That consultant started work before 8 that morning and was probably still at the clinic till after 7pm that night (there were still several people waiting when I left at 6.30). He could have left the surgery to another surgeon, but he's a specialist in shoulders and elbows, so was the best man for the job. He wasn't even the consultant down to deal with emergencies that day.

I think he did exactly the right thing, and think it was pretty awesome of the other 2 staff to stay that late to make it possible for him to see everyone.

Everyone knows the NHS is overstretched and underfunded. Until enough people change the way they vote, it will remain so. Anyone who doesn't want to do that, and objects to waiting, can always go private.

From an efficiency POV, it makes far more sense to get the people who aren't being paid for their time (ie, the patients) to do the waiting.

I've helped run clinics that had fantastic patient perception. They were disgustingly inefficient. Doctors and nurses sitting around through appointments where nobody has turned up but they can't just skip to the next person because that person's appointment time isn't for another 15-30 minutes so they haven't arrived. One of the worst ones I've helped with had a doctor and a nurse running it. Only 1 patient showed up all day. There's even loads of waiting when everyone turns up because many don't need to full allocated appointment slot. Patients love these clinics because they're always seen on time and have plenty of time to discuss their issues. But the NHS essentially ends up paying for consultant doctors and specialist nurses to wait around doing nothing.

The NHS has a money problem. Having patients get frustrated waiting while the staff are at capacity working is the lesser of two evils.

I've also had to see my surgeon about every 2 weeks during this period. My appointments with him have been between 9am and 10.30am. Not once have I seen him turn up in clinic before 9.30am and once or twice it's been past 10am.

They do ward rounds first thing in the mornings sometimes, he may well have had to deal with something that hadn't gone as planned.

'No-one got arsey about it. Receptionists and nurse clerking the clinic kept apologising, there were plenty of magazines, a coffee machine that produced surprisingly drinkable coffee, chilled water, tv to watch, comfy sofas, spotless toilets, it was air conditioned on a boiling hot day and about as pleasant as waiting for something can be. '

Well that sounds lovely. The ones I go to are are usually full without enough chairs. I've never seen one with a coffee machine, telly or chilled water . Actually there was one once, but removed due to infection control concerns apparently.

Your story about the Dr saving a motorcyclist and that why he was late is the very rare exception. They usually just have poor time management and get used to working in a shambolic environment.

I see a lot of angst about receptionists, secretaries and clerks here too. I completely understand. I've met some who are absolutely amazing and really improve a service. They're massively underpaid for what they do. The fact is, most people who are paid peanuts won't give their all to their work. Especially when they end up being the face of a service that's become extremely frustrating for patients. They're certainly not paid enough for people to be pissed off with them all day. It'd take a work ethic made of steel to do your best at work despite all that.

I just wanted to reiterate that it's not the waiting per se that's the issue, it's the management of expectations. If I knew I would've been there for nearly 3 hours I'd have arranged things accordingly. If someone had been there to communicate about the delay I'd have felt better about it - even if it had been a note on the screen which was 'calling' patients. I was not certain I was in the right place or that I'd been forgotten until a HCA came by and checked after I'd been there an hour.

My OP is very much about clinics which habitually run hours late - not one-offs where doctors have been called to emergencies or are running late owing to rounds being more complicated etc.

As I've said several times, I know how horrifically overstretched the NHS is but I do feel that sometimes a bit of joined up thinking would help, even if it's just in a small way.

I do not have to option to 'go private' and I don't think I should have to - the more that attitude prevails the worse the NHS become. If wealthy people get to 'opt-out' then the NHS isn't an 'issue' for them and becomes less important which in turn means it's less of a priority when voting. I used to be a higher rate tax payer before going part time, my husband is - neither of us voted Conservative and both of us would he happy to pay considerably more tax for the NHS - VERY happily.

Staff wandering round constantly looking for colleagues, patients booked into the wrong clinics.

Which is exactly what the problem is. Just throwing more people at the NHS would actually make it worse. It needs efficiency and streamlining. Those staff are wasting valuable time - no, it's not their fault, but it's still wasted time. If it was streamlined, you wouldn't have expensive staff running around like headless chickens and taking half an hour to do something that could have taken five!

They wanted to admit him to a ward to do an ultrasound. How crazy and wasteful is that

Exactly as happened to me. I had a severe lower stomach pain and the GP told me I needed an urgent ultrasound scan. He phoned the dept only to be told there were no appointments available. He then told me to present at A&E, where I had to be tri-age'd etc and was eventually admitted to the gynae ward - full admission, bed all the usual blood tests, monitoring, etc., and ended up having to stay overnight, then just sitting around all the next day until I finally got my scan the following afternoon, then all the paperwork/bureacracy of being discharged again. All for a simple scan!! The waste and inefficiency is bordering on criminal!

I'm not sure that staff are wandering round looking aimlessly for colleagues. They might need to check something, or get something actioned like getting a script done so the patient doesn't need to come back.

I certainly don't recognise this waiting business. It just doesn't happen at my hospital in my experience.

We get texts to remind us of appointments too.

The waiting only frustrates me a bit because I am literally there to have blood drawn, for consultant to go "your neutrophils are X/Y/Z today, you ok?" And to collect my prescription that he's already signed
I can be in and out in 4 minutes but the actual waiting/collecting prescription takes the time so it's more like 3-4hrs

So, bit of an update: my consultant obstetrician's secretary called me to ask if I could see the Consultant next week. To start blood thinners. Which I've already started.

So the Haematologist had already recommended treatment prior to my appointment and referred me back to Maternity for the treatment when I had my Haematology appointment on Tuesday.

I even called Haematology on Tuesday morning to confirm the appointment. Then would've been an opportunity to check my file and see. But they didn't.

The appointment was a total waste of time for everyone. I'm really quite annoyed. Plus there was probably someone who needed that appointment more than I did.

I've made a complaint focusing on the prescription error and the poor organisation.

The problem is, unreasonable patients expecting the speed of private service, from a deliberately under-funded and chronically under-appreciated NHS.