To support the NHS but...

[AudTheDeepMinded]

Think that sometimes people's time and money is wasted due to needless stupidity?
Two recent cases in point. Few months back received a letter regarding son's flu vac. Great, I'll book an appointment. Rang local surgery's overloaded telephone system, as requested, spent flipping ages in a queueing system. Eventually reached a real person to be told flu vac apps not yet available for booking. What a pointless waste of my time and their resources! Why not either send the letters out later and/or include when the bookings can be made? It's not rocket science is it?
Last week I received a letter to make app for son's jabs. Went into the surgery the next day. Queued up, spent a good few minutes sorting out a suitable app with receptionist. Went to app today to be told that son had to be two weeks older in order to get the jabs. Great, this info was not on the letter and the receptionist had not been trained to check. So I wasted their time, my time and the nurses time we were attending.
When you hear how overstretched the NHS is it is so frustrating to feel that I have unwittingly contributed to wasting much needed resources. So AIBU?

Totally agree.

The inefficiency is astounding at times, especially when it comes to correspondence.

The NHS does a great job, but that doesn’t mean it should be immune to reform.

No there's a lack of joined up thinking in a lot of the system.

I've had a hysterectomy. I don't have a cervix. The NHS keeps reminding me to book a smear, sending increasingly "naughty you for ignoring us" letters, leaflets and other stuff. I have phoned the number on the letter several times and every time they say they'll remove me, they never do.

Quite tempted to pitch up and allow them to try to smear my non-existent cervix.

I have been under the gynae at the hospital for a prolapse. She sent me for more tests. I received a new appointment for a surgeon for December. I then received another appointment for the gynae to see me in. September. So I rocked up and was very surprised when they said they didn't know why I was there as they couldn't tell me anything until I had seen the surgeon. I was very polite but did point you had sent me the appointment. I hadn't asked. So again an appointment wasted. I had to take unpaid leave from my new job to make the waste of time appointment.

Was expecting to get flamed, almost sad to be agreed with as it means it's not just a problem with my local surgery.

An ex of mine worked in communications for the NHS and the system is daft, so letters from your Gp/local heath centre actually come from a comms base somewhere else and if there’s a communication breakdown all sorts of shit happens.

The flu jab thing happens every year for me. I now wait at least 3 weeks after the reminder before bothering to book.

I think you're quite right, OP. When people slag off the NHS it's usually about the managerial side, or certainly the effects that has on the nursing / clinical aspects. Unfortunately that 'slagging off' is mistaken for having a go at the medical side. Too many clerics (who can't communicate between each other) and not enough clinicians methinks...

I was annoyed when, three weeks after my miscarriage, where I'd attended the EPU twice, the midwife called for my "Booking in". I can't understand why there was no communication.

Both my parents worked in the NHS (medical roles, not administrative, now retired) and would 100% agree with you, OP.

I think the problem isn’t mindless inefficiency but people thinking “The NHS” is a single organisation when it isn’t.
GP practices are private companies that have contracts with CCGs.
NHS trusts are each a separate organisation.
Screening programmes are not within the control of either hospitals or GPs. They are managed centrally by NHS England.

I work in the admin side in the hospital (exp outpatients, secretarial work, and most recently admin and clerical supervisor) and completely agree with you.
It's mostly down to time pressure etc and miscommunication between admin and medical staff.
E.g. the doctor asks for a follow up after surgery, and assumes surgery will take place within 3 months. Outpatient dept are asked via an outcome form to book a 3 month follow up appointment, secretary is told to list patient for surgery.
Surgery is booked outside of the 3 month time (or, cancelled and rebooked outside the 3 month period), due to wait times, secretary doesn't pick up the appointment time due to other issues that they need to deal with (e.g. making sure patients are seen and treated within the 18 week time scale, filling out reports, typing clinic letters, chasing results from diagnostic tests and generally being swamped). Outpatients don't pick it up because the outcome form says "3 month follow up" and the appointment is booked 3 months after the original appointment.
The whole system is overwhelmed and in dire need of reform.

I had a smear test booked (my first one) I went to the appointment, surgery running behind. Left my 11 week old son for over an hour with driving time and very long wait.
I was told I had to be 12 weeks post partum for a smear!
The NHS sent me the letter, the staff booked my appointment in person.
Can't it be in small print somewhere as it definitely wasn't something I was aware of.

Sadly flu had letters are centrally generated by health protection and are not sent by GP. 2017 particularly was bad as letter came out long before vaccine was every available for stock in practices. Absolutely agree a waste of time for patients and staff alike!

@PiperPublickOccurrences My Mum is in the same position - the last time she had a reminder she wrote across it in Sharpie:

"I've had a radical hysterectomy - if you can find it, you can smear it!"

and popped it back in the post to them!

I work as frontline NHS staff and see how hard everyone works. I give everything to my job including unpaid overtime, working at home to provide training and keep up to date.

However, I also cringe at the organisation and admin side of things, particularly on the 'other side when I/family are patients.

Understaffing, lack of clerical admin support, out sourcing to private companies, patients living with increasingly complex conditions who previously wouldn't have survived (a wonderful thing!) all make an impact.

There is a definitely lack of joined up systems and we still rely heavily on paperwork rather than decent IT systems, that's half the battle! I cannot believe how inefficient some clinic are - e.g. antenatal, but you have to invest time/money to improve things. 2 things that are being cut through funding. I still think we are lucky to have it rather than greedy corporations desperate to make a profit from people's illnesses.

So some problems caused by lack of resources but others due to sheer inefficiency. Would it be worth my while writing to the practice manager in this instance. Or would my letter just be filed under 'b' for bin?

Absolutely agree with this. Every time I went to antenatal clinic at the hospital they checked my mobile number. After my son was born the hospital noticed I had a UTI. It took a week for me to be notified via the GP about it. The letter said they had tried to contact me by phone - no missed calls on my mobile or home phone. Three weeks later when I was being admitted to hospital for the second time with a severe kidney infection and urosepsis they checked my home phone number and it turns out they had it wrong on their system; no wonder they couldn't get hold of me!

Had it been right in the first place it would have probably saved:
2 trips to the GP
1 trip to urgent care
2 stays in hospital totalling 13 nights

Such a simple mistake which I dread to think how much it cost the NHS, not to mention the emotional toll on a mum being away from her premature, newborn baby who was only 5 weeks old

I have supported two family members through admissions to hospital recently.

Without exception all the staff are lovely, but boy are the processes inefficient!

As a process improvement guru, I would love to get stuck in.

I had a phone call to tell me off for missing my 33 week growth scan... I was across the corridor in the post natal ward still after a premature birth 3 days before. I'd even seen the obstetric consultant the day after giving birth, as she had been told that I'd given birth and we agreed my next appointment with her wasn't necessary any more...!

I don't understand how clearly there had been some internal communication and yet still my record (in the same hospital, where I'd been seen for all of my high risk pregnancy) hadn't been properly updated.

My hospital spent probably a couple of million on a computer system and interactive boards that we barely used and have no been phased out. Complete waste of money and so longer term thinking.

I've just received some truly wonderful medical care on the NHS while having my second baby. Every midwife, consultant, anaesthetist , surgeon, everyone has just been fantastic. I needed an ELCS for medical reasons as a result of my elder daughter's birth.

However - the actual booking of it and the admin side was nothing short of appalling. I had no other option, medically but to have an ELCS. Natural birth was too risky. But there is so much red tape I was referred to no less than nine different unnecessary appointments. So many I suspect because every time I cancelled one - with the agreement of my community midwife - and explained it wasn't required someone would spot that I hadn't been for one and rebook it somewhere different.

Prior to the booking of my ELCS (which was agreed in writing after my first birth with the consultant in charge of obstetrics and was in my notes ) they tried to send me, in order to 'discuss my options' to a couple of different consultant midwives, a method of Birth clinic, a VBAC clinic (I'd never had a CS before!) to name a few. Eventually I got thoroughly fed up with it and contacted the consultant who'd delivered my eldest directly. She took one look at my history and the letter she'd written to me following my birth debrief and booked the appointment for me to see her to book in the date for my ELCS there and then. I saw her a fortnight later and bobs your uncle I was booked in. Not her job though and shouldn't have been necessary.

There is much room for improvement on that side. Thing is, where does the time and money come from to make those improvements?

I used to work in hospital admin and the system is useless. For instance- if I had a patient DNA an appointment, we are not going to investigate why. Several times I had people on the phone saying they hadn't DNA'd, they had been admitted as an emergency. Annoying, and inefficient, but there just aren't the resources to check every list to see who may have been admitted (although the system could surely be updated to alert somebody that an OP is now an IP!)

Omg dont even get me started had a txt last year stating a time and date of flu vaccine drop in clinic at local docs and please bring dd along blah blah.
I thought this would be better to try as she has addditional needs so doing it at school hasn’t been possible.
Had the same txt through 3 more times leading up to the date. So went along on the day..... oh no sorry shes to old for the drop in clinic you need to do it at school.
Showed her the 4 txts stating dds name etc oh yes we send those to everyone no matter childs age....
So i said what’s the point in that if it’s only for very young children (dd was 6)
One of the nurses then said she would do it but spent the whole time saying how we shouldn’t of come to drop in out of age range etc i said i was sent txts etc but she wasnt having any of it, she then wanted dd to agree to vaccine and say she wouldnt move her head. But my dd has severe speech delay and couldn’t do it so she sent us away.
I felt so deflated when i left and when i got home another txt saying please come along to todays clinic tipped me right over the edge!!
Was such a stressful and pointless journey.
Iv also had voicemails from receptionists saying to call them regarding xyz when I call back nope We haven’t rang u.... hour later another call oh you haven’t called us back! Apparently they were using agency staff who weren’t allowed full access to certain things on the system so had no idea if people were asked to call the surgery etc was so pointless.
Although i do know people who work in the nhs who are fab i met fantastic staff when going through a missed miscarriage aswell as when i had my dd so its not all bad. But the frustration of the basic admin side really lets it all down x

50% of my job is to engineer processes and make efficiencies..

I never new just HOW inefficient the NHS was until I had my child, there is so so so many basic things, that given the scale of the NHS, would save hundreds of thousands, if not millions of pounds a year...

I have to bite my tongue when I engage in any services, because the wastefulness is astonishing.

However, my experience tells me that due to the fact the NHS service is extremely stretched (and often abused) they like many organisations I work with, just don’t have the time to see what’s blindly obvious to “outsiders”, because they are far too busy firefighting.

Also it might help if doctors didn’t work part time employed and part time as a locum.. As well as the general public not using the NHS for minor problems that could be managed with the help of a pharmacist

It’s not hard to believe that the “back office” is in a mess. It’ll take money to sort it out but surely that will save a lot of money in the future - kind of like screening for cancer.
Ds has yearly appointments at a particular clinic, at each appointment I ask to rebook for a years time, they say they’ll send me an appointment. Every year the appointment falls on the rhe first or second day of school which ds can’t miss for various reason. I phone and explain, they say “yes most people are cancelling for that day” and insist they’ll send another appointment. But I cannot book one. It’s such a waste of time. This year he had surgery scheduled there were various times he definitely couldn’t attend. 3 appointments made and letters sent, 3 times cancelled. Waste of time and money. And the appointments only come with 2 weeks notice so probably end up not being filled. I’d love a bit of 6 Sigma on it