To be pissed off with the NHS over being referred back to GP by hospital......

[ACautionaryTale]

So I've been on the waiting list to have the mirena removed by the hospital as the GP couldn't manage it. I've been waiting over 14 months - which is fine as its not urgent. I don't need it for contraception (DH had the snip) and I'm not planning on getting another one put in.

I got a letter through telling my my appointment was the 19th Feb. Except that I can't do that day. Im self employed and working on a critical project for a major company which goes live beginning of June.

If it goes well, I'm highly likely to get quite a lot of repeat business. We are talking enough to keep my income going for the next few years.

Wednesdays are the one key day of the week that its very visible if you are not around. It was planned that way so that people could have long weekends during the project as it was acknowledged that for anyone involved, taking a whole week would be difficult until end of June.

I phoned up to re-arrange my appointment and they offered me another Wednesday two weeks later. They only do this procedure on a Wednesday. I said this was not possible and could I just go on the list for some time after the end of June as I knew it was not urgent.

This is not possible as you can't delay over three months - if you do you get sent back to the consultant who sends you back to the GP and you have to go through the whole process again.

I feel like banging my head against a wall.

Could you remove it yourself?

This is probably some of the worst medical advice ive read on MN

"they can make me wait 14 months but I have to jump when they say."

I understand your frustration OP but that is patently untrue.

I'm sorry but no-one is so important to a project that they cannot take one of 26 days off in 6 months, giving notice and preparing carefully for that abscence. I understand it is your business and an important thing for you but you either want this free (at the point of delivery) service or you don't?

Are you under a lot of pressure? You seem to have lost your sense of perspective.

Why not ask if they can give you the last apt of the day on a Wednesday.

Then you can leave work a bit early for a medical appointment having planned your workload/meetings around this weeks in advance.

I completely get why this is frustrating, and yes having to go to the back of a 14 month waiting list if you can't make two dates is nuts.

If those are the only two options, I would take the day off work rather than leave it in another 14 months.

I think you are going to have to be flexible. There is one of you and lots of patients.

The doctor who does this will have it as a scheduled clinic around lots of other things.

If you can't miss a bit of a wednesday I'd be worried about the viability of hour work a d I say this as a self employed 'expert' to organisations.

I had a hysterectomy at a private hospital. Even then I didn’t get a choice of dates. It was urgent. The gynaecologist only took consultations at certain times on certain evenings. He was operating during the day. I’d have been a twat to expect him to accommodate me. I just needed it out

Me too, the surgeon just operated on a Tuesday afternoon. But she was very clear that if that didn't suit, Mr Smith operated on a Monday, and Miss Cook on a Friday, but if I really wanted her, it would have to be Tuesday afternoon. But I could have whatever Tuesday I wanted.

Private does give you a lot more options, especially for something routine like a coil removal. If you're prepared to pay OP, you'll be able to get a private appointment at a time of your choosing.

I have a chronic illness and every time I get a clinic appointment, it's on a Friday at 3pm. It would mean getting a childminder to pick my 2 kids up from school (cost of £20) and I would miss my self employed work (£60)

I get quite annoyed tbh that they can't see this! I can also do any time in the day between 9.30 and 1.30. Lost count of how many times I've had to phone up to say, sorry, cannot do.

I can barely afford the prescriptions for my illness never mind losing income like this.

you can't delay over three months - if you do you get sent back to the consultant who sends you back to the GP and you have to go through the whole process again

So it sounds like being discharged to GP isn't automatic - personally I'd write to PALS and the Consultant stating you are available any Wednesday after X date and please don't discharge you. I have previously been put on a 'clock stops' part of waiting list where I can come back in the future without adding to their waiting list statistics.

Waste of everyone's time to discharge you, waste a GP appointment to get referred back to the same list, wait 14 months and maybe something will come up next time too.

I haven't read the full thread but just wanted to say I had the exact same problem. it seems to be a bit of an issue now as to who can and can't fit and remove a mirena

In the end I went private. £130 and 15 minutes.

No, they would not probably mind but I want to make sure I do everything I can to secure four years work
Just as the hospital is trying to run in the most effective manner and that it involves the clinic to be only available in Wednesdays.

Why is your business so essential you can't take one Wednesday off but the hospital is not so important that it should be flexible to suit every patient?

The GP is unable to do it because it is involved with a fibroid which is why they have referred you to a hospital clinic in case there are issues when removing it, is that right ?
All the other clinics suggested may not be able to remove it for you if it is entangled with a fibroid.
If it is not causing you any issues I would go back to the GP and get re-referred and wait and see, you may get a appointment after June or after June you could explore private options.

Just as the hospital is trying to run in the most effective manner and that it involves the clinic to be only available in Wednesdays

But that isn’t what’s happened here is it? OP would like a date on a Wednesday but after June. The only problem here is the hospital’s sclerotic referrals system that can’t cope with actual patients with actual lives.

I work in the NHS and this “Computer says fuck off” attitude from some quarters is frankly embarrassing. But then I suppose all administration has been deemed to be bloated bureaucracy and unnecessary, without any thought to how we organise ourselves and meet patient’s needs...

OP I will echo others’ advice and contact PALS.

I’ve had a very similar issue with my mother’s podiatry appointments (rang up to change an appointment, I couldn’t take her to the offered slot and was told because I had “cancelled twice” she would have to go back to see the referring consultant to get a re-referral.... seriously). PALS cut through the crap in a single morning.

If it is not causing you any issues I would go back to the GP and get re-referred and wait and see

But this is insane, isn’t it? OP will be taking up a GP appointment for no reason at all.

I think one of the downsides with centralising the appointment systems is the computer says no syndrome. When I've worked in offices where the appointments are made by the consultants admin team they would try to work round these things because they were more directly involved with the patients and understood circumstances. You don't get that with large centralised departments that do all the appointments.

I don't think you can have it before the end of the project because worst case scenario, you may not necessarily be well enough to work the Thurs and Fri anyway.

Either have it done privately on a Friday, or suck it up and go back to the GP and ask for a second referral. You could ask for a telephone appointment with the GP to discuss if you don't want to go in person.

WiseUp It is daft isn't it, that they can make someone wait 14 months for an appointment but can't make an appointment for them in 5 months time !
I don't think OP would need to take up a GP appointment though, she could email the practice and explain the situation, nothing clinically has changed, no additional pain or other symptoms, she just needs putting back in the 'system' .

frumpety one would hope so. But still unnecessary!

Hi op sexual health clinics usually do this so you could give your local one a ring and possibly get a more suitable appointment

Contact PALs. But if not, wherever you are in London will probably have online appointments for specialist removal, might just take a bit of repeat checking. Guys and UCH both great.

"They can make me wait 14 months but I have to jump when they say."

There's no shortage of patients.

There's big shortage of professionals.
1/12 positions vacant in hospital or community services.
40k shortage in nurses & midwifery.

Do you by chance live in Thames Valley, OP?

Can you get short notice leave from work? It might be worth offering to take a cancellation if so, then if they get one on another day...

I do get it - my work is busiest Monday and Tuesday. I have to take a days annual leave every 10 weeks, on a Tuesday because it's the only clinic my consultant does. I lose out on bonus because I'm not in and it's busy

Unfortunately it's tough. The service is free so you will be limited on when you will be offered it. If the 2 dates don't suit then it shows that this is not a priority to you at this moment.
People saying the "you can't complain about NHS", well you can but complaining about them not working around patients timetable is ridiculous. Just think how many people there are in this country, if they do it with one person they would have to do it with everyone and that is not possible.

Go to a GUM clinic, you can self-refer.

Irritating but tough luck really :/

I am waiting for surgery on my jaw, currently can open it about 12mm and have permanent toothache and earache. Clinics only available on a Monday 12-4, and I started a new teaching job in November, with Thursdays off, clinic doesn't run on a Thursday. I had to take time off un-paid for the appointments, and was hoping the surgery would be half term but apparently not.

You either want the procedure done or not. Like you say, it's not urgent, so a re-refferal is appropriate. You are of course also contributing to their statistical waiting list by turning down appts. This is hugely relevant, their waiting lists can't accommodate people while they find the best time for you to fit it in.

I have a chronic illness and every time I get a clinic appointment, it's on a Friday at 3pm

Because that's the day and time that particular clinic runs. A different clinic, with different doctors runs other days at 9:30-1:30.

I work for a doctor who has 4 different clinics a week. Plus theatre 1 day. On Monday it is the booking clinic for newly pregnant ladies. Tuesday is theatre. Thursday afternoon is her Gynae clinic and Friday afternoon is her antenatal clinic. Her clinincs for in around a similar schedule for the 4 other doctors in the department.

In between that she sees Gynae inpatients, antenatal and postnatal women. Women in labour. She also works through her paper work, dictates letters, follows up scans, smears, blood results, histology results, semen analysis reports for partners of people having fertility issues. She refers patients to fertility specialists, to incontinence specialists, to oncology where necessary, urology. She liaises with these specialists as well as her own multidisciplinary team to ensure the women get appropriate medical care and treatment.

If you have a Gynae issue, the slot she has allocated (or has been allocated to her) is Thursday afternoon. If you ask can you come in Thursday morning, the answer is no because someone else is using the clinic space for something else. If Mon morning suits you better than Thu afternoon, I still can't do anything for you because she is doing other work that day.

If removing it really isn't an issue for you, then why so worked up about not having it done now. If it was a necessary procedure and something you needed then you would make yourself available. Right now, your work is a priority ahead of this. The hospital (like most others across the world) have a 2-strikes-and-you're-out-rule. You were offered 2 appointments. You choose not to accept either of them despite being given sufficient notice to rearrange work. You are one of thousands of patients all looking for something "more suitable".

If you need something more suitable where you can pick and choose your day, then you need to go privately where the consultant isn't juggling so much for inpatients and outpatients every day. If it's not a pressing issue then be discharged back to your GP and let them rerefer you. When the appointment comes back around again you'll must likely be in a better position to accept it.