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.

Just accept the appointment. Then call up nearer the time to rearrange and continue until you can actually make one.

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"

Why have you chosen to misrepresent the problem?

OP isn’t worked up about not having it done now. She’s not worked up about the clinic being a Wednesday. She’s worked up about being given 9 days notice and then just one other option before being taken off the list. She wants to delay til after June.

A system that can’t allow this is inefficient and is not patient focused.

I think everyone is being very harsh. This lady works and effectively pays her share for the NHS.

Whilst I agree they can’t bend to everyone’s whims I think only running this clinic on one day is completely unreasonable to working people.

If there’s a 14 month wait the service is clearly underfunded.

What a surprise women’s health care is underfunded as we don’t matter!!

This is how it works for all clinics not just women's health ones.

It’s ‘now or back to the GP’ because they’ve offered you two appointments and you’ve turned them down. So they’ve referred you back for your GP to either deal with it or refer you back later.

I had to have mine out in hospital. It’s done by a obs and gynae consultant who frankly, is more tied up with more important patients most of the time. Hence you’ve had to wait, I did too. You are not sick, you just need something removed.

Either pay for private care, rearrange London or wait. Those are your options.

The obs and gynae consultant are busy with sick and pregnant women. They don’t often run appointments for this story of things.

£150 to have it removed here:
Call: 020 71831049
Email:[email protected]

There must be plenty of other places that do it.

Just accept the appointment. Then call up nearer the time to rearrange and continue until you can actually make one.

That's not how it works. And people accepting appointments, and cancelling too near the time to allow for an appointment to be sent to another patient is why waiting lists across every health care system in the world are the way they are.

If the patient accepts the appointment and then cancels, she is still cancelling/rescheduling and will still be subject to the 2-strike rule. She gets chances. Whether she accepts and then cancels, or just cancels it's the same end result.

She’s worked up about being given 9 days notice and then just one other option before being taken off the list. She wants to delay til after June.

And if it was something that she wanted/needed she would arrange it and accept one of the two appointments like thousands of other hospital patients do every day. If she was sick, or somebody close to her had an emergency, or somebody died, she would be able to not be in work on a Wednesday.

This is not important to her, so she's not prepared to rearrange things to attend the appointment. Hospitals have enough to be dealing with without holding appointments for people who aren't too bothered about whether they have their procedure or not.

It is a universal rule across most health care organisations. Patients who want their appointments organise themselves to be available. Patients who don't, don't.

Go and attend your Wed appt. One Wed out of the whole project will be fine. Just do it.

I am Not frustrated they can only do wednesday

I am Not asking for them to do it at a convenient time for me outside normal clinics

I am not asking them to make their service revolve around me

I am frustrated that after being referred to one clinic they refused to do it because the reason for it being there was not on their list

I am frustrated that after waiting 14 months - which I do not mind because I know it’s non urgent and there are other more pressing issues people have - I get given 9 days notice then one more option 14 days after that and if I can’t do either of them I get removed front the system.

I am happy to do any Wednesday after then end of June.

I would be able to do any day other than Wednesday before the end of June but I know that’s not possible because of clinic schedule so I’m not throwing a strop over that.

I just cannot fathom why they can’t put a delay until July!

I recently removed a coil myself as I couldn’t get an appointment and I was in a lot of pain for weeks preceding. I read a bit first and felt comfortable doing so and the pain was immediately relieved.

😳

OP’s GP can’t remove it. It’s caught up in a fibroid.

Trying to remove it herself is the worst possible thing she could do. Believe me, in the year I had to wait for mine to be removed while having hours of intense contractions every day, if I could have pulled the fucking thing out myself I would have! But given the three attempts with speculums and tools and the consultant who basically treated me like a cow giving birth, I doubt it would have done much good.

I agree it's ridiculous, and far more of a burden on the service to put you back for a referral and on the waiting list rather than just give an appointment after June. I agree that it can't bend to everyone's whim, but it seems reasonable in this case, and you are more than happy to wait which surely gives someone else the chance to have theirs done sooner; you aren't wasting appointments or demanding you are seen on a certain day at a certain time. If you were a teacher or something it would be hard to get a weekday off at a particular time, self employed seems to be thought of as fully flexible though which it's not (if you want to make money anyway!).

There is a hell of a lot of inefficiency in the NHS. 9 years ago, DD had an eye appointment. Afterwards, she needed a follow up, so I went to the desk to arrange one.

Oh no, they said. We send you a letter with an appointment on, and if you can't make it you phone up and rearrange.

Letter arrived with an appointment and it was a date I couldn't do. Phoned up, and they didn't discuss a date with me, just said they'd send an appointment out in another letter.

That letter never arrived, I phoned up to be told we'd missed the appointment and would have to go via GP for new referral. The appointment we'd missed had been the first, cancelled one. 🙄 It was sorted out eventually, but it wasted a lot of time.

The strict targets has led to inflexibility in the system, and I reckon that's costing the NHS more in wasted appointments and admin, than being able to be flexible and actually discuss suitable times with patients.

@ACautionaryTale

I completely understand your frustration, there is a woeful lack of commonsense approach being adopted by referring you back to your GP. Sadly this is common practice in NHS because your request has sadly dragged you into the bureaucracy of the hospital trying to achieve the agreed waiting time targets.

I'm hopeful that you can resolve this with your GP reception. Suggest to the receptionist that your referral is resent towards the end of June. Hopefully they are super efficient and you won't need to chase them or make another appointment to see your GP to kickstart the referral process.

Good luck

Oh my gp is fine. The problem is when I go back on the list it will be a 12-14 month wait again.

Which I don’t mind. But we could end up in the same scenario again!

I just cannot fathom why they can’t put a delay until July!

Because then what was a 14 month waiting list becomes a 20 month waiting list. And you wouldn't be the only person on just one waiting list looking to delay an appointment. This is reported back to hospital management, to area management, to central statistic figures etc.

You were offered an appointment for 23 days time. Over 3 weeks away. That would be appropriate notice for most people to arrange. If you don't like the free public system that is on offer and can't work it around your schedule then there are other options.

But we could end up in the same scenario again!

In which case your probably better staying out of the public system and going privately at a time that suits.

I can see both sides here OP.

Unfortunately, the hospital is going on strict protocol which will revolve around targets. The procedure you need is only done in Wednesday’s clinic. But you can’t (understandably) make the next 2 Wednesday appointments offered. So they are unable to book you anything further ahead & protocol is to refer back to the GP. If they offered you an appointment in July for example, while totally logical, that would add 5 months on to their “time on waiting list” for you. That has consequences & that is why protocol doesn’t allow it.

I completely understand your frustration though. Of course you aren’t going to jeopardise such a big project for something fairly routine. But I also understand the reasons the rules are as they are.

I work for one NHS trust & have appointments & treatments in a different one. Arranging appointments drives me crazy too!

Can you not go private for this one off procedure?

Have you contacted PALS?

What they have said is 100%, I worked in women's health for the NHS and that is correct

t is a universal rule across most health care organisations. Patients who want their appointments organise themselves to be available. Patients who don't, don’t.

Actually, as an expat, I can state with confidence that most other nations don’t put up with such an inefficient health service that shows such disrespect for people’s need to be able to work.

@ACautionarytale you've been referred back to your GP until you are available. The hospital will have "stopped your clock" when your gp re refers they need to specify to reopen your pathway from this date and should continue from where your "clock" (ie the 18 week pathway) stopped last time. Therefore you shouldn't go to the back of the queue.
They can't let you breach the 18 weeks which they evidently will do, due to patient unavailability, because there will be a fine. The more fines = the less money the trust gets = less funding to put on a range of clinics to expand this one from a Wednesday to a Wednesday and a Monday for example.

Call PALs and ask to speak to the Access team for clarification of your rights on re referral.
The hospital have done everything right. The national access standards say they have to offer you 2 appointments with reasonable notice. If you can't do them you get discharged back to gp until you are available.
Not ideal for you, no, but do you realise how many patients come through the service? It would be impossible to manage any other way.

I hope you get success and get a timely appt following a call to PALs and discussion with your go. Ask to speak to the directorate manager, they will usually bring you in early to avoid a complaint!

It's such an inefficient system in many respects, both from the NHS POV (handling appointment rescheduling/cancellation) and for the patient. It would be much easier to give the patient a referral and then allow them to book an appointment themselves, rather than requiring them to attend a specific clinic on a day that isn't convenient.

It’s now or back to the GP as that’s how they work, it maybe to do with targets, it maybe they can’t book that far ahead who knows. Although you say you are self employed, you obviously must be working with a company if you all have to be there on a Wednesday, so either say you can’t be due to a procedure that can only be done on a Wednesday, or go back to the Doctor. No point banging on about it