About inflexible NHS appointments?

[RedLemonadeNTaytos]

I’m willing to be told AIBU if there are any NHS hospital staff that know better than me, but I am SO frustrated today with the attitude of the guy I just spoke to in the ultrasound department and need to get some perspective.

GP referred me for a scan due to heavy periods & bleeding between periods. I got an appointment within a month but the day before it I was ‘pinged’ by Track & Trace. I phoned the appointments line & the hospital switchboard repeatedly that day and the day of the appointment to tell them I couldn’t make it l, but never got any answer. I also sent an email to the generic appointments address. I think I tried the phone about 30 times, though! (Luckily I obeyed T&T, as I did actually have covid).

Anyway, called GP to explain and ask to be re-referred. Letter came through 3 weeks later with an appointment time but it’s on the first day of my new job. Not ideal, in fact a massive pain, as I am attending a large staff meeting as their new manager in the morning, then going on an expensive and non refundable bit of training in the afternoon.

Finally got through to hospital on the fourth day of trying the ever ringing line, hoping to rearrange l, and was told because I had ‘DNA’ one appointment, this was all they could offer me, they couldn’t give an alternative date, and I will need to go back to my GP to ask to be re-referred, but they may NOT offer me an appointment because I have ‘failed to attend’ two appointments.

I wasn’t expecting to be given any date or time I fancied, just an alternative to my first day in a new job. It just seems so bureaucratic and time wasting, and the reasons the guy on the phone gave were jumbled and didn’t make sense and he was really bloody rude!

Why is the system so inflexible?

You can pay privately and book at a convenient time but free healthcare can’t be as flexible due to the sheer number of people using it. We are very lucky to have it.

This attitude is the cause of so much of what's wrong and as it stands unfixable in the NHS - because it's seen as heretical to complain and we should just doff our caps and be thankful for any treatment at all, any phones answered, anything resembling half-decent service.

We're the clients here. The NHS is not some sort of benevolent overlord that heals the poor ad hoc Mother Theresa stylee, it is an enormous organisation that receives money from gov't and ultimately from taxpayers to provide a service. If no one answers the phone time after time - that's not good enough. If you have an appointment booked but haven't been notified of it (if only there was some sort of communication faster and cheaper than the 2nd class letter...) - not good enough. If as a patient you're routinely kept hanging around for 2-3 hours for an appointment - not good enough. Not being able to access primary care within a reasonable timeframe - not good enough.

What's the alternative, really? "Oh yeah, I have stage 4 cancer that's gone untreated for months and my kids will be left without a mum soon, but it's alright because we're lucky to have the NHS"?

YANBU - NHS admin is a total joke and we are not lucky to have a system which is not fit for purpose. We could have a much cheaper and more efficient system if we could get things like this right

@NotPersephone

I can empathise with that. My DH needed a MRI scan to check for bone damage due to his bone marrow cancer. He can't tolerate the marker dye and needs sedation for the tube. All that is on his medical records. Oncologist told us she'd send him for a scan, we reminded her that he needs sedation and can't tolerate marker dye. Appointment came through, and we went - no one to sedate, so wasted appointment. Next appointment came, someone there to sedate, but it had been put down as a marker dye scan, they tried to contact the oncologist but couldn't reach anyone, so couldn't do the scan, another wasted appointment. Third time, down as no marker dye this time, but no one to do the sedation. Yet another wasted appointment.

As you say, too many people not doing their jobs properly. There's a complete lack of attention to detail. No one seems to read the notes, no one seems to care that others don't read the notes. There seems to be an air of "couldn't care less" attitude about the sheer amount of waste and inefficiency.

Yes because OPs health will be fucking fantastic if she doesn’t have a job, can’t pay bills etc Honeslty.

@UseOfWeapons We DNA patients who ring to cancel too late for us to give that appointment to another patient, no matter what the reason.

That's not acceptable as it makes a mockery of the statistics. It's not the patient's fault that you can't fill an appointment slot that they've cancelled.

I got a (rather nasty) did not attend letter for a consultants appointment for dd. I had no idea she even had this appointment and it was months after I had given up trying to get one on the NHS and paid privately to see a consultant and have an operation.

This has happened many many times to me and my friends and family. A close friends mother died of cancer- she had been diagnosed a year earlier in the hospital but not even informed never mind treated. She only found out when she had to have an emergency appointment overseas.

Decent administration is a critical part of a good or even just acceptable health service. Something needs to be done about the mess it’s in.

We are not lucky to have shit healthcare with staff who feel entitled to be rude and obstructive to patients, because of the toxic mindset of "NHS heroes vs ungrateful patients".

You just need to decide which is more important - the job or your health.

That's such bullshit. Do we have meaningful financial safety nets for people who can't work due to health problems? No.

NHS staff might get full pay for sickness absence but the rest of us do not. They would do well to remember that when being arsey and judgemental towards people who cannot afford to bin their job on a whim for every health appointment.

Unemployment and poverty are also not good for anybody's health so the argument does not wash on that front either.

I got a slap on the wrist for not attending a physiotherapy appointment for a condition which I didn't have, so I certainly hadn't ever been to see the GP about it - and I didn't receive a letter about it either (which is why I didn't know about it).

I found out about it a long time later when a GP mentioned it. When I said I didn't have the condition, hadn't seen a doctor about this "condition", and had never received a letter for this appointment (so that I could have queried it) - he clearly didn't believe me. He said that I shouldn't miss appointments, it was wasting NHS time!

This was pre-Covid, but it was bad even then.

Also people who are not doing their jobs should be losing their jobs. But how many do?

This sort of thing isn't widespread it depends on the apartment. But he's very silly of them to insist you keep and Dna an appointment instead of rearrange to a time that suits you (and someone else could have their appointment sooner by taking the slot perhaps!).

My son got a DNA for an appointment we didn't know he had. They begrudgingly arranged another, but the system of a single letter in the post with no means of knowing if you ever received it must create a lot of missed appointments.

YANBU. Contact the hospital pals department

Some clinics are less flexible than others. Dd's eye clinic is a nightmare , she tried once to ask for one slightly earlier than suggested time frame to fit in with uni term dates and the receptionist refused. Her first in-person appointment in two years (over phone only in interim, one of which she waited 2 1/2 hours for only to be left a voicemail) is also in term time and she is fearful of trying to rearrange.

Please contact PALS at the hospital.

This is exactly the sort of thing they are there for. You shouldn't be penalised for not attending while isolating because of covid contact.

I needed to have a 'procedure' and my GP asked if I had access to private health. So I got appointments at a time that suited me, operation on a date that suited me, own room and everything went like clockwork. A friend that needed something similar was mucked about within the NHS system for over 2 years.

The inefficiency of the NHS has led to the growth in private healthcare including GP services.

[quote Badbadbunny]**@UseOfWeapons* We DNA patients who ring to cancel too late for us to give that appointment to another patient, no matter what the reason.*

That's not acceptable as it makes a mockery of the statistics. It's not the patient's fault that you can't fill an appointment slot that they've cancelled.[/quote]
There is also research that shows that when healthcare settings disrespect their patients with policies like this that it is responsible for people deciding there is no point cancelling unneeded appointments.

Same research shows that the dominant reason for patients not seeing the need to arrive on time for appointments is because of previous disrespect by that healthcare setting failing to keep to time on appointments.

Disrespect is the term used in the body of research in this area, because such conduct by healthcare settings makes patients feel disrespected and therefore damages the normal social contract that would mean patients turned up on time and cancelled appointments etc.

Sending nasty letters and being rude to patients only inflames matters. It is an abuse of power.

The NHS needs to take responsibility for its toxic conduct and policies instead of demonising and blaming patients for being affected by its own actions.

OP you actually reminded me I actually got an appointment on a Saturday afternoon for a similar issue in another London hospital.

Interestingly one of the clinical staff actually phoned me up in the morning asking if I could come in earlier on the day as their clinic wasn't fully booked up.

@JazzerMcCreary

YANBU. You’re not taking the piss, there is one date that really wasn’t suitable and the appointment was arranged for that day. It’s unfortunate but that’s that!

Goodness it makes our bending over backwards to accommodate women (and still being told that we aren’t doing enough) in midwifery laughable.

Absolutely! "hello Mrs Smith, we have a slot for you to be induced on the 10th at 08:00, please make sure you attend on time otherwise you may be delayed until later." gets to 10am "where are you Mrs Smith?"

"oh sorry, 08:00 was too early but ill be in after lunch"

And then they complain when we can't get their inductions started til the next morning.

As my favourite colleague has said before multiple times, "you wouldn't get that sort of flexibility if you were having an orthopaedic op!!"

The admin for appointments is sometimes just terrible.
I was referred for an urgent scan, didn’t get a letter so rang the hospital doing the scan - I’d missed the apt because they had sent the letter to an address I hadn’t lived at for 15 years (despite my gp having up to date address)
I changed address with them & waited for a 2nd apt letter, when I rang to chase that had also been sent to the wrong address so I was down as not showing up twice (and they were very rude about it) would not rebook, had to get gp to refer again.
More recently had apt with at hospital x - called a few days before to double check it was going ahead - yes but the apt has been changed to hospital y (5 miles from hospital x) had I not phoned I would have gone to the wrong hospital & missed that one too because nobody had let me know it had changed.

These are just a couple of examples, it’s happened so many times.

I know a lot of people don’t turn up & apts are wasted, you have to wonder how many no shows are actually people that never got the letter/hadn’t been informed of changes.

www.nhs.uk/nhs-services/hospitals/book-an-appointment/

You need to request an e-booking from your GP.

The thing is, all these services ARE available, it's just getting primary care to use them. Some of them do still love their paper. Hopefully the pandemic will prompt them further into the 21st century.

Why is the system so inflexible?

Management and data capture.

Way back when I worked for the NHS we had got waiting times for some tests down to 48 hours, but appointments had to be sent out by letter.

We had lots of no shows and people phoning say, "I got home from work and the appointment was for this afternoon".

Asked management if we could delay appointments - nope.

Asked if we could at least delay the ones for prisoners because the prison needed time to arrange escorts.

Write to your local hospital, the most senior person you can find and ask them why the system is so ridgid.

It can work, I had an appointment at a clinic at 8.30am, the medical staff were there but couldn't start because the admin staff didn't start until 9.00 am - when you put it in writing just haw ridiculous it is management sometimes see the point.

This thread has just reminded me of a "FTA" at my GP surgery. My infant son had an appointment which OH was going to pick him up from pre-school and take him. A couple of days beforehand, an important works meeting was re-arranged, so he phoned the GP to change son's appointment, and got an appointment a day after the original one. Completely unrelated, I had a routine GP appointment a couple of hours later on the same day as son's original appointment. As soon as I sat down, I was told off by the GP for my son missing his appointment earlier that day. He soon backed down when I told him it was HIS receptionist at fault for not cancelling the original appointment when she made the re-arranged one - he checked the system and saw there was an appointment booked for the next day, cue, lots of muttering under his breath. It's amazing how NHS staff rush to blame the patient rather than thinking perhaps it's their own staff who make mistakes!

@sashh

Why is the system so inflexible?

Management and data capture.

Way back when I worked for the NHS we had got waiting times for some tests down to 48 hours, but appointments had to be sent out by letter.

We had lots of no shows and people phoning say, "I got home from work and the appointment was for this afternoon".

Asked management if we could delay appointments - nope.

Asked if we could at least delay the ones for prisoners because the prison needed time to arrange escorts.

Write to your local hospital, the most senior person you can find and ask them why the system is so ridgid.

It can work, I had an appointment at a clinic at 8.30am, the medical staff were there but couldn't start because the admin staff didn't start until 9.00 am - when you put it in writing just haw ridiculous it is management sometimes see the point.

But why aren't NHS staff raising this kind of issue internally themselves? Why does it have to be the poor patients who have to cause a fuss? Lots of patients will put up with that kind of crap because of how the NHS has been made into a national religion that no one is allowed to criticise!

In the letters I received for 2 appointments for DS2 recently, they say that if you cancel they may not be able to offer you another appointment. Is that how busy the NHS is?

My GP was told I FTA appointment and therefore discharged , despite me ringing to cancel appointment. I was furious.