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?

There would be plenty of spare appointments if the system was set up better. The reason there are no appointments is because they are "taken" by people who will either never show up (because they never receive the letter in the first place or have tried in vain to cancel the appointment that they cannot attend but nobody will answer the phone) or are wasted because adjustments necessary for the appointment to happen haven't been made. That is not the fault of the patients, it is the system/administration's fault.

This!! It’s absolutely ridiculous that in most cases you can’t go online or call and book an appointment time. Actually it’s completely unacceptable. It’s like the bloody dark ages. And it’s not free!

I received two text message reminders about an appointment for my DD last week, referring to a letter that apparently had the appointment details. I hadn’t received a letter and the text didn’t identify the department the appointment was with. My DD has complex needs and is being seen by 6 different departments across 4 hospitals at the moment, I phoned all of them trying to trace the appointment without success. Today I got a DNA letter.

@HmmmmmmInteresting it's free at the point of access- when we actually need it. And yes we are incredibly, incredibly lucky to have it.

Plus if you were really prioritising your health you would make the appointment and miss the meeting. Its embarrassing to miss the meeting but not life threatening.

That’s a nonsense - in one of my jobs my diary is planned a full year in advance, with dates that can’t be changed at short notice without incurring significant cost and inconveniencing 30+ people. Me being told about an appointment a couple of weeks in advance may need me to reschedule the appointment because some parts of my job are just not that flexible. Not all health issues are necessarily life threatening, but still need specialist attention/health care.

And I’ve just got home from work to another appointment letter giving details for an appointment for DD - again dated after the appointment

Fortunately I knew we had the appointment, and attended it because the paediatrician’s secretary had emailed me the information .

It was a short notice appointment and it has been all over our local press that 45% of the staff in our local sorting office are isolating as they’ve been pinged so postal services have been massively delayed so it seems mad to send out a letter for a short notice appointment by post, especially at the moment.

@EssentialHummus

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.

I'm Mrs Smith in this situation (pregnant, attending lots of appointments). I turn up to all of them on time or a bit early, sometimes at moderate effort - it's safer to drive than use public transport at the mo with covid, but there are all of 12 (!) parking bays available outside the hospital I'm at, which serves at least three London boroughs. Amazingly though the borough aren't short of traffic wardens - funny that. So I drive around, find somewhere to park - this whole process can take up to 30 minutes - and then walk in to the appointment from whatever distance, often in pain from bad SPD that my midwifery team has also let me know it doesn't treat. (They've sent me to my GP, my GP has shrugged and added me to a waiting list that would have me seen when my - currently in utero - twins are about 6 months.)

You know what happens then, every time? I'm kept waiting 1-2 hours. I'm not surprised Mrs Smith turns up late, if that's the kind of crap she's had for 9 months. But god forbid I turn up 1-2 hours late - I won't be seen.

Seriously @TammyS86, if you're aware of all this and this is your attitude to the women you're treating, fuck you. I hope that you too are soon on the receiving end of this magnificent "care".

Crikey your hospital sounds shit! I guess that's the problem with the huge London hospitals where parking is a shit show.

We don't have a DNA system in our hospital, we keep providing appointments whatever the reason for the DNA and we don't penalise people for forgetting/rearranging.

If a woman tells us she can't come in, cool, fair enough we'll rearrange, but when she literally called to say she couldn't be bothered, when we have rearranged staffing to accommodate someone who doesn't arrive it's frustrating.

Soooo my comment was a bit tongue in cheek, I'm an excellent care provider but sorry, obviously due to your experiences my sense of humour (necessary in a caring profession) has triggered you.

p.s try Physio for your SPD. Bypass the GP completely if you can afford it and go private. If not, as you're in London they should have specialist women's physio services that can see you antentally

@wselesda

"Why is the NHS so inflexible?"

Because we have hundreds of thousands of people on our waiting lists!

Because when people cancel we have no alternatives to offer them

Because hospitals are still operating under COVID rules, masks, 2m gaps, cleaning between every patient... etc etc

My advice is use email whenever you can.

Vote in a government that invests in the NHS

Because hospitals are still operating under COVID rules, masks, 2m gaps, cleaning between every patient... etc etc

That’s hilarious, my DH and DF were both in hospital last week. It was filthy. When I went to put my Dad’s stuff in the locker it was full of someone else’s dirty clothes. The nurse went to remove the items and when I said presumably this will now be cleaned she got a dry wipe and wiped one shelf.

Vote in a government that invests in the NHS

How much? It’s a yawning black hole of inefficiency and apathy.

In case it's not clear, I think the people who expect to drive to zone 1 and 2 London hospitals have the wrong expectation. I don't think hospitals should be offering parking. NCP can do that, if they think there's enough demand.

It’s zone 3 in my case, but I don’t want to have this discussion derailed into one about why some people may feasibly need to park near a hospital - as in, we seem to disagree about that, but that isn’t the point. As @NotPersephone said there’s a point here about delay and blame, and how unilaterally that falls.

I find it abhorrent personally that there are traffic wardens circling a street with no parking adjoining a hospital entrance where people are coming to drop off women in labour. It’s an extension of the same “don’t give a fuck” attitude - yeah, your wife’s 10cm dilated and you can’t find anywhere to park. You can park illegally and pay a £60 fine, or find a cab willing to take a labouring woman, or teleport here, not our problem. Any vaguely holistic system would acknowledge this as a need. What our system does is acknowledge this as a need, respond to that need by sending out a dozen traffic wardens to patrol three streets continuously, but leave the underlying problem for the patient to solve - sorry mate, not our problem. Can’t make your appointment because you’re starting a new job? Soz. You didn’t know you had an appointment at all? Soz. There is just across the board a real lack of functionality. Parking is the tiniest example of this, late running is a much larger one, the departments not speaking to one another even larger, and on it goes.

It is not too much to ask for some consideration of the patient to be central to healthcare. Otherwise what should be?

I don't think you are unreasonable - ask to be put on a waitlist for last min cancellations - its like you are not the only person needing to isolate last minute.

Funnily enough, after giving the secretary a piece of his mind, an appointment miraculously appeared a few days later and the oncologist apologised for missing the first appointment and for the appointment clerk attitude. It really pays to complain!

Funny that - the woman who had fuck all to do with it had to then put up with somebody ripping into her and still had the professionalism to put the patient first and speak to the consultant. And no sign of anybody apologising to her, just the patient's wife being really pleased that the woman was 'given it with both barrels'. Even though speaking to her politely would have got exactly the same result without potentially ruining her entire day.

I work for the NHS and genuinely don't recognise most of these issues as things that happen in my department - fortunately. We run a tight ship and hardly have any DNAs, but I can assure you that doesn't mean we have loads of appointments free.

OP definitely go to pals, they will sort it

Happened to use before Christmas.

My DD had a time sensitive appointment due to treatment she'd had, it needed to be done by Christmas Day otherwise any other rectifying treatment wouldn't work and she'd have to have the treatment again.

Offered 22nd December with any treatment taking place on 23rd December.

Same day (22nd) I'm offered an appointment for a condition I have with my GP. I couldn't attend both. Trying to get through to my GP to cancel my appointment (mine was the less important one as it could of waited a month or two) was hard and when I finally got through the secretary didn't seem to get why I needed to cancel I can't be in two places at once kept saying I should get someone to take DD to her appointment not seeming to get I'm a single parent and because I have PR I needed to sign any treatment that needed doing before it could take place on 23rd.

My GP personally called me to ask why I didn't turn up when I explained she booked me in for her next available appointment, was very understanding.

The system needs changing. I love the NHS but sometimes it's not fit for purpose.

p.s try Physio for your SPD. Bypass the GP completely if you can afford it and go private.

I do. I pay £100 for 1.5 sessions weekly to see a physio now so that I can do exciting things like get out of bed and walk 10-20m at a time. What about everyone without £400 a month to spunk on physio? The question isn’t directed at you, I presume you have as much as me to do with the allocation of resources within the NHS but truly - is this a system we ought to be celebrating?

Soooo my comment was a bit tongue in cheek, I'm an excellent care provider but sorry, obviously due to your experiences my sense of humour (necessary in a caring profession) has triggered you.

Yes, staff seem to fall back on their sense of humour a lot when after, say, 1.5 hours of waiting I come up to reception and ask (politely) when I might be seen, and point out that I’m there for an 8am appointment and it’s now gone 9.30. It’s such a wonderful joke, keeping a bunch of people waiting with no explicable cause and certainly no apology. It’s the patients or interlocutors “triggered” when they deign to point out or query something, and it’s lovely to keep being able to fall back on those incompetent, demanding patients.

[quote opalescent]@HmmmmmmInteresting it's free at the point of access- when we actually need it. And yes we are incredibly, incredibly lucky to have it. [/quote]
We'll have to agree to disagree.
I'd prefer something that was less soul-destroying to access even if it meant it wasn't quite 'free'

@EssentialHummus

p.s try Physio for your SPD. Bypass the GP completely if you can afford it and go private.

I do. I pay £100 for 1.5 sessions weekly to see a physio now so that I can do exciting things like get out of bed and walk 10-20m at a time. What about everyone without £400 a month to spunk on physio? The question isn’t directed at you, I presume you have as much as me to do with the allocation of resources within the NHS but truly - is this a system we ought to be celebrating?

Soooo my comment was a bit tongue in cheek, I'm an excellent care provider but sorry, obviously due to your experiences my sense of humour (necessary in a caring profession) has triggered you.

Yes, staff seem to fall back on their sense of humour a lot when after, say, 1.5 hours of waiting I come up to reception and ask (politely) when I might be seen, and point out that I’m there for an 8am appointment and it’s now gone 9.30. It’s such a wonderful joke, keeping a bunch of people waiting with no explicable cause and certainly no apology. It’s the patients or interlocutors “triggered” when they deign to point out or query something, and it’s lovely to keep being able to fall back on those incompetent, demanding patients.

I agree with everything you're saying. Obviously I've upset you which I apologise for. Staff who care about their patients (like myself) and who want to do right by people and give good care feel just as frustrated and more than often, as has been pointed out by a previous poster, I am the one that gets it with both barrels when there's nothing I can do about it.

@alloalloallo

And I’ve just got home from work to another appointment letter giving details for an appointment for DD - again dated after the appointment

Fortunately I knew we had the appointment, and attended it because the paediatrician’s secretary had emailed me the information .

It was a short notice appointment and it has been all over our local press that 45% of the staff in our local sorting office are isolating as they’ve been pinged so postal services have been massively delayed so it seems mad to send out a letter for a short notice appointment by post, especially at the moment.

It's this kind of lack of attention to detail that is so frustrating.

That letter did not write itself, it did not print itself, it did not put itself into an addressed envelope and add itself to the outgoing mail stack. Someone did all of those things and yet not once did they notice the fact the appointment date had already passed or flag it up. Its not fucking rocket science.

And it is this constant, low level of incompetence that means people don't take appointments seriously - I once had an 8:45am appointment, turned up at 8:43am and was told to take a seat ... 20 minutes later there were 3 other people in the waiting room and we were all waiting for the same doctor (as it was so quiet and a small waiting area it was hard not hear "Hi, I'm X to see Dr Y at Z time" as everyone booked in. At 9:25 the doctor rolled in through the main door, zero haste, stopped for a little chitchat with the receptionist before disappearing to his consulting room. I was finally called in at 9:40am with zero apology for the wait nearly an hour after my appointment time and as I was the first patient he was already 5 patients behind schedule. None of that was the patients fault but its the patients who are penalised - when I came out I had to get a form from reception and was stuck behind someone who was trying to book a new appointment as their appointment was supposed to be at 9:10 (by this point it was nearly 10am) and they had to get to work so could not wait any longer and the receptionist was umming and ahhing about it and trying to persuade them to stay as it "wouldn't be much longer".

I am a chronically early person, but pretty much every NHS appointment I have ever been to has been late, so now appointments times are more guidelines than rules. If the appointment is 12.00 then if I turn up at 12.02 then its not really late since the clinic is running an hour behind schedule anyway.

I can only assume that the general disgust towards the NHS on this thread stems from the fact that Mumsnet is largely middle/upper middle class. And therefore people are used to far 'better service' and not having to (gasp) inconvenience themselves to fit around an incredibly overwhelmed and understaffed organisation.

If you have the option to go private, you do not represent the majority of society.

That said, there are obviously examples here of genuinely difficult situations. Surely most hospital appointments can just be negotiated through a general booking office? That's what I've always done 🧐

My trust send a letter when there is space asking you to book an appt. sometimes they send an appt, but change it willingly, although they will only deal with 2 cancelled appointments. Any more and it is referred back to gp.

I had to cancel one as my Covid jab was rescheduled, then again as l was pinged. However it has annoyed me in the past when they ask the reason for cancellation. It’s inconvenient, why else would l be cancelling?

@opalescent in lots of my family and friends cases they work in healthcare and other essential services where if they don't turn up, the general public don't get what they need.

So a doctor being 3 hours late seeing them has a knock on to their own patients/service users.

@HeyDemonsItsYaGirl

It's 2021 and time for the NHS to set up an online system for appointment management, like most GP surgeries.

This. I think that some initial NHS consultant appointments can be booked online? Why they can’t be rescheduled online too just doesn’t make sense. If someone is sick and cancels a day or two before, that leaves free an appointment that could be booked last minute and therefore not wasted.

Also, in the case of CFs who decide they cba to attend, if they could see how many days/weeks it will take to get their rebooked appointment, they would most likely reconsider and just attend their appointment in the first place.

There was a brief period of time when l could book online. But the appointments were all between 2and 3.30om every second Thursday or similar.

The NHS appt system is unfit for purpose. They cannot record reasons for cancellation properly. Your initial cancellation was obviously justified and you wanting to move the second one equally justified. I'm a GP waiting for a gynae scan and it's a nightmare. I done want to take too much time off work as it's the holidays and others are off but trying to change things is a nightmare. I'd complain to PALS if you're in England as it's outrageous how inefficient the system is. And whilst you're at it try and get rid of half the middle managers and the place will have more money overnight!!