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?

Our system sends our letters, texts and emails and despite requesting that people keep their contact details up to date, A significant portion of patients will swear blind that they never received the information
In my case I live in an area where you have to live a certain distance from a gp to get registered with them & you have to prove it. If I had registered with my 15 year out of date address the gp would not have taken me.

My DD used to have lots of hospital appointments. On one occasion I remember rearranging one in person at the outpatients reception desk as I knew DD couldn't attend the date they'd sent. They gave me a new date. When we went to the appointment the consultant made a comment which seemed a bit odd. I knew the consultant fairly well so I questioned him about it. Turned out he thought we'd failed to turn up to a previous appointment - the one I'd rearranged. Seems the receptionist had given me a new date but failed to cancel the old one off the system. So it's no better if you do actually get to speak to someone to change an appointment!
Similar happened for a GP appointment. Receptionist rang to ask why DD hadn't turned up for her appointment 10 mins ago. I advised her that DD didn't have an appointment as it was now on another date! If only we could publish stats for how many hours of appointments are 'missed ' due to the inefficiency of the NHS admin systems rather than just the ones missed due to patients failing to attend!

I work for the NHS and book follow up appointments and I can tell you that it is really bloody difficult to book the appointments at the moment.

Today, for example, I had to book a live face to face appointment for a nurse’s clinic for 4-6 weeks time (this is considered an urgent). There wasn’t any capacity so I emailed the nurse and she told me to just book the next available appointment. The next available appointment was 3 and a half months later. I ended up having to overbook the clinic.

We’re playing catch up due to covid and are constantly overbooking clinics (much to the annoyance of the doctors and nurses running them) because we have too many patients requiring urgent attention. One of my colleagues is actually facing disciplinary action because she overbooked a clinic for a very distressed woman at reception and she didn’t clear it with the doctor.

And I only deal with the follow up appointments. I can’t imagine how stressful it must be for the central booking office booking the new appointments at the moment, especially with their 2 week waits. Again, I know for a fact that less urgent patients are having appointments cancelled and rearranged to accommodate the more urgent cases because we don’t have enough staff or clinics on.

I really hope you get your nee appointment sorted soon!

@HeyDemonsItsYaGirl

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

I work in healthcare and fully agree with this. It would save a lot of appointments as people would be much more likely to attend (or to be able to attend!). I'm sorry this happened OP, if you discuss with your GP they should be able to re-refer and on the referral form explain the circumstances if you let them know.

I’ve never worked in appointments booking but I thought it was only a DNA if you didn’t call and notify them first. If they can reallocate the appointment then it’s fine.

SnottyLottie I think most reasonable people know things are busier & more difficult at the moment, however these issues have been happening for years before covid. We know people are doing their best but it seems there is too much room for error.
The admin systems need an urgent & drastic overhaul.

You do realise that tax payers pay for NHS dentists through taxes and then we pay again. Some dentists charge for late cancellations and DNAs. Should we have that system?

Dentists charge for late cancellation/DNAs because they allow patients to manage their own appointments. Patients are the ones who are in charge of scheduling the appointment and therefore it is a 2 way negotiation when an appointment is made and any issues with an appointment time can be sorted then.

If I call up and book an appointment at the dentist and agree to show up at 9am Monday, then it is my responsibility to arrive by 8.59am Monday morning. If there was an issue with that time (barring an unforseen emergency) then you have the opportunity to broach that in the initial appointment call.

Additionally the information re:charges for late cancellation/DNA is provided up front before the patient commits to an appointment and appointments are booked in that knowledge and therefore if you call up and nothing is suitable then you can decide if it is a risk worth taking to book anyway.

With hospital clinics etc you are usually sent a letter saying "We have made an appointment at X Clinic on Y day at Z time". The patient is given zero say in this appointment decision and if it is not convenient then instead of being given some flexibility you are usually just given another appointment and so the cycle continues, and that is provided you can even get hold of someone to tell them you can't make the appointment in the first place.

You’d be surprised how overbooked the clinics were before covid. The NHS is really underfunded and Covid is highlighting how severely that is.

In regards to the poster who said their letter was dated after the appointment, I’m really curious about how that happened. We’re not able to backdate anything or edit dates (to the point that if we put a patient on a 3 or 12 month PIFU plan i have to physically print off the standard 6 month letter, cross out the 6 and put the correct timeframe for their plan, then send it the letter out with a first class stamp - whereas standard letters are sent to an unknown printer and are sent out by a completely different department).

My husband got his hospital appointment letter the morning of his appointment!!! He was at work so missed the appointment rang the doctors explained The letter arrived at the day of the appointment and it was impossible to meet it. Told he would have to be referred by his Gp again as it went down as a no show so have to start the whole process again !! Pathetic like banging your head against as into a brick wall. I trued explaining the situation to the lady on the phone how can he be at his appointment when the letter arrived we had both gone to work that day , but she was adamant he was a no show so there was nothing she could do! Of course he was a no show he hadn't got the appointment letter till the day of the appointment 🙄

The underfunding is why we need to stop wasting the resources they do have.
My previous post about moving appointments from one hospital to another & not telling anyone - the dr I was seeing is one of the most senior Neurologists for a big London hospital. I see him once a year & know the apts change so I always call to check it’s still on a few days before - how many people do that? My last appointment I was the only person in the waiting room (never happens, ever!) I went in early because the person before me hadn’t turned up - maybe because they also hadn’t been told he was in a different hospital to the one on the letter. Given his job I would imagine this man earns a lot of money, what a waste of his time & our money to have him sitting around waiting for people who are not coming because they’ve been sent to the wrong place.

Contact your locals PALS & ask for their help.

Something similar happened to me, but turned out they were texting my landline🤦‍♀️ & we think it might have come through to our phone sounding like automated spam calls, which we often get bugged by. However it happened, I didn't get the appointments, so had no clue I was meant to go & of course didn't turn up. This Lara does to a load of problems getting appointments I could attend. They even gave me 2 almost at the same time, at different hospitals

PALS sorted it all out

You'll find their details on your local hospital website or maybe even GP website. Patient Advisory & Liaison Service (I think)

Oh & during sorting out my appointments problems, I found out that our local appointments service is privatised. Yours might well be too, so you aren't even complaining about the NHS itself

I’ve said this before. The NHS isn’t fit for purpose anymore. It’s not the 1940s.
We need a total overhaul. A cross party system that operates with joined up thinking.
Instead we get new governments every 5/10 years with new ideas. Which wastes time and more importantly money.
But it won’t happen. The NHS is too political.
There is too much resistance to change and it’s seen as a sacred cow that can’t be changed.

YANBU. The system is a mess. I was recently referred to a consultant for a possible pregnancy issue picked up at 20 wk scan. I arrived 15 minutes early and was seen almost 2 hours late. The appointment itself lasted 15 minutes and consisted of my answering questions that were already answered in my blue notes folder at my booking appointment. The sole purpose of the meeting, it turned out, was to establish whether I could stay under midwife rather than consultant led care. Again, all the necessary information to reach that conclusion was already on record and the decision could have been taken either in my absence or after a quick phone call. Yet I spent money and time travelling to hospital, and ended up having to organise additional childcare from the hospital to cover the ridiculously long wait. I’m sure the consultant also had more useful things she could have been doing. Just a huge waste of everyone’s time, money, and facilities.

I work in the NHS - your first appointment outcome should have been recorded as Can (cancelled) or UTA (unable to attend). The second should have been a UTA. As others have said, contact PALS and send evidence of you trying to cancel it beforehand and I'm sure they can update your record. 😊

And for lots of people there is never a good date/time.

Actually I agree, there’s never a good time for me to wait 3 hours for a 15 minute appointment, you’ve got a point there.

@FizziWater

Send a copy of your email cancelling the first appointment along with proof of isolating and proof of your new job to PALS.

She should do but what a fucking waste of time this is for everybody when they should have just answered the phone in the first place when she needed to cancel!

The system is not fit for purpose.

I have T1 diabetes. Wasn't seen for 2 years during the pandemic (I was due to have my annual appointment in March 2020). When I finally complained and was given a telephone appointment the consultant simply never rang.

During the 2 years I would get letters every few months from the department pushing the appointment further and further back and each one read: "You have requested to change your appointment."

No. I fucking haven't. YOU keep changing my appointment. And for no reason since the staff don't give a shit about them anyway.

@EssentialHummus

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.

Like a PP I suspect it's that we're a literate and generally middle-class bunch, some with experience of different healthcare systems, who recognise the gross inefficiencies inherent in the NHS. A patient should not have to routinely "inconvenience themselves to fit around an incredibly overwhelmed and understaffed organisation". We're not here to protect the organisation, none of us.

But this is exactly my point. To a large proportion of mnetters, the NHS is disposable. Not really necessary. Could go private if they really wanted. In that context I can appreciate the general annoyance when it is clunky and inefficient. To those of us for whom private healthcare is not a viable option....well I'm just really grateful to be able to see a Dr of any specialism for free, as needed. Clunky appointments system, waiting times and all. And I feel I am here to protect it.

I'm not suggesting for a moment that the NHS wouldn't benefit from more streamlined processes. But I do believe that a free, NHS appointment to see a consultant or specialist nurse should be treated as a priority by the patient, and not repeatedly rescheduled unless absolutely necessary. Resources are finite, and that's all there is to it.

Absolutely ridiculous - completely their fault for not answering the phone nor responding to your email. You should definitely make a complaint (I say this as an NHS clinician who is used to dealing with true "DNAs" - you apply a bit of common sense to figure out the time wasters from the genuine ones!)

YANBU. The NHS is a paternalistic, badly organised nightmare.

I wish I didn’t feel that way about it but my experiences as a person using services, a carer of those using services and also a staff member (for a short time - I couldn’t WAIT to get out) have been overwhelmingly negative.

I think that’s a different point opal (or maybe for you the NHS really is something to protect at almost all costs, I don’t know).

To my mind if I as the patient need to wait months for an appointment that leaves me in pain, or miss an appointment because I didn’t know about it, or any of the other examples raised on this thread - that’s not a system I want to protect or defend. If it doesn’t work to treat the patients it is supposed to be for the benefit of, that isn’t good enough. And people resignedly shrugging shoulders and saying “Oh well, they’re very busy” isn’t good enough (for anyone, at any income level) - I am as patient as the next person waiting in, say, a busy A&E where I know demand can fluctuate and life-threatening cases need to be prioritised. But the examples on this thread just speak to gross inefficiency. Resources may be finite but if they are routinely allocated in a way that delays treatment, increases costs etc - why is that something to protect/cherish?

I do have private healthcare and financial means but I will speak up against a system that doesn’t do what it’s supposed to do. And frankly it seems like I have a double advantage - the means to opt out and the literacy / articulated-ness to research NICE guidance and present myself to doctors in a way that works to my benefit. What about people that don’t? I think about the time I presented my 6m old daughter to the GP with bleeding eczema that kept her up at all hours. He wrote up the referral for dermatology and let me know that the wait would be 6-8 months. I rang up BUPA. We had an appointment the next day. What about the person in the waiting room next to me, who can’t just ring up BUPA? Is that kind of waiting time something to protect?

@opalescent

The NHS is NOT FREE. Taxpayers pay into it to fund it! Did you not know that?

Why does this ignorant remark keep coming up? That the NHS is 'free?'

Are these the same people who think that people who live in council houses/social housing get the house for free?!

It’s honestly absolutely shambolic.

I’m ‘lucky’ that I have private health care, I was supposedly referred on the 2 week cancer pathway, received a letter about 3 weeks later to say they were busy so it might be months!

Rang my private healthcare and got an appointment two days later. If I needed treatment in future I’d just go to them, one less person needing treatment on the NHS.

I attended hospital for my son's day operation recently. We arrived at 7.30am to an empty ward. The nurse said the other three children just hadn't turned up.

It worked for us because we got the undivided attention of the nurses, play specialist, anaesthetist, surgeon and theatre staff, but what a shocking misuse of resources!