To wonder what happened to this letter during the 37 days between being typed and arriving?

[cottonwoolbrain]

Hospital letter typed on the 29th April and arriving today - it was actually written on 15th but that's another story

. Not hugely urgent as such but a change of prescription which GPs refused to implement until they'd got the letter - understandable they'd not do it until they had the letter but means I've not started switching meds as I was instructed to do weeks ago and as they're strong ones it's a very long switch over period.

But how did it take so long to arrive? What happened to it during the 37 days between then and now... the Royal Mail is bad but not that bad surely? How has it got to the stage where it takes weeks to put something in an envelope and post it? I feel very sorry for the staff trying to keep up with all of this it must be horrendous.

How has it got to the stage where it takes weeks to put something in an envelope and post it?

Short staffed?
Too busy?

Often when it says typed on a certain date has been auto filled for the date of appointment or when your pathway was last updated, it doesn't always mean it was actually typed that day. There is also a time lapse between a letter being typed by an administrator and it being reviewed and signed off for sending by a Doctor especially if the Doctor in question is on leave or very busy with other clinical commitments for example. It then needs to be printed and posted by someone and no one does that as a job all day every day so there can be a delay unfortunately.

Short staffed?
Too busy?
Basically yes. The NHS is massively understaffed and overwhelmed.

How has it got to the stage where it takes weeks to put something in an envelope and post it?

Because that is the system in the UK.

The Consultant dictates the notes into a dictaphone or voice file. The medical secretary types up the notes, but she only works 2 days a week, so the voice file doesn't get touched for a week . The letter goes in the internal mail and takes a week to reach the Consultant, who only signs letters once a week ... but then puts the signed letter back into the internal mail for the secretary to post when she comes in next week ...

Everywhere else in the 21st Century has Consultants that type the letter or use a standard form themselves while the patient is there (it takes no longer than it takes to dictate) then prints it out and signs it there and then - and gives a copy to the patient and emails/intranets the letter to the GP.

I’m more intrigued by the postcard which arrived at my mother’s house 18 years after the date it was posted! We were a bit confused because her friend wasn’t away, then we noticed it referenced something I hadn’t done in over a decade, and when we checked with her she confirmed the date of the holiday. A bit of digging revealed that our local sorting office had just had new equipment fitted so I imagine this was found when the old machines were removed.

I had a letter 4 months after the appointment, which totally misrepresented what had (not) been said to me. I'm still raging about it. Clearly a box-ticking shit show.

It was more than likely

Dictated
Put in an electronic queue with others to be typed by a part time secretary, who has partially retired and only works three mornings a week
Typed up
Printed
Put in an envelope
Waited for the porter/postman who has other duties and may be carrying a emergency bleep, which takes priority when it goes off
Bought down to the mail room
Put into a pile with the thousands of other letters where it could have taken a couple of days to be franked (second class)
Put in the mail bin
Collected by Royal Mail
and then delivered by an increasingly unreliable Royal Mail

I can’t get over the fact that things like prescriptions/appointments are sent by post, what’s wrong with email.
I know it’s probably not suitable for people 80+, but surely most people under 70 have an email address?
DH has missed two appointments because letters took weeks to arrive.

@Fairyliz

Exactly or an app would be better.

I got 3 letters for the same appointment. I a week before and 2 the day before. I often get as many as 4 copies of my consultant letter. I am signed up for online letters.

Most hospitals now do have the option of accessing your appointment letters on an electronic portal or the NHS app. If they emailed you directly, it wouldn't be encrypted which is a problem when it contains all your details, NHS number and your private medical info.

It can be done, and is done by some trusts and all private consultants. You personally receive your letter by email direct to you, within a couple of days, copy to your GP. If urgent you attach email to GP econsult request, and they action it that day.

Yes it can be by hospitals that have systems that can process consent from patients to receive emails. Some hospital systems are very old unfortunately.

Where I live (I'm no longer in the UK) there is no waiting around for emails "within a couple of days".

The Consultant uses templates to write the letter / appointment summary there and then and I take a printed copy away with me if I ask for it. I can also receive a letter through the post instead, or request an email. The system automatically and instantly sends an electronic copy to my GP.

In the case of the OP waiting for a change of medication, the Consultant would have written the recommendation ("In my opinion the patient should stop taking Drug X and try Drug Y for 3 months"), would have given the patient a prescription for the first month and told the patient to book a follow-up appointment with the receptionist on her way out.

@Gingernaut Thank you for explaining

It's all a bit of a mess really. As i said I feel sorry for the staff dealing with this chaos - still at least it's here now.

Why ???

If the Consultant types up the notes there and then, with an automated, electronic system all of the other steps become redundant.

"Some hospital systems are very old unfortunately" - as are the attitudes of some Consultants (how dare they be asked to type up their own notes..!) and those of the NHS as a whole. Things seem to be done the way they have always been done ... because that's how they have always been done.

I believe that Fax machines might finally have disappeared (at one point about 10 or 15 years ago, I believe that around 90% of all remaining Fax machines in the UK were to be found in NHS hospitals and offices) but it still sounds like modern data-handling technology has yet to make any significant inroads in many institutions.

Think of the money wasted on stationery and postage. The time and effort wasted by people just moving one piece of paper from A to B - and sometimes back again. The time lost by the patients while they wait for letters, prescriptions, appointments etc. while their conditions deteriorate and their anxiety increases.

[For clarity, this is not aimed at NHS staff in general, but more at the culture that has been allowed to develop at Ministerial, Board and management level]

So I took a copy of letter and went to GPs. After much confusion they have finally managed to issue me with the correct prescription - well I hope so will find out when I go to chemist this evening - good thing I took a copy as their copy hasn't yet arrived with them.

Now going to be on 2 strong meds at once with one sliding up and the other sliding down over 12 weeks until the new one finally takes over completely - the only other time I've switched like this it was not pleasant so not looking forward to this particularly but since original is no longer as effective as required I'm stuck with it. Will probably need a couple of weeks off work in the middle when they'll be almost equal

That’s a nonsense. My DD had a hospital appointment this morning, her follow up appointment has just arrived electronically and our GP has just phoned to confirm a change in treatment - within 3 hours of the appointment ending. There’s literally no need for it to take weeks.

@Jellycatspyjamas

Depends where you live

@Jellycatspyjamas Very glad to hear it's working for you wish it was like that everywhere. I hope the treatment works well for your DD

Have just looked again - letter was actually written on the clinic date of 22nd April not 15th then typed on 29th .. looks like the drug confusion is kicking in before I've even started changing them

DH has missed two appointments because letters took weeks to arrive.

I can do better than that.

Moved house 22 years ago. Around about the same time I had a referral to a local hospital from my GP. After a couple of months, I queried it. GP said the letter had been sent but I was a DNA. Re-referred me, Again heard nothing.

Then, just by luck, I popped past the old place and a neighbour had the letter for me (had forgotten to forward it). Sure enough it was the missing appointment.

Attended and told everyone to update my details.

Letters were still going to the old address.

This went on for over a year. Every time I complained, they checked my address was up to date (it was) and the mystery deepened.

Finally, about a year after then I had 2 separate tests and the consultant gave me my notes to take to the second appointment. Obviously I looked, and there, at the back was a sheet of pre printed labels with my old address. I threw them away and haven't had a problem since.

The worrying thing is I have escalated this through PALS and my MP, and every time the hospital has insisted they have never used labels. So it can't have happened. So I am a fantasist full of shit.

Also no one I have spoken to in any role at the hospital says they have ever used labels.

If the Consultant types up the notes there and then, with an automated, electronic system all of the other steps become redundant

Maybe so, but consultants are not paid over £90k per annum to do the typing

They are mentors, teachers, on call out of hours, developing their own skills, overseeing and doing research, writing their own research papers, leading ward rounds, speaking at conferences, reviewing lab results, preparing surgeries, in theatre and are often part of a hospital's governance

Dictating what they want in the letters and clinic notes should be enough

It's not their fault that the people doing the admin work are on almost minimum wage and they are short staffed due to poor pay and prospects

The newer hospital systems work this way but not every trust in the UK has the funding to upgrade to an electronic record.

This! NHS administration urgently needs brought into the 21st century. There is a huge waste of money.

Maybe so, but consultants are not paid over £90k per annum to do the typing

I thought AI was going to do it all ?