To think that the NHS should phone you with a diagnosis before prescribing medication?

[illfallforward]

My mum has just been called to say that a prescription is ready for her. Turns out it’s a chemotherapy cream for skin cancer. Now fair enough it’s not the worst diagnosis to have, but surely someone should speak to her before she finds this out?! I’m just flabbergasted

OP l really think you need to contact PALS. Explain what’s happened, and your concerns, and ask if it’s possible to see someone at the clinic, or even arrange a telephone call to clarify the diagnosis and treatment. I don’t think the fact that the biopsy results were early is necessarily indicative of a mistake. Eight weeks is a guideline, but it depends on lab procedures/timescales and the results may have indicated a different diagnosis than that expected, requiring more timely treatment - and that could have played a part in what’s happened.

Whatever the case, you need clarification. Having had a cancer diagnosis last year, l can certainly empathise with the fear that just hearing the word can bring, and l can’t imagine being left to get on with it, without even an explanation of the condition, treatment or prognosis.

It’s dermatology not a&e, love. Clinicians shouldn’t get away with being like this.

It absolutely does need the input of a clinician, so if a formal complaint is needed to ensure that, then so be it. You’re right in that OP has no idea what’s happened, since no clinician has contacted her mother. How else is she supposed to get answers if no-one will return the calls and her GP refuses to get involved ?

You accused OP of being pedantic in your last post. Why is it pedantic to want a proper explanation of a cancer diagnosis and to have the opportunity to discuss the treatment protocol and any associated side effects before actually starting the treatment ?

Because for some reason everyone who doesn’t fall on their knees for the NHS is seen as a problem.

I always find it odd how accepting people can be of low standards of care. Telling someone their diagnosis isn't exactly a high bar to clear.

Agree. The kind of treatment your mum has received so far just makes you wonder what else may have gone wrong. The NHS isn’t infallible and mistakes do happen, and the advice from some posters here seems to be to simply shut up and get on with it, and don’t cause a fuss. Really bad advice when you’re talking about healthcare.

It's classic MN. An OP suggest they have received poor service, or that they want to complain about something and there's a massive pile on telling her she's being ridiculous.

I'm happy to decry the NHS. They are a despicable organisation. Greedy, bought out, not fit for purpose, lazy, dishonest..I could go on......

There. Now you have an ally so don't feel alone!

I genuinely think the biopsies are for the wrong person

I doubt it. It's possible that they just got the results back more quickly than anticipated and a script was generated off the back of that.

It's very poor though that no communication has been received; keep trying the dermatology team, and hopefully by next week the GP may have received a letter too so you could ask them (though in my area the letter is sent to the patient and the GP at the same time - we are in effect copied in to the patient's letter - so we don't get the into any quicker).

I hope you get some answers soon and that it's just a BCC or solar keratosiis needing Efudix and not a SCC.

I would rather have a diagnosis by letter and start my recommended treatment. Than wait who knows maybe 3 months, maybe longer for an appointment having no treatment, no knowledge of anything wrong. If she has questions or concerns about starting, she can choose to wait and not start until her appointment.
Maybe it’s a way of the NHS trying to avoid unnecessary delay in sharing a diagnosis and starting treatment when no face to face appointments are available asap.

My aunt had an appointment re her heart, then received a prescription for some fairly powerful heart meds without any diagnosis or discussion of treatment. She went through PALS to complain and I think 12 months later finally had an appointment to discuss her condition and was told she didn’t even need one of the meds!

I’ve managed to speak to someone and I’m baffled.

They’ve said she has to leave a voicemail. She then gets a call back from admin staff within 3 working days.

She then may have to wait up to six weeks! It’s unacceptable

You can't start treatment without informing the person receiving treatment what their diagnosis is and why they need treatment in the first place.

People already tend to panic enough when they hear the word cancer and finding out like this can make it worse.

Might not need a Dr to answer them all. We need to work together to be efficient. The pharmacist could answer qs about the treatment so could the GP or a specialist nurse. If we want to keep 2ww times for suspected melanoma then we need to work as a team and a consultant dermatologist should be able to delegate follow up of a non serious condition. I agree that there should be a better mechanism for this and that she should not have been alarmed by getting the cream with no explanation but we have to move away from one Dr being responsible for the whole treatment pathway as it is not sustainable. All the pieces in the system need to work better together. We can’t wind the clock back to a series of OP appts for non serious conditions that can be managed in other ways or wait lists will grow.

I don’t know why you’d worry it’s the wrong persons results. Clinically it looked like a mild form of cancer and that was confirmed on biopsy and a treatment suggested. This is all in line with what she would have expected surely it’s just that the communication has been wrong but no reason to think anything else is wrong.

Call her gp and ask if they have the hospital letter yet. If so, then explain your mother is very upset and needs a gp appointment or phone call to explain the result and the treatment. (And a copy of said letter and results.)

At this point that will be simpler than trying to get info from the hospital.

To be fair unless your mum has consented to them
talking to you then they can’t give you any information at all. Hence her having to leave a message.

I’m not saying any of this is right or how it should be, but most of us who work in the NHS are just trying to do our best, and we have to prioritise patients in order of need. I always tell my patients that hopefully no news is good news.

She finally got to speak to a consultant.

I never expected them to give out her information to me. But I expected them to at least organise a call, not tell her to leave a voicemail!

She will be making a PALS complaint.

That's great news, I hope they have managed to set her mind at rest.

The letter would have to be written by the secretary - s/he may not have typed it yet

The consultant confirmed it had been typed. But not sent.

In some departments in my NHS it goes into a typing pool. Both my husband and I are receiving letters stating they were dictated a month before they were typed up.

More unnecessary NHS failure. Our private consultants record our meeting into a system which uses AI to produce the notes and the letter to the GP which are emailed to us the same day or very shortly after.