Joined up thinking NHS- sent to A&E when clearly it is neither

[Frankcat19]

AIBU to think we could save a lot of time and money with some joined up thinking. My son has broken his finger on holiday. We went to the nearest minor injuries department and spent 4 hours of our holiday getting the fracture and displacement of bone confirmed with x-ray. We were discharged and told to contact the fracture clinic back home when we arrived home to arrange follow-up.
Arrived home today and tried to call the fracture clinic. Was told I couldn't contact them directly and was transferred to the appointments line.
Appointments have told me the only way I can get a follow up appointment is to start again either through our GP but this could take months or their advice was to go to A and E today to start the process again and get him on the system.
I said but this is neither an accident or emergency that needs looking at today surely this isn't the only way. I was told it was.
I suggested I could try the minor injuries department instead and was told that might work.
So now I have to sit through the triage and possibly further x rays wasting mine and the hospitals time to get back to the same point I was at on Saturday! I am very grateful to have the NHS but this seems utterly ridiculous.

Assuming the original x-rays were done in the UK then yes this sounds like a waste of everyone’s time. If the x-rays were done outside the UK then maybe they don’t consider them to be valid (grasping at straws here..).

Why did you not try minor injuries? Ours tends to be a lot quieter than A&E, we were in and out in half an hour when DD scalded herself during cooking class at school.

Yes UK x-rays

If you read my original post I did go to minor injuries and that is also where I will go back to( It was a 4 hour wait).
However the suggestion made to me was AAnd E.

I guess it's because you started the process in a different area.
I suppose it needs a referral to a local fracture clinic and is something to do with cost codes and budgets.

This is kind of my point, no joined up thinking

I did read your post, you said you suggested it and "it might work" but you weren't clear that it was where you went.

Yes it's very frustrating. NHS Trusts are different organisations and (other than some very specific things) can't see patient records from other Trusts. They act like independent organisations essentially, so to move between Trusts, you'd generally need a referral which could take ages and since you're not actually a patient yet, no one could even make the referral.

I agree it's silly and a waste of everyone's time. It's infuriating for staff as well as for patients.

Yes, the bit that read “we went to the nearest minor injuries department” was especially hard to follow.

Probably be quicker to drive back to the hospital where you were on holiday (only half joking).

The holiday hospital did give me the notes and emailed our local hospital fracture clinic with x-rays so I guess I was just hopeful it would be more straightforward. It must be incredibly frustrating to staff and as I said before costing money and making waiting times longer.

Why don’t you try reading the OP before replying 🤦🏼‍♀️

OP - that’s nuts. Glad you had the common sense to suggest minor injuries - I imagine an and e would have been triple that 4 hrs!

Im surprised with the app these things aren’t automatically passed over?

Although it’s probably passed to GP and as you said that can take months

Do you happen to know who it is who insists things happen this way?

@Frankcat19 I hope everything gets sorted

Similar experience here, and same - like, why is it this hard, and why waste so much time and resource?!

Injured abroad (fracture), travelled home in plaster with printed notes and X-rays and instruction to get follow up on x date.

GP were contacted when I got home, and given all the notes etc, but totally failed to make the fracture clinic referral, and were very off when chased up to check that it had been done (which it hadn’t)

Fracture clinic directed me back to GP, then to minor injuries unit when I said GP had not done anything.

Lost a full day in MIU purely to get a referral to the Fracture clinic, which now doesn’t run for another week. Argh!!!!

Sorry to hear you are having similar issues 😞

I'm always gobsmacked when posters miss a vital part of the thread. It happens so often on MN. I hope this isn't an indication of adult reading comprehension in this country.

I live in Scotland. A couple of years ago I had to go to minor injuries in Devon after an insect bite on my face got infected (was sent there by a pharmacist). Staff were great but they could not access any of my records as the NHS Scotland and NHS England systems do not "talk" to each other, when she asked me to put in my home postcode it came up as foreign.

Organisation which is far too big, far too complex and stuck in the 1980s with technology.

There was something on the news today about the number of NHS appointments being missed because thety insist on sending out letters in the post.

Honestly it’s bonkers. My DS had a lump come up on his chest a couple of years ago, nursery insisted it was an A+E job so we went. They were very good, x-rayed it, came back clear. Said he needed an ultrasound but they couldn’t refer me, I had to contact my GP. Rang the GP 3 days later when the hospital said they’d have had paperwork by. Had to make an appointment with the GP for him to refer us back to the same hospital for an ultrasound. What a massive waste of time and resources.

We had a similar thing years ago when DS broke his arm on holiday. We went to the nearest a&e they xrayed and decided he didn’t need surgery and discharged him. We travelled home the next day as it was the end of our holiday. The only way we could get to local fracture clinic was to go to local a&e even though he didn’t need it.
I agree it’s a ridiculous situation and seems a waste of nhs a&e resources.

If the MIU emailed the x-rays to your local fracture clinic, why on earth didn't they send a referral to them, rather than telling you to self refer, which often isn't possible?

Ive heard of this before, a child who broke or fractured an elbow, the referral process to the fracture clinic wasnt done or no joined up thinking like you say and now been left with life long problems from the fracture not being treated properly

We had this when my daughter had an accident on holiday. Basically had X-rays in Portsmouth and needed fracture clinic in Dudley. They wanted us to start again. After about 3 hours I finally spoke to someone with a brain and managed to get them to email it over. It was beyond ridiculous.

A huge amount of time and money is wasted in the nhs. I had a cat bite a couple of years ago, knew it would more than likely get infected, called my gp, spoke to a dr on the phone with a call back, antibiotics prescribed and collected from my local pharmacy within three hours. Similar happened to my husband earlier this year, called the gp, apparently they don’t deal with bites any more so had to drive 40 minutes to MIU and wait for two hours to be seen, and another couple of hours for the prescription. Could have been dealt with five minutes down the road or over the phone.

No one says things must happen this way. It's been an evolution from when everything was paper based. As Trusts are separate entities, they procure their patient record system via the legal procurement routes which means they often end up on different systems. Some areas are joining up to do joint procurements now but this would only be in an area so it wouldn't make any difference in this case.

There have been attempts at various national IT / digital initiatives in the past. The complex ones tend to fail. NHS app has worked but it doesn't contain hospital records, that would be extremely complex and would cost too much.

If the government wanted to change all this they could, via NHS England (soon to be subsumed into the Department of Health & SC) but it would cost far too much so they won't.

If every gp practice and hospital was able to access your medical notes, everyone here would be shouting about data security and privacy. It will all be so much easier when it's on the microchip in my left bicep.