to really have it in for GP's surgeries...

[mersmam]

Had an appointment with my community midwife today (I'm 30 weeks pregnant and haven't seen her since I was 16 weeks, which was when she made the appointment.)
Got to the drs surgery to find it locked and a notice up saying that the surgery is closed this afternoon for staff training! As far as I'm aware there has been no attempt to contact me about this! I rang the midwife's office straight away but could only leave a message and have so far had no response.
Am really annoyed as have arranged my whole day around the appointment (and DH had arranged to work from home so he could come too).
Generally I am just sick of the whole GP system - I can never get an appointment at a convenient time - when I do I always have to wait at least half an hour (no joke with three DCs under 5) and the staff on reception are rude.
I asked for a home visit once as I was ill along with all the DCs and you'd think I'd asked for the moon...

The thing with the midwife today feels like the final straw...

Should I change surgeries to somewhere further away (which would be less convenient?) or are they all like this?

You're right Macdoodle, it isn't acceptable for the patients to speak to us in the way some of them do. I've had some absolute horrors in the way they've approached me and the things they've said.

But you just don't respond to it. I'm not wanting to come across as smug, but if you persist with trying to be friendly and helpful I have found lots of them actually calm right down and end up apologising.

And I'm not ranting about the rude staff (and again it's not just GP receptionists) I've had dealings with, I'm just relating my experience over 30 years working in the NHS. That doesn't take anything away from those who are friendly and helpful - there are plenty of those. But if we never raise our concerns about those who aren't like that how are things ever going to change?

I just don't see how rudeness and being unhelpful can be justified.

It goes further than that.

It is made very difficult to complain at a time when people should be treated with compassion.

I spend more time than I would like talking to Dr's receptionists and MHS admin staff and have to say IME they have generally been very good although there is always someone having a bad day.

Where I have been really shocked though is how some of hte admin staff treat both Drs and patients as not worthy of their notice or interest - this seems to happen particularly in hospitals where DH has been standing with consultants who are waiting to give instructions on what steps need to be done next while the admin staff file nails and talk about their weekends thereby either dramatically limiting the nos of appointments (20 extra minutes to deal with admin) or delaying everyone else waiting.

Myfriendflicka - I'm sorry I missed your post. Of course the way you were treated is not acceptable - and your practice showed that by changing their procedures. What I will not accept is the extrapolation that therefore the NHS in general and GP practices in particular are indefensible! They aren't - they provide an excellent service in difficult circumstances.

'The NHS, and its staff, should be a lot more accountable than they are.' - I'm afraid that is simply a very ignorant statement. The NHS has a culture of audit, scrutiny and patient safety which is highly developed and continually improving. It's employees work to internationally recommended standards of care. If Macdoodle messes up she faces being struck off by the GMC and unable to work. The same sanction applies to all other health care professionals. I am tempted to think however that none of this is enough to satisfy angry patients - but I'm not going to subscribe to public flogging so it will have to do.

I can see why your experience has coloured your impressions of the NHS but it is totallky untrue and unfair to say that the organisation is incapable of care for the dying or of showing compassion.

Surfermum - I have never said rudeness is justified. I have tried to explain some of the factors that act on staff but I have never said (though several posters obviously feel that I have) that their bad experiences are self inflicted. The NHS isn't perfect (I think that's probably my third time at least of saying that) but generally it does an excellent job. What I and other NHS employees are NOT prepared to do is be everybody's whipping boy.

littlestbadger - what kind of hospital is your dh attending? I can assure you that in my NHS trust any member of admin staff attempting to file their nails instead of responding to a hospital consultant would swiftly be moving towards the door! However you can be reassured that these arrangements don't limit the number of appointments offered - no extra time is built in to clinics for admin - the doctor is just expected to finish their list when it's finished.

I'm not saying that that GPs are indefensible - I am saying that when things go very wrong, it is difficult to complain and it is the last thing you feel you have the strength to do at the time.

The time limit for taking complaints to the Healthcare Commission, for example, should be a year or maybe 18 months. People get stronger during that time, and would be able to try and sort their complaint out using that route. Because it is only six months, you are still reeling from the death, or whatever has happened, and it feels too stressful to launch a complaint within that time.

A small change like that would make a world of difference.

I have reread a lot of the thread to try and make sense of it all.

Certainly it does seem that some people have had very bad experiences. Some people seem to always have bad experiences which i would think is probably due to the culture at those particular places. It is clear that different places of work have different "atmospheres" and ways of doing things, not just in the NHS but in all jobs. Those of us who are having a bad time maybe are at places where the culture is that it is OK to be dismissive of the patients.

I did complain once to my GP surgery - about the time I had to pay £££ to make an appointment (I said £9 earlier but actually can't remmeber now - it may have been more but i didn't want to exaggerate - there was a thread about it at the time). The response was that there was nothing wrong with the phones and everything was fine. Despite the fact it kept sending me round in circles and back to the beginning.

So I don't phone for appointments any more, I go in person with my DH which isn't too bad as luckily he works shifts and so is around quite a bit to come with me.

If he worked normal hours I don;t know what I'd do about getting appointments - but luckily that hasn't come up yet.

The hospital thing is different and I really don't have the strength to complain. All I know is they are really rude, never make eye contact, just hold their hand out for the letter, and then sometimes it turns out the appointment has been rearranged but no-one has told me so I just have to go home again. I just feel so totally worthless and it upsets me so much. Why not just say sorry your appoitment has been cancelled? Why be aggressive about it? And all the time I am using up precious time off work.

I have talked again to DH about cancelling my remaining appointments but he is right - what do we do when it is time to have the baby. I really want to just cancel them and try to forget the whole thing, I'm just so tired of being treated like I'm wasting their time by coming for appointments and ebding up in tears the whole time.

Lke it has been said maybe it is my attitude that is wrong -many have said that patients are rude and awful so maybe this is how I am coming across without realising it. If I don;t know I'm doing it though I don't see how I can change. In the meantime I am going to keep thinking hard about what to do I have a lot of appointments booked in and I am really frightened about them.

Flicka - just been doing a quick google and have found reference to the fact that you should complain within 6 months of the event (or of you becoming aware you had a complaint - so if your smear was misread but you don't find out for 3 years you can still complain) but that this timescale can be waived in exceptional circumstances. I would have thought that your bereavement and consequent mental strain qualified as such. Were you told that you couldn't complain because it was later than 6 months? If so that was wrong imo. Also I've found that the complaints procedure is being simplified from April and if you are not happy with the Trust response you can go direct to the ombudsman rather than the commission.

I'm not singling you out Northernlurker as having said anything (I rarely remember who said what in a thread like this ). Lots of us in the NHS have the same factors in our workplace and don't feel the need to be rude or unhelpful. It's not the factors that influence the member of staff's behaviour, it's how they choose to react to them. And I am bearing in mind that none of us are perfect and we can all react in way that we wouldn't normally. But having said that, my experience is that there are people who are just very abrasive all the time and it's not just a "bad day".

There are times though when the perception of the patient is that we are being unhelpful, when in fact our hands are tied by the systems that are in place. But again, there are ways of getting this across to the patient without being rude.

What do you mean by you aren't prepared to be everybody's whipping boy Northernlurker?

The thing is I don't understand why it's not acceptable to complain about genuinely bad experiences.

On the one hand people on this thread are saying it is important to complain and on the other hand they are condescending, accuse complainants of 'ranting' or being 'bitter' or implying that they are a bit stupid, not entitled to an opinion and lacking in knowledge or undersanding and that their experiences probably didn't happen that way at all or that their feelings about how they were treated are not legitimate.

Can you see the problem here? Especially when attitudes about those who legimately complain or speak frankly about the distress that they have experienced are mirrored on a wider scale in the NHS.

When somebody has had a bad experience they want sympathy or an opportunity to discuss this experience and assurance that their experience will not happen again to them or anybody else.

They do not want or expect to be attacked.

Actually on this thread there are many positive comments about the NHS or various aspects of it. But just because you value the NHS or parts of it does not mean you should shut up about its failings.

If the NHS or the parts of it that are failing do not listen to patients or take their concerns seriously then they will not learn from mistakes or improve.

It is wrong for people to defend some of the errors that people describe on this thread and deeply unhelpful. When people have lost trust in the NHS or parts of it what they want to know is that their concerns are taken seriously and this is not what's happening here.

surfermum- sorry that last bit wasn't particularly directed at you either! What I meant is that I feel it is often the first port of call for patients to blame the NHS for incidents which in a purely objective sense have attributable factors lying outside the organisation or to blame all the organisation for the error of one part at one time.

Most of us accept that many people who work in the NHS do a wonderful job.

That doesn't mean it's not OK to talk about the times and places where it doesn't.

Where people express disillusitonment with the NHS as a whole may very well be the way in which refusal to acknowledge failures or respect the views of patients and their feelings has become institutionalised. This is not just the experience of one or two people. It is backed up by the research which suggests a huge number of patients' complaints are badly handled or ignored. You cannot then blame patients for not using the complaints procedure or for feeling let down by the NHS as an institution.

The fact that people on this thread like Northern are setting themselves up to defend the NHS against any sort of criticism and imply that people here don't really know what they're talking about or haven't hadnled their problems properly adds to the perception that the NHS does not always have compassion for patients and is not always willign to acknowledge or learn from its failings.

But Northern there is not one complaint on this thread that is like that.

I'm sure your right that there are some patients who complain without grounds but that is partly a result of poor communication on the part of the NHS or the fact that they feel very vulnerable etc but for every one person like this there are 10 people with legimate concerns which need to be acknowledged.

Nobody mentioned my example earleir. It is typical to be kept waiting for an appt. but atypical to be told why or to receive an apology for this. Patients would be a lot more sympathetic and less likely to get stressed or feel let down by the system if they were treated with this basic respect.

You have my sympathy Flicka. But also as I've said complaining especialyl whre it is badly handled can just add to patient's distress. In the end for many it is easier just to try and forget about the incident. There are no doubt many hundreds of patients who are put off by the complaitns procedure or don't have the emotional energy to complain and even where they do the complaints are often badly handled or ignored or met with the awful sort of attacks as on here where it is implied that it is somehow the patients fault..

I'm really glad that I have been on this thread it has enabled me to see things a lot more clearly. I think I have seen a way forward, and am going to look forward with some pointers I have had from people on another thread. It should entirely get around the whole hospital receptionists/cancelled appointments/getting really upset stuff without having to complain or have any further difficulties. I just have to convince DH! Feeling a lot better though

I still think that some of the things that have happened to me and others have been really awful, whether it was our fault or not I don't know, but certainly if these situations can be avoided then so much the better.

I'm getting pretty fed up of reading that I (and others) have told you everything is your fault fivecandles. That is not the case. I just won't accept that the NHS is the negelctful, uncaring organisation that you are implying it is. You speak of a huge number of complaints being ignored - whilst I was looking at the information for Flicka earlier I came across the healthcare comission's latest stats:

Each year approx 380 million treatments are carried out

These result in 135 000 complaints or 0.035% overall

of which 8 949 or 6.6% were referred on to the commission

30% of these were upheld - about 2685 - and 17% sent back to the Trust for 'more work to resolve'. Now I believe that this is 135 000 complaints too many, no complaint rate is 'reasonable' but surely you can see that we are talking about very small numbers here who feel their issue was unresolved. The commission found in favour of the Trusts in 18% of the complaints.

Tumtumtetum - I personally think you need to take somebody with you to advocate for you at your next appointment. Do you have a friend who has had children who could do this - or you could try approaching a doula to be your ante-natal back up then support you at the birth? Failing that - the PALS officers I work with in my trust wuould certainly come to the clinic with you to ensure you were comfortable - I can see no reason why your Trust's PALS wouldn't do similar?

But you see I've never said or even implied that the NHS is neglectful or uncaring as a whole.

I have spoken very specifically about particular examples of unhelpful attitudes or incidents or systems.

The fact that you interpret what I and others have said as some sort of general attack on the NHS is worrying.

As I've said, if there are people who are disillusioned with the NHS it's because of attitudes like yours - that it's not ok to raise specific issues without being interpreted as 'ranting' or 'bitter' etc etc.

And also you've not read the data on how those complaints have been dealt with.

Or read my posts and others where they've said that the complaints procedure is so intimidating that many are put off from making a complaint in the first place. Or feel so emotionally traumatised or distressed or lacking in trust with the NHS that they just want to try and move on rather than deal any more with the very institution that has caused the problem.

When I tried to complain offically through PALS I never got a response. In the end complaining was adding to my distress and I just wanted to forget about it. There must be many people who never even get to the point of complaining as is evident here because they don't feel that they have the strength. And when you look at how the complaints are dealt with you can see their point!

Please read this for example:

www.guardian.co.uk/society/2008/oct/10/nhs-health

And this 'Roughly half of all NHS patients' complaints are likely to receive an "inadequate response" from NHS trusts supposed to deal with them.'

?.htm

Northern please think about these questions:

1.) Can you not see that it is possible to be unhappy with a particular experience, system or attitude within the NHS but still appreciate the wonderful work done within the NHS and really value the principle of the NHS?

2.) Can you not appreciate that often patients who have had bad experiences just want somebody to listen to them, accept their point of view and provide some sort of assurance that lessons will be learnt as a result of their complaint (however this is made and whoever it is made to)?

3.) Can you not see how your blanket defense of the NHS as a whole is adding to some people's feeling that their concerns are not being acknowleged or taken seriously?

Sorry this was the other article ?.htm

No, still not working. Last try:?.htm

'As a result the biggest single cause of complaint was that a previousl complaint had not been properly responded to. This rose as a proportion of the total, from 16 per cent last year to 19 per cent now. '

?.htm

Really it beggars belief.

But people like Northern need to realize that although the incidents being described here may seem isolated they all add up and the stats. do point to systematic failings.

There's an irony in that the attitude which refuses to take patients' complaints seriously nationally is being reproduced here on a smaller scale.

And this from the Times Online (can't seem to get links to work,

'The report by the Patients Association described the NHS complaints system as ?cumbersome, variable and takes too long?. Of nearly 500 patients polled, 69 per cent said that they had wanted to complain about the healthcare they had received in the past five years.

For those who complained, 29 per cent described the process as totally pointless, 20.5 per cent as pointless and 19 per cent as slightly pointless. Only 2 per cent said that the experience had been ?very useful?.

More than four fifths (81 per cent) believed that there was not a culture of openness in the NHS when errors occurred and that staff were not encouraged to report mistakes.

Related Links
Patients ask for second opinion on hospitals
The association's report concludes: ?While patients will always accept that errors will occur in any health service, what they will not accept is the fact that staff are not open about admitting such errors occur.?'

Sorry, but the evidence is overwhelming.

135 000 complaints - just about 9000 go to the healthcare commission - that's 124 000 that are 'adequately' dealt with by any standard we can use to judge. I've read the information on the HCC website - where they express a concernthat people are not complaining because the process is not transparent enough - the HCC has made recommendations and the overall process is being simplified from April. I have continually said that patients should feel empowered enough to complain - because we can't fix what we don't know is broken. If you don't do that - whilst I regret the system which has so disempowered you, I am limited in what I can do to fix the situation.

You said 'for every one person like this there are 10 people with legimate concerns which need to be acknowledged.' - which implies that there are in your opinion at least 1.5 million people out there unable to complain - but you have no data to back that up. The implication you are making is a negative one - and I'm not prepared to let that stand. You also said 'Where people express disillusitonment with the NHS as a whole may very well be the way in which refusal to acknowledge failures or respect the views of patients and their feelings has become institutionalised. This is not just the experience of one or two people. It is backed up by the research which suggests a huge number of patients' complaints are badly handled or ignored. ' The most recent figures are as I quoted - less than 4, 500 complaints where this was the case - out of a total of 380 000 000 treatments. Can you not see why I feel your statement is unfair and unwarranted? I'm not sure what you expect me to do with the piece from the Guardian. The quote from the patients association is opinion not data - whilst I would agree with aspects of it - and it's not clear how the NAO established that '1 in 7' are unhappy but fail to complain. There is obviously an issue of perception here too - I think it was flicka who had quite rightly complained and seen her practice change it's policy? She still felt negatively about that situation though and I would ask you - is it possible do you think for the NHS to properly address your concerns? Could we ever get you to a place where you would say that the NHS is broadly delivering a good service TO YOU? Quite honestly - I'm not sure that it is - which is very depressing. You're obviously aware that the complaint process is being simplified this year - does that not strike a chord with you at all?

Tbh - I'm not you even sure you're reading my posts properly? I've just used the search function and established that I have NEVER even used 'ranting' or 'bitter' on this thread. It is unfair to suggest that is my opinion of service users.

Your other points:

'Can you not see that it is possible to be unhappy with a particular experience, system or attitude within the NHS but still appreciate the wonderful work done within the NHS and really value the principle of the NHS?' - of course I can see that - what I resent is the failure to display any of that appreciation on threads such as this. The founding principle of the NHS is universal healthcare free at the point of use - you'd have to be very perverse and/or conservative to not appreciate that principle!

'Can you not appreciate that often patients who have had bad experiences just want somebody to listen to them, accept their point of view and provide some sort of assurance that lessons will be learnt as a result of their complaint (however this is made and whoever it is made to)?' Of course I appreciate this - I do this in my job every day.

' Can you not see how your blanket defense of the NHS as a whole is adding to some people's feeling that their concerns are not being acknowleged or taken seriously? ' I think you mean your conerns - and if you persist in misreading my posts I'm afraid you will feel like that.

Right - better go do bedtime now.