DD's NHS appt cancelled but same consultant is seeing private patients

[ketchupthebear]

Can anybody direct me to the Govt rules saying which NHS clinics are allowed to run (with PPE, obv) for in-person appointments, and which are not?

I'm that DD's long-awaited review appointment that will involve the standard height, weight check, listening to chest, examining abdomen as well as taking blood and possibly altering meds has been cancelled "due to Covid-19" but the SAME consultant is seeing patients privately. Yes, I checked, and in-person appointments are available with him this week at the Portland Hospital.

I understand the initial pause on all non-immediately-life-threatening care, but what is the current situation?

Is the same consultant seeing patients in the same hospital though? I think often its more an issue of capacity, needing extra time between appts to change ppe, not having people sitting next to each other in waiting room, maybe less clinic rooms available etc.

In my Trust we are doing a mix of telephone and face to face appointments but each clinic should have no more than half of patients being face to face and ideally less.

The issue in my department is that most of the clinic rooms are not large enough to enable appropriate social distancing and if we saw the usual numbers of face to face patients then the waiting rooms would be overran with patients (normal pre-Covid).

It is highly unlikely to be a decision made by your daughter’s individual consultant but a wider decision as to how the department or Trust have told that consultant to run their clinics.

The private clinic is likely to be set up differently and in particular it is probably easier to manage social distancing in the waiting area.

We had this but with a different area of medicine. I think it came down to the NHS hospital's/Trust's guidelines, which were more restrictive than what the consultant could do in their own private practice.
I was v cross though.

It might be the NHS trust who has stopped face to face appointments rather than the doctor.

Yes as pp have said, it is probably not as black and white as it seems. And maybe there are different reasons that the consultant is seeing other patients (severity etc...) but I agree it must be frustrating for you.

The consultant's private work is irrelevant. It's their choice to do private work, but it's the NHS Trust's choice (working to DHSC guidance) how they operate NHS consultations.

If you're unhappy with your child's appt being cancelled then contact PALS and complain. If you believe your child needs medical assistance more quickly then contact your GP.

It won't be the doctor that stopped the appointments. My husband was pulled of his clinics into other roles on the wards for a while. Private practice was determined by the conditions at the hospitals where the clinics run. The doctor won't be doing private work when they should be working for the NHS.

agree with last 2 posts.

This is what happens when people vote tory. I hope your daughter gets seen soon.

I agree it’s infuriating. I’ve just had to pay 5.5 k for surgery. Not considered urgent because not life threatening despite suffering from a failed surgery and in agony.

You have to also think of the whole work chain. For a patient to be seen you need a secretary, who books the appointment. You need a filling clerk, who locates the file. You need a coding clerk, to assign the right codes to the case notes, so that the hospital gets paid. You need a secretary to type up the summary of care letter. That's all aside from the support staff needed to clean rooms, etc.

The hospital may not have the capacity to do all that. Whereas a private hospital will.

Unfortunately, I think this sort of thing has been happening for a while. Over 8 years ago, I had an NHS appointment with a consultant that kept being put back. Three times I got within a month of the appointment, only for it to get put back another 2 months. Then we realised I was also covered under DH's work private medical cover. I saw the same consultant at a different private hospital a week later and had my operation within a month.

Yes. Agreed. It won’t be down to the doctor, I’m sure he’d like to be seeing DD. That’s why I’ve asked about the Health Dept or other directions as to how / which NHS clinics can be run as it’s curious that the same service with the same key staff is being run in a private hospital but not in an NHS one and I’d like to understand what the differences in the set up are rather than simply moaning.

How does one get hold of the “Trust’s rules”? I appreciate the responses above, but we are reduced to guessing what is going on (not enough chairs in the waiting room? No filing clerk or typist?) which isn’t transparent or satisfactory. I’ve called to ask and had no call back. GP has no more information than we do. Perhaps I need to say the words “Freedom of Information request”.

The correspondence we have had suggests that no patients are being seen in person by the NHS service. Of course, that may not be correct. Perhaps you don’t let on to the families you are cancelling that others have been luckier? But then I’d expect to be told what the criteria are for who will be seen so that I can (once again) advocate for DD.

Social distancing within the consultation isn’t possible (see OP for the clinical detail) so, like dental treatment, it would need to be with PPE.

Saying “FOI request” won’t help, you need to make one. I do understand your point though I have to say having been seen in a clinic that was doing predominantly telephone appts, those who were being seen were definitely not lucky. :(

You have to submit an FOI request in writing, they then have to reply with in 20 working days.

@ketchupthebear

Yes. Agreed. It won’t be down to the doctor, I’m sure he’d like to be seeing DD. That’s why I’ve asked about the Health Dept or other directions as to how / which NHS clinics can be run as it’s curious that the same service with the same key staff is being run in a private hospital but not in an NHS one and I’d like to understand what the differences in the set up are rather than simply moaning.

How does one get hold of the “Trust’s rules”? I appreciate the responses above, but we are reduced to guessing what is going on (not enough chairs in the waiting room? No filing clerk or typist?) which isn’t transparent or satisfactory. I’ve called to ask and had no call back. GP has no more information than we do. Perhaps I need to say the words “Freedom of Information request”.

The correspondence we have had suggests that no patients are being seen in person by the NHS service. Of course, that may not be correct. Perhaps you don’t let on to the families you are cancelling that others have been luckier? But then I’d expect to be told what the criteria are for who will be seen so that I can (once again) advocate for DD.

Social distancing within the consultation isn’t possible (see OP for the clinical detail) so, like dental treatment, it would need to be with PPE.

Maybe look up what freedom of information requests actually mean before you go shouting it, OP. Wouldn't want to look a dickhead, would you.

The NHS have made it quite clear that they won't/can't offer appointments for lots of conditions. I don't agree with it and I worry just how many will die or suffer unnecessarily due to Covid-19 neglect.

Thank you @RevolutionRadio and @Haenow. Yes, it's straightforward, isn't it. The important part is confining the request to very specific information, a short range of dates, and, of course, not expecting personal data or commercially sensitive material to be returned. There are a raft of other exceptions too but those are by far the most common.

@ilikebooksandplants you made me chuckle. In a previous occupation I was very aware of how the process worked and had to use it many times for our clients ... am sure I could bore you with war stories ... but feel really the issue is how much public sector capacity is taken up by responding to FoI requests. I'd rather those resources be used in supporting the provision of other services so it's not my first option but hey ho, if I have to be the "dickhead" that demands openness and transparency, I'll be the one to stand up and do that, no thanks needed. It just shouldn't come to having to do that!

Enough side tracking though, has anybody got a reference for the actual Health Dept guidance to Trusts? I can't find it on gov.uk although there is so much info on testing, stats, new Covid rules that comes up on searches it could be there somewhere and I'm not finding it.

@StopGo @CornishYarg @Mummyoflittledragon , I'm sorry to hear you've been let down.

The Consultant is presumably still doing NHS work, but perhaps there is a backlog or change of priorities etc.?

It is your DD's appt that is cancelled - not all NHS work by that Consultant?

@RepeatSwan yes, it is the appointment that is cancelled.

The relevance of the consultant is just that the same speciality and type of clinic is being run at the private Portland Hospital and I'm curious as to how can be.

I'm not sure you'll find any 'specific guidance' in the guise you are looking for.

The hospitals I work in are using the summation of whatever the government decides is flavor d'jour and their own internal infection control and health and safety assesments.

To give you an idea, we used to see 180 patients per day in our clinic area, we're now reduced to 40 because of the extra time to clean the clinic rooms, the waiting area can only seat 7 patients with the requisite 1m spacing, add in that we have backlogs of thousands of patients that have to be seen in priority order, plus new referrals.

Compare to the private sector, far, far, fewer patients, larger waiting areas, and its obvious why there's a difference.

repeatswan exactly this- everything has been cancelled and postponed. Things are looking up again especially with paediatric elective surgery, and a lot of extra lists are being made with short notice -( much to the detriment of me sorting out staffing😢😢).
Private consultations have been going ahead due to their very different areas that they do them. If you were a PP due to come into my ward then you would have been cancelled sae as NHS. We take private and NHS as the same. No difference in treatment for children.

I would also say that - your appointment for your child does not meet urgent need. If you are concerned then fair enough, but a regular review would not currently be deemed as urgent anywhere.

Things are slowly opening up. I have a follow up appointment for a scan I had in March. I’m fully expecting that I’ll need surgery and I’m expecting I’ll have to go private if I want it done in a reasonable time frame.

Yes it's all bullshit.

NHS clinics are sometimes still completely shut, sometimes telephone only (which is nonsense if you need an injection for example), sometimes Zoom only and sometimes just open. There seems to be no central record of this or of the waiting times for the different clinics. Depending on where you live you might never be able to get to the appropriate clinic at all. I am amazed the Department of Health has tried to sort this out.