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?

I meant hasn't.

But why couldn't/shouldn't the consultant be carrying out clinics at the private hospital? If the NHS are cancelling appointments due to covid issues (increased waiting lists, PPE/social distancing requirements, staffing levels etc etc) then surely that's irrelevant to whether he is also running private clinics.

If the consultant had specifically cancelled your DDs appointment so he could see a private patient at that time instead I could see your point. But you said it wasn't the consultant who cancelled it. So what the consultant does with his time when not employed by the NHS is irrelevant surely?

Hope your DD is able to be seen soon though

Thank you @FixTheBone, that is interesting.

So it sounds like there will be a set of criteria by which the "40" are selected then. I'd be interested to find out what those are for our clinic. As I mentioned, there was a suggestion in the (pro forma) letter that nobody is being seen but I do not think based on the responses here that that is necessarily the case.

@Gizmo79, you're right, it's not urgent, but it's not optional either, I truly wish it were. And of course she is no less urgent than any other paed patient attending that particular clinic. I'm glad to hear your paed patients are all treated the same

The formula is whoever is going to breech their RTT waiting time. If your on an annual review (normally called 'watchful wait') the RTT stops, which puts you near the bottom of the list of priorities (decided by management, unless your consultant has a clinical reason to prioritise you)

@WatchoutfortheROUS I'm not saying he shouldn't be doing private work, he's a great guy, probably has a mortgage and been doing private work Wed and Thurs for years and all that.

The consultant himself is kinda irrelevant, but I'm using him to illustrate that SOME services for the exact specialty, exact type of clinic, hell, the exact STAFF are going ahead, but only in a PRIVATE setting.

What I'm looking for is an understanding of what the rules are that mean that that is possible, but DD's NHS appt is not.

@Laaalaaaa that sounds like a good plan.

@notevenat20 oh dear, that is ridiculous. How frustrating. It's a major NHS hospital DD is at, I really hope it isn't like that.

Thanks @FixTheBone

If the consultant had specifically cancelled your DDs appointment so he could see a private patient at that time instead I could see your point

It's not all the consultants fault but they have a lot of status in hospitals. The fact remains that the longer the waiting list, the more they can charge for private care. They are highly incentivised to make the waiting lists as long as possible.

I had an appointment changed to a telephone one. I was very polite and asked if there was any chance I could be seen in clinic and explained my urgency. The secretary said they’re all telephone appointments now which isn’t correct. I said the reason I needed to be seen was because of a face to face appointment (biopsy) that I needed another one. I needed to be seen to have a wound examined, swabbed, packed and de-dressed. The secretary was quite huffy about my request to be fit in at some point. I ended up in A&E and needed IV antibiotics. I ended up more unwell than necessary and it certainly cost the NHS far more.

@Haenow oh no, that really is cr8p.
Have you got to the bottom of why you weren't seen in person when you should have been?

[quote ketchupthebear]@Haenow oh no, that really is cr8p.
Have you got to the bottom of why you weren't seen in person when you should have been?

[/quote]
Once I eventually saw the consultant, she wasn’t impressed. She said she’d happily see more patients. They are reducing the number of patients in clinics for social distancing and safety but it should be a clinical decision not a blanket “we aren’t seeing patients on Tuesdays”. I have another long term condition that I’ve had forever and it’s quite well managed but I need 6 monthly check ups. For those, a telephone appointment or even delaying the appointment is fine. I really do think cases need to be considered clinically but I do recognise the amount of time this would take.

@Haenow that makes me really cross on your behalf. Have you made a complaint?

I have to admit when it's me I often let things slide but when it comes to DD being d1cked around, I am ferocious.

My understanding is that cancellations should be triaged by a clinician: Some departments had to all but close down for a few months ( except for urgent cases) because either their staff were redeployed or the clinic and Ward space were taken over for other clinical uses.Appointments due now may have to delayed or triaged by phone, ( unless urgent) to get through the backlog caused earlier.

No Govt rule on it OP because it isn't the Govt who are preventing the doctors from carrying out their work. They want all non-covid work in hospitals to be up and running. Blame lies with management at the hospital/trust.

If you call the consultant directly he may arrange a NHS appointment for you at the portland (or another hospital). Have you asked?

We don't have specific rules. Our Trusts guidelines are very much down to local factors, local interpretation and individual departmental management trying to do the least risky things by all and therefore a changeable situation. We wouldn't be able to give you any formal rules as it were.

Thanks @Itsabeautifuldayheyhey, @Flittingaboutagain that's the picture that's beginning to emerge. @GrumpyHoonMain good point, I'll give it a go though I suspect the Portland won't subsidise the pathology and U/S that he'll need.

Purely on the logic side, what I don't see is how if you cancel / delay appointments you'll ever "catch up" if the list is growing anyway ... without a massive increase in capacity which would mean more people, space, equipment which I cannot see happening. So if triaged again, she'll be pushed down the list again by new "urgent" cases (they will actually probably all have the same condition) or those cases with a "time to treat" clock ticking.

I'll try the consultant's private secretary, any other ideas gratefully received. The NHS clinic have an answering machine on permanently and so far have not responded to my message or email requesting a call back.

Sorry OP. I hope you get sorted soon.

As others have stated it may not be that simple. The clinic space may have been reallocated to accommodate Covid red areas, staff reassigned to other duties, priorities reassessed. Is the Portland a non Covid centre while the other hospital is not perhaps.

I recently paid for a private important via Portland and it was also online.

@Itsabeautifuldayheyhey
What would you like hospital trusts to do ?
We are long term patients at a central London hospital - they have treated my child for 6 years and she is often an impatient.
We have been inpatients during covid for emergency reasons and due day surgery on Friday which actually isn’t an emergency. She needs a covid swab tomorrow and then to isolate until Friday.
The nhs hospitals tend to be home to many more patients than private patients, the most vulnerable patients are unlikely to be on private health care so keeping the nhs hospital safe is paramount. All our hospital appointments have been over the phone since March, her bloods have gone from 2 weekly to 8 weekly for the first time in 6 years and her heart echo has been postponed however I can vouch that emergency treatment is still going ahead and when needed treatment is still there.
I don’t know what you think the hospital trusts should do !

I honestly think some hospitals are making things up as they go along.

My DD (4) is short-sighted and has been wearing glasses since she was 2. She's meant to have checkups at the hospital every 3-4 months.

She last had a proper sight test in January and a check up in March.

We got a letter through for a phone appointment which I had last week. After pushing, they changed their plans for a clinic appointment from three months time to 1-2 months time.

HOWEVER, her two-year-old brother had his two-year check on the phone (fair enough) at the beginning of July. I mentioned the family history of early short-sightedness (I'm affected too) and asked for a referral to the hospital - my DD's opthamologist suggested he also get checked.

Three weeks later we get a letter with an appointment in the clinic for the next day.

So my DS who is not yet short-sighted (though they said from his check that it was likely he would at some point) got seen in clinic three weeks after referral (which was actually a lot quicker than my DD did originally pre-Covid!!) whereas my DD who is pretty short sighted for her age and hasn't been seen since March was fobbed off with a telephone appointment!

@Someonetakemebackto91 are you really asking @Itsabeautifuldayheyhey what she wants? I think it's pretty obvious ... to have access to the health service, which is what we all want for ourselves and our families, PPE'd up and phone but only where that's appropriate (not for wound dressing ... still can't get over that!).

From your report, your family has had access to urgent and non urgent care throughout the last few months and I'm really pleased for you.

I'd wager though that if that were not the case and you also had struggled to get care for yourself or your child, you'd be agreeing with many of the posters on this thread, and be baffled and more than a bit upset.

Speaking for my DD, we've had no care at all and her care is certainly 'needed' and not just for fun.

@Silversun83 did you see the post above where the "RTT" time was mentioned? I had to google it but it might be that the clock is ticking on new referrals and that explains the speed.

[quote ketchupthebear]@Silversun83 did you see the post above where the "RTT" time was mentioned? I had to google it but it might be that the clock is ticking on new referrals and that explains the speed.
[/quote]
Yes, that probably was the case. It just seemed bizarre to me that based on clinical need, it's obvious that my DD needed seeing sooner.

And I also don't understand how it took three months from referral for my DD to originally be seen two years ago when it only took three weeks for DS's referral during Covid when they're supposedly behind and unable to see my DD!

@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?

The NHS makes it's own decisions, as do each authority. Same as private dentists are allowed to do check ups and NHS are not allowed until January 2021 at the earliest.