NHS 18 week referral to treatment - help!

[NoManJan]

Just wondering if anyone knows anything about the NHS policy of 18 weeks from referral to treatment?

I was diagnosed with gallstones in December last year, I suffered a terrible attack with ridiculously high liver function readings. Soon after this, my GP sent me a e-referral log in so I could choose a hospital/consultant.

I have had 2 appointments with the consultant and an MRI since then my local private hospital where I chose to be treated. I have been patiently waiting for my op date for months and received a letter today telling me to go in for a pre op in late May and my gallbladder will likely be removed a week or 2 later.

The 18 week deadline is the 2nd May, however before I start kicking up a fuss and complaining - does anyone know if the 18 weeks is from the date I booked the appointment or the date I first saw the consultant?

Also, will they class the MRI as treatment or is the treatment in this case my gallbladder removal?

Thanks

Hello

I used to be responsible for updating our 18 week data and if I remember correctly clock stops at first appointment offered.

Thanks for your reply five. I've just found the page on the NHS website which states the clock starts when you book your first appointment through NHS e-Referral Service which means the deadline I worked out as the 2nd May is correct.

Not sure how to follow this up really...

If you're in England you could contact PALS but not sure you will make any headway with bringing it forwards. If they haven't got the space they haven't got it. Good luck though it's tough waiting.

Oh goodness if I was being treated at an NHS hospital I would absolutely suck it up and wait a few extra weeks without complaint. The consultant I saw last week told me that the op would be sooner hence my annoyance really.

I had a similar delay with an endocrinologist. Phone up your consultants secretary and say you're in pain and suffering and do you really have to to wait till then as it will be xx weeks since you first saw the consultant. You could also say how long you had to wait to see consultant for 1st appt if that was ages too. there is a fair bit of info on the Internet if you google it which may be helpful. In my case everything fired into action, so it was worth doing.

I think the 18 week wait is from the time you book to the date you see the consultant for the first time - not to the time you get your issue resolved . If you ring the waiting list person and tell them you are happy to take a short notice op that may expedite it and IME the waiting list people are normally very helpful.

Thanks for your reply Penny that's really helpful. I've emailed the NHS coordinator and director of the hospital, I will try and find out the details of the consultant's secretary to contact too.

I hate being a moaner but my quality of life is awful at the minute. I'm living on a very limited diet and I am too scared to go anywhere alone with my baby DD in case I have an attack. My liver function is still too high so I feel I need the op asap! Firing them into action seems a good plan.

Thanks Floral the NHS choices site says:

^The clock will stop (your waiting time ends) if no treatment is necessary or when your treatment begins. This could include:
being admitted to hospital for an operation or treatment
starting treatment, such as taking medication, that doesn’t require you to stay in hospital
beginning your fitting of a medical device, such as leg braces
agreeing to your condition being monitored for a time to see whether you need further treatment
receiving advice from hospital staff to manage your condition^

I've not had any meds or any real advice from the consultant so I think in my case the 18 weeks should be until I'm admitted into hospital for my op. It's as clear as mud!

Have you had any medication or treatment?

Clock started when you saw the consultant. Clock stops when you get any form of treatment I believe.

Best point of call is PALS not directors. Sometimes the PALS/Patient Experience Team are on Twitter too.

Clock starts on referral (or as you say your e-referral log in date). Clock stops when you receive treatment (not diagnostics) or when it's decided you don't need it. So it seems that you are right about it being 2nd May.

You say you are at a private hospital, but are you still a NHS patient? You can probably google the RTT failure rate of your area but not everyone gets in in 18 weeks. I think it's unlikely you'll get your date changed.

I've not had any medication or treatment at all. Only an MRI.

I'm an NHS patient at a private hospital, yes. Would it still be worth contacting PALS or do they only deal with NHS hospitals?

According to the NHS choices website 9/10 people are treated within 17 weeks in my NHS trust for this type of surgery, 15 weeks at the private hospital.

Thank you everyone for replying. I've never had any medical treatment other than when I was pregnant/giving birth. It's all a bit worrying.

PALS are unique to each hospital although every NHS hospital has one. Sorry I don't know if private hospitals do. I'd take the 9/10 with a pinch of salt, before November it was only counted at the time of the treatment - some hospitals deliberately book 10% over 18 & 90% under to meet guidelines.

thatwhichwecallarose has it right about RTT. By the sounds of your condition, your clock will stop on your op admission date (i.e. when treatment has commenced).

If your op is on the NHS, it will still be covered by PALS but I think that sounds a bit unnecessary at this stage. PALS will just refer it on to the dept manager who will speak to the booking staff. You may as well just do that yourself and cut out the middle men! Ask the booking team for you 18 week breach date (just to check) and for an explanation of why your op date has exceeded this. If you're not satsified, then go to PALS. But please don't be too annoyed with them, they have a hard job and may be struggling to adhere to the 18 week standard due to reasons completely outside of their control!

Thanks for the replies rose and cowbag it sounds as though my best option is to speak to the booking dept first.

It feels like it is being dragged out, more so because the consultant led me to believe my wait would be much shorter but obviously he doesn't make the schedules!

I definitely won't be annoyed with anyone, it's just one of those things. I think it's easy for it to take over your life a bit when you're ill.

It does sound odd that it's taken longer than you were told. In my experience, sending ops out to another provider does get them done much quicker (even when they remain under the NHS and the same surgeons). Maybe something unforseen has happened, like illness, problems with equipment or a problem at the private hospital itself? Definitely ring , you may have slipped through the net unfortunately so it's always worth checking.

Just want to say thanks again.

Cowbag you were absolutely right, it seems as though I slipped through the net. I spoke to the hospital at 9am and 5 minutes later I received a call back telling me they've now booked my surgery for the 20th April with my pre-op a fortnight before. The end is finally in sight!