Long awaited Neurosurgical Appt just cancelled, can I...?

[Smee]

Have had a back problem for 3 years. Seen the surgeons a few times before, but they wanted me to try some spinal injections before operating. I had an appointment booked for next Wednesday, and have just heard the surgeon's cancelled his clinic. A letter's come saying my appointment is rebooked for the end of May Does anyone know if I can/ should / have a right to insist on being seen earlier. Am so hacked off, as the pain and lack of mobility's crushing and I thought by seeing him, at least I'd know what was coming next. To have to wait another three months is just cruel. I do know they can over book clinics as they've done that for me in the past. I just want to be clear before I call them, what my rights are.

bumping as I have to call them this afternoon. Anyone got any idea?!

i don't know about your 'rights' from an nhs perspective, but it sounds like utter bullshi* that they have cancelled your appointment for all the reasons you mentioned. i think you should call and say as much, with a smile, if at all possible. if that person doesn't help, just simply ask to speak to their supervisior. be nice but firm. if you can, maybe try and visit in person rather than over the phone. don't let them fob you off! good luck!

Thanks Mimsy. I have had a quick friendly conversation with a rather lovely woman at the central appointments line, who said she thought it outrageous. She gave me the Consultant's secretary's number. Which is of course on answerphone.... I will pursue with a smile, but with determined grit

ah well done - sounds like you made good progress. hope it works out for you.

at such short notice, it's unlikely to have much to do with the consultant, unless it's an emergency (compassionate leave etc)

What DH has found is that central appts overbook his clinics all the time. Or they book up a clinic for his registrar, who'll be unavailable cos he's on holiday or doing nights. The week before, he gets his secretary to print out the clinic, and then makes central appts cancel the overbookings. He's 99% sure that central appts say to the poor patients, 'the consultant has cancelled your appt' Hmm For 4 years now, he has complained, complained, complained and got nowhere

Highlander - that's awful but makes a lot of sense. My last pregnancy, which was very medicalised, was full of 'bait and switch' where I would be told I'd be getting a consultant and ended up with very junior registrars. [nothing against registrars but when you expect someone senior...]

Can I just say as someone who works in outpatients appointments that we don't do it for fun and in my trust we do not overbook without the sec or consultant say so. Why the hell would we cancel a clinic for fun ? Have you ever done it ? Especially at short notice it is shit. In my Trust is generally a case of a consultant/reg/clinical asst having something in their diary and forgetting to notify us in time so the clinic has to be cancelled at short notice. Given that we have to physcally cancel the clinics, move the pts and contact them direct, I can confirm that we are very very very rarely the instigators of the cancellation.

Are you a new pt, Smee ? If you are a new pt then you have to be seen and given your first treatment within 18 weeks. In my trust new pts have to be seen within 5wks.

FWIW, I feel your pain as we have big wait list problems with our neuro patients. Our next avail f/up appt is September.

Our hands are tied.

Some consultants will allow overbooks, some won't.

If there are no slots then we can't offer you anything without arranging extra clinics which lots of consultants refuse to do (despite getting a HUGE amount of overtime for, which everyone else involved in the setting up and running of the clinic is not privvy to), which we have to get confirmation of funding for, confirmation that there is actual physical clinci space to run a clinic, available nursing staff to assist. Sometimes we can;t even get funding for the extras and so pts end up languishing on a waiting list. Some of our dermatology patients are waiting 18 months for a follow up because there aren't enough doctors and the trust will not fund extra staff in the long term.

TBH, OP. Your best bet is to go back to your GP or whovever referred you and ask them to request by letter, that your appointment is brought forward due to the severity of your symptoms. Unfortunatly there is only so much a phone call of 2 can do.

Thanks everyone. I'm a bit like your DH Highlander, as this has been ongoing for 3 years, so in some ways I am a bit of an expert on the games one has to play, but this one's stumped me a bit. I'd guess your DH is the same, but these appointments are so precious, and I was so well prepared and geared up for it, that to have it snatched away has really hit me.
And TTP, I honestly do feel for you as one who is on the end of the phone. I know it's not the central people's fault, nor probably is it the Consultant's, but it does bug me that it's three months 'til the next appointment. Apart from the physical pain, the psychological effect of having to live with all of this is far from great.
To put this into a bit of perspective when all this started and I was first put on the list to see the Neurosurgeon (same consultant), I had to wait ages for an appointment so I looked him up on the net, found his private clinic and called. Surprise,surprise for £200 I could see him in 4 days time . The big man himself was a bit embarrassed when I explained, and agreed to me being treated back within the NHS system, but there's something wrong here isn't there. Okay so I could afford £200, but I still hated queue jumping, as it's just so unfair. He is a good man who I trust, and they're doing their best for me in lots of ways, but the fact that he rakes it in with his private clinics, whilst NHS patients have to wait and wait really gets my goat. Am trying to stay Zen though really I am (like yeah.. )

The number of pts seen by a consultant on the NHS compared to their private lists is, sorry to say, completely irrelevant as whatever work a consultant chooses to do privately has no bearing whatsoever on his/her NHS lists. A private clinic is almost always going to have a much shorter wait list to an NHS clinic, just because of sheer volume of people referred.

The consultant will have very little say in the number of patients he can see on the NHS as the funding is set out by the individual Trust, not the doctor themselves. So instance, a Trust may only provide funding for 2 neurologists to each see 10 new patients a week, regardless of whether the consultant wishes to see more or less than the funded amount.

The waiting lists are incredibly frustrating to all involved, believe me . Pts get frustrated because they can't be seen, doctors get fed up because they are seeing 3 month follow ups in 6 months etc and admin staff are fed up because they have no slots to offer and therefore end up as the whipping boy go between who takes flack from all sides. It is completely rubbish. The only way things are going to improve is if Trusts get more funding for more consultants / more clinics to get the lists down. Unfortunately the peole who make those big fundung decisions are happy up in their ivory towers and seemingly oblivious to what the people of the floor are dealing with.

Smee - Highlander's DH is the consultant in his scenario, not the pt

Oops, sorry Highlander. Your DH sounds like a very sound, sane and undoubtably lovely Consultant.
Thanks for the info TTP. It's good to hear the background, and honestly I don't blame any admin staff, or the Consultants. The system however does as you rightly say stink. Money seems to come before patient care in private and NHS, and though I agree many Consultants want to help more, they also often have their private clinics now don't they? In my area, it's probably lack of funding from those in the ivory towered inhabitants that get your goat, but equally there just aren't sufficient Neurosurgeons to employ. Possibly because they're too busy seeing their Private Patients . I was also told by another lovely admin person that he despairs as to how many people who really can't afford Private treatment end up taking that route because the waiting on the NHS system is too long for them to cope with.
On a more positive note, my Consultant's most excellent secretary has managed to double book me into one of his March clinics, so I no longer have to wait over 3 months. Hooray for sane person at end of phone .

as a new patient, under Royal College guidelines, you should have 30 mins of a consultant's time. As a returner, you get 10 mins, possibly with a junior doctor or nurse consultant - and that appt should be reviewed at the end of the session by the consultant.

95% of consultants are now on the new contract. That means they have to work 11 'sessions' before they are allowed to undertake private work. Private work should not be undertaken during Mon-Fri 9am-5pm without declaring it to the Hospital trust or taking annual leave. A session is the equivalent of a half-day. Consultants with busy specialities (and thus busy on-call) are awarded the extra session for the annoyance of being on-call.

Many hospital trusts, particularly for tertiary hospitals, turn a blind eye to consultants doing private work during NHS time. This will probably change with the roll-out of job plans for consultants. The job plan includes 'fixed sessions' - the half-days where the consultants time is fixed in a clinic/operating theatre. The less fixed sessions, the more flexible the consultant's time for extra-curricular activities .

example - DH has 6 fixed sessions/week (2 clinics, 3 theatre slots, 1 echo slot). The sheer volume of admin from his fixed sessions makes up most of the rest of hius time (in fact he brings tons home), and that doesn't include ward rounds and service development meetings. he took 2 weeks off work recently to look after me after my surgery, and had to rearrange 200 patient contacts. Up at the tertiary hospital - his collegues have 2 fixed sessions

I think the point I'm making is that when his clinics are overbooked it often knocks into other fixed sessions. As DH says, 'how can it physically be possible to double book?'

And here's the awful thing. There is a bone idle consultant in his dept who sees half the number of patients of everyone else. So the waiting lists lengthen - and DH gets offered extra payments to do extra clinics - because he is efficient. (he does do them).

He's too exhausted to do private work. And I coulodn't bear private patients 'buying' him and ringing us in our home.

not entirely sure what the point of my post was

Would be interesting if patients knew how many fixed sessions consultants had

Very very interesting Highlander - I had no idea how the system worked. I know they're overworked, and that the majority are like your DH, ie despairing. The system it seems works for nobody apart from the money people who twiddle the sums.
My Consultant is very good and highly regarded by everyone I've spoken to about him, but somehow he does seem to manage a weekly private Clinic, plus private ops in relative plenty. I know there's a shortage in our area, as last time I went to see him at the NHS clinic before Christmas he yet again wasn't there - no reason given, but two embarrassed registrars were desperately trying to cover and appease patients and one told me Neurosurgeons were like gold dust. Trouble is, I can't help but wonder if his cancelled NHS clinics, etc are down to his private commitments. I have no proof of this whatsoever, other than it's a logical conclusion as it's obvious even from a brief trawl on the net how much private work he does. Now admittedly I haven't a clue what he's contracted to do by the NHS, but still there's something a bit weird about it all that leaves a bad taste in the mouth, and that's not mentioning the continuing pain in my back.
I wish there was a way to change things instead of just moaning. Like many, I really hesitate to complain for fear of somehow getting put to the back of the queue. I know it shouldn't happen, but the whims of the system seem so capricious, that you can't help but fear.
So here's to a revolution. Let good souls like your husband work as he wants to work. Let patients be seen when they should be seen. Surely it can't be that difficult. It's hardly rocket science after all..