THE APPOINTMENTS SERVICE IN THE NHS IN ENGLAND

THE APPOINTMENTS SERVICE OF THE NHS IN ENGLAND

Well, is it a Service ? I do not think so.
However, let us be fair. The NHS suffers from a number of hurdles. These are -

- Increased demand unmatched by Human Resources.
- Lack of Consultants and Doctors.
- Poorly trained Support Staff.
- Culture of Consultants and Doctors work schedules more important than the patients needs.
- A Prima Dona attitude from many Consultants.

These are not excuses but reality and we must bear these factors in mind when judging the Appointments System.
There are a number of irritating defects that should be addressed.

I have already suggested some solutions to the problems facing the NHS in previous articles on my Blog - Google EUREKYS.
Scroll down my Profile and read Future Strategy of the NHS.

Here is Case Example -

Day 1 - your Doctor submits an urgent request for an appointment for you to a hospital department, such as Urology. There is suspect infection or maybe a cancerous lump.

Day 14 - The Urology Appointments Department posts a letter to you offering an appointment 16 days later, or Day 30.
Although the date is Day 14, you receive the letter in Day 18. Yes, they have predated the latter. It may be the fault of the Postal Service.
So, it has taken 29 days for you to see a Consultant for your URGENT condition.

This is quite a normal procedure. For some urgent illnesses, it may take much longer. If you need follow up surgery or treatment, you may wait months for an appointment.

If you telephone the hospital to change the appointment, you are greeted with a voice recognition message.....Speak the name of the person or department which you want to speak to....you say clearly....Urology. The reply is.....you want to speak to Pathology ? No you say .....Urology. Maternity the phone replies. You hang up.

 Either perfect Voice Recognition or let us speak to a human being again. This example is taken from Bucks NHS Hospitals.

Some of the excuses for lack of convenient or urgent appointments are -
Unavailability of Consultants at your hospital of choice, so you have to shop around.
Inefficiency of the appointments service. Why should it take 14 days to reply to a Doctor's letter sent by email ?
We live in a fibre optics broadband world of rapid response computer systems. They should be able to respond instantly.

Another problem is that if you cannot accept the date of appointment you are offered, you night have to wait another 4 weeks or more.

OK, let us assume that you have been lucky and you disagree with my views. Consider this......
You go to the hospital 15 minutes before your appointment at 10am in the Eye Department.
At 11.00am you are still waiting ! Why ? The Nurse tells you that you were advised in your letter that you must be prepared to wait up to 4 hours !
You them ask - why are you running so late ?
This is the answer that I once had from the Nurse:
We had a few patients who turned up late and we had to wait for them ! That is why we are running so late.
I told her that this is crazy. I arrive well in time for my
appointment but late comers are still given priority.
I proposed this solution for the future.

Letters of appointments should say that the patient should arrive 15 minutes before their appointment let us say 9.45am for a 10.00am appointment. If they are more than 20 minutes late ie they arrive at 10.05am then they go to the back of the queue.
The latecomers should be inconvenienced not the early birds!

There is one final shortcoming that needs to be highlighted .
There is never any feedback from the Nurse on duty to advise patients in the waiting room why there is such a long delay.
No feedback, no apology, no regular updates.
Patients are treated in a manner which exudes the feeling....
We are doing you a favour. Just sit there, be quiet and be grateful. The Doctor will see you when he is ready.

Now for the worst part of the appointments service. They book up to 10 patients in at the same time. Their reasoning....
Some patients do not turn up so we overbook to compensate for this. True but a rubbish explanation.
This overbooking means that on average you could wait for about 45 minutes, that is my experience.

So, NHS, you are a wonderful facility for us frail human beings. Probably, the best in the World. But, you need to improve the Appointments Service.