WHY ARE HOSPITAL DEPARTMENTS SO SLOW TO REACT?
The new Royal London Hospital.
I am seriously concerned over the time it takes for hospital departments to respond to a General Practitioners’ referral of a patient, the time it takes for appointments to be made, the amount of time it takes for letters to be transcribed and sent to GPs’ and patients, and the difficulty patients have when trying to chase up missing or delayed appointments.
Living in the East-End of London, most of the treatment and tests I have are now at the newly rebuilt Royal London Hospital in Whitechapel, or at St. Bartolomew’s Hospital in Smithfield. I have noticed that since the restructure of this Hospital Trust, almost all and any referrals, appointment bookings or letters to GPs’ and patients seem to be disasterously slow.
I have lost count of the number of times that I have had to ask my GP if they can chase up this department or that, as I had heard nothing from them after a reasonable period and I have been unable to contact the relevent people. It would appear that I am far from being the only patient to have this problem. I am now constantly hearing moans and groans about the same problems from others in the area, specially amongst the local elderly.
One department even had to go to the lengths of including an apology for how long it has taken for letters to be sent out attached to their letters, one of which was sent to me, the letter is below.
On another appointment the consultants verbal dictations from my previous two appointments had not been transcribed, and so the registrar had to listen to the registrars verbal recordings of both appointments to bring my records up to date before he could continue.
Could it be that they are now paying the price for previous reductions in the administerial staffing levels, where they reduced the number of administrators and managers a few years ago, to appease politicians and the outcry of wastages in the NHS, and transferring more of the management and administrational roles to other hospital staff (including medical staff!), before they had the move to their nice new buildings in Whitechapel, and the newly refurbished buildings in St. Bart’s?
The reduction in these personnel would have been seen as a good political action to take with the old structure in the old buildings, but when the moves were done, they probably found that they no longer had the experienced managers and administrators they now desperately needed to meet the increased turnovers they now face. They are finding that it takes time to allow new personnel to acquaint themselves to their new environment.
I have no doubt the health trust will offer the usual churn of excuses, saying that it’s just teething problems. The fact remains that if they had the right experienced managers and administrators in the right places, there would not have been any need for the teething problems to have gone on for anywhere near as long as they have.
The fact remains that there are still unacceptable delays in follow-ups of referrals, delays in the carrying out of tests, delays in the transcription of letters to GPs’ and patients, and delays in appointment follow-ups. All of these delays place the care of patients at risk.
Your GP has told you that you need to see a consultant, and that he will refer you. You hear nothing for months. Eventually you have to ask your GP just what’s happening, and he assures you that the referral was made, and they can even give you the date it was made. They promise to chase it up for you. You go back home and wait another couple of months before you receive that awaited letter telling you that an appointment has been made for you in six weeks time. When the appointment comes, you get to see the consultant (or more likely one of their registrars), who then asks for some tests to be done, for example, an ultra-sound scan. It can be up to a couple of months before you receive the letter with an appointment for your scan, which will be done in six weeks time. Once the scan is done, you have to wait weeks again for an appointment to see the consultant or registrar to get the results.
It has now already been around six months since the first referral was made by your GP, and you still have not had a stroke of actual treatment yet. But the best is yet to come. You wait for your next appointment, which doesn’t appear, so eventually you try to contact the department concerned by telephone, but can’t get through, or no-one is answering the phones, so you are forced to go to the department yourself to see what’s happening. When you get there, they are smugly polite, full of apologies and inform you that you must have fallen through the cracks somewhere, and make an appointment on the spot – for next month.
By the time you see the consultant or registrar again, it has now been up to nine months since the initial referral, and you have still to receive any real treatment.
And so it goes on – and on – and on.
This service is totally substandard, and you all need to get your acts together.