Hospital Tales Part 5 - The Farce Continues

I finally got to speak to the clinic which I was having trouble with earlier in the week and they have received my referral. "You are now on a waiting list" she informed me. "We will write to you to tell you that you are on a waiting list and will be contacted within a maximum of 4 weeks". "So I can't book an appointment now", I queried. "No", she said, speaking slowly as if I were stupid, "You will get a letter in 4 weeks asking you to call to make an appointment. We send out a bundle of letters and then it is first come first served as to the appointments".

So I have waited 2 weeks for the referral whereon I will have to wait another 4 weeks to receive the opportunity to fight to get an appointment on a first come, first served basis from a clinic which will only answer their telephones on Monday, Wednesday and Friday until 4pm, except if you call at lunchtime, when they don't answer them and you get put through to Islington PCT and the line goes dead.

There has to be a better system.

Hospital Tales Part 4

Just when I thought my experiences with the NHS were getting better, this happened.

Referral from my GP to a(nother) clinic. According to the paper she gave me I needed to ring them 2 working days after the referral to make an appointment which would be approximately in 6 weeks time. Instead of being able to ring up each day of the week and arrange an appointment when available, I could only ring on a Monday, Wednesday or Friday, with each day relating to appointments booked for a specific day. I.e. call on Monday for a Thursday or Friday appointment. So far, so good, if a little confusing. I, however, was referred last Tuesday so the next day that they were open to book appointments was the Friday. Which was a bank holiday. Or Monday, which was also a bank holiday. I finally called the following Wednesday where the conversation went along the lines of this:

Me: "I'm calling to make an appointment for XX clinic. My GP referred me last week"
Them: "Date of birth"
Me: "xxx"
Them: "which clinic"
Me: (repeats initial statement)
Them: "what's your name?"
Me: (spells name)
Them: "your date of birth?"
Me: (repeats date of birth, again")
Them: "how do you spell your name?"
Me: (spells name)

Turns out, they couldn't find my referral. "Your GP must not have sent it. Contact them and ask them to fax it, marked urgent". Phone went dead. So I called the GP surgery where I was greeted with a barked "hold the line". A few minutes later I explained the issue. "Date of birth?" she asked... "Yes, you were referred to XX clinic last Monday" she confirmed, confidently. "Well", I responded, "they don't seem to have any record of it being received. Can you re-fax it today, marked urgent?", I pleaded. "OK" she snapped and again the line went dead. So, as I have to wait 2 (clear) working days, that will bring me to Monday, two weeks after the initial referral.

Strikes me that Islington PCT could do with an integrated computer system...

NHS saga

At 11pm on Tuesday evening I went to take my pill and realised it was the last in the packet. Unconcerned I went to get a new packet from the first-aid box and discovered that somehow I had managed to forget to get some more. Cue mild panic that I had 24 hours to procure some more. A relatively easy task one might think; I live in London, how hard can it be.

Pills do not qualify as an emergency so I couldn't call my doctor at 9am and make a same-day appointment. I am prepared for that though and for the past 2 years have instead made an appointment with the family planning clinic nearest my work. If they don't have any appointments left for the same day there is usually a clinic one can turn up to and wait. Not ideal but acceptable if one plans ahead and doesn't need same day treatment. I.e. Becomes an issue if you have an 'emergency' and need emergency contraception. I called as soon as I got to work and finally reached a recorded message indicating that they were closed until 12pm. At 12pm I started calling, going round and round their system until it finally kicked me out and then wouldn't let me back in, stating "this line is busy" ad infinitum. At 1.45pm I finally managed to speak to someone. They had no appointments (for that day or the next). Clinic times had also changed. They now closed at 3.30pm. Definitely not ideal. I couldn't leave work at 3pm at no notice. "What do you suggest I do" I enquired, "I really need to see someone today". "Call X in X" she replied and hung up. Called X at X clinic. Yes, they did have a clinic until 6.30pm every day. "Excellent", I said, "so as long as I get there before 6.30, I can see someone?". "No" came the answer " if you're not here before 5.30pm at the latest, we will have filled our quota and you won't be able to be seen". At least that one was open - I tried 3 others to be told the earliest I could be seen was next Tuesday.

Boss allowed me to leave at 5pm so I raced to get there before their seemingly random deadline, running down the road looking at a map hastily printed from google. I made it at 5.32pm only to hear the administrator attempting to turn away the girl at the desk in front of me. I explained the whole saga, the other girl explained hers. Administrator claimed that "on health and safety grounds we can only allow a certain number of people on the list" and "don't you know it's the end of the financial year". We negotiated for a while; in the end I found out that the whole of the area had been on a training course all morning and that all family planning clinics were closed that morning in the borough. Eventually she consented to letting us both wait and if the doctor (the only one on duty) had finished the list before the end of the clinic, she would see us. The administrator herself explained that she should have left 15 minutes earlier and left the clinic, handing me a printed piece of paper stating clinic hours - 5pm to 6.30pm. Presumably she was simply following instructions:she then said she was locking the doors on her way out so that no-one else could get in. And with that, she left. Nothing I could do but sit and wait and sit and hope. With growing frustration I watched the doctor accompany each patient back out into the reception area and place their notes in a basket and collect the next set of notes - a three or four minute time delay accompanying each patient. To the doctor's credit she did see me, eventually, at 6.40pm. She was so rushed she barely listened to any of the questions she fired off in rapid succession. 3 minutes later I had my pills and was back in reception, mission accomplished, finally.

In this specific instance it was in many ways my own fault for my mistake in not realising I needed to get more pills ahead of time, but it raised significant issues in my mind. The majority of the administrators I spoke to were more concerned with quotas, targets and so on than helping patients. No-one volunteered more information until I asked for it. The doctor seemed to be wasting time between each patient by having to collect and return each set of notes herself. There surely must be a more effective system. All of the clinics I spoke to seemed surprised I couldn't attend daytime clinics. I work 9.30 until whenever every day of the week. Thankfully my boss is fairly understanding about personal issues and generally lets me leave on time if I really need to and there is nothing of vital importance happening. The majority of days I wouldn't be able to leave on time as a matter of course. This is unfair on those who are attempting to be responsible by having a job and using effective contraception. If I had needed the morning after pill, such reduced options would mean I would in all probability have been forced to purchase it at a chemist for £25 when I should be able and am entitled to get it free. I could envisage a situation where someone with more dubious morals who found it hard to schedule an appointment for contraception would be tempted to leave it to chance, taking the morning after pill (if they could get it) or even simply arranging an abortion (which seems even easier to get than simply trying to arrange contraception in the first place). Surely we do not want our system to punish those trying to be responsible and to put quotas and targets ahead of patient care and safety? I am pleased people are being sent on training courses, but surely staggering them is a more viable option than crippling the system by closing everything on the same day. Until there is improvement in basic services, I cannot see confidence in the NHS improving.

NHS

I paid a visit to UCH yesterday to undergo some tests. I've had some unusual pains recently and after a visit to my GP was referred to the hospital. I have two fears - that the tests will either show up something serious or that the tests will show up precisely nothing and I will be left with the realisation that it is all in my head. That I am stressed or anxious or exhausted and allowing this to affect my physical health. I realised whilst I was waiting for the scan that I was worrying about catching something worse from the hospital, that I was concerned about the lack of sanitizer to clean my hands, that all the doors had handles which must be touched rather than just lent against, that there was lumps of dust and clumps of hair all over the corridors, that the place smelt (and not of disinfectant) and that I could not understand the nurse as English was not his first language.

The nurse showed me to the room and then left. It was dark. I didn't know what to do so I put my bag on the chair and took off my coat. A doctor came in. She didn't check my name. She said to get onto the bed and to take my scarf off because I might get hot. I started to wonder what she was going to do to make me so hot that I would be glad that I had taken me scarf off. She didn't elaborate but started doing the scan. "It's a good job that you're skinny" she said, putting cold gel on my stomach and peering at her computer imaging screen. "Too many fat people wonder why it takes so long. How am I supposed to scan properly through all that fat". Once it was over I asked if she could see on the computer what had happened to my other appointment. She couldn't tell as there was no proper centralised record. Instead she directed me to another department where the other scan would take place. After walking along miles of grubby corridors with no hand cleanser in sight I found where I was meant to be. A very tall receptionist wearing her handbag was sat behind the desk. I wondered whether NHS cuts meant that they now had to wear their handbags as there were no lockers. I explained I was still waiting to hear in regards to an appointment date. She responded that there was a 500 patient backlog and no staff to process the appointments. I sat down whilst she went to find out about my appointment. They have never heard of privacy as the entire conversation relating to the nature of the scan was conducted infront of all the other people sitting waiting. After a few minutes she returned and offered me an appointment for Thursday afternoon of the same week. There are free appointments but not enough staff to process the forms to allocate patients to those appointments. The back-log must be getting larger everyday. No wonder the official figures say that there is a 14 week waiting list for such scans - perhaps if they employed some admin staff they would be able to reduce this dramatically.

Not for the first time, I wished that I still had my private health insurance which I had enjoyed as a perk of my previous job and which had allowed for me to have my impacted wisdom teeth removed in a private hospital which was beautifully clean. Not for the first time, I considered the NHS hospital, where non-smoking rules mean that in order to get into the front door one has to walk past a line of patients in their hospital gowns attached to drips/monitors and so on, pale and yellowish, smoking outside the front door of the hospital which fronts directly onto a busy A road, the most polluted road in London. Not for the first time, I thought of my friends that are doctors and nurses and must come to places like these every day to work.