A patient story

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Omg, annual leave during purdah so this is a late posting, (a wants to stay anonymous) relative wants to talk to me: re NHS care.

I have to to take a deep breath, wait for when this starts. I am a Doctor, but not that kind. Relatives don’t always understand that, so I smile and find my listening ear.

They first had an issue back in spring 2018, 3 yrs ago, pre-pandemic!! went to GP, immediately got a secondary care referral.

Had to wait about a couple of months or so for first outpatient appointment. They tell me that they didn’t mind waiting, the NHS is busy. It turns out that the appointment was just a triage, and the waiting list was after. My relative, resigned to that, and I had pre-warned to help manage expectations of an immediate fix.

In fact wait is so long, healthcare professional (HCP) in appointment suggests discharge as low risk but with a phone number if feel need to return … after consideration, and resignation, my relative does this (in convo with me.. because it felt like that’s what they wanted them to do).

Spring 2021, recurrence at more severe level.

Relative revisits the GP (telephone appointment this time due to covid) relative indicates their health issue has been an issue throughout but didn’t want to make a fuss cause of what was said in first outpatient, so a re-referral to secondary care, same as before, (sighs in frustration).

Then after a very short video triage consult, to check for urgency
Triaged to another service, for 4 months this time, then a very short notice contact at weekend for a video consult following week.
Appointment is relayed to me as a repeat of 1st outpatient 3yrs earlier.
Relative is now super frustrated, feels passed pillar to post.

The HCP in video consult this time again says very long waiting list, & low risk so very very politely suggests referral back to GP, because ‘shorter waiting times’ in primary care for appointments.
Relative again does what they think the HCP is recommending
Health issue remains unresolved. I’m thinking, yep but now your waiting list clock, wherever it is held, has gone back to zero, even though you are 3 years or so in.

Relative is now very confused: why GP didn’t do that in first place three years ago if faster in primary care? Resigned, frustrated, still ill. Relative is copied on a few letters, read out to me as make no sense to relative.

Approx 3 months later, short notice appt made with primary care service for condition. Hurrah says relative, finally. I caution, with insider knowledge, let’s hope, but not too much, it might just be a triage call again, apparently I’m pessimistic… guess what….!

Yep, that’s right, added to another waiting list, this time in primary care. Relative still waiting, illness still ongoing.

Let’s add up, 2x GP appointments, 2x telephone risk/appointment calls, 2x secondary care 1st outpatients, several letters… 3 years elapsed time, and STILL NO DEFINITIVE TREATMENT. I’m as frustrated as my relative.

I work for the NHS and yet it is full of these broken processes everywhere, it is so frustrating… and with my QI hat… sooooooo fixable!

[note though that probs no waiting time rules broken cause of all the referrals back to GP, and first appointment, might be counted as clock stop, as some symptom management advice given. From my relative perspective, nothing has happened yet tho… still waiting]?

And we wonder why we lose capacity in healthcare?

Basic value/non valued added assessment of this patient journey so far… None, nada, but lots of capacity wasted for triage! Imagine if all that capacity for traiage, referral letters and risk assessments had be redeployed into treatment?

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