Mostly patient admin this week. Not v exciting but time consuming!
My GP practice rings me and says that my prescription has been done and they’ll send it to the pharmacy. They don’t usually do this, and it’s not like they’re asking me to pick it up, so not entirely sure why this prescription got a special phone call!
My endo said he was referring me to a cardiologist at the same hospital. I hadn’t had an appointment through yet, but had all my other referrals come through over a week ago. So I rang the hospital to chase it. The woman dealing with it was a bit impatient and rude about why I was ringing up to see where it had got to. Referrals in the NHS are stupid and depend on which trust you’re in and who’s doing the referral. The options that can happen near me for referrals are:
1) choose and book. Usually from the GP, where the central system gives you a reference number and login and you can go online and choose where and when your appointment is.
2) GP referral gets sent to the hospital, somebody in the hospital agrees that it needs doing and sends it either to:
– the department who books it for you
– the outpatient coordinator who books it for you
3) a HCP in a hospital refers you for an appointment, and it either:
– gets sent back to your GP for them to refer you on via options 1 or 2
– gets sent to the outpatient coordinator who books it
– gets sent to the department who books it
It’s a lot more complicated than it needs to be. And it gets more stupid:
– sometimes appointments are ‘triaged’ by someone non-clinical and they don’t see how their department might be needed in someone’s care. So the referral gets rejected
– no one necessarily tells you that the appointment has been rejected, so if you don’t follow it up, you just get no appointment
– whoever ends up booking the appointment copies in the original referring doctor’s secretary who might say that the appointment needs to happen within a certain amount of weeks/after a certain test has taken place. So the whole process starts again and the original appointment gets cancelled
– humans are involved, so people have days off, sick leave, holidays etc so some referrals just sit in people’s inboxes for ages
– sometimes people leave their posts and their workload isn’t passed on. So the referral goes missing
– doctors have time off which wasn’t built into their clinic hours so appointments have to move to accommodate those needing sooner appointments or because your clinic was cancelled
– there are so many wasted appointments on the NHS that every clinic is overbooked to not waste time, and sometimes they overrun and have to move people around and cancel future ones
– the system doesn’t necessarily generate an appointment letter until a month before your appointment. So you think you’re waiting for your time to come in the waiting list, unless one of the above things happen.
– the computer system is stupid as a whole and referrals go missing all the time before you even take into account all of the things above.
– the clock starts from the point that the person accepts the referral. So 6-8 weeks recommended time might be 3 months or more just because of the referral process alone. Then you’ve got to factor in that there almost definitely won’t be an appointment when your consultant requested it for, it’s usually a month longer at least. Unless you get force booked into clinic and then you end up making someone else’s appointment get moved…
Knowing all of these things, I spend a lot of my time trying to work out where in the system the referral is so that I can chase it up if need be. It got so ridiculous in one hospital that I used the time between 2 appointments to walk between secretaries to try and work out what on earth was going on. On today’s occasion, it turned out the cardio department had only just received the referral the day before (where had it been for 3 weeks then? Pick from the options above!) so someone needed to action it there before sending a letter out.
Quick trip to the pharmacy to collect my injection fluid replacements the GP had rung me about on Monday. Then I had to swap out the expired ones for the new ones in my injection kits.