Just sent off an email to Chesterfield Royal Infirmary complaining at being kept waiting for an hour and a quarter for an appointment to see a neurosurgeon. I told the receptionist I wasn’t prepared to wait any more and that I wanted her to arrange me an appointment with someone else – I have no confidence in letting someone who can’t even cope with managing their own time poke around in my back with sharp things – and walked out in disgust.
I see this as just plain, outright rudeness and incompetence. How would these people react if patients turned up for their appointments whenever they felt like it?
(Oh yes – add to that – the complaints form on their web site returns a 404 when you submit it)
For once, I don’t agree with you at all.
What reason were you given for your wait?
None.
Perhaps they were running the same system I’ve encountered at other medical practises in this area – they send everyone the same appt time, and then see you in random order, supposedly governed by what time you turned up. Which seems a little off, if you’ve turned up for the appt time you thought you were supposed to, but three other ppl turned up a minute earlier, so you end up waiting an hour.
Chris, when someone arranges an appointment to see you in the course of your work, would you keep them waiting over an hour and a quarter?
If you had an apointment arranged and were going to be that late for it, would you phone the other person to reschedule the time.
If it is reasonable for him to keep me waiting that long, if I had turned up an hour and a quarter late, would I would be justified in demanding that he see me?
Did you really expect to be seen at your appointment time when you went? A genuine question because it *never* crosses my mind that I will be seen at the time on the card/letter and am pleased if I am. Same goes for my dentist (private) and the GP.
What’s more I don’t actually think I should expect them to. I would prefer doctors spent their time giving appropriate time and care to each patient rather than given rushed, crap care just for the convenience of people not having to wait. How would you feel if in your appointment you were about to ask some questions and the doctor said sorry no time, make another appointment I have to see the next patient.
And if over one in five of the people coming to see me just failed to turn up each time then *yes* there would be times when people had to wait.
I was just browsing some of the information provided by trusts across the country, several have statements like this in their information: ‘You should allow at least two hours from your appointment time to leaving the hospital. We try to see every patient within
30 minutes of their appointment time, however, there may be an
unavoidable delay.’ Some even say to allow 3 hours.
It sounds, to me, that your Trust is not communicating this to you very well.
Put bluntly, yes I do expect to be seen at the appointment time. Or at least very near to it.
This was not an accident or emergency visit, where I would agree that unforseen delays should be forseen. This was a routine appointment arranged in advance. If there was some occurence which prevented the consultant from keeping to his schedule to the point where he was as late seeing people as was the case then a) people should have been contacted and told that this was the case, they could have then delayed setting off b) they should have had the extent of the delay clearly explained on arrival so that they could go eat, go have coffee, come back later, or reschedule if they had other pressing engagements.
Putting a statement on your web site to the effect that you are incompetent and cannot plan your time is not a substitute for showing proper respect to the people who you are there to serve by managing yourself in an efficient manner. If they did manage their time properly then they might discover that almost all these “unavoidable” delays were avoidable.
Poor time management will mean that the service and care doctors provide will be more rushed, not less. It means that when a genuine emergency does arise, then it will inevitably lead to unnecessarily excessive disruption to their work.
The argument that it has always been that way does not make it right. If I had been there under BUPA what is the betting that a) I would have been seen on time or b) my appointment would have been managed in just the way I suggested.
Sorry Tim, I missed the part in your career where you ran a hospital 😉 What you are saying is that the people who run and work in the NHS are basically all incompetent as this happens in every hospital. It couldn’t be that there is anything complex about running a hospital. I’ll pass that on to my colleagues.
If it’s so easy why doesn’t it happen, who’s benefit is it for….sorry I was forgetting everyone in the NHS in incompetent.
Why don’t you go private if it so fantastic?
I have run a business. The issue is the same, inefficient use of time is commonplace and I note that you didn’t respond to my question about your habits with your own appointments.
I don’t see that a consultant seeing a string of appointments is intrinsically different from a hairdresser doing the same thing except in the vanity and puffed-up self-importance of the person concerned. Yes, hospitals are complex to run, that is no excuse for failing to run them in a proper and efficient manner.
Yes, you are right, it probably does happen in every hospital, that does not mean that it is necessary any more than dirt under the beds and crap food and any of the other things which are wrong with the NHS. Yes, maybe I should go private, the only previous operation I have had, which admittedly was very minor, was carried out at a time when I was in a company BUPA scheme and yes, I was seen promptly each time by the consultant and the operation was carried out on time and very quickly indeed.
Ho hum. We’ve been on occasion *very* late being seen – up to three hours, once. We have also been the cause of a clinic being cancelled, after people had waited more than two hours, when the consultant was called away to – well, save Hannah’s life, I guess, when the registrar ran out of ideas. Maybe we use the NHS *so* much that it feels for us that it evens itself out over time. Sometimes we are the winners (in the time stakes, not because of the reason we’ve caused it to be late), other times we’re the losers (or maybe that means actually we were the winners that month, as we didn’t need anything much, so inevitably slipped to the end of the queue). I thank god, or my lucky stars, or *something* every month in life, that we live in a country where medical care is free at the point of delivery. In a third world country, Hannah would be dead. In the US, we’d be bankrupt. I agree, it’s not good to be kept waiting, especially if you are worried or anxious, but I never really known that to be about anything other than the needs of other patients being more urgent, to be honest. Yes, people should be told what’s happening, if possible, but at the front desk level, its people often paid minimum wage, with no real power. Dirt in hospitals certainly stresses me out beyond belief, and I have several times not allowed people to touch Hannah till they wash their hands. But to be honest, I’m much less forgiving about the fact I need to wait in all day for someone to read my gas meter (a task I think could be scheduled into a 30 minute time slot), than I am about waiting at the hospital. Anyway, be interested now to know how long you need to wait to be seen again. The hospital wouldn’t normally transfer you to another consultant, so you may need to start again with a new referral. How IS the back, anyway?
Oh, and yes, I’ve had a couple of things done privately as well, and no, haven’t had to wait. But that is becuase, i suspect, I’m being seen in a non-acute place, where the consultant won’t have to leave the clinic to do anything else.
I am not going to continue this for fear of getting irritable 😉 Suffice to say that I await the day when Vidal Sasoon is made chief executive of our hospital.
If that meant we had one hospital which was managed properly, and where patients were treated with respect, then I would be all for it.
Oh, Joyce, the back is getting better. having been fobbed off by Chris’s beloved NHS, I have had it treated privately, by an excellent osteopath, who always sees me on time.
My beloved NHS, where did I say that? Well pay the NHS the same as private rates and you *might* get the same service. Does you Osteopath charge you if you don’t turn up?
You don’t seem to think the NHS is as good as private care so why do you think it should be paid the same rates? My complaint is I think it is taking first class money for third rate service.
The choice is not a stark one between the crap system they have in the US and the crap system we have here. There are other alternatives. I would like us to operate on a system similar to the one the Germans have. It is not perfect but it is enormously better in every respect than what we have in the UK.
Interesting thread, nothing to add, except that Tim/Angus (!) I think you’re putting the cart before the horse in your last comment as surely if the NHS received the same rates as private, it would then be as good (theoretically at least!). Can’t really expect it to deliver the same standard on LESS money and then reward it with the money it needs to meet the standard-IYSWIM??!!
And I’m always suspicious of mixing buisiness ethics with provision of healthcare, although I doubt I could articulate why.
Is the NHS good value for money? Increasing funding only makes sense if it is. Personally, I don’t think it is good value, and has survived only because of its political sacred cow status.
I don’t know 🙂
Hope you get another appointment soon.
Do you think Germany’s system would be so good if they had the same number of doctors per 1000 of population as the UK? They have about 50% more.
You see I’d argue that the problems with the NHS are in the main about trying to deliver a service with an inadequate resource. I am not saying there isn’t inefficiency and incompetence (and removing that needs to be done), there is any organisation and should be addressed. But to say that your wait (when compared to the service in the private sector or Germany) is due to incompetency is I believe wrong.
Germany spends 50 per cent more of their GDP on healthcare than the UK. Their life expectancy is the same. Not sure how one compares impact of care on health of the nation,
so not sure how it can be demonstrated that their healthcare system is more than 50% better in VFM terms than UK. A number of academic papers comparing health systems find that the UK is better (marginally). http://www.davidgratzer.com/report1/5.html for example, but I don’t understand the methodology enough to know if these have any real meaning.
I must admit, it struck me that the kind of measures referenced (infant mortality and life expectancy, for example) might be much more attributable to sanitation and living conditions than to healthcare.
“For decades, the alibi for the NHS’ failure to meet the expectations – and the needs – of patients has been a supposed lack of funding. Despite the evidence from across the Channel that almost any other method is more successful at giving patients what they require, the NHS’ cheerleaders have been able to live in a political comfort zone.”
“I would much rather be treated under the Belgian system than I would under the NHS, it’s a “no brainer†as they say.”
Both quotes are Stephem Pollard, New Labour ‘guru’, more here
You know that I am no fan of New (the party formerly known as Labour), but a lot of what Pollard has to say makes considerable sense to me.
Yeah I’d much rather be treated under the Belgian system too. They have more than 100% more doctors and more than 100% more nurses per capita than the in the UK.
So you think we should scrap the NHS then?
Never really considered it. If I could compare different health care systems with the same resource levels then perhaps I could judge. I don’t know how one can judge between the British and Belgian health care systems if one has twice as many resources as the other.
It’s a bit like trying to compare two pairs of speakers where one is being driven by a £1k CD player and Amp and the other a by a £500 CD player and Amp. How can you tell what of what you hear is the difference between the speakers and what is the difference between the sources.
Well, not quite. The % of GDP spent on healthcare in the UK and Belgium are quite similar. So using your speaker analogy it would be more like having two £1K CD players and amps one of which is crap.
Well I guess we disagree. Would I really want to pay personally for 25% of my health care cost just so I didn’t have to wait for 2 hours in a hospital waiting room…….er no. At least if I have to wait I can, not sure I could find 25% of the cost of my last asthma related stay in hospital at the drop of a hat.
And this is where I have to respond. For someone who is self-employed, they are effectively paying any time they have to take time off work – a situation that also applies to a number of the more vulnerable workers in society who don’t get paid sick leave and so on. So they, the ppl who can often least afford to wait for an extra two hours, get stung all ways round. Is that fair?
Chris, I don’t think we are going to agree on this. You appear to think that the NHS can do no wrong and exists principally for the benefit of its managers and doctors. I think that it is exists for the benefit of patients and that there is tremendous room for improvement in the way it uses its resources (as an aside it would be a help if it started treating nurses a little better).
At the end of the day, my real complaint, which triggered this thread is not specifically about the NHS at all, since I have experienced similar bad practice in business and in private life. It is just that the NHS has institutionalised it.
Put simply, if you arrange an appointment with someone to meet at a specific time, then you should make every effort to keep that apointment and you should be realistic in your scheduling in order to achieve that. If you cannot keep the appointment, or will be late, then you should make every reasonable effort to minimise the inconvenience you cause. Frankly, the fact that you are a doctor, a celebrity, a senior manager, a parent, old, young is no reason to depart from this.