Friday, 13 January 2006
A patient's experience / Got (another) little letter
Another service snapshot from the patient perspective...
I have made the appointment now or as it turned out the two appointments necessary.
Obviously I have entered some system or other for an endoscopy and was invited to make an appointment 'as requested by your doctor'. (Great - did I know about this?)
The letter was dated 20/12/2005 and was that weird combination that the NHS manages so well of a clear and polite invitation text - thinks 'what nice people' - but finishing with bold heavy black type describing the penalties of non-compliance with the request to contact the department within two weeks: removal from list / notification of GP - thinks 'what unthinking and ungrateful people these patients must be'.
Duly on 04/01/06 the reminder letter arrived - a tribute to automated customer contact systems that is not fine-tuned to the great national hibernation at home or elsewhere. No reply within 10 days and removal from list happens. Take the snake back down to the end of the queue. The big black bold type at the end of the letter was now 16pt caps urging contact now.
I responded at once on my return - well no not on the day because the appointments office is only open till 2pm. And then not on the next day because the call was answered by a recording saying that staff shortages precluded bookings on that day.
Finally got through today to what sounded like a friendly if flustered teenager. Much shuffling of ledgers and flapping of sheets, breathing and silence. Date offered, accepted, withdrawn when it turned out we were making a pair of appointments within one week or so of each other. Start again and make the deal. Letter in the post to confirm.
Managing consistent service levels in the NHS is so hard. Somewhere in the service is a system that puts my name on a list for a needed medical examination and a request letter pops out of the system. Good for system. But apparently people throw the letters away and do not bother to reply so hence the need for vague threats of withdrawal of service - down the snake you go, naughty patient. System wags reproving finger at delinquent.
When the contact is made, the system is shut - a major London Hospital's appointment line closed for a day? Why? If there were staff shortages predicted, is there not a means to sorting it? Poor management of system. Then when you do get through, you coach some nervous young person through the system, asking them how you can best help - which date should we fix first? You feel extraordinarily relieved that the person on the other end of the phone has not burst into tears at the frustrations of it all and thrown the appointments book in the bin and hung up. Fragile system.
Have got the appointments. Must keep them.