"14 to 18 month wait from seeing my GP to receiving treatment"

About: Telford referral and quality service (TRAQS)

(as the patient),

Let me say at the outset that everyone to whom I have spoken, face-to-face or on the telephone, at Dawley Medical Practice (DMP), at TRAQS, at the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry (RJ&AH) and at the Princess Royal Hospital, Telford (PRH) has been courteous, kind, understanding, sympathetic, helpful and willing to do the best for me. I also fully accept and understand that the first priority for medical practitioners is the seeing of patients and not the writing and disseminating of reports and recommendations for further action, and that the production of such reports etc takes time. I also believe that, in general, everybody has taken the appropriate action as soon as the relevant information has been received. Nevertheless, the end result for me is that there will have been an interval of 14 to 18 months between my telling my GP of the increased severity of my symptoms and my receiving any treatment for them, which seems to me to be excessive.

I therefore make the following comments, in the hope that administrative procedures and protocols may be examined and possibly refined so that in future patients may not have to wait quite so long for treatment:

a. It seems a pity that GPs in the Telford area cannot refer patients direct to a hospital where they have already been seen, been given tests such as x-rays or MRI scans, had the condition diagnosed and treated and where, presumably, there may still be records of such events. For me this protocol has meant that I attended a clinic at PRH which I could otherwise have expected to attend at least a year previously.

b. I wonder whether there was some confusion in the administration/communication in the initial referral from DMP to TRAQS after January 2013, because I had not only been offered but had even attended an appointment at the Urology Clinic, for which I had also been referred at the same time, some 4 weeks before TRAQS wrote to me offering an appointment at RJ&AH, which was also after I had made enquiries at DMP about the length of time I could expect to wait to hear about an appointment.

c. It seems unsatisfactory that the protocol in the Oswestry area does not also obtain in the Telford area, so that, as in this case, what appears to be a routine request by RJ&AH for a GP to refer a patient for an MRI scan in the Oswestry area lies outwith the protocols in the Telford area.

d It also seems unfortunate that the letter from DMP to RJ&AH advising them of this inability was not noted and actioned before I attended the clinic in Oswestry in June 2013. Had someone read the letter and noted that a procedure that had been requested to be carried out before attendance at a clinic could not be arranged elsewhere perhaps RJ&AH might have arranged the scan themselves – as they did subsequently – before my attendance at a clinic, thereby avoiding not merely a comparative waste of my morning but more importantly would have allowed the Consultant to devote the time spent on a comparatively fruitless session with another patient, and might have reduced the time before I did see her when she had fuller information after the MRI scan, as well as saving the NHS money.

e I have to wonder why DMP, when they realised they could not refer me direct to the Radiology Department at PRH as requested in the letter of referral from RJ&AH dated October 2013, did not refer me straight back to RJ&AH as requested in that same letter. Had they done so I might have received treatment earlier. This further highlights the unsatisfactory nature of the difference between protocols within neighbouring areas.

I iterate that what appear to me to be unnecessarily complicated systems of administrative procedures and protocols has led to a delay of between 14 and 18 months before I shall have received any treatment, during which time my symptoms have progressively worsened, severely limiting my ability fully to enjoy holidays in the summer and at Christmas of 2013, when I might have expected treatment before the spring of 2013.

I would be grateful for your comments.

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Responses

Response from Helen Handy, TRAQS & CAB Co-Ordinator, Telford and Wrekin CCG

Thank you for taking the time to provide feedback relating to your recent experience of a referral via TRAQS.

I am unable to comment on all of your points but in relation to point

a) GPs are able to refer direct to a specific hospital and/or consultant they only have to ensure that the referral letter is addressed appropriately and TRAQS will honor their request. Likewise if a patient requests a specific hospital when Choice is discussed with the Patient Advisor at TRAQS we can change the mileage to give us a greater range of options/Providers to offer the patient greater Choice or a specific hospital.

b) I am unable to comment on this further without additional information to identify patient details, as all information is anonymous on this website. If you would like to discuss your concerns further please do not hesitate to contact me and I will be happy to look at the audit trail for this referral episode for you. 01952 580367 08.30 - 16.30 Monday to Friday, except Bank Holidays

Point c) Telford and Wrekin Clinical Commissioning Group (TWCCG) have commissioned services from local hospitals/providers and the process for accessing the services may be different from processes agreed with the Shropshire Clinical Commissioning Group (SCCG) and local hospitals/providers. This is the case for MRI referrals as RJAH have alternative processes agreed with SCCG which do not apply for TWCCG. We have raised this issue with RJAH and they are aware that consultants should not be refusing referrals on the basis of a lack of MRI results if the patient is registered with a Telford and Wrekin GP Practice. Apologies that this appears to have caused a delay with your referral. However, DWP are aware of the correct process to follow for MRI requests and are aware that they can refer directly for specific MRI requests and do not have to send referrals via TRAQS.

I am unable to comment on your additional points as they relate directly to concerns relating to your medical practice. I would therefore suggest that you take up your concerns relating to the delay you experienced direct with the practice manager.

Thank you again for taking the time to share your concerns with the TRAQS team and I hope that my response has helped to answer your concerns. However, if you would like to discuss your points relating to TRAQS further please do not hesitate to contact me direct on the number above and I will be happy to look into your referral history in more detail as it relates to the process followed by TRAQS.

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