"wished I never bothered waiting for it or attending it"

About: NHS Fife

(as the patient),

Hello,

At the end of last year, I published an account online where I had complained that despite having waited since June 2014, I had still not received a follow-up appointment from the NHS Fife Psychology department.

Well since then I would like to report that I did receive a follow up appointment from the NHS Fife Psychology Department – which for the sake of brevity, will be shortened and referred to as the NFPD from now on in this account – and that I attended the appointment, unfortunately with poor results, but more on that later.

At this point before I go any further I would like to state that this account is to the best of my knowledge and recollection of events. If there are any discrepancies in this statement, then I unreservedly apologise for any issues that arise due to this statement.

Now that's out of the way, we'll go back to the main story. Soon after publishing the previous account, an appointment for the NFPD arrived through the post giving me an appointment in January at my local medical practice, which to be fair was really convenient for me.

However, I would still like to go on record by saying that having to wait more than 6 months to get another appointment, with a resultant almost 7 month gap between each appointment is disappointing and ridiculous for anybody. But when you factor in that I have been suicidal, have had severe anxiety for almost 20 years, which is viewed as possibly being a disability by Occupational Health, job issues, relationship issues, gender and sexualities issues, it's flat out atrocious! It really does not paint a good picture of the NFPD, they either look incompetent or that they don't care or don't take people's issues seriously.

The fact that no-one even thought to give me an update to let me know roughly how I long I would have to wait really paints a negative and uncaring impression of the NFPD at a time when people really need to feel that someone cares for them! Even just an update every month or two, just to say, “hey, we're still working on getting to you and we haven't forgotten about you! ” would be more than welcome, it would give hope and something to hold onto in those really dark times.

As for the appointment itself, well of course I attended, but I have to say that it was a waste of time in my view. I personally feel that overall the psychologist I saw did not really understand how serious my conditions were and failed to appreciate how bad things can get.

At first this did not seem to be the case as we discussed how I was doing, and I explained – to the best of my recollection – my issues and how things were variable or fluid (or something to describe how things varied and up and down things were for me mentally), basically in that some days things were good and some days were really horrible due to the issues that I have previously mentioned earlier on in this account, and I thought that I was getting somewhere.

However, this was sadly not to be the case. At some point during the conversation, I had mentioned that I was attending private counselling for one per hour week. Now, before I go any further, I would like to provide some background information about this private counselling. I had started attending this counselling – which I am still attending - in the month after my first appointment with the NFPD in June 2014. This was because I was in a really bad way - I was suicidal - and I felt that I really needed help and couldn't envisage going that much longer without at least having some kind of help, especially as I was told by the psychologist (a different one) for my first appointment that I would have to wait some time before getting another appointment, (but I certainly didn't envisage an almost 7 month long wait between appointments), so due to my situation at that time, I started to attend counselling privately.

Anyway, so how does this impact upon my appointment? Well to be blunt, as soon as I had said that I was attending private counselling for one hour per week, basically like Elvis, compassion and understanding left the building.

By this I mean, that as soon as I had mentioned that I attended private counselling, I was told that the NHS does not usually, or does not like to mix therapies I. e. my counselling with their treatments. And from that point onwards it was like our previous discussions regarding my conditions I. e. how I was previously and currently doing, never existed.

To be blunt, it honestly felt like that as soon as I said that I attended private counselling, it was I had just provided the psychologist and the NFPD a cast-iron reason and excuse to boot me off their treatment list, as if to say “Ah well, they're already going to private counselling, we don't have to treat them” and basically using the “we don't mix therapies” reason as a way to justify not treating me and effectively closing the door on me, cutting down their waiting list and costs.

I apologise if I'm way off the mark with saying that, but that is exactly how it appeared to me. Instead of being offered treatment, I was offered a anxiety/stress course to attend as a morsel, a sop, a way of paying me off so to speak, like one does when they throw a bread crust at a hungry duck in the local pond and they hope that the duck is sated and leaves them alone.

As a result of what happened in the previous couple of paragraphs, I had lost all faith in the psychologist and the NFPD, my confidence was shattered and I was just so bitterly disappointed. Here was me waiting 7 months, looking forward to getting somewhere in my life, getting the right treatments to help me with a long list of issues, working hard to actually stay alive and fight through my depression, only to be dismissed and denied the proper sympathy, compassion and treatment because I attended private counselling one hour per week!

So at that point, I didn't mention that I had previously attended a similar anxiety/stress course, and that for me they are like putting an elastoplast on a bullet wound, I. e. next to useless. I didn't mention this because I honestly felt that there was no point and that they were not going to change their mind no matter what I said. The same goes with when I was asked if I had any questions or me asking about trying to combine NHS therapies and my private counselling even for a short time, because given the psychologist's attitude, coupled with my anxiety and simply being so dismayed, demoralised, disappointed and disheartened at that point, I didn't bother bringing it up because I felt at that point that they had basically decided not to bother treating me seriously or appropriately due to me attending private counselling.

How is it that someone such as that psychologist after talking about and knowing the issues that seriously affect me, can easily just dismiss treatments on the basis that I'm attending private therapy – I don't put too much stock into this “we don't like to mix therapies” idea, I see it as a contrived way to bring down costs and waiting lists. Should they not see that someone in my condition, who is willing to wait almost 7 months for an appointment - even though they attend private counselling once a week - is waiting so long for help, because they really need help! I should not be punted onto an ineffectual course that's about as much use to me as a gas fire is to a snowman, and have the door slammed shut on me with regards to treatment, simply because I attend other counselling. Pardon me for trying to stay alive and maintain/retain a level of sanity!

I'm sorry again if I come across as harsh or out of order, but I feel justified in saying what I've said, due to the way I've been treated by that psychologist and the NFPD. I feel like my situation and my health is being cast away in order to save costs and bring the waiting lists down, which to me only further reinforces my view that that psychologist and the NFPD become so bereft of compassion, sympathy and are uncaring when they find out that the patient attends treatment outside of the NHS! It's not my fault I saw sought help outside the NHS, I was desperate, I seriously think I'd wouldn't be alive today to type this account if I did not seek private help last year after the first NFPD appointment and instead had waited for and relied solely upon the NFPD to get back to me for the follow up appointment. That's not hyperbole, that's just how bad things were and can still be at times.

I'm sorry if that is at odds with what the NFPD or that psychologist perceives things, I appreciate some people may not be very happy with what I've said, but that's tough! For years I've been and am still being dragged across hot coals mentally on a daily basis, I'm in serious mental pain every day, and if I'm not getting the treatment that I feel that I need, deserve and have paid for in the form of taxes and national insurance when I was working (I've been unable to work since Spring 2014), and especially after the way I've been treated, then I'm going to complain and tell it like it is.

It seems these days you have to scream and shout to get somewhere, so that's what I'm going to do, it's a rather sad indictment of how mental health issues are treated/dealt with in this country, and it really irks me because if I had a severe/serious physical ailment, or indeed a substance dependency issue, I would treated a lot faster and taken more seriously.

Finally, I'd like to say one more time, that I again apologise in advance for some of the comments that I have made. I really, really, really, really tried to write this as fairly, as objectively and as constructively as possible, but due to how poorly I've been treated by the NFPD, I found this impossible due to the anger that I feel every time I recall what happened to me. This is especially when knowing that there are people who really don't need treatment, who have been able to contribute towards society, but never have I. e never worked, nor paid taxes etc, but get treatment, whereas someone like me who does really need treatment, and has worked and paid taxes, effectively earning the right to treatment, is brushed off and given almost next to nothing!

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Responses

Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dear Concernedparent2014

I was saddened to read your account of your recent experience and felt it was important to give the service concerned an opportunity to respond to you directly. Here is what Dr Katherine Cheshire, Consultant Clinical Psychologist and Head of Psychology Service NHS Fife has said:

"First I would like to offer my unreserved apology on behalf of our service for the experience you report. We clearly failed to meet your needs and we have let you down. Again - I am sorry that this has happened. I can understand why you wonder if we care or take people's issues seriously given your experience. I believe that the answer to both those questions is 'yes'. Our clinicians are committed to doing the best they can for the people referred to our service - but I also accept that this was not evident in your case.

It is true that the pressures on our service are significant and increasing in terms of the volume of referrals. Obviously, that says something about the world we live in and the people we see do come with increasingly complex issues to address. It is also true that we try to 'manage' the demand for our service as effectively as we can, so we do offer both group and individual treatment and often 'share the care' with other health and non-health services. In fact the latter decision is not all about reducing the pressure on our service. Sometimes other agencies are able to offer services which are a better fit with someone's needs than ours does. Of course we may work jointly with these services. At other times we may suggest that someone attends another service first before they come to us in order to get some help with problems that may impede progress in therapy.

Your point about combining therapies - NHS or otherwise - is an important one. I entirely agree with you that seeking private treatment while on an NHS waiting list should not in any way undermine your case when seeking NHS treatment. Having said that, it is well accepted in the therapy world that difficulties can arise when someone is working with more than one therapist - even when the therapists are working within the same service. Sometimes the difficulties arise because the therapy models conflict; at other times the problems reflect differences in the therapeutic relationships and the expectations of the participants. When someone comes to see us and reports that they are already seeing another therapist, within the NHS or elsewhere, we do generally seek to reach an agreement that the individual will continue with that therapist or begin therapy in our service - but we rarely recommend trying to do both in parallel. It is also relevant to say that when someone tells us that they are already receiving help within an established and productive therapeutic relationship we typically caution them against disrupting it. Therapeutic relationships, as you will know, take time and effort to build and there is never any guarantee that another therapist, however competent, will be as good a 'match' with that individual as their current therapist. Despite these caveats, I also accept that, in your case, private therapy suggests a financial outlay, and that as well as the therapeutic issues should have been considered. Just as importantly, it appears from your account that you do not feel these issues were collaboratively discussed or your views heard and understood. Again, I apologise for that.

I appreciate the time you have taken to share your story with us. It makes for uncomfortable reading and we must learn from this. I have shared this with our adult service lead, Dr Frances Baty, and asked her to discuss it further with her Consultant team to consider how we can best address the issues you raise. If you feel able to speak to one of us on the phone or meet with us to discuss it further, we would value that opportunity. If not, it would help us if you could provide us or NHS Fife Patient Relations with your name and date of birth so we can investigate your story more fully and maximise the leaning from it.

Thankyou again for telling us your story".

Having recevied Dr Cheshire's response, please do get in touch with me directly if you would like to take up the offer of a follow up discussion or to provide me with the necessary information to allow us to look into the specifics further.

Regards

Louise Ewing

01592 648153

patientrelations.fife@nhs.net

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