"Walk-in waiting times and early morning scrums"

About: Horsham Hospital / Phlebotomy

(as the patient),

April 2015: I am a regular patient for INR blood tests at the phlebotomy clinic in the Rainbow Unit at Horsham Hospital.

The queuing and waiting times first thing in the morning since the ticketed system was introduced have been getting worse and are now at a ridiculous level.

The unit does not start testing until 8am. At 7:15am there were several people waiting outside the unit for it to open to ensure that they were early in the queue because they had to get to work. The doors to the unit waiting room were unlocked to allow people to sit down at 7:30, by which time there were 15 people waiting. By the time the tickets were placed in the machine to allow us to take them there were 25 people present, including elderly and disabled, and there was a scrum to take tickets regardless of when people had arrived, resulting in upset, arguments and annoyance.

When the unit opened at 8am there were 80 people waiting with, of course, insufficient seats for all. This is pitiably poor organisation. At the very least, why can't tickets be in place, or put in the dispenser, when the doors are unlocked? Or is that a case of '"jobs worths"?

Is anyone reviewing this system with the intention of improving it to make it, at the minimum, fit for purpose? Or are we to be told that we simply have to lump it?

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Responses

Response from Michael Rayment, Pathology Services & Quality Manager, Pathology, Surrey and Sussex Healthcare NHS Trust We are preparing to make a change

Dear tjsussex.

You are quite right, the situation is far from ideal and I do apologise for your poor experience.

There is a history to this situation which I would like to explain.

The Receptionists that used to book appointments were re-deployed to other duties by the Hospital Trust that employs them with little notice. As I only manage the phlebotomists I had no control over that decision and was forced to implement a walk-in and wait system. We run similar style services at Crawley and East Surrey hospitals but they close at 4.45pm.

The issue at Horsham is that the service closes at 12noon and not 4.45pm because the rooms are used in the afternoon for other purposes. This time constraint puts a great deal of pressure on the staff as they have to finish by 12noon to vacate the rooms. In order to ensure that happens they sometimes have to remove the tickets early (but should not do that before 11.50am). I can reassure you there is no “jobs worthy” attitude from any of the staff.

This is a completely unsatisfactory situation, I do agree. However, I am working on some plans. Firstly I am negotiating with the Trust that owns Horsham Hospital to rent the rooms into the afternoon as they are not used as much as previously thought. This will allow the service to run until 4pm.

Before that I will need to recruit more staff to work in the afternoon and is taking some time.

Once all of these plans are approved and in place the service should improve dramatically and we should be able to offer a fast track service for INR patients too, but until then I can only apologise for the poor experience.

I hope this explanation reassures you that plans are in train to improve the situation as soon as possible.

Thank you

Michael Rayment CSci FIBMS

Pathology Services & Quality Manager

Surrey & Sussex Healthcare NHS Trust

michael.rayment@sash.nhs.uk

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Update posted by tjsussex (the patient)

Thank you. I was in no way criticising the Horsham Hospital phlebotomists who are friendly, hard-working and efficient.

You have not, however, answered why it is not possible for the person who unlocks the door of the Rainbow Unit at 7.30am to put the tickets into the machine at that time, which would help ease the situation in the short-term until a decent solution has been found. It was to this that I was referring when I wondered if it was due to "jobs worthy" attitude.

I do hope this overall situation gets resolved quickly, as we patients have been enduring this poor service for many months now and this is the very first indication that I have heard that anything is even being thought about to improve it.

Response from Michael Rayment, Pathology Services & Quality Manager, Pathology, Surrey and Sussex Healthcare NHS Trust

Dear tjsussex,

My apologies for not answering your question. My staff do not arrive that early to open the doors and I don't believe they have the keys.

At that time I think the doors must be opened by Horsham hospital staff (porters / security) so they wouldn't be in a position to load up the ticket machine. However, (and I will need to check with the Phlebotmists tomorrow) the simple solution is for them to load the ticket machine before they leave so that its ready in the morning when the doors open.

I will confirm this arrangement tomorrow via this post and I note your frustration about the service overall. I do understand and will do my best to recruit more staff as soon as possible.

Regards

Mike Rayment

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Update posted by tjsussex (the patient)

April 2016: I first wrote about the phlebotomy clinic in the Rainbow Unit at Horsham Hospital one year ago.

In mu opinion, no improvements have been made and things have actually got worse.

The queuing and waiting times first thing in the morning since the ticketed system was introduced are still at a ridiculous level. But now, to add insult to injury patients are not even allowed to queue inside the hospital but have to wait outside the hospital until 7.30am.

The unit does not start testing until 8am. At 7:15am there are still several people waiting outside the unit for it to open to ensure that they are early in the queue because they had to get to work.

I would have hoped that 12 months after my initial complaint the issues raised and recognised would have been addressed. They have not been.

I ask again whether anyone is actually prepared to act to resolve this appalling system with the intention of improving it to remove the frustration felt by patients?