"Waiting times and process of access to care"

About: Crosshouse Hospital / Trauma & orthopaedics

(as the patient),

I attended my GP back in March of this year regarding a hip complaint, prior to this appointment I facilitated at my own cost various alternatives to try and alleviate the symptoms of my complaint, however having exhausted this my physio advised that no further treatment could be applied without more in depth detail on the causation on the complaint and advised I attend my GP. Scene set my GP agreed that an x-ray was the way forward to help establish causation.

Following my GP referral for this x-ray by the beginning of June I had heard nothing from any source and as my pain was increasing I chased up my GP to ensure that the appropriate action had been taken, and was advised it had. It was recommended that I contact the orthopaedic centre to see what was happening, on doing so I was offered the opportunity of a cancellation at Crosshouse Hospital the following day at which I attended.

On arrival for my appointment I was seen by a Physiotherapist who advises that she would exam me with the potential to establish what action to be taken, I explained that I have been referred by my GP for an x-ray, only to be advised that she would assess me to establish if an x-ray was required. I did explain my situation about and requested that an x-ray be arranged as per my GP, I was then advised that she would refer me to a Snr Physiotherapist who would have to assess me and make the decision if an x-ray was necessary. The lady very kindly got me a quick appointment and I was diarised for next Monday . On arrival at this appointment I was seen by a gentleman who again explained the process and I in turn again explained my situation and my frustration, however understood there was a process to be undertaken, however it was an x-ray that my GP had requested not a course of physio. I was progressed for an x-ray that morning. On returning to the out patients department was seen again by the snr physio and a colleague, at which time I was sat down and explained that there was no gap between my hip joint and socket and that there was some fraying around the edge of the joint this would require me to be seen by Mr Holt a consultant who would advise the course of action required. I left advised that this would be progressed and I would hear in due course.

As time progressed and my pain continued become worse, I contacted my GP in August. At this meeting I advised him that I had not heard anything, checked if he had and there was a letter on my record dated from the beginning of June from the snr physio I had attended, advising that the x-ray had shown deterioration of my hip, he did not have a copy of the x-ray so could not give me any further info. He recommended I contact the orthopaedic team and find out when my appointment was scheduled for.

I contact Crosshouse department on the that day only to be advised that it was way too early for an appointment to have been issued. I asked the approximate waiting time for such appointment to be advised approximately 12 weeks, couple week over as it was a busy department. When I pointed out that I had now been waiting now 10 weeks and had not heard anything, the lady advised I had only been seen in middle July, I explained all of the above and the lady was very helpful and stated she did not know what had happened but would put me down for a cancellation, she was very apologetic, but explained that the department had only had my information passed to them around the middle of July (6wks approx after I had been seen in June).

I waited again with the potential of either my appointment coming through due to the waiting time or a phone call to advise of a cancellation (of which I could attend a short notice), no nothing. I called back to Crosshouse again in September to see if any progression regarding an appointment, only to have the same story repeated to me that I was to early probably would be end October beginning November before I would be seen.

As you can imagine my frustration has been great from the start of this process right through so far and as of today I still do not have any communication of an appointment date. Firstly I would consider that if my GP has requested an x-ray it is because he requires this information, if he had wished me to have physio then that would have been what he would have requested, not only do I have an issue with the fact that a Physio now seems to be able to diagnose better than my GP, without any background, what did they think they were going to give me physio for? As I said at the beginning of my e-mail, I had gone to physio privately and through my work, to try and save having to take up precious NHS time that others who are less fortunate then myself would require would it not be adventitious to listen to what the GP is requesting rather than take up time giving patients treatment that may have no outcome.

One very frustrated and disappointed NHS Ayrshire and Arran service user.

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Responses

Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran

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Dear alc999,

Oh dear, this pathway does not seem to have worked very well for you and I am so sorry it has meant you have had pain for a long time before seeing an Orthopod. I know that GPs do not have direct access to X-rays for many things but it sounds like it would have been helpful for you in this instance.

I wonder if you would like to discuss this with one of our managers who can discuss this with both physiotherapy and orthopaedics to learn from this. If you would like to do so, please call Ms Marshall's secretary on 01563 827015.

I hope you get access to the orthopaedic team quickly and get things sorted. Thank you for letting us know about this.

Best wishes,

Eunice

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Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran We are preparing to make a change

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Dear alc99,

We have looked into your case and we would like to report our findings to you.

I am sorry your expectation was different and your GP referred you for physiotherapy not an x-ray. You rightly say that the Physiotherapist referred you for an x-ray and based on the result of that an internal referral to an orthopaedic surgeon was made. Our records show that while that referral was made on the 29th of June, it took 15 days to reach the waiting list. This is most certainly something we need to improve upon and as an organisation we are taking this forward. There is work on going to improve this process in the form of an electronic (IT) system for internal referrals. It will take time to develop, train and implement this system but it is a high priority for the management of referrals from one speciality to another (internal referrals). I believe you saw your consultant at the start of October which made a three months wait from physio referral to the orthopaedic consultation, which I appreciate, was a long time to wait in such pain.

I am really sorry this has all been distressing and your expectations have not been met. I believe you are now on the list for your operation and I do hope your op. and recovery is rapid. If there is anything further you would like help with or clarified, please do not hesitate to contact me.

Best wishes

Eunice

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Update posted by alc999 (the patient)

Thank you for this update, I can confirm that I have now been seen by my consultant and things have moved significantly and professionally handled. Thank you

Response from Eunice Goodwin, Patient Feedback Manager for NHS Ayrshire and Arran, Quality Improvement and Governance Team, NHS Ayrshire and Arran

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I am very pleased, thank you for letting us know.

Eunice

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