"Appointments - a better way?"

I've worked in the NHS for years and have recently retired. The way appointments are made has long been a concern for me. The process can be confusing, bossy, inefficient or just plain dotty. And now Trusts, like the rest of us, are supposed to be 'eliminating waste' . So recently I've been interested to see how this works while being a patient myself, using local podiatry and physiotherapy services.

I've nothing but praise for the clinical service, which is helpful, respectful and friendly. But the appointments process is still as mad as a box of frogs - and an even worse element has now popped up - The Appointments Line.

I take my diary everywhere and could easily pop in an ongoing appointment at the desk after seeing the clinician, thus eliminating any further bureaucracy. But no. OK then, just drop me an email - I look at it every day, here's my address . . . 66% of households have broadband, you know. No. They have to send me a letter. Snail mail. How much does that cost The Trust?

So I get the letter and it's a time I can't do, so I call and arrange another time . . . so they have to send me another letter. More cost - multiplied by letters to thousands of other patients. And all the while, behind the scenes, Sauron is weaving his ugly influence . . . The Appointments Line, down there in Milton Keynes.

So I get a letter from this setup saying my appointment has been cancelled and to see my GP. No identification of which appointment (I have a couple on the go) or why the cancellation. Warily (any appearance of NHS bureaucracy must be treated like a flickering snake's head) I call the secretary at the practice, the team who is supposed to be treating me, and finally, the other team who is supposed to be treating me. No, the appointment isn't cancelled at all. You should always take Appointments Line letters with a pinch of salt, someone says wearily. They tend to confuse things.

Then I get another letter from the Appointments Line. It's identical to the first. I decide to ignore it (correctly, as it turns out). Then I decide to complain. How much does my local PCT pay to have the Appointments Line mess things up? So I write a clear letter detailing events - copies to my GP and to the local PALS. Six weeks later I've had no reply from the Appointments Line; a simple matter of good manners, I would have thought. PALS have contacted me by email - the first sane response! And they say they will pass my comments on to the PCT, though I've heard nothing more.

So - why not make appointments in person where possible, by email where the patient uses it, or as a last resort by letter? If we really are trying to reduce waste and save money, it would be good to do a cost/benefit analysis of this process across all services - not my job any more, thank heavens. Ditch the Appointments Line and assume patients are usually sensible. They sometimes even have diaries and use email. My goodness, whatever is the modern world coming to? It doesn't seem to be coming to the NHS yet.