"Anticoagulant clinic at Ormskirk felt like a cattle market"

About: Ormskirk & District General Hospital

Posted by B J N (as a carer),

I my sister and I attended the anticoagulant clinic at Ormskirk with our 92 year old mother who suffers dementia. We have done so before but this most recent visit was by far the worst experience yet. Our immediate reaction on entering the clinic was that it resembled a cattle market. The place was packed. The seating is very close together and it was hot and noisy.

After booking in we had to sit and wait for my mother's name to be called for her to go into the first room for the thumb-prick blood test. Because of the noise it was difficult to hear. We only waited a matter of minutes; her name was called by the nurse; so far so good. The blood test took less than a minute; then we were ushered out to the waiting area again with no indication at all of how long the next wait would be.

It turned out to be a wait of 1 hour 20 minutes. During this time we could not leave the waiting area to get any refreshment for fear of missing our turn; there were no magazines to read and it continued to be hot and noisy. The worst part was straining every time a name was called to see if it was my mother's.

The doctor calling the names was sitting on the far side of her room at her computer; she called the next name without looking up and the experience was far from patient friendly. It was most undignified.

When we did eventually get to see the doctor for the result, we were with her again for less than a minute. We then had to queue at the reception desk again to get the next appointment to go through the whole humiliating experience again.

The total contact time with a nurse or doctor was no more than 2 minutes, yet we were in the clinic for over 2 hours.

Surely there must be a better system! I understand the machine which tests the blood gives an immediate result; so why can the doctor not sit in the same room and speak to the patient immediately after the blood has been taken, rather than the herding around from one room to another with a ridiculously long wait in between?

And if this is not possible, then at least can a more civilised way of calling patients not be found? A nurse standing at a door and yelling to make herself heard is neither civilised nor polite. Many of the people attending the clinic are, like my mother old, disabled and hard of hearing. Our general feeling was that we were just bodies being shunted around and there was a distinct lack of respect.

The doctor, when we finally got to see her, commented factually that we had had a long wait - but there was no apology forthcoming. It was just a statement of fact; one that we already knew. There must be a better way of running this vital service.

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Responses

Response from Matthew King on 25/04/2008 at 10:09

Dear BJN,

I have spoken to the pharmacy team who run the anticoagulation clinics and they first of all send their apologies for the way you feel you have been treated.

They are aware of some problems and are trying new ways to try to overcome them. As you will have seen, the anticoagulant clinics are extremely busy with between 80 and 130 patients per session and even then we are limited in number due to clinic space. The Doctor, who is actually a Pharmacist, does indeed have difficulty letting patients know when it is their turn due to the number of patients and conversations occurring in the waiting area. This is a frustration to her. We have considered this and continue to look into other ways in which to identify the next patient in the mean time.

Unfortunately your suggestion of the pharmacist sitting in the same room would not be feasible for a number of reasons. Firstly there is the problem of confidentiality when counseling the patient, and secondly, while it may only take a minute for the results of the finger prick test to be ready, some consultations can take longer than a few minutes for some patients, which will inevitably cause a back log.

Having said that, the pharmacy team are working on a triaging system, that would mean patients having stable finger prick tests being seen by Technical staff at the finger prick stage. This will hopefully mean a shorter attendance time for those patients and allow longer for the patients needing advice and dose changes.

We can only apologise for the delays in these clinics and take on board your comments. We continue to explore alternative such as the Triaging to improve the situation.

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Update posted by B J N (a carer) on 09/09/2008 at 13:04

I have visited the same clinic on two or three occasions since I wrote this story on Patient Opinion. I am sorry to report that nothing has changed. I even filled in a second “suggestion” slip while I was waiting, and left my e-mail address for them to contact me, but I have heard nothing. The same system is in place. In fact last time I visited, the queue to both check in and make the next appointment was ridiculously long as the same desk was being used for more than one clinic. And the same name-calling system was in operation. I did notice a number of people muttering that they couldn’t hear the names being called and I wondered how many of them had complained or if it was just a disgruntled grumbling. To me it was still more like a cattle market than an Outpatient Clinic.

Fortunately, my Mother is soon moving into Residential Care in another county, and the District Nurse will come to her home to do the blood test. No more visits to the cattle market!