"Numerous problems experienced with TRAQS service "

About: Telford referral and quality service (TRAQS) The Princess Royal Hospital (Telford)

(as the patient),

In late Sept 2012, I asked my GP to investigate a persistent cough which I thought might be linked to gastric symptoms. He asked me to:

- make an appointment with the nurse

- report to PRH for a chest x-ray (times etc. on the envelope)

- take a prescription for a nasal spray

He also made a referral for an endoscopy. I asked if this appointment would come through the post and he said it would. With several things in hand, at the end of the week, not being given a yellow TRAQS leaflet is understandable.

A few days later, whilst I was at work, my husband received a phone call which he said was something to do with a patient survey. The caller said he/she would telephone again, but to my knowledge no one did. In any case I would have been at work. I was not aware that this was linked to the endoscopy until I received a letter in early October from TRAQS, explaining that I would hear from Wellington Road Community Clinic. As I did not know where Wellington Road Clinic was, nor indeed what a community clinic was, I telephoned TRAQS, a service I had heard nothing of either. The person I spoke to said I would receive an appointment through the post for a GP surgery in Newport and I could not speak directly to the surgery to avoid being given an inconvenient time.

Being away from home for a few days, I returned at the end of October to find that an appointment had been made for me on the following day at 1.50 pm. Fortunately I had just enough time to re-arrange my commitments to enable me to attend. It was just lucky that I was not still away. Upon presenting for the appointment I explained my anxiety about not being offered sedation. I know several people who have had an endoscopy, including my mother and late mother-in-law, who had been able to have sedation for what they describe as an otherwise unpleasant experience. Despite 2 attempts, I was not able to tolerate the procedure and I was then referred to Princess Royal Hospital.

One month later my husband took a call from the endoscopy unit. At 10.00 at the end of November, I was asked to attend at 9.15 the following day. These were both working days for me, so I asked if I could have an appointment in the next 2 weeks. The caller explained that the hospital had to do the procedure in the next 2 weeks but was unable to offer an alternative date/time. I was therefore not in a position to decline the appointment the next day, so I lost a day's pay.

As a newly initiated service, TRAQS may like to reflect on:

1. For someone who lives 10 minutes walk from PRH, why would an appointment in Newport be convenient?

2. If appointments are given out without discussion with patients, why would there be an improvement?

3. Does an additional layer of bureaucracy make a positive difference?

4. Is it acceptable to contact patients with a day's notice with the offer of a 'cancellation' (3 people in the waiting room on that Friday seemed to have been offered these, including myself)? Does the level of cancelled appointments correlate with their random allocation, without consultation with the patient, who has work and other commitments?

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Response from Helen Handy, TRAQS & CAB Co-Ordinator, Telford and Wrekin CCG

Thank you for taking the time to provide feedback relating to your recent experience of a referral through TRAQS.

You state that you did not receive a TRAQS leaflet from your GP, this is a fundamental part of the process as it alerts patients to expect a call from TRAQs to discuss their referral and also reminds the patient to inform their GP of all contact numbers to ensure that TRAQS are able to contact the patient without delay.

Referrals of this type are reviewed by GP's who work within TRAQS as a large number of patients can be seen at clinics within the Community, which is both quicker for the patient and more cost effective for the PCT. If a patient feels that they would need to have sedation we would hope that the GP has included this information within the referral letter. If this information is not included then the patient will be reviewed on the clinical information and referred to the most approriate service by the GP reviewing the letter from the referring GP. Referrals suitable for the Community Cinic are sent electronically via a secure method to the relevant admin team at the clinic and are then reviewed by the clinician to ensure that the patient is suitable to be treated in the service. Because of this we do not normally give out phone numbers to patients as this can cause confusion at the practice dealing with the referral. TRAQS are more than happy to contact the Community clinic on behalf of the patient if there are any dates that are not suitable for the patient to attend due to holidays, etc.

1. The is currently a long wait for appointments at PRH therefore if the patient is suitable to be treated in the Community - Wellington Road Clinic this is offered as a first option. Patients can choose to wait for an appointment at PRH but TRAQS are unable to give any indication of how long they may wait to be seen by a consultant.

2. Wellington Road Clinic manage their own clinics - this is not something which is bookable by TRAQS

3. Patient Choice has been part of the NHS Constitution since 2009 - Patients registered with an English GP have the right to choose from any NHS funded provider if their GP refers them on for further care.

4. Offers of short notice appointments are sometimes offered if the clinician is able to offer an extra clinic at short notice - some patients may find it difficult to attend but on the whole patients appreciate the offer of an earlier appointment even at short notice. Obviously this is a personal decision. The booking process at the Endoscopy Unit is managed by the hospital. If you have any comments to make relating to this please contact the PALS Officer at Princess Royal Hospital NHS Trust

01952 282888

Thank you again for taking the time to comment on your recent experience. I hope that you are feeling better now that you have had your procedure and hopefully received a diagnosis.

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