The rights of patients.

granjura On the face of it, it seems a fair idea to charge people for not keeping appointments.

However, to make it viable, I think the charge would have to be significantly more than £30 at the lower end. There would have to be an appeals process because there may well be a valid reason for a person not keeping an appointment - a sudden emergency, illness, death in the family, etc. etc. Evidence would have to supplied and investigated. I would therefore imagine there would have to be a person allocated to the task of administering all this.

No doubt there are some people who are just irresponsible, but there may also be people with early onset dementia, mental health issues, mild learning disabilities, substance abuse issues, etc. etc. who may lead chaotic lives and who, in any event, may be unable or unwilling to pay.

I can see why this idea is tempting but I'm just wondering if it would mean that those who are truly vulnerable would end up becoming distressed or paying money that they can't really afford and those who are just irresponsible/uncooperative would make the system too expensive to operate.

The only email address on their website is [email protected], but we'll see what they say. The problem is that I already know the answer, so annoying them just makes the situation worse.

Crun I think the responsibility for particular policies lies with the individual NHS Trusts, rather than an overarching body like NHS England.
So that if your grievance was with, for example, Gruntfuttock Hospital, you should ask the Chief Executive of Gruntfuttock Hospital NHS Trust what their policy is.
If you get an evasive answer, or none at all, a Freedom of Information request is a good way of annoying them.

Not sure about charging for A&E- but I've for a long time said 'no shows' should be charged a significant amount of money. Something like £30 for a GP appointment, and £60 for out-patients app, and £200 for a missed op.

Was always told it would cost to pursue, and also that many patients on DNA, are on social help and would not be able to pay. Disagree- it would be a true deterrent, and I am not convinced at all the majority of DNAs are on social help.

What do you think?

"The NHS does have a constitution Crun "

The Handbook to the NHS Constitution says that:

"the fact that you have complained will not adversely affect your future treatment"

I have emailed the Health Ombudsman to ask what policies they have in place to ensure this, and they didn't even reply. I also asked NHS England, The CQC, Healthwatch, The Patients Assoc., PALS, and Voicability, but none of them had an answer either. I have already had my own safety put at risk by deliberate vindictive behaviour, so I know the answer.

I have all the proof I need to pursue a complaint, but I am too frightened to use it, the AVMA report that many of their clients are also too frightened to complain, and the Patients Assoc. recently reported that many of those who do complain live to regret it. The Health Ombudsman boasts that they reject 98% of all complaints without even investigating, and only half of the remainder are upheld. The IPCC upholds fourteen times as many complaints about the Police.

If there were a league table on the waiting room wall, too, of those PATIENTS who had missed appointments without good explanations, with the serial offenders highlighted in neon orange, it might just make an impression on the numbers.

But, of course, that would be breaching their right to confidentiality!

Our GP surgery shows the number of appointments which patients fail to keep - last time I went it was 59 appointments in one month.

Some patients do have strange priorities too- and when offered the only appointment left for EMERGENCIES (as described by patient to receptionist or doctor as such) say 'no can't possibly come then, I am having my hair/nails/pedicure/ etc done then ... I remember one such patient who when insisting for a same day emergeny appointment didn't turn up- and when she was phoned to ask why, said that she could not get an ambulance to pick her up (she was NOT handicapped and totally able to make journey by bus, door to door practically)- said she had already paid for taxi to go to hairdresser's that day and didn't want to spend money on one to doctors'). Another who said she didn't turn up for appointment because if she cancelled her hair appointment she would have to pay, but doctor's was free! And so on...

When I had an arthroscopy on my knee a few years ago, 3 patients on the morning list had NOT TURNED UP- despite reminders by post and phone sent, without bothering to inform the hospital- wasting surgeon's, aneasthetician, nurses, theatre, bed, etc, etc. And the same patients going absolutely berserk when told they would go to back of list again.

As said, the NHS is the best in the world- but part of its demise is that too large a % of users have taken it so much for granted, including its staff.

If you feel that things are not right between you and the NHS you can contact The Patients Association. www.patient.co.uk/directory/patient-advocacy-advice

How many of us have grasped a convenient hand in the midst of labour? Sometimes it might be a spouse or birth partner, but I seem to remember that a nurse was just as useful.

Medicine is not a 9-5 job- and a GP could not possibly tell you in advance when s/he is going to call you. The official surgery times maybe 7.30 to 10.30 (as an example) but the nature of the job is that some patients who turn up for 5 mins appointment suddenly need double or treble time, for all sorts of reasons. And often the doctor maybe called to deal with an emergency, either in house or house-visit (yes some still do home visits!)- or have to speak to a hospital doctor about a patient's history, or whatever.

I know things are changing fast- but many doctors never have time for lunch- or a break. And when the 'medical' part of the job is over, they have tons of admin to do, letters to consultants, insurance reports (which take ages, as all notes have to be gone through before doing). Many also train students and registrars (trainees) and teach at the local med school, on top of their GP work- which takes huge amounts of time, energy and preparation.

Hope all go well with your appointment on Friday- and that you can find ways to deflect your anxiety in the meantime.

Does the GP have a right to withold his/her number to avoid intrusive calls?

My surgery does telephone appointments, giving an approximate time, but their number is withheld. I would not dream of phoning them back on that number if I missed a call, I would ring the surgery instead.

The NHS does have a constitution Crun where the rights of patients are set out.
www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx

"I feel I have no rights as a patient."

I haven't been able to find much evidence that anyone has any rights at all over the NHS.

I have a Dr. friend who was severely reprimanded ten years ago because she did not inform a young man and his family how bad his cancer was. She says she was too upset, their little girl was the same age as hers and she kept on hoping for a miracle for him. As a result the family were in shock, because they felt she had raised their hopes falsely. It haunts her to this day, and so now she does feel she has to be blunter than she would like.

Ethel sorry, but if I met you now I would want to give you a big hug. That's just the way it is. Nothing patronising, it's me, not you, I would do it for my own benefit because I would be the one needing to hug you. No different from all those other ladies you come across, I have several friends who are nurses and doctors and every case upsets them. They wouldn't have chosen their profession if they hadn't been kind people.

Tell the receptionist that you are a medical emergency. Because, judging the state of your mind from only what you write on here, you really are one.

our GP surgery always call after morning surgery and before afternoon surgery so the doc is probably drinking cup a soup etc as they call between 1:45 AND 2:45!

If ethel is in an area with mobile phone coverage then this could be a very good way of getting access to treatment/results and other info quickly and efficiently.

As a GP's wife I know how difficult it can be from their side with hundreds of patients all wanting to speak to the surgery at the same moment and not enough resources to do the job.

Anything that will make it easier for your GP to get hold of you ethel is worth doing - they are on your side; as we all are.

The problem I have is that I live in a mobile notspot, so giving anyone my mobile phone number is a waste of time as I cannot receive calls. In fact my phone lives in my car because I only use it when I am away from home. However I do not hesitate to give my landline number and tell people I have an answaphone.

However I am with etheltbags1 when she complains about being expected to stay in all day because she has no idea at what time a promised call will come. I can see no problem with a doctor giving a patient a window when they will call 'before mid-day', 'after 2.00pm'.

Doctors do live in the same world as us and I am sure they would consider it more than slightly unreasonable if someone told them they will ring on Tuesday with no indication at what time

Oh yes, now I do remember gripping the hand of a poor nurse as a doctor carried out a very painful procedure years ago. I apologised to her afterwards!

Ps I think the problem with your surgery ethel is probably that the receptionist is rigidly following the rules and not using common sense. Mention the problem to your GP and suggest nicely that an adjustment needs to be made to the system re sick notes.

We are all so different and long may that last but i guess it makes it hard for some professionals who appear to be damned if they do and damned if thy don't!

I have held the hands of nurses during procedures and that human contact has been very comforting. I can appreciate others may find it intrusive.

I can't remember being hugged by any healthcare professionals, they always seem to be friendly but professional.

However I do remember a friend telling me that she got quite angry when she was nursing a sick relative. The Macmillan nurse would come and say 'I think what you need is a hug'. She said that no, she didn't, she just wanted some practical help and a break for half an hour.

Don't keep fighting the system ethel there is no conspiracy, these are professional people doing their very best in an over stretched system, so if you can help them by giving your mobile number it really would help them and help you. You would be really annoyed if you made a bus trip to an appointment only to find that it had been cancelled due to illness or emergency, so give them your mobile number and then you can be alerted to cancellations and postponements. ! Don't take this the wrong way, but you sound a very uptight person, always taking the worst view of what people are doing, being suspicious of motives and harking back to the so called good old days. Well, to be brutal, in the good old days you would have likely died from bowel cancer, now, thanks to advanced treatment and more open acceptance and discussion of bodily functions, you are likely to survive. Sorry to be brutal Ethel, but you are fortunate.....your illness has been diagnosed early, you will receive kind and professional treatment, don't make it worse by being suspicious and resentful of everyone's motives. Hope all goes well, today, and do keep in touch, because we do all care. Take this telling off as being for your own good!

Elegran that last paragraph reminds me of an elderly relative of DH who treated kindly ex-GP neighbour as her private consultant 24/7. His daughter was a friend and she said X phoned day or night expecting a visit and advice.
The poor chap eventually told her he was going ex-directory if she persisted so she said that was ok, she'd bang on the wall!!

Intrusive phone calls are a two-way thing too. The GP is probably phoning you from his personal phone at home, or from his mobile - the surgery number is being kept for people making appointments (or trying to!) and emergency calls from people who are really ill and need immediate attention.

If he/she gave out a personal phone number to all the patients on his/her list to ring back to, imagine how their day would go! Calls every five minutes, perhaps in the middle of a serious talk with a patient, from patients who want to bypass the receptionist and get an instant chat and diagnosis.