Every month Rutland Patient’s Voice publishes a monthly column in the Rutland Times. Shorter versions of each column are available below.
Today’s Doctor joke
St Peters Way
Two doctors and a senior manager at the NHS die and line up together at the Pearly Gates. One by one they approach St. Peter.
1st Doctor: “I am a paediatric surgeon: I have saved hundreds of children’s lives”
St Peter: “Wonderful, you may enter”
2nd Doctor: “I am a psychiatrist, I helped thousands of people live happier lives”
St Peter: “Thank you for your work; you are welcome, please enter”
NHS Manager: “I am a financial manager and I saved millions of pounds by making budget cuts”
St Peter: Welcome my son; you may enter. But only for 3 days. After that, you can go to Hell”
Administrators in large public organisations are never popular. The bigger and more public the organisation; the more likely that dissatisfaction will arise. And organisations do not come any bigger or more of a public service than the NHS.
We know that the NHS faces challenges and that there will be some patients who will find the changes difficult to deal with. But what is sometimes difficult to understand is the inefficiency and lack of consideration with which changes are sometimes introduced.
Certainly, the recent hiccups in the daytime services, for minor injuries, at the Rutland Memorial hospital (RMH) in Oakham, would give some cause for dissatisfaction. We, at the Patient’s Voice, think that some explanation is appropriate and we will attempt to set out the facts as we understand them.
Several medical services are available at the RMH; these include a residential care ward, consultant appointments, an X ray unit and a short notice and drop in service for patients with minor injuries or urgent concerns about health. It is only one of these services of which I am reporting.
The service is called the Minor Injuries Unit (MIU) and provides an 8.30am to 6.30pm basic response to injuries for Rutland residents and visitors to Rutland. It is delivered by the Oakham Medical Practice (OMP, which is situated on an adjacent site).
This MIU service is paid for, under contract, by NHS Commissioners known as the East Leicestershire and Rutland Clinical Commissioning Group (ELRCCG)………… not a catchy title, I am afraid. It is the renewal of this contract, due at the beginning of April, which has been the root of the problem. Dramatic financial changes to the renewal terms of this contract, which were offered at the 11th hour, were unacceptable to the OMP. Over the last 2 months the OMP have managed to keep this service operating whilst talks are continuing. However, there has been uncertainties and hiccups, which have impacted on staff and patients alike.
As I write, it has been announced that new contractual terms have been finally agreed. The service will continue. We will give more details of just how this service can fit into your health needs in a later article.
We hope that services settle down quickly, but we are asking patients to recognise that it is not receptionists, nurses, doctors and back office staff who should bear the brunt of your frustration and anger. Please convey your frustration, but not your anger – you will know what it feels like to be unfairly criticised.
This column is submitted by the committee of the Patient Participation Group of the Oakham Medical Practice. All medical practices are required to establish such a group. The PPG group tries to act as the ‘Patient’s Voice’ to the medical practice on behalf of all the registered patients; the group is a special Partnership forum between patients, GPs and the Practice management. All patients are encouraged to join the group and you can do so by emailing your details to firstname.lastname@example.org
Today’s Doctor joke:
Patient: “Doctor, I just can’t stop singing ‘The green, green grass of home’. It goes on all day and all night and I am exhausted”
Doctor: “That sounds like the ‘Tom Jones Syndrome’”
Patient: “Is it common?”
Doctor: “It’s not unusual”
Another thing that’s ‘not unusual’ is for patients to have difficulty making telephone contact with the Oakham Medical Practice surgery between 8.30am and 10am. When we hear the engaged tone, what do we do next….. put the phone down and think: “Bl***y receptionists…….they can’t even bother to answer the phone.
Then we ring again and now we hear the recorded message. “Ha, couldn’t organise a p**s-up in a brewery, that lot.” Now we put the phone down again.
The Practice receives a phone call every 40 seconds, on average, throughout the working day. Now, that is the average and between 8.30 – 9.30am it receives an eye-watering one every 12 seconds. There is no practical way that this number of calls can be dealt with…. so, patients and the Practice must work together to ease this problem-spot.
A new and improved telephone system was installed in March last year. The system can take many more calls and allows the manager to monitor incoming calls. Staff can be deployed from other tasks, at busy times. Callers who have hung up can be identified and contacted later. Reception staff really are efficient and hard-working and achieve the best result for patients within the resource constraints that they work.
So it is going to be necessary for patients to change the time and method of contact in the future. Resources will not increase sufficiently to meet the early morning demand.
The single biggest way that patients can help is to make telephone contacts after 10am. Even more helpful would be to make calls after 12 noon. Afternoon calls are generally answered immediately.
Other ways that patients can help are by not hanging up when their call is being held, using the online appointments system, using the self-referral system. Please save yourself the frustrations of ringing first thing in the morning… ring later if you possibly can.
Are you an invisible patient?
Today’s Doctor joke:
Receptionist at the Surgery: “Doctor, there’s a patient on the phone who says he’s invisible”
Doctor: “Well, tell him I can’t see him at the moment”
You might think that invisible patients are pretty rare. Yet every day, reception staff are searching and calling out the names of patients who have booked to see a doctor or nurse. The doctor is waiting and receptionists are neglecting other duties elsewhere and these invisible patients seem to be crouching silently in a corner of the surgery.
Research has now revealed that the problem is not one of invisible patients, but it is a problem of patients who have not turned up for their appointment and have not informed the surgery.
You might think that the majority of DNAs (Do not attend) are elderly patients with failing memories. But no………, many are patients who change their mind or find the time inconvenient and then do not have the forethought to ring the surgery.
In the last 12 months there have been 4,479 missed appointments at the Oakham Medical Practice. That is an eye-watering 86 appointments per week or 17 per working day. It is 5% of all appointments that are missed. This wastes the time of half a full-time doctor or clinical nurse.
The good news is that 78,963 patients arrived for their appointments as planned.
Congratulations and very well done to all and every one of you for supporting your local surgery in a thoughtful and efficient way.
But for all those ‘invisible people’ out there, please make a big effort to record and remind yourself about appointments. Just think that you can help someone see their doctor by just making a quick call to the surgery.