‘Threaten to make a complaint.’
I never thought I would ever utter these words to a patient, but I’m afraid it’s sometimes the only way to get hospitals to stand to attention and take notice.
I’m sure you have all experienced the situation weekly if not daily: a patient who has been an inpatient, or attended an outpatient clinic appointment, had a scan or other investigation in hospital and been told they will be followed up in clinic – but (surprise, surprise) no appointment is forthcoming.
The patient’s next response is to book an appointment with us, with the request we chase it up for them.
The health service should not work only when shouted at and threatened
My reply to these requests is often along the lines: ‘Well we can ask our admin team to phone up for you, but to be honest the hospitals are more likely to respond to patients than GPs.
‘My advice is to phone up the consultant’s secretary daily and if possible go in person to see them; a physical presence is harder to ignore than a phone call or email. If that fails, say you are going to make a complaint – that usually kicks them into action.’
It should not be like this. The health service should not work only when shouted at and threatened.
Yes, hospitals are over stretched and underfunded, but so are we – and in all but rare exceptions we make follow-up appointments for our patients to discuss tests we have organised.
Many hospitals are trying to do follow-up on a shoestring with nurse-led virtual phone clinics, which are cheap fob-offs. If a consultant has ordered an investigation, that consultant, or a doctor in their team, needs to sit down face-to-face with that patient and discuss the results and follow-up plan.
This is a fundamental part of medicine, which cannot and must not be cut out just to save money.
It is not only rude and inappropriate to dump follow-up of hospital investigations on the GP, it also contravenes safe medical practice.
So while there is very little chance of hospital practice improving in this regard, we should fight back and perhaps like toilet training dogs in less sensitive times, ‘rub their noses in their own mess’.
It might be crude but certainly keeps your carpets cleaner.
Dr David Turner is a GP in north-west London