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Appointment ‘chaos’ for hospital patients

Patients suffering delays and disruption

21 February, 2020 — By Tom Foot

The Royal Free Hospital in Hampstead

CHAOTIC systems for booking hospital appointments are leaving patients experiencing “very severe disruption, confusion and delays”, a report found.

Camden Healthwatch has published its findings following months of research and interviews with 153 patients at the University College and Royal Free hospitals.

Most of the patients – from orthopaedics, rheumatology and dermatology – said they were “confused” by what happens after a hospital appointment because of poor communication.

More than a quarter of patients reported “things going wrong” with the booking process, including letters sent out with the wrong dates and appointments being “cancelled with no explanation”.

Information was not properly given to the patients about steps after an appointment, while a majority were not offered a choice of hospital.

One patient, who is also a GP, told Healthwatch: “I had to follow up with [the hospital] myself. I was ringing everywhere to chase the results. It wasn’t clear who to call. I was on the phone for two hours last week just trying to find out who to call.”

“Then they rang and said there was an appointment today but we didn’t know where. I rang them and couldn’t get any information. I spent so much time on this and I am someone who knows the system.”


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During a debate at Camden Council’s health scrutiny committee last week, Healthwatch Camden director Matthew Parris said: “There are a multitude of issues around the patient booking process.”

He added: “As patients came out of their appointment, almost all told us that they understood the next steps. Within moments, however, we saw this certainty change to confusion – where do I go with this piece of paper, how will I hear about the next appointment, is my blood test here or somewhere else?”

Councillors raised concerns about letters getting lost in the post and that non-attendance figures – the number of patients not making it to scheduled appointments – were high because of administrative bungling. UCH and the Royal Free use two different digital systems for booking patient appointments and sending out letters to patients. “I read the report and my heart sinks,” said scrutiny chairwoman Cllr Alison Kelly. “Poor patient experience is not what anyone wants.”

Last week, the New Journal revealed how 20,000 patient letters had not been sent out because of problems with the Royal Free’s digital systems. The report recommended hospitals “standardise patient letters and electronic messaging about outpatient appointments”.

UCLH medical director Gill Gaskin said: “There were no surprises. We knew that our administration and booking processes not as good as our clinical care. It has helped us narrow down our areas of focus – in that sense it has been very helpful.”

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