{"id":42656,"date":"2018-07-20T14:09:18","date_gmt":"2018-07-20T13:09:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=42656"},"modified":"2018-07-26T12:22:20","modified_gmt":"2018-07-26T11:22:20","slug":"richard-smith-the-shambles-of-the-nhs-two-week-urgent-appointment-system","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/20\/richard-smith-the-shambles-of-the-nhs-two-week-urgent-appointment-system\/","title":{"rendered":"Richard Smith: The shambles of the NHS two week urgent appointment system"},"content":{"rendered":"

\"richard_smith_2014\"<\/a>I have a lesion on my chest that could be a skin cancer, one of the slow growing non-lethal ones. I\u2019ve had it for about two years and thought little about it. My daughter, a medical student, thinks I should see a doctor. I visit the GP, where a locum takes less than a minute to say he\u2019ll refer me. The shambles begins.<\/span><\/p>\n

Because this could be CANCER the NHS insists I should be seen within two weeks. A few days later on a Friday the practice rings me to say that they\u2019ve made an appointment for the following Tuesday. I say I can\u2019t do that because I\u2019ll be in Bangladesh. They say they\u2019ll ring me on Monday before I leave in the evening to make a new appointment. They don\u2019t.<\/span><\/p>\n

While in Bangladesh I\u2019m sent an appointment by text for a day I can\u2019t make because of an important meeting arranged months ago. When I get home I ring to say that I can\u2019t make the appointment. I spend about 10 minutes listening to a woman against a background of distorted music saying: \u201cYour call is in a queue and will be answered as soon as possible.\u201d I hear it perhaps 15 times. At least she\u2019s not telling me that my call is important.<\/span><\/p>\n

Eventually, a woman answers. I tell her that I can\u2019t make the appointment and tell her dates I can make. She says she\u2019ll ring me back. She doesn\u2019t.<\/span><\/p>\n

Two days later I get a text telling me to come to the hospital the next day, on the day I\u2019ve told them I can\u2019t make. My appointment hasn\u2019t been cancelled. I ring the hospital again, and I spend another 10 (possibly 15) minutes listening to the distorted music and the voice. Eventually a woman answers, and I tell her I need to cancel the appointment and retime. I tell her as well that I rang two days\u2019 earlier and somebody said they\u2019d ring me back but didn\u2019t. She doesn\u2019t apologise but tells me they are busy.<\/span><\/p>\n

This is when it becomes very silly. She tells me that she has no appointments for next week and that as it is now two weeks since I was referred she can\u2019t give me an appointment. I have to contact my GP again. \u201cThis is crazy,\u201d I say, \u201cI know it\u2019s not your fault.\u201d<\/span><\/p>\n

I ring the GP and spend perhaps 10 minutes listening to a voice saying \u201cYou are first in the queue.\u201d Eventually I redial and get through quickly and explain the problem. The receptionist says she\u2019ll make another appointment with the doctor. I explain that I don\u2019t need to see the GP again but simply to be rereferred. She says she\u2019ll send a message \u201cto admin.\u201d<\/span><\/p>\n

A few days later I get a text telling me that I have an appointment with the GP. I can\u2019t face phoning again, so I attend the appointment. When I arrive the receptionist says: \u201cWhat are you doing here? This is supposed to be a phone appointment.\u201d I say that the text didn\u2019t say that, and she tells me that the system doesn\u2019t have that capacity\u2014it can tell you only that you have an appointment, not that it\u2019s supposed to be by phone.<\/span><\/p>\n

I see the GP and tell him my story, cutting out all the absurdities, which is most of the story. He glances at my skin lesion and rerefers me on the spot through his computer.<\/span><\/p>\n

I then begin to receive a stream of texts, telling me both when my appointment is and that my former appointment is cancelled and that I need to get referred again. Then I get two letters telling me to get rereferred. The system doesn\u2019t know that I have been rereferred.<\/span><\/p>\n

After all this, I reflect on the acute observation that:<\/span> \u201c<\/span>If there were no patients the system would run perfectly.\u201d I think too how North West Airlines, which I had the misfortune to use regularly, was known to people in Minneapolis as \u201cthe F\u2026 You Airline.\u201d Sometimes the NHS feels the same.<\/span><\/p>\n

I\u2019ve now attended the clinic and had my cancer removed, learning when I went that the two week requirement to see patients with possible cancer is overwhelming dermatology (see here<\/a>). Luckily, the dermatology and surgery was better than the appointment system.<\/span><\/p>\n

Richard Smith<\/strong>\u00a0was the editor of <\/em>The BMJ until 2004.<\/em><\/p>\n

Competing interest:<\/strong> None declared.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

I have a lesion on my chest that could be a skin cancer, one of the slow growing non-lethal ones. I\u2019ve had it for about two years and thought little […]<\/p>\n

More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":42658,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236,955],"tags":[],"class_list":["post-42656","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs","category-richard-smith"],"yoast_head":"\nRichard Smith: The shambles of the NHS two week urgent appointment system - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/20\/richard-smith-the-shambles-of-the-nhs-two-week-urgent-appointment-system\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Richard Smith: The shambles of the NHS two week urgent appointment system - The BMJ\" \/>\n<meta property=\"og:description\" content=\"I have a lesion on my chest that could be a skin cancer, one of the slow growing non-lethal ones. 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