Anyone know their way around hospital procedures/targets etc. ?

Tricky Dicky · Jun 8, 2015

I know we have all sorts on here and I'm sure someone will have a clue :

I had bowel cancer last year, that was successfully operated on and scans are all clear, so that's great, but the op left me with a temporary stoma bag. I was told I'd have it for 4-6 months before reversing. I have now had the reversal op cancelled 3 times, today I turned up as scheduled, saw the surgeon, the anaesthatist and did all the paperwork .... and was then sent home due to "no beds". The second time this has happened.

My basic question is, are there targets that they have to meet to do certain operations ? Speaking to someone today, they said they'd been told his knee op had to be done within 4 months according to the guidelines.

Just wondering if I have any route for challenging them, this is ridiculous.

Indurain's Lungs · Jun 8, 2015

Tricky Dicky said:
I know we have all sorts on here and I'm sure someone will have a clue :

I had bowel cancer last year, that was successfully operated on and scans are all clear, so that's great, but the op left me with a temporary stoma bag. I was told I'd have it for 4-6 months before reversing. I have now had the reversal op cancelled 3 times, today I turned up as scheduled, saw the surgeon, the anaesthatist and did all the paperwork .... and was then sent home due to "no beds". The second time this has happened.

My basic question is, are there targets that they have to meet to do certain operations ? Speaking to someone today, they said they'd been told his knee op had to be done within 4 months according to the guidelines.

Just wondering if I have any route for challenging them, this is ridiculous.

Many of the targets (2 week cancer wait, 18 week wait for ops etc.) apply from referral by GP to hospital. You have received first treatment and therefore are probably not subject to any imposed targets. Your friend's knee op would be his first treatment and, therefore, subject to the 18 week target.

Sorry to break that to you but you'll get cancelled in favour of targets as that's what the hospital will be fined/paid according to. Stinks but that's what the government wants.

Since1982 · Jun 8, 2015

Sorry to hear that Tricky. I hope you get the reversal sorted sooner rather than later and that in the meantime you are keeping well and that the stoma is behaving!

Triggaaar · Jun 8, 2015

Tricky Dicky said:
I had bowel cancer last year, that was successfully operated on and scans are all clear, so that's great, but the op left me with a temporary stoma bag. I was told I'd have it for 4-6 months before reversing. I have now had the reversal op cancelled 3 times, today I turned up as scheduled, saw the surgeon, the anaesthatist and did all the paperwork .... and was then sent home due to "no beds". The second time this has happened.

Wife says you can try and get it done elsewhere, perhaps privately but paid for by the NHS.

Indurain's Lungs · Jun 8, 2015

Triggaaar said:
Wife says you can try and get it done elsewhere, perhaps privately but paid for by the NHS.

To have the NHS pay generally involves the NHS trust in charge of your care outsourcing to a private hospital. Often this happens to meet waiting time targets.

Unfortunately, the thing that can work is making a nuisance of yourself. Keep phoning the secretary of your surgeon and asking when it'll be done. Just make sure you're really nice to them on the phone so they both feel sorry for you, and have you at the forefront of their mind when someone cancels.

skipper734 · Jun 8, 2015

Indurain's Lungs said:
Many of the targets (2 week cancer wait, 18 week wait for ops etc.) apply from referral by GP to hospital. You have received first treatment and therefore are probably not subject to any imposed targets. Your friend's knee op would be his first treatment and, therefore, subject to the 18 week target.

Sorry to break that to you but you'll get cancelled in favour of targets as that's what the hospital will be fined/paid according to. Stinks but that's what the government wants.

Do you really think the Surgeon, Anaesthetist and the rest of his firm would waste their time joining in your conspiracy theory?

Tricky Dicky · Jun 8, 2015

Triggaaar said:
Wife says you can try and get it done elsewhere, perhaps privately but paid for by the NHS.

At one point last year I received a letter saying that to get their waiting lists down they were sending some reversal patients private and I "may" be eligible. I never heard anything more, but my guess is that because I am on dialysis, they took one look and decided I was too complicated.

Drumstick · Jun 8, 2015

Tricky Dicky said:
At one point last year I received a letter saying that to get their waiting lists down they were sending some reversal patients private and I "may" be eligible. I never heard anything more, but my guess is that because I am on dialysis, they took one look and decided I was too complicated.

Very much this. PM'd you.

seagullsovergrimsby · Jun 8, 2015

I work with someone who is waiting for a hernia op. He has currently been waiting for 41 weeks and still doesn't have a date. He expects that in 3 weeks time when the 18 week limit is up all that will happen is he'll go on to a new waiting list.

Triggaaar · Jun 8, 2015

Tricky Dicky said:
I never heard anything more, but my guess is that because I am on dialysis, they took one look and decided I was too complicated.

Ah, yes. Wife says do this:

Indurain's Lungs said:
Unfortunately, the thing that can work is making a nuisance of yourself. Keep phoning the secretary of your surgeon and asking when it'll be done. Just make sure you're really nice to them on the phone so they both feel sorry for you, and have you at the forefront of their mind when someone cancels.

From my experience, complaining makes things immediately better. On the couple of occasions that we've felt the need to complain, we've suddenly noticed an immediate improvement in the service we've received.

Indurain's Lungs · Jun 8, 2015

skipper734 said:
Do you really think the Surgeon, Anaesthetist and the rest of his firm would waste their time joining in your conspiracy theory?

Odd comment.

skipper734 · Jun 8, 2015

Indurain's Lungs said:
Odd comment.

Just find it strange, that you think Tricky Dicky's Op. being cancelled at the very last minute is down to targets.

Indurain's Lungs · Jun 8, 2015

skipper734 said:
Just find it strange, that you think Tricky Dicky's Op. being cancelled at the very last minute is down to targets.

I work in the NHS, I know how things get prioritised. I know how my patients get fitted in. Those patients who are under target waits are prioritised over those that aren't. It's a management decision.

That's fairly common knowledge even outside of those that work in the system.

Alex Alex Dawson oo! oo! · Jun 9, 2015

Tricky Dicky said:
I know we have all sorts on here and I'm sure someone will have a clue :

I had bowel cancer last year, that was successfully operated on and scans are all clear, so that's great, but the op left me with a temporary stoma bag. I was told I'd have it for 4-6 months before reversing. I have now had the reversal op cancelled 3 times, today I turned up as scheduled, saw the surgeon, the anaesthatist and did all the paperwork .... and was then sent home due to "no beds". The second time this has happened.

My basic question is, are there targets that they have to meet to do certain operations ? Speaking to someone today, they said they'd been told his knee op had to be done within 4 months according to the guidelines.

Just wondering if I have any route for challenging them, this is ridiculous.

I've been treated for bowel cancer for last nine years and during this time have had numerous surgical procedures, courses of chemotherapy and radiotherapy. My advice is to keep in regular contact with your surgical team by all means and do ask if there are other hospital options, it may be that your surgeon operates at more than one. For example; some of the Orthopaedic surgeons at the Royal Sussex also operate at the Princess Royal in Haywards Heath.
However, I would also complain formally about your treatment delays, short notice cancellation etc via your hospital's PALS group (Patient Advice and Liaison Service) group. In my experience they're very helpful, call them first to discuss your frustrations etc and then put it all in writing; such complaints get a detailed written response from the Hospital Trust and tend end up on the CEO's desk if it looks remotely politically sensitive. You might also request your GP to raise the case with the local commissioning group; they are paying the bill after all (but don't hold your breath).
As for the cause of your recent cancellation, I can't see it being down to some target or other. Assuming your hospital has an A&E unit then what's most likely to have happened is that admissions via Trauma A&E and MAU (Medical Assessment Unit) over the previous afternoon/evening/night had taken up all the spare bed capacity in the hospital and/or they've been unable (for medical or social reasons) to discharge the patient occupying "your" bed.
I've had a liver operation postponed for 24 hours after I'd been admitted because the ICU bed I would need immediately after the operation was taken by an emergency RTA patient and in February this year some poor soul had their op cancelled at the Royal Surrey in Guildford because I developed a GI bleed and needed admission for a few pints of the red stuff etc.
Anyway, best of luck with the re-plumbing when it happens and with the cancer.

Indurain's Lungs · Jun 9, 2015

Alex said:
I've been treated for bowel cancer for last nine years and during this time have had numerous surgical procedures, courses of chemotherapy and radiotherapy. My advice is to keep in regular contact with your surgical team by all means and do ask if there are other hospital options, it may be that your surgeon operates at more than one. For example; some of the Orthopaedic surgeons at the Royal Sussex also operate at the Princess Royal in Haywards Heath.
However, I would also complain formally about your treatment delays, short notice cancellation etc via your hospital's PALS group (Patient Advice and Liaison Service) group. In my experience they're very helpful, call them first to discuss your frustrations etc and then put it all in writing; such complaints get a detailed written response from the Hospital Trust and tend end up on the CEO's desk if it looks remotely politically sensitive. You might also request your GP to raise the case with the local commissioning group; they are paying the bill after all (but don't hold your breath).
As for the cause of your recent cancellation, I can't see it being down to some target or other. Assuming your hospital has an A&E unit then what's most likely to have happened is that admissions via Trauma A&E and MAU (Medical Assessment Unit) over the previous afternoon/evening/night had taken up all the spare bed capacity in the hospital and/or they've been unable (for medical or social reasons) to discharge the patient occupying "your" bed.
I've had a liver operation postponed for 24 hours after I'd been admitted because the ICU bed I would need immediately after the operation was taken by an emergency RTA patient and in February this year some poor soul had their op cancelled at the Royal Surrey in Guildford because I developed a GI bleed and needed admission for a few pints of the red stuff etc.
Anyway, best of luck with the re-plumbing when it happens and with the cancer.

Very sensible advice, people working in the system, on the whole, want to do the best for patients and sometimes a complaint helps them do that.

Tricky Dicky · Jun 9, 2015

I have an ongoing mail conversation with PALs after I complained in Feb - so, far they have come back with nothing, citing shortage of their own staff, but I shall continue.

After Feb, I tried to get through to someone sho could tell me what was going on, but I found it impossible. I went through my renal consulatant, my MacMillan nurse, my stoma nurses, my GP and my surgeons secretary, but I could not get to talk to anybody who could tell me anything, and they had no idea themselves who actually deals with these things - they just said "I'll email x for you" but wouldn't tell me who the end-point person was.

I shall be starting to ring today to make a nuisance of myself as soon as I'm off my dialysis machine.

Indurain's Lungs · Jun 9, 2015

Tricky Dicky said:
I have an ongoing mail conversation with PALs after I complained in Feb - so, far they have come back with nothing, citing shortage of their own staff, but I shall continue.

After Feb, I tried to get through to someone sho could tell me what was going on, but I found it impossible. I went through my renal consulatant, my MacMillan nurse, my stoma nurses, my GP and my surgeons secretary, but I could not get to talk to anybody who could tell me anything, and they had no idea themselves who actually deals with these things - they just said "I'll email x for you" but wouldn't tell me who the end-point person was.

I shall be starting to ring today to make a nuisance of myself as soon as I'm off my dialysis machine.

Sorry to hear you've had such a crap time of it. I think a cheap way to improve the NHS would be greater transparency. Often people just want to know where they stand.

Tricky Dicky · Jun 9, 2015

Indurain's Lungs said:
Sorry to hear you've had such a crap time of it. I think a cheap way to improve the NHS would be greater transparency. Often people just want to know where they stand.

Indeed. Last time, in Feb, I just wanted info - if they'd said 4 months, it would have been bad but at least I would have known, but they told me nothing. I can't work, I can't sleep more than 90 mins at a time, plus, as a dialysis patient I have open access points on my arm and the stoma bags leak, so I have open wounds and shite around which is extremely dangerous.

I am so angry now, I don't want to take it out on whoever I get to speak to, I know it's not their fault, but it's getting hard to control myself with the frustration. That's not my nature either, but it may be shortly !!

ROSM · Jun 9, 2015

I found PALS at the RSCH to be disappointing. I fear that hospital administrators see all complaints as attempts at compensation and therefore legal pitfalls which is quite a sad indictment of current times

Tricky Dicky · Jun 9, 2015

ROSM said:
I found PALS at the RSCH to be disappointing. I fear that hospital administrators see all complaints as attempts at compensation and therefore legal pitfalls which is quite a sad indictment of current times

Well, I am now thinking about compensation. As I can't work and I now make them responsible, I may start to charge them at my normal contractors rate, which is £1,000 a day.

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