"I am a patient suffering from ..."

About: Brighton General Hospital

(as the patient),

What I liked

I am a patient suffering from a painful and disfiguring skin condition, for which I have received treatment in various cities in the UK and abroad, in both the nhs and private sector. My experience in the Dermatology department at Brighton General is mixed. I find the facilities good and the nursing staff excellent. However, I find the clinic logistics ridiculous and the Consultant I saw was dismissive and difficult to communicate with.

On the occasion of my first appointment the Dermatologist's consultation was entirely perfunctory, having sent some very nice, though inexperienced, students to practice alone on me for 10 minutes; the consultant then spent less than 4-5 minutes with me. This was 2-3 more than was spent on my follow-up appointment.

There simply was not enough time to discuss my condition or the options for future treatment properly. The later being particularly important as I have had my condition for such a long time that treatment the options are increasingly worrying and requiring proper understanding and consideration.

I found the consultant's approach extremely disappointing and upsetting. I know for a fact that it is in stark contrast to the practice of many other specialists at teaching hospitals. Whilst I am very happy to have students present at a consultation and even to be engaged in giving supervised treatment , I found that in this case it was simply a way remaining completely removed from the patient both literally and figuratively.

Having been prescribed phototherapy, I have found the nurses running the clinic are very professional and caring. However, the treatment itself is shambolic. In another unique (in my experience) approach to patient 'care', the treatment has been whittled down from the recommended 3 to 2 times a week. This is bad enough, but the timetabling of the treatment is at best inefficient and at worse harmful.

This excellent clinic is underutilised as it is only open 4 days a week during normal working hours. At least one of the specially trained nurses that run the clinic is reluctantly put on notes shuffling duties when its closed, rather than being put to use in the empty clinic. The clinic is a wasted resource, which could be providing significantly more value for money as well as better patient care.

Exposure to phototherapy treatment should be regular and staggered. However, It is given on either Monday and Wednesday OR Tuesday and Thursday. This means that there is a significant gap before the first treatment of the week. The result is that the patient is potentially burnt by increasing the dose or prevented from proceeding with the increase to avoid it. Both will ultimately slow the treatment down and may cause unnecessary damage too.

What could be improved

Compel Consultants to spend at least 10 minutes in direct contact with patient's during their consultation.

Open the phototherapy clinic at least 5 days a week, preferably on Saturday mornings too. The hours should also extend earlier and later in the day (as they do in every other clinic I know of) to take account of peoples' schedules. This will allow much better utilisiation of this resource. At very little more cost, many more patients can be treated, which is ultimately money saving.

To properly maximise the efficacy of the treatment and utilisation of the facility, the scheduling of treatment should also change. There should be a option for thrice weekly treatment for those who can and will attend. For those receiving twice weekly sessions, these should be evenly spread out. Monday and Thursday OR Tuesday and Friday schedules would eliminate the problems I have already raised.

Story from NHS Choices

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