"Access to psychological services"

About: NHS Borders

(as the patient),

Since 2003 I have had on and off episodes of mild to moderate depression. Last year 2013 I received excellent support from a Clinical Associate at the clinic in Galashiels (NHS Borders). I said at the time that I felt that I may need access to a telephone consultation from time to time and she said she would put this on my file.

Earlier this week I telephoned as I had a question about something that I was confident could be dealt with over the phone. I was told this was not possible, when I related my story I was told that because it had been over a year I would need to see my GP and get a referral. When I questioned the wisdom of this and that it was not meeting my needs as a patient I was told that there was a waiting list and this was the process to be followed.

It occurs to me that many other people will find themselves in a similar position to me and that a 10minute conversation will be enough to deal with many patient questions. A good clinical psychologist can stop the consult at any point if it is felt a more detailed and/or face to face meeting is required. I believe this would remove the pressure on waiting lists and also help GP's who are having to provide 10minute consultations to patients only to then refer them.

What I am effectively proposing is a triage system similar to A & E. Patients are not "jumping" the queue in that example and modes of delivery such as minor injury units are all examples of considering a challenge through the eyes of the patient.

Just because something has always been done in a particular way does not make it correct and you may have what you consider to be a stable system delivering outcomes that patients are not happy with.

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Response from Stephen Bermingham, NHS Borders

Dear Frustrated but a fan

Thank you, for taking the time to provide constructive feedback about access to psychological services. We have discussed the issues you have raised with the Head of Service. The service is constantly reviewing their systems – and they agree that the fewer barriers there are to access the better. There are challenges to implementing a system with a contact name and number due to a changing workforce and high workload, but that is not to say it cannot be done. The Head of Service has agreed to consider your feedback at their next management meeting. If you have specific issues you want to raise about your access to treatment, please can you contact the Feedback and Complaints Team on 01896 826719. Thanks, Stephen Bermingham – NHS Borders

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Update posted by Frustrated but a fan (the patient)

Thanks for the response it was positive and I am hopeful of a good outcome. It would be helpful for patients to be part of any service re-design of course.

Something that did concern me was the statement by the person I spoke to on the phone that "if I wasn't happy with the process I would need to speak to the Chief Exec". Essentially saying that we will not change our service design based on feedback from patients but only if the Chief Exec tell us to. A bizarre way to think, I understand it was probably a challenging conversation to have but at least ask the patient why they think the proposed change would be a good idea?

Updates, changes and questions related to this story