"If I am to be seen in the community, surely I should expect to be seen in my community?"

About: NEMS (Nottingham Emergency Medical Services) Specialist services / Podiatry

(as the patient),

I was referred to Podiatry by my excellent GP Dr Pathy from Trentside Medical Practice in late July for an ingrowing toenail for which I was experiencing extreme pain. I was given antibiotics for the infection it had caused and of course the referral to Podiatry was made. Approximately one week later, I received a letter for Choose and Book and when I went on to the website, I was given the option of Park House for early September or Arnold which stated they had no appointments.

In the six weeks until my appointment, I checked the choose and book website to see if it was possible to get an earlier appointment. This was not possible and I had to go to NEMS as I was hardly able to walk and the nail had become re infected. The doctor I saw stated that I needed surgery and that the infections would reoccur until the surgery had been done. The doctor was aware of my appointment in early September and said that the antibiotics would kerb the infection so the podiatrist could do what was needed.

When I got to my appointment I was told that I needed surgery and that they couldn’t do it then because it required two members of staff and I was offered an appointment at the end of September. I did not feel that I could wait a further 3 weeks as I was already finding it difficult to put shoes on to walk and drive to work and when I mentioned this to the Podiatrist I was given the option of the following Monday at West Bridgford or a Tuesday at Mansfield. I opted on the appointment at West Bridgford because of the pain. The change of location was at a cost to me of £20 which the Trust feels is appropriate. I tried to explain to them at there is a difference between choices and options and that if I am to be seen in the community rather than an acute setting surely I should expect to be seen in my community.

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Response from Duncan Heaney, Head of Service - Podiatry, Health Partnerships - Nottinghamshire Healthcare

Thank you for taking the time to leave your comments, the department welcomes all feedback from service users., and we are constantly striving to improve the service we provide.

The department operates within nationally agreed timescales of 8 weeks from referral to initial asessment, and 13 weeks from referral to tretament. In reality waiting times are often substantailly shorter than this. For example, the average waiting time for the Nottingham North and East Clinical Commissioning Group for August was 4.2 weeks.

We offer nail surgery clinics at various venues across the county, to maximise patient choice.

I am sorry if you feel that the service has failed to meet your expectations on this occasion, and would be happy to discuss further.

Please feel free to contact me on 01623 785208

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Update posted by Ryder (the patient)

Thank you Duncan for your response. We can all use data to serve a purpose, but unfortunately the people who use your service are not numbers or nationally agreed time scales, they are individuals, some of which are in pain.

As to constantly striving to improve services, how can you do this if you don't listen to what patients are telling you? It is obvious that you still haven't taken on board my comments.

As to 'sorry if I feel the service has not met my expectations' it is not about expectations it is about my needs and outcomes. This seems to be something you feel is secondary to your service meeting the nationally agreed time scales.

Response from Vanessa Briscoe, Divisional General Manager - Specialist Services, Health Partnerships - Nottinghamshire Healthcare

Thank you for your comments, we consider all feedback important in developing and improving our services. From your original post as I understand it, you were seen within a week from assessment to treatment. I hope this surgery went well and that the specialist podiatrist took the time to explain your treatment plan and treat you with dignity and respect., I hope you are now feeling some relief from your infected toe. It would appear from your postings that you are still feeling aggrieved at your treatment. I would advise you to contact Laura Flanagan on 01623 673 769 to register your concerns formally so we can investigate your individual situation. I am sure that the commissioners would also welcome your views on podiatry service provision and they can be contacted through PALS at Nottingham North and East CCG.

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Update posted by Ryder (the patient)

After going through the complaints procedure with Nottingham North & East CCG it would seem that whilst they are sorry that I had a bad experience they feel that as long as they are meeting the current guidelines they don't really care if you are in pain. There are obvious inequalities taking place and improvements that can be made but the Management of this service I feel are not willing to take responsibility and step up to the plate. I would like to point out that I had no problems with the Podiatrist I saw, the podiatrist was excellent. My advice to anyone would be to REFUSE this service and ask for referral to the hospital (after all as a patient you have a choice), at least you know where you stand with them and perhaps a drop in referrals will kick the antiquated management into touch.

Response from Lisa Metcalf, Specialist Podiatrist, Podiatry, County Health Partnerships

picture of Lisa Metcalf

Hello Ryder,

Many thanks for letting us know about the experience you had with our podiatry service. I am one of the podiatrists working at Park House, although I didn't have any input in to your care. Park House has been a particularly busy clinic recently, and unfortunately the wait for new patient appointments has been 4 weeks or so.

For a lot of patients with routine foot problems this time frame is not too bad, but I completely understand that when you have an acute condition with infection, such as you did, 5-6 weeks is a very long time to be in pain.

We have a staff meeting on Tuesday 11th November and I am going to raise your experience there. I intend to talk to colleagues to see if they have any ideas about how we could try and offer patients with more urgent conditions a faster appointment. This could be quite difficult with the choose and book system, as effectively we would be asking whoever is referring you to triage whether your condition is routine or urgent. However, my promise to you is that we will discuss it to explore if there is anything further we can do.

We have recently recruited three new podiatry staff, one of which will be based at Park House. Hopefully increased staffing levels at this clinic will start to help reduce waiting times for new patients.

We really do want to hear from patients about their experience of our service, and I want us to learn from this and see if there is anything we can do to improve things for people with particularly painful podiatric problems such as yourself. Thank you very much for taking the time to tell us about this.

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Update posted by Ryder (the patient)

Hi Lisa, thank you for your response. At last someone who gets it.

You have also managed to answer a couple of questions that your senior management seem to be skirting around.

I wanted to add that my complaint was never about the actual Podiatrist I saw Hannah, because she was excellent. My complaint has only ever been about the systems and processes, the lack of Patient Choice and the apparent health inequalities I have experienced.

I am hopeful that with people like yourself changes can be made.

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