"Poor Rheumatology service"

About: Western Isles Hospital / Rheumatology

(as the patient),

Rheumatology admin - Letters from Consultant to GPs keep going missing, Blood results not passed to Consultant by admin and then not filed properly, letters typed up are not on the system for GP to see months after appointments, and paper copy is not put in the notes for other departments to see. Not a one off, has happened lots over the years. The service itself is proper poor, and the poor admin makes it all even worse. No one knows whats happening to the patient, and of course then you get a locum GP or Consultant, and with no proper record of copy of letters and results on your file, lots of results go missed, medicine not listed, and no proper plan on record of tests and things which manage the condition, are on file so all involved have no idea whats going on.

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Response from Denise Symington, PFPI Development Officer, NHS Western Isles

Dear Crofter 1

Firstly let me thankyou for taking the time to give us your feedback which we welcome. I wish to apologise for the problems that you have faced with your appointments and receiving your results, I passed on your comments to our Patient Services Manager, who has provided a technical explanation of the process for letters and results-

Our Clinic letters are dictated onto a digital system that allows us to track the letter to transfer to the GP. It is unfortunately still possible for things to go wrong through either human or IT system failure. To illustrate this:

1. After dictation, we have a target of processing our letters as 10 working days for Routine correspondence; 1 day for Urgent. We have achieved this target 94% of the time for Rheumatology typing since January 2015

2. After transcription, the clinician reviews & verifies the letter.

3. Verified letters are transferred electronically to the GP Patient

4. Should a letter fail to be transferred electronically, it is bounced back to the secretary for correcting. If after checking the above issues the letter still does not transfer, the letter is printed & sent via mail. The Patient Services Manager daily receives an automated report of failures.

5. A copy of all clinic letters is filed in the patient notes.

In relation to your comment about Lab results, our Lab prints and sends lab results to the clinician who requested the test, in practice most clinicians look up lab results in our electronic store, as the results are available as soon as they are verified in the lab. Lab results are also automatically electronically transferred to the GP patient management system.

A patient’s full hospital casenotes are present at every outpatient appointment and are prepared in advance of every appointment to ensure that the clinician has the relevant information at hand. These should include

• the last referral letter to that specialty

• any clinical communication from the last appointment

• any clinical notes made during previous outpatient appointments

We have had no incidents reported on our Datix system within the last year for Rheumatology clinics and our Patient Services Manager has asked that you consider contacting him directly as he would welcome the opportunity to investigate any specific failures so that we can improve the system.

I hope this feedback has provided you with some reassurance.

Yours sincerely


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