"Trouble getting an ophthalmology appointment"

About: West Suffolk Hospital / Ophthalmology

(as the patient),

I developed a blind spot in one eye, which became noticeable and therefore distracting, even though quite small, early in 2011. It is accompanied by other visual distortions which I now believe to be the blood vessels supplying the retina.

Naturally I went to a high street optician for a checkup, as my GP doesn't have the facilities. My prescription (short sighted) hadn't changed in four years. Initial FoV test confirmed the blind spot but visual exam, including retinal photography, couldn't detect any unusual areas, scarring or other damage. The ophthalmologist was concerned enough to recall me for 3-monthly checkups (at no further cost): each time we discovered that my prescription hadn't changed, and the blind spot seemed to come and go - sometimes it was visible on the FoV test, other times not. At each visit I was offered a referral, which I declined, hoping to get a proper history and save some time going back and forth with the specialist.

On the first visit of 2012 my prescription changed, not by much, but making my vision slightly worse. The blindspot is still there, and the other distortions are noticeable more often now. Although my ophthalmologist had changed and it is possible the prescription was merely the result of using different equipment, the change isn't drastic enough for me to be able to tell. As there had been some negative change, I decided to answer the question properly and requested a referral, which was sent at the end of January.

At the end of February I went to check with the opticians again: they claimed the letter had been sent, but as a sign of goodwill printed it, signed it, and sent it again (without prompting) while I was in the store. A fortnight later I checked in with my GP as I had still heard nothing, and the delay was unusual from both GP and local hospital (West Suffolk Hospital, a teaching hospital attached to the University of Cambridge medical school). My GP's receptionist confirmed receiving both referral requests but was clearly distressed to have no reply from WSH.

I waited another week before contacting WSH Ophthalmology myself. They are near impossible to get through to during the day, and go to answering machine at 5PM. When I finally found time to get through, yesterday, I was told they had only received the second (!) request, eight weeks ago, and that I would hear from them regarding the date of my first appointment sometime in the next ten weeks. I didn't argue for six weeks as I doubt I will even be seen in the next ten weeks as it stands.

I'm clear on what has actually happened, but I've never had this level of difficulty getting a simple, and urgent, healthcare assessment performed.

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Response from West Suffolk NHS Foundation Trust

Thank you for providing feedback on our service. We were very sorry to hear of your poor experience.

If you would consider contacting PALS (Patient Advice & Liaison Service) on 01284 712555 or via email: pals@wsh.nsh.uk, we will endeavour to look into the matter and respond to you in detail.

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Update posted by Magnus (the patient)

Without wishing to seem ungrateful for your response, it is clear to me from my own dealings with WSH Ophthalmology that this is simply a matter of capacity. There is no spare capacity. That is not unreasonable; the department has something like twelve clinical staff to see to thirty thousand appointments a year and three thousand operations. Eighty two appointments a day including nine operations hardly suggests there was much spare capacity even before Mr Lansley got a bee in his bonnet and decided to arbitrarily slash NHS funding across the board in the name of efficiency.

I understand that there is no spare capacity. I understand that this means I will probably be given just a few weeks' notice of my initial appointment (which has yet to occur), and I am satisfied that my details are on the system and my referral is pending. I do not believe it would be fair, while my blindspot remains more or less stable, to jump the queue. Clearly there are a great many other patients in the same situation as myself. Should the situation deteriorate I will of course seek immediate assistance via the accident & emergency department. Naturally should the full eighteen weeks (seven weeks from today, or three by the date of the initial referral request) go by without confirmation of appointment, I will contact WSH PALS and take up the matter formally.

My point was not simply that I had not been seen promptly or that the initial referral request had been mislaid, but that the chaotic reorganisation of the NHS, ordered by our present government despite supposedly binding promises to the contrary, was already having a discernible negative effect on patient care well before Matthew Hancock MP (Cons., West Suffolk) decided to slavishly support the privatisation of the service without ever debating the merits of his chosen course of action.

"Free at the point of use" is a meaningless statement when one considers this case: I cannot use the service as it is oversubscribed, nor can I freely travel to other parts of the country to use similar services. Nor would there be any point. I am unlikely to receive better treatment anywhere else, or faster treatment. I have reached the limits of my ability to access private eyecare and must rely on this service; the service is clearly insufficient to meet the needs of the local population but will likely face further cuts before the next general election, as the NHS budget as a whole is to be reduced still further.

Putting the problems the reorganisation and now privatisation of the NHS have caused for patients out into the open merely seemed good sense. I apologise if the source of my frustrations was unclear.

I am not afraid to go blind as a young man, you understand; it is merely that it would be a shame to do so as the result of a doomed attempt to satisfy a political theory.