"Wait for Breast Screening appointment"

About: Crosshouse Hospital NHS 24

(as the patient),

I discovered a change in my breast in the middle of August. Like a lot of women I tried to fob it off as nothing.

At the beginning of September I came out the shower and while drying myself felt a sort of 'thickening' to the breast. I asked my husband what he thought and he said there was a definite change. For 2 days I did nothing then eventually went to get my mum to check it as she had experience of breast cancer as she worked in this area locally. She examined me and told me to phone and get an appointment to see my GP.

Well, like every surgery, I had to phone at precisely 8am to try and get an emergency appointment. On this occasion I was successful.

I saw a young locum doctor who was excellent. The doctor examined me and agreed that there was changes and I would be referred to the Breast Screening Clinic at Crosshouse Hospital.

I was informed that an appointment should be through within 4 weeks. I was also offered antibiotics in case it was an infection. This I declined as I otherwise felt well in myself.

Three weeks passed and there was still no appointment through. I then phoned my GP surgery again and asked them if the referral letter had been sent. They told me it had been sent to Crosshouse on in early September and gave me a number to phone at Crosshouse Hospital. This I did, to be told by the girl at appointments at Crosshouse Hospital, that it would be probably another 12 weeks before an appointment came through. This was explained as being due to the lack of Consultants available.

Fortunately I am not one of those people who unduly worry about things but as you can imagine being told you needed to wait 4 weeks for an appointment to then being told a further 12 weeks for something which could in fact be life threatening, did make me panic.

As a new campaign had recently been launched, starring Elaine C Smith, regarding different aspects of breast cancer (not just finding a lump) I felt strongly enough to phone NHS Inform. The nurse at NHS Inform could not have been kinder. The nurse agreed that this was an unacceptable waiting time for anyone and informed me to phone my own GP Surgery and ask to speak to the Advice Doctor. I promptly did this to be told to phone back at 10am or 3pm as these were the times the Advice Doctor would be able to speak to me.

I phoned at 10am and the Advice Doctor was not in the least bit pleasant....and in fact made me feel as if I was making the whole story up. The Advice Doctor explained that the referral letter that the locum had issued did not say that they thought I had breast cancer but that it said it could be a 'benign' cyst or a hormonal changes. How on earth can a doctor diagnose whether any changes are cancerous or not...surely that is up to the Consultant once you have had a mammogram?

I put this point across to the Advice Doctor, whose attitude was terrible and who then proceeded to tell me that I would need to make yet another appointment with another doctor to get examined again before my referral would be classed as urgent.

I questioned the Advice Doctor and asked why the word of the first Doctor was not good enough and was more or less told that I would need to make another appointment. On a plus point I was put through to appointments who gave me an emergency appointment for that day.

As you can imagine, after the conversation with the Advice Doctor, I was quite upset so telephoned my mum to come to the Doctors with me. I felt like a child not a 43 year old, working mother of two children. My mum came into see the Doctor with me and I must admit this was a far more acceptable situation. The Doctor I saw was very apologetic and caring and explained it was the way the referral letter was written...non urgent.

My point here is that, following the campaign, all changes in breasts should be classed as urgent it should not be left up to the individual doctor to decide just by examining the person.

The Doctor then asked to examine me again. I agreed but made it clear that I felt as though they did not believe me or the first doctor who had examined me. It took less than 5 seconds for the doctor to feel where the 'thickening' was. The doctor agreed that it should be seen as a matter or urgency and would send an urgent referral letter to the hospital. I was given no indication of time factor for this though.

I left the doctors and went outside and burst out crying....and believe me this is not usual for me. I was crying out of sheer frustration of what I had to go through for the doctor to take me seriously. This should not happen. I fear for women who are not as strong as myself or who do not have family or friends round about them who can speak up for them. If the Scottish Government are launching a campaign then they should ensure that all NHS Boards and GP Practices are aware of it and onside with the programme.

They should also ensure that there is enough staff, nurses, radiographers, Consultants etc to provide a fast service.

This only happened 2 days ago so I am still waiting for an appointment at the Breast Screening Clinic at Crosshouse Hospital, hopefully it will be through soon and all will be well.

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Response from Craig White, Assistant Director, Nurse Directorate, NHS Ayrshire and Arran

picture of Craig White

Dear HolidayGill

Thank you for taking the time to use Patient Opinion to provide feedback. I was concerned to read of your distress and frustration while waiting for details of appointments for further assessment of your symptoms. You should have received a response through this site before now and I would like to apologise that you did not.

I will arrange for your feedback to be passed to our Associate Medical Director for Primary Care and the Clinical Director responsible for this clinic - this way your experiences can be used to inform discussions on the learning and improvements that can be made to ensure that someone else does not have this experience.

I have also asked about what arrangements are in place to offer support and information to people while they are waiting for appointments, and will share this on the site for others interested in learning from your experiences.

Best wishes

Craig White

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Response from Craig White, Assistant Director, Nurse Directorate, NHS Ayrshire and Arran We are preparing to make a change

picture of Craig White

Dear HolidayGill,

I have received feedback from our Clinical Director for Cancer Services and Associate Medical Director for Primary Care.

We very much recognise the apprehension and anxiety linked with a referral for tests when the possibility of cancer has been raised. We want to make sure that GPs have accurate and up to date information about the waiting times, as well as providing information and ensuring maximum support for people in relation to the understandable stress that can arise during this time.

I have asked our specialists working in this area to ensure that GP colleagues have access to the information that they need from both perspectives – waiting time and resources to support people. This information outlines a range of services that can be accessed when people are becoming distressed in the way you described.

Communication is so often the most important part of support in situations like the one you outlined. I will also use your feedback as part of our Board’s commitment to support learning and deliver continuously improving high quality care. This will include reference to this at Board learning and improvement events and a request for colleagues in primary care to consider your feedback when reviewing the quality of care experiences for the people they provide care for. I am confident that this will support discussion on how to ensure effective and supportive communication for all.

I am aware that there are many people who review the content of the site as they may identify with the issues raised. I have therefore included this link to support resources for anyone worried or concerned while waiting for a referral to a specialist when cancer is suspected:


I hope that this response is helpful and want to thank you again for taking the time to use the Patient Opinion site.

Professor Craig A White

Assistant Director

NHS Ayrshire and Arran

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Response from Shona Lawrence, Patient Affairs Manager, NHS 24

picture of Shona Lawrence

Dear HolidayGill

I read with interest your feedback on your wait for a breast screening appointment. I am sure this was a very worrying time for you. I am pleased to note that NHS Ayrshire & Arran have responded to you in this regard and that they have intimated that they plan on making a change due to receiving feedback such as yours. This is an excellent outcome and demonstrates the value of providing patient feedback.

On reading the content of your post, I note that, at that time, a breast screening campaign was being promoted by NHS Inform aimed at encouraging women, and men, to look for any changes in their breasts and to seek additional help or information if they had any concerns. I note you called the helpline number and I am pleased to read your positive comments on the service provided by our Health Information Staff.

Since it was launched in 2010, NHS inform has grown and is now firmly established as Scotland's national provider of quality assured health information. NHS Inform provides a co-ordinated, single source of quality assured health and care information for the people of Scotland.

As feedback posted on the Patient Opinion site is read by many people, I set out below the link to the NHS Inform website as this may assist others who have a health question or who may be seeking support or advice. www.nhsinform.co.uk

Thank you again for your posting and I wish you every success for the future.

Shona Lawrence

NHS 24 Patient Affairs Manager

0141 337 4582

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