We don’t have a referral letter … (or why is that the Pts problem?)


Had another bizarre encounter with the NHS today. Is it me or am I just becoming good at spotting them?

Had an OP appointment at a local hospital today for follow up about my cheek business of a month or so ago and quite frankly after it I was left wondering if the staff attitudes in the NHS were fossilised in the ‘good old days’ when patients weren’t the awkward cusses they are now.

Hospital is in a town some miles from where I live and now largely functions as an OP and UCC. I’ve visited it a few times over the last 20 years and for some reason, never fails to put the heebie jebbies up me – something always goes wrong when I head there. Either I get lost (even following sat nav) etc etc.

Walked into the reception area. One receptionist on duty, but not a huge queue -the hospital is being run down bit by bit and the OP area was very sparsely inhabited. Got to the desk. The conversation went like this

“I have an appointment with Mr X.”

“Name” I told her. She types rapidly and then frowns and types again. “Is your phone number ccc- hfeg? “

“No, its ccc-fheg.” (I don’t know why but no one in the local hospital system even after me telling them time and time again can’t seem to get the right phone number on file for me.)

First big sigh. “Someone’s put it in wrong.” (I didn’t see any signs of her correcting it – but she may have done) More tapping of the keyboard. “Who’s your dentist?”

I look at her puzzled – why on earth does she want to know that? Never been asked it before.

Question repeated. “I need to know your dentist.  We don’t have a referral letter for you so I need to know who to contact.”

“But my dentist didn’t refer me.”

Cutting me off midsentence, “Need to know your dentist anyway.”

I give her the details – but she asks for them again because she’s never heard of that one – despite it being a *very* longstanding practice in the area.  Completely confused now, I await the next question with dread.

She says how did you get referred here (at the same time as lifting the phone up and dialling someone) and I tell her. So I’m kind of stuck as the outer point of this conversation. She looks at me as if I’m nuts when I tell her the name of the clinic that referred me and relates this down the phone to  colleague. (I can hear the mental eye rolling s I do a lot of it myself!)

Eventually after moaning about another ladies missing referral letter, she puts the phone down and says “go straight through, but you haven’t got a referral letter so …”

I head on through and then a Nurse calls me onward and shakes her head, “You haven’t got a referral letter…”

Eventually I was seen. Scan and another review after scan in 6-8 weeks. During that conversation it turns out I can actually be seen at a more local clinic.  Given the green slip and told to go back to the front desk to hand it in.

I go back and yes, she is still on duty.

The desk is free so I go up to it and she looks at me and holding up some paperwork. “Go back and wait as I have to do this first.”  (I’ve been to the USA and she wouldn’t be out of place in border control)

I obediently go back (not before a man tried to sneak in and go up to the desk – he got the glacial stare of death). Apparently he thought I’d finished.

She then starts to have a conversation with a male colleague, about holidays, this and that and the other, all while shuffling paper very expertly. After 2-3 mins the guy disappears and she beckons me forward and takes the proffered green slip. 

“Six to eight weeks?” Her fingers begin to dance over the keyboard while she is perusing the rest of the slip. They stop abruptly. “They want you to be seen in Mr Y’s clinic at CC hospital?” A point of frustration appears.”I don’t know whether I can get into their system or not.”

(same trust so why not?)

“Are you going to have an operation or not?”

“Hmm I don’t know”

By this point I feel she’s looking at me as though I’m a bit slow.

She puts me an appointment on and then has to get up, leave the desk and go to the back office of the reception area to get the appointment letter. Why can’t the printer be next to the receptionist stations.

I am finally released from her workflow and await my transport home. All the while thinking about my OP experience and thinking why is something that should have been dealt with seamlessly, in a back office (cough) electronically be used to make the pt feel as though they’re somehow the cause of the problem?









One response »

  1. Sloppy, sloppy, sloppy. And people wonder why I never go to the doctor if I can help it. Although the last time I went (for bronchitis about a month ago), I was pleasantly surprised when I finally met my assigned doctor. Of course, there was no paperwork to fill out, making me wonder if this was more of an urgent care kind of place than my primary physician’s office…

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