As some of you will know I received one of these dummy letters which raised concern as to why such letters were being sent out. Original letter received attached on my post of What tests should be requested when seen by a gastrologist ? ? ?
Here is the response received from my MP after he contacted the chief executive ------
I am writing in response to your email which we received on 20th February 2023. I am very sorry that you have had reason to raise concerns about your constituent’s experience in how The Great Western Hospitals NHS Foundation Trust have communicated.
To respond to your concerns, our Deputy Director for Outpatients has undertaken a review of our processes. In your email you have identified several areas of concern including the purpose of the hold letter received and the reporting processes for patients on wait lists (referenced as a process to meet government targets). I would like to explain the issues that you have raised.
Firstly, please accept my apology for the need to hold patient referrals at this time and for any confusion that our holding letter has caused.
Regarding the hold letter, there are limitations with the national referral system (ERS) which has not been designed to support referrals that cannot be booked within 6 months. Due to the backlog of referrals generated by the Covid-19 pandemic, the Trust have been required to take steps to manage this backlog. As mentioned, the national system can hold an un-booked referral for 6 months before a risk is presented whereby the referral is no longer visible to the Trust. The steps that many Trusts have taken (including Great Western Hospitals NHS Foundation Trust) is to create holding clinics.
A holding clinic is a virtual clinic that allows for the Trust to migrate a referral from the national system (ERS) into the Trust’s patient administration system. This also allows for us to accurately count and report the quantities of patients waiting for which services. This in turn allows us to manage our demand and provide NHSE with accurate patient waiting numbers. As this clinic is “virtual” it is held on a date where clinics do not run, in this case December 25th, 2024. Our system sends a “holding letter” to all our patients that are virtually held in this clinic. The purpose of the letter is to acknowledge receipt of the GP referral, explain the current delay in providing an appointment date, explain the Trust’s 6 week booking process and indicate how a patient can contact us. The intent is to provide clarity and reassurance, it is designed to avoid confusion. I understand that in this instance the letter sent has caused confusion and generated potential mistrust in the system at work. For this I once again would like to apologise.
With regards to the Trust reporting processes, I would like to make clear that the use of holding clinics does not contribute towards our national declaration in the context of appearing to be a booked patient appointment. There is a systemic process in place that ensures that any patients within a holding clinic are declared “un-booked”. All patients held in a holding clinic are counted and declared as part of our monthly NHSE submission. Each patient referral to treatment (RTT) time/s are reported and unaffected by their time held in our holding clinics.
I hope that my response has addressed your constituent’s concerns.
Yours sincerely
Chief Executive
Written by
Jillymo
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Thanks for posting Jillymo . I wonder what the reporting requirements re: 'referral to appointment' are. Seems there are some huge delays going on everywhere, but unless you're in the system you don't see how much of a mess the NHS is in. I would suggest if you require a referral to a specialist and you can't be seen within 6 months, that's way too long. How many people are getting sicker and sicker in that time?
Was talking with a Polish woman the other day who has lived and worked in the UK for years, but still goes back to Poland for medical treatment as it's so much quicker. And she gets a B12 SI prescription!
What did your MP think. Have they just accepted this?
The Mp very cleverly put the ball in my court to respond if still unhappy with the explanation - Oh yes I will be responding thats for sure.
I agree covid created a back log but they are very reluctant to admit the huge influx of imigrants entering the country has put an enormous strain on the system. It is now at the point of where the NHS is putting patients lives at risk,
I had to smile at the bit where the letter states the intent is to provide clarity yet the dummy letter states you have an appointment ! Yet it goes on to state the letter is not sent out to create mistrust or confusion ?
Sadly the NHS was held together by a dedicated migrant workforce (as were many industries) which have now left the UK as a result of Brexit. The UK underinvested in training NHS staff for decades choosing instead to poach from other countries. We are now paying the price for that short sightedness as are other industries.
I doubt very much that the current demand exceeding capacity to treat is due to increased immigration. The NHS was creaking long before Brexit and Covid and a reduction in supply of resource (Brexit) combined with an increase/backlog in demand (Covid) are straws that are breaking the camel’s back.
What is putting patients' lives at risk is not down to covid nor any convenient scapegoats like 'foreigners', although the government would happily like you to think so. The pandemic was a crisis waiting to happen and the blame lies entirely with austerity politics and the managed decline of the NHS to make way for private healthcare, US style. Please don't believe the hype.
From USA where we spend twice as much on healthcare as the next closest country and 7.5 times what is spent on healthcare in the UK. The UK is way ahead of the US with B12 treatment. Scary isn't it. When you read about the miraculous treatment in the USA you are reading about what is available to the wealthy. The rest of us get standard tests. and standard treatment based on what the tests indicate. It is a healthcare factory which waits until symptoms are very severe. 80% of treatment is lifestyle and doctors do no have a higher life expectancy than the general population.
I would agree with Mixteca and Nackapan here, that there are many reasons the NHS is broken, but narratives pushed by the gov and media re: covid/immigration etc, are just smokescreens. As an ex NHS manager I know the ridiculous levels of burocracy and mismanagement which have led us here. Just discussing with my husband yesterday how this is privatisation by the back door. You either wait for months or years for treatment, or pay to go private. If the NHS is putting you on a 'holding' list, then it looks like they're saying you've no chance of an appointment for at least 6 months. Completely unacceptable. Worrying that the CE doesn't think this is worth commenting on in his letter.
I've not seen the gastrologist as yet but I did insist on a follow up appointment and an explanation of the biopsies taken. It is now another waiting game as to when I am seen in clinic - that's providing the wretched hospital transport dont let me down again. 🤞
I would also like to find out what the swelling in my abdomen is as I suspect an epigastric hernia. After waiting all this time if it were a ruddy cancer I would be well in the 💩 if not in my ⚰ by now.
The NHS is putting patients lives at risk - I've not even received my anual cardiac angiogram !
Scientist, not medic. Having worked inside the NHS for very many years, I am delighted to see that there is clearly a Minister for Bull Excrement at work here. The inclusion of the following
'I understand that in this instance the letter sent has caused confusion and generated potential mistrust in the system at work.'
[Really?]
Good to know that we are employing Cat Jugglers and Snot Jugglers, to keep the process running. How did we ever manage without them?
I apologise for my flippancy. I look forward to my virtual clinic appointment and my hospital transport drawn by reindeer.
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Does the liver store B12 after loading? 
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Another one bites the dust !
