Patient Ombudsman?

[AndBreathe]

Anyway, I sent off the final draft to NHS Lothian feedback, my MP, MSP, local councillors and support workers this morning and got an immediate reply from the "Patient Experience Team":

🙄

For reference, my final draft was:

As and when "they" respond, I would suggest if you reply that your emphasis is on your personal safety (from crossing roads, to potential for opportunistic thefts by "helpers", to your inability to assess your own safety in your home).

Risk to life and limb is more likely to galvanise actions that someone being generally miffed about the length of waiting lists.

Again, I am sympathetic to your plight, but it now comes to playing the game. It's hateful, but unfortunately, it is what it is.

 

[Lucyr]

I want them to give the senior management at the Eye Pavilion a good shake up. They are obviously just bureaucratic button pushers with no actual managerial talent. If challenge, they will pull out several reams of paper and say something like: "Oh! We did this and this and this ..... and oh yes, we have had this problem and that problem and ...."

Yet, and the end of the day, the bottom line is they don't even have a simple check in procedure in place, nor a method of keeping patients informed about the triaging process. These two aspects in particular are so basic that their lack speaks volumes about their actual managerial ability [as oppose to bureaucratic].

If you recall Baby-P, the senior manager stood in front of the cameras with a very thick sheaf of papers and said: "We did everything we were bureaucratically required to." Which, while technically true, demonstrated a complete lack of judgement for which she was universally condemned.

It is inconceivable that my experience with the Eye Pavilion is unique. So, given the length of the waiting lists, in the Edinburgh region there are almost certainly at least a couple of hundred people who are in serious danger of going permanently blind before they manage to see a consultant. When the consultant at Golden Jubilee heard about my lack of treatment for the glaucoma, he was visibly shocked!

I still can’t understand what actions you’re asking for here. Can you do a simple bullet point list of the changes you want them to implement? “Giving someone a shakeup” isn’t an implementable action point

Eg patients to be informed of xyz within xyz timeframe

 

[Bloden]

@IrvineHimself I’m just reading this for the first time. So sorry to hear about your eye conditions and the less than ideal service you’ve received. Great letter, btw - I sometimes feel powerless as an nhs patient, so we must complain. Good for you! 🙂

 

[IrvineHimself]

"They" will always have a window for replies - usually 5 days for acknowledgement (although that automated response would count, in my view), then set times for their responses, to allow for investigations, and all parties to have their say.

I doubt it'll be quick.

Too true

 

[helli]

I still can’t understand what actions you’re asking for here. Can you do a simple bullet point list of the changes you want them to implement? “Giving someone a shakeup” isn’t an implementable action point

Eg patients to be informed of xyz within xyz timeframe

Irvine has said that the email has been sent.

 

[Lucyr]

Irvine has said that the email has been sent.

I know, but he’s waiting to hear back so it makes sense to have the list of actions he’d like to see ready, because I can’t imagine them being able to understand what actions he wants them to take from the letter so they might ask for that.

 

[IrvineHimself]

... I sometimes feel powerless as an nhs patient ....

For many people, this is the real problem. In general, with my diabetes, stroke, et al, I have nothing but good words to say about the NHS, But, faced with the possibility of irreversible blindness and/or transplant surgery due to lack of prompt treatment.... I well understand this feeling of powerlessness.

I am lucky that I have the capacity to fight back in a manner which won't land me in court or get me banned from the Eye Pavilion. But yes, I do understand why some people start screaming threats and obscenities at junior members of staff; however, I would counsel anyone feeling that way to quietly leave and go see Citizens Advice.

Always remember, the really serious bad guys don't issue threats or engage in screaming matches. As far as I am concerned, doing so just shows me that you are little league. The people who scare me are the ones who bite their tongue and ambush the offending party at a suitably opportune moment.

 

[IrvineHimself]

so it makes sense to have the list of actions he’d like to see ready,

I have already outlined to you the gist of what actions I would like taken in my reply above

.... Yet, and the end of the day, the bottom line is they don't even have a simple check in procedure in place, nor a method of keeping patients informed about the triaging process. These two aspects in particular are so basic that their lack speaks volumes about their actual managerial ability [as oppose to bureaucratic]......

And, in the letter I quite clearly state that:

... my experience demonstrates a basic failure of senior management at the Edinburgh Eye Pavilion, and somebody in authority really needs to hold them to account....

Anything above that, such as suddenly receiving a surprise appointment to see a consultant about my Glaucoma and/or Fuchs' Dystrophy would be pure bonus and not the speciffic intention of my initiating the complaint.

 

[Lucyr]

And, in the letter I quite clearly state that:

What does that actually mean though in terms of the actions you want? “Held to account” is such a vague term that has no clear patient impacts.

 

[trophywench]

Well - that is exactly why the NHS appears to be such an amorphous mass for a patient to negotiate !

All one can do personally, is TRY - and that's what Irvine is attempting.

 

[IrvineHimself]

What does that actually mean though in terms of the actions you want? “Held to account” is such a vague term that has no clear patient impacts.

It means exactly what it says: Getting dragged up in front of a committee and asked to explain:

• Why is there no sign in process?
• How is patient triaging carried out?
• What steps do you take to inform patients about the triaging process?
• Why exactly are your waiting list so long?

In addition, once in front of a committee [or responding to questions from an MP], they will be exposed to a whole host of hobby horse questions. Believe me, I have been in front of sympathetic boards before and they are no fun, when the board is hostile and looking for a scapegoat to pacify the public about a national crisis........ Let us just say that if it goes that far, I pity them.

 

[Lucyr]

It means exactly what it says: Getting dragged up in front of a committee and asked to explain:

• Why is there no sign in process?
• How is patient triaging carried out?
• What steps do you take to inform patients about the triaging process?
• Why exactly are your waiting list so long?

In addition, once in front of a committee [or responding to questions from an MP], they will be exposed to a whole host of hobby horse questions. Believe me, I have been in front of sympathetic boards before and they are no fun, when the board is hostile and looking for a scapegoat to pacify the public about a national crisis........ Let us just say that if it goes that far, I pity them.

How does that help patients?

Sorry but I felt like your letter was pretty waffly and that complaint letters should get to the point of what actions need to be taken to deliver what improved outcomes for patients. My reply here is to try and help you have some ideas how you could be clearer in getting your point across to them.

So rather than saying “someone should be held to account” and meaning (but not saying) “to explain why there’s no sign in process”. Just say in the complaint “a sign in process needs to be implemented because xyz” and explain how that improves patient outcomes or how not having one has impacted you.

I say this because I know you’re autistic and so by definition you struggle with theory of mind. The people reading your complaint aren’t mind readers and if you get a response from them and an opportunity to give a better explanation of the things they should implement to improve patient outcomes, you should definitely give that in a clearer format.

 

[IrvineHimself]

How does that help patients?

Sorry but I felt like your letter was pretty waffly and that complaint letters should get to the point of what actions need to be taken to deliver what improved outcomes for patients. My reply here is to try and help you have some ideas how you could be clearer in getting your point across to them.

So rather than saying “someone should be held to account” and meaning (but not saying) “to explain why there’s no sign in process”. Just say in the complaint “a sign in process needs to be implemented because xyz” and explain how that improves patient outcomes or how not having one has impacted you.

I say this because I know you’re autistic and so by definition you struggle with theory of mind. The people reading your complaint aren’t mind readers and if you get a response from them and an opportunity to give a better explanation of the things they should implement to improve patient outcomes, you should definitely give that in a clearer format.

You have your strategies, I have mine. Time will tell how well mine work🙂

 

[IrvineHimself]

Well my, oh my oh my! That certainly put the cat amongst the pigeons

First thing Monday morning, by pure luck, I had to stop in and see my GP [the big chief herself] for blood work and the like. So, since I was there anyway, I asked if she could send in a separate referral for my glaucoma. Then, when I got back from the Docs', there was a letter from the Eye-Pavilion asking me to come back for another retinopathy scan. From the tone of the letter, I gathered they were intending to be thorough. Bizarrely, it also emphasised sign in procedures along with a whole host of changes.....

The real shocker came this morning though, when I got a frantic phone call begging for forgiveness and promising me an appointment with a consultant for the 24th of Aug for my glaucoma and other vision problems😎

Okay, I have got to admit, I really struggled with the ethics of all this, and to anyone who feels I might I have gotten their place, I apologise. But, remember this: The system [or senior management] really did need a good shake up. While having decent management with the correct procedures won't, by itself, eliminate waiting lists, it will go a long way to ameliorating the length.

Since a member🙂 seemed to have problems following along, I shall explain what happened. Essentially, the problem of being 'stuck on a waiting list' falls into a class of problems that aren't amenable to being solved directly.

Basically, you have a very limited number of options:

1. Threats of physical violence: Never works, and usually results in jail
2. Blackmail: Hmm, has possibilities, but it is really difficult to pull off and will most likely result in jail
3. Join Freemasons {or similar]: This is probably your best bet, but the problem with secret societies is that they are secretive and can be very difficult to join.

So, since I couldn't tackle the real problem, all I could do was wait until they screwed up and gave me something 'actionable' to work with. (Believe me, from direct observation, this was inevitable.) Anyway, once they screwed up, there was absolutely no point in holding anything back. I was either going to win or I would languish on the waiting lists for years. So, I CC(ed) my letter of complaint to all my big guns: MP, MSP and all three local councillors.

Now, with a new, fresh referral from my Doctor, and a lot of VIP's nosing around asking difficult questions about me and my treatment..... Need I say more, this is every bureaucrats worst nightmare, and you can be a {Edit: insert 'almost'} 100% certain they will play it safe.

By the way, this has absolutely nothing to with anything as waffly as 'theory of mind'. If anything, it is a a branch of mathematics called "Game Theory"

Irvine😎

 

[IrvineHimself]

Well, another day and the cat continues too shake up the canaries..... It occurs to me that if this thing continues to grow legs, I might actually be able to get a face to face with someone who can make a difference.

The obvious points I would raise are the ones I mentioned above:

• Why is there no sign in process?
• How is patient triaging carried out?
• What steps do you take to inform patients about the triaging process?
• Why exactly are your waiting list so long?

However, I was curious as to how the forum thinks the management of long waiting lists could be improved?