Editorial Comment

Here is your NHS E-Referral Appointment letter!

Where is your Appointment?

These days, Patients are getting used to their GP handing them a letter setting out the details of a hospital appointment. In fact, I suspect that many patients are quite impressed by the doctor’s keyboard dexterity and the speed at which an appointment is offered, although it might be a few weeks to wait, but at least there’s an appointment date and time. There will be a telephone number to ring and a password (I’ve noticed that it always the same password) to use if you want to look at the NHS E-Referral web site to change or cancel your appointment. What is probably missing from the paperwork that is handed to you by your doctor is the name of someone at the hospital to talk to and more likely than not there may not be on the letter the full address of the hospital and outpatient department you are intended to attend, not even a postcode!

It Get’s Worse

So your appointment gets nearer. It could a physiotherapy appointment or an outpatient clinic to see a skin specialist. It could be many things. But it is your appointment and you have patiently waited for the date and time to arrive. However, an envelope arrives through your letter box. Inside the envelope there are two letters. One letter disappointingly cancels your appointment. It says it is necessary to cancel the appointment due to a rearrangement of clinics. The letter is Dated but not signed by a named person. There is a simple apology for any inconvenience, but no real reason given. To soften the blow the second letter moves the appointment two weeks on and you have a fresh time and date.

It Gets Worse Again

Now that might be all very fine once but when a few weeks letter another envelope lands on  your doorstep with an almost complete repetition of the earlier cancellation letter. No named contact. But there is a telephone number for a Booking Centre. No address. Investigations reveal that the Booking Centre is located in another town over thirty miles away – I found the address on the internet, but it was not on the appointment (or cancellation) letter. I telephoned the Booking Centre simply to be told that the consultant had cancelled the clinics (three times). No other substantial reason was given.

What is Reasonable?

Personally, I think one cancellation is reasonable as long as there is an open and honest explanation. Two cancellations is really starting to push your look and three cancellations starts to question whether you are being referred to an imaginary service. Added to that why were you referred in the first place and does the passage of time not being seen increase the urgency of the requested appointment. Once a GP has made the first appointment does that GP get to know about the cancellations and the potential risks involved in delays. Is the patient sensible enough to ask their GP whether the passage of time creates a more urgent situation. Answers on a postcard!!!!!!!

What are the Rules for Cancellation?

Well, so far I have been unable to find any specific rules about how frequently outpatient clinics can be cancelled. There are rules once a patient has been seen and booked in for a procedure or operation, known as the 28 day rule.

Robert Campbell – October 2018


Robert Campbell

By Robert Campbell<br><img src="" alt="Robert Campbell" class="avatar" width='50' height='50'/>

Started work writing medical cards in 1966 at Staffordshire Executive Council. Have worked at Inner London Executive Council, Hertfordshire Executive Council, Lambeth Southwark and Lewisham FPC, Birmingham FPC, Dudley FPC and Wakefield FPC and Family Health Services Authority. I was seconded to the NHS Appeals Unit and have worked as a full time GP practice manager since 1992 until 2010. I was also an AMSPAR trainer at Park Lane College, Leeds. Now I work as a freelance author.