PATIENTS ‘WAITING TOO LONG’
SURVEY REVEALS CONCERN OVER HOSPITAL TIMES:
PATIENTS have told health chiefs that they are being forced to wait too long for appointments at Carmarthen’s Glangwili and Llanelli’s Prince Philip hospitals for diabetic, podiatry and dentistry appointments.
Some people have to face their long-awaited appointments being cancelled at short notice, the health board has admitted.
There was also concern among some patients that the emotional impact of being diagnosed with diabetes was not fully explained to them by the hospital, despite it being a life-long and life-changing chronic condition, they were left to feel that they were managing it alone.
Hywel Dda University Health Board Community Council surveyed patients at diabetic clinics in all its hospitals including Withybush in Haverfordwest and Bronglais in Aberystwyth.
The community council aims to independently and without bias represent the interests of patients and the public in the way that NHS services are planned and provided across the counties of Carmarthenshire, Ceredigion and Pembrokeshire.
Out of 42 patients surveyed on a particular day in February, around half had waited up to a month for an appoinment, while the remaining patients reported waiting anywhere between four and nine months-plus to be seen by a diabetic consultant.
The findings published in a report this week by the health board said: “Patients we spoke to at Bronglais and Withybush hospital diabetic outpatient clinic said they had received timely access to community services. However some of the patients seen in Glangwili and Prince Philip hospitals felt they had waited too long for podiatry, dentistry and diabetic appointments. People also told us that appointments were cancelled at short notice.
“Out of the 42 patients we spoke to, 29 said they didn’t feel they had waited too long to be seen, however 13 people felt they had waited too long.”
In a letter responding to the community health coucil findings, Mandy Rayani, director of nursing, quality and patient experience said “currently the 36-week waiting time target for diabetes referral to treatment has been achieved with the longest wait at 35 weeks.”
The report added: “Most people we spoke to were happy to travel to a hospital for their diabetic appointments, but this depended on how far away they lived from the hospital. People who lived further away preferred to be seen more locally either at their GP surgery or local community hospital.”
Another aspect of the survey saw patients quizzed over how the NHS staff helped them to understand how to manage their diabetes.
The board said it found: “Most people we spoke to were happy with the support and advice they were given by staff on how to manage their diabetes.
“However one person from Prince Philip Hospital clinic complained there was no inflammatory bowel disease nurse and the patient felt the consultant was dismissive.
“One person said they were not aware of any psychiatric support and more help should be available to support patients and their families with day to day problems.”
The report added: “Patients also told us that they were not given full information on how diabetes could affect patients emotionally. One patient stated that one of the most difficult things to come to terms with is the fact that diabetes is a life-long condition and felt low after the diagnosis.
“Patients also noted that they were not treated holistically and this was unhelpful if they had a number of long-term conditions that all had to be managed.
“Their care could be split into different specialties but they had to manage their whole situation themselves and this could be difficult.”
In light of the responses and despite “most people” being happy with the support offered, the health board said it will now aim to “ensure all patients understand and know where to get information about diabetes and other related services”, along with “patients knowing how to get emotional and psychological support from healthcare teams.”
The snapshot of diabetic care was just one of the services surveyed by the health board community council.
Others were carried out into what patients thought of services at Prince Philip’s phlebotomy clinic and the Antioch Centre in Llanelli’s Copperworks Road.
This is a church-run community centre hiring rooms to various groups and hospital for blood tests, in a bid to ease congestion at the hospital.
Once again a snapshot was taken over the course of one day last November, at both the phlebotomy clinic at the hospital and the Antioch Centre.
The CHC report said on the day of the visit it heard from 80 people in the phlebotomy clinic and 30 people at the Antioch Centre.
The survey focused on what people accessing the service thought about waiting times to be seen and whether GPs are signposting people to the service at the Antioch Centre as a hospital alternative.
At the phlebotomy clinic waiting times predominatley varied between 10 and 25 minutes to be seen.
However, the report did concede that car parking was a concern when attending a blood test with some experiencing long waiting periods at the clinic and one patient resorting to travelling to Glangwili in Carmarthen.
It stated: “A few patients told us they typically had to wait between 40 minutes and two-and-a-half hours to be seen.
“One patient told us that the clinic and one of the car parks both open at the same time at 9am, which causes a problem because then a number of people can all turn up to the clinic at the same time making it feel very busy.
“One patient told us that they have previously travelled to Glangwili General Hospital for a blood test because the waiting time is so long at Prince Philip Hospital.”
Waiting times at the Antioch Centre were lower but feedback suggested it needed to be advertised better within the community as somewhere for blood tests.
Finally the CHC took a snapshot look at the Cadog Ward at Carmarthen’s Glangwili Hospital which has 19 beds and described as “very busy.”
The report stated nine patients were surveyed, most of them being treated for chronic medical conditions.
It added: “Some people had arrived on the ward having been admitted from the emergency department. We heard that some people had waited a long time to be seen by a doctor or nurse before being admitted to a ward.
“Even though some people had waited a long time, people were very positive about the care they received in the emergency department.
“They told us staff were caring and helpful.” But the report added while the ward was clean, it was often busy and lacked a sense of calm sometimes.
Regarding food on the ward, in turn a snapshot of food across the hospital, the report found patients had mixed views about their food and drink, adding: “Some people told us they liked the food. We heard that others thought it could be better (and) some people told us they would like to be able to choose their portion size as it was often too much for them.”
The CHC found patients were “very grateful for the care they received while in hospital, and so they didn’t want to make a fuss or complain about the food.”
An umbrella to these snapshot findings was the issue of how the health board communicated with patients, this was examined over a period of months between July and November last year.
In terms of appointments and how they were issued and managed by the health board, there were mixed reactions from patients. The CHC said: “We know from our independent complaints advocacy service, that poor communication is often a factor when people have concerns about the NHS. Misunderstandings may increase the risk of potential harm, lead to a lack of confidence by patients and waste valuable NHS resources.
“We know from our engagement with people, that they can become confused and frustrated when trying to access information about their health or treatment. We asked people across Hywel Dda to tell us about their experience of NHS communication good and bad, also to give us their suggestions on how it might improve.”
The report found that in some cases patients felt they weren’t being listened to and particularly in difficult circumstances where bad news needed to be broken to a patient, there was a lack of empathy flagged up by some patients and their experiences.
The report said: “Reference was made that not all staff were able to display an appropriate level of empathy with the patient during difficult times.
“It was highlighted that some staff appear to have limited roles once diagnosis had taken place and were not able to assist or signpost people to the most appropriate service or organisation.”
Waiting times and referrals also left some patients feeling lost, as the report stated: “Some people told us they were disappointed regarding communication around waiting times and would like to have better and more communication regarding the times they would have to wait to be seen or referred for treatment.”
This also applied to cancelled operations or procedures, with some patients arguing they were not informed of changes.
Appointments across clinics and departments was another sore point highlighted by patients with the CHC report summarising that “there were numerous and varied views from people regarding the communication encountered, in order to arrange and change appointments.
“There were substantial numbers of negative views surrounding appointments and their systems compared to limited positive views.
“In primary care GP surgeries, in particular, were mentioned by a significant number of people we spoke with.
“We also heard from many people who provided examples of poor administration regarding their appointment letters, with co-ordination of their appointment times when they lived considerable distances from the place they needed to attend.”
Directly linked to appointments was the issue of transport, again a major concern for patients. The watchdog found “many people had encountered issues regarding transport, especially when needing to attend appointments a significant distance outside their local area.
“Many people felt that there should be improved organisation surrounding transport and that on occasions long journeys could be eliminated by having routine tests carried out in a local setting, prior to a more specialised appointment.”
Better communication with the patient regarding journey times was another area of concern that people told the health council about.
Technology and how that could be used to contact and liaise with patients was also welcomed by some patients.
The CHC said: “Many people suggested that more healthcare services and advice should be available online, in order to reduce pressure on NHS staff and departments.
“Those people who were comfortable using technology, felt that the NHS should use more varied methods to communicate with patients providing as much information and access to services as possible.”