Dear Editor

A little over a decade ago, some West Wales NHS Manager or Chief Executive (no not Trev, he came later!) dreamed up the ‘bright’ idea of ‘partial booking’ to deal with the problem of patients who failed to turn up to follow up appointments. It also accommodated doctors who attended conferences or in-service training or took holidays at short notice. And it covered up staff shortages. In all, a brilliant ‘wheeze!’

And so, partial booking was born, replacing the simple tried and tested card booking system. Patients who should be at the very heart of NHS services, were told by clinicians, “I need to see you in three months; we’ll write to you nearer the time.” If that letter arrived, it was often late and always required the recipient to call the ‘forever engaged’ Health Records Department. For the persistent caller, an appointment was duly arranged and then confirmed by post. Just think of the cost in time, postage, delay, anguish and NHS reputation caused by this system! Of course, the new centralised system also required a manager and a team of eight thick skinned telephonists. More cost! Then add the human cost. Readers may recall the case of Pembrokeshire ‘patient C’ whose cancer spread from being monitored and curable to becoming advanced and incurable because he failed to receive any follow up appointments and appropriate intervention. We know of too many other patients who have simply slipped off the ‘radar.’

To be fair, some clinicians seeing the damage this system would cause to patients and patient morale, opted out from day one; others followed later. Their patients were the lucky ones.

Our support group became involved in this issue when cancer patients spoke to us about the additional anxiety of not knowing when their next appointment would be. It was not at all uncommon for patients to wait six, seven or more months for a three monthly appointment. I first wrote to Trev. (now in post!) in June 2010 expressing our collective concern. His reply stated, “This system is there to provide patients with a more flexible and convenient approach.” Naughty! Whenever were patients ever allowed to attend hospital on a Wednesday afternoon when the appropriate clinic was on a Tuesday morning? The reply added “...the partial booking system we employ works very efficiently.”

However, dear readers, there is good news! After three and a half years of campaigning on this issue and an ‘inch thick’ dossier of correspondence to anyone and everyone who would listen to us, sanity has prevailed and all, yes all, Hywel Dda UHB patients requiring follow up appointments are once again to be issued with paper appointments slips when they leave clinic. This is a victory for common sense!

Our support group would like to thank all other patients who have complained about partial booking and follow up appointments. We would also like to thank Health Inspectorate Wales, Hywel Dda CHC and any other organisations and clinicians who supported our just cause in thought or deed.

The moral of this tale for patients is to value your health and the time and expertise of our clinicians and ensure that you keep your hospital appointments, or ring to cancel them if not needed. The moral for Chief Executives and hospital managers is to listen in a timely manner to the voice of the patient.

Meanwhile some readers may have spotted a photo of a very cheerful looking Chief Executive in the local press. I like to think that Trev. is delighted that on this issue, he has finally made a lot of patients very happy.

Phil Burr, Chair, the West Wales Prostate Cancer Support Group