Can the paediatric dr do that??

sari

Unsure if this is the right place for this question.
Couple of months ago I noticed my sons left foot turned out a lot. He also wasn't waking so I took him to me GP. He said that he would like to refer him to a specialist in local hospital. I waited for nearly 2 months and got an appointment to see the paediatric dr. Two days before his appointment he was sick and I didn't want to bring him into a hospital sick, so I called and explained I was told it was no problem and they would cancel the appointment and that it would be rescheduled.
1 month later and I still hadn't received an appointment so I called the hospital. I was told by the drs secretary that the peads dr had discharged my son and taken him off the waiting list as I had cancelled his appointment. She said his policy was that if an appointment was missed or cancelled that the child would be discharged and dr would not give another appointment. I argued with her about this and he kept saying that was the drs policy and nothing we could do.

This just seems crazy to me, how does he have the right to deny my child an appointment surly this is not ok? What can I do my son needs this appointment?

wolfpawnat

Find another consultant if possible and say to them that you can get a reference off your doctor if needed. A consultant can choose to do what they want, same as any other profession, should they, definitely not! If you feel that you are being taken for a fool or that they are in the wrong, you are more than entitled to make a complaint against them.

sari

Is this the case even though he is employed by the HSE and I have a medical card?

wolfpawnat

sari wrote: »

Is this the case even though he is employed by the HSE and I have a medical card?

If it is a public consultant, regardless of whether or not you have a medical card, I am pretty sure no, he is obliged to see who he is referred. I don't know who you contact, but you should find out and report them, public waiting times are long enough without your little one being fobbed off any longer!

sari

I'm going to ring citizens info now. It's a bloody disgrace really, I mean refusing to see a 16mth old because I cancelled 1 appointment with 2 days notice.

wolfpawnat

sari wrote: »

I'm going to ring citizens info now. It's a bloody disgrace really, I mean refusing to see a 16mth old because I cancelled 1 appointment with 2 days notice.

I didn't turn up to an appointment for my son, totally forgot about it and all they did was reissue one for 6 months after. A long time to wait, but it was my fault and cardiologists are busy people, but nothing was said other than "you missed an appointment for X date, it has been rescheduled for Y date, please let us know if you are not able to attend"

sari

So citizens info directed me to HSE info line, they couldn't answer my question, directed me to patient liaison in my hospital, again they wouldn't tell me if a consultant could make their own policy like that. Said she would look into it and get back to me.

How Strange

Make a complaint to the HSE your service your say. Also get a new referral later from your gp and make another appointment.

http://www.hse.ie/eng/services/Publications/Your_Service,_Your_Say_Consumer_Affairs/

Hannibal Smith

If you have the name of the consultant look him up in the phone book and send him an email directly. This is down to some administrative error and not your fault the doctor probably knows nothing about it. I contacted a consultant via email before even though I was a public patient and got an email back from the consultant with a solution to the issue I had.

sari

Oh don't start me on that your day complaint thing. I made a complaint through it in January, it took several follow up emails from me until it was actually passed onto the relevant place. It's been with them now for over a month I've emailed twice and been told that someone is dealing with my complaint and will get back to me in 2-3 days. Anyway I'm not going to let it go and I'll keep following up on the complaint to make sure something is done.
Waiting on a call back from the hospital in relation to the peads dr so will wait and see what happens.
I just can't get my head around a dr refusing a baby an appointment

Gatling

Only ever heard them discharging a patient for multiple missed appointments ,
Pretty harsh discharged for one missed date

How Strange

Really? Why am I not surprised! I made a complaint earlier this month so I'll see if I get a response within 30 days as promised in the reply email.

Sligo1

No advice here... Just wanted to say I think it's a disgrace and I hope your wee one gets seen soon. I would not of thought it possible for a consultant to discharge a case for one missed appointment. I would not have thought it possible for a consultant to discharge a case until they had seen the patient... Unless perhaps for multiple missed appointments.

Best of luck and I hope you get it sorted.

sari

Thanks sligo, funny as the hospital in question is sligo

Sligo1

sari wrote: »

Thanks sligo, funny as the hospital in question is sligo

Lol... Well in that case it doesn't surprise me!! I used to work there but in Dublin now! The Dublin hospitals are a lot better IMO! I find it very strange the paediatrician has discharged ur wee one from his care....

sari

Sligo hospital is not great alright. Was meant to hear back from the patient liaison women today but nothing, ill call again tomorrow

Sligo1

sari wrote: »

Sligo hospital is not great alright. Was meant to hear back from the patient liaison women today but nothing, ill call again tomorrow

Yes do call her back... There also should be more than one paediatrian at Sligo hospital so perhaps if u have lost faith find out the name of the other consultants, get another referral for one u would like, ring the new consultants secretary, explain your situation and go from there... However, that could be starting all over again... And I'm sure you have already been waiting long enough! However, if you do explain your situation to the new doc (or their secretary) they may take you sooner... No harm in asking. Do let us no how you get on. Best of luck.

sari

I still hadn't received a call back from the patient liaison women so I called today.

She said she spoke with the consultant and he informed her that all of the paediatric drs from Sligo had jointly agreed on this policy. He said that if a patient didn't attend or cancelled the dr would review the patient files and notes and make a decision,based on this, whether another appointment would be given or not.
I argued that how could he make a decision on my child when this was to be his 1st appointment? The only info he had was the referral letter from the GP and based on this he made the decision there was nothing wrong with my child's foot and discharged him. She agreed that it was "strange" and put my son back on the waiting list.
She said they do this because of high waiting lists.
Totally understand that there lots of people waiting, this is why I called as far in advance as possible so that the appointment could be given to another child.

I also asked her was there a HSE and hospital policy in regards this, she couldn't tell me. Does anybody know HSE policy or guidelines on giving appointments after cancellation? I have spoken to citizens info, HSE info line and sligo hospital and no one has been able to tell me.

I'm glad that my son has been put back on the waiting list but I'm so angry and imagine that is not such a rare instance

Sligo1

absolutely ridiculous sari! at least you're back on the waiting list tho... even tho id say you have been waiting long enough for your wee one to be seen. Im sure you really dont want the hassle, however, if it is something that is bothering you still...
All hospital, medical, pharmacy and nursing policies and guidelines that are followed, need to be written into a document and signed off by the hospital and their various committees. i know this as i have been involved in writing many of these policies. So if it is something you want to follow up on... you could always ring back and ask them to email you a copy of this so called policy!!! i very much doubt it has ever been documented let alone been signed off!!! therefore, technically there is no written policy to be folliwed in such instances. I could be wrong and the policy document could exist.... but i highly doubt it!

But im glad your back on the list. Hope the little one is ok and it all get resolved quickly for you.

?Cee?view

Sari,

A quick google came up with this document

SLIGO GENERAL HOSPITAL
Outpatient Department Management Policy
Information for General Practitioners Issued April 2009

You'd need to check if it's the up to date version.

That policy refers to "Did Not Attends"

DNA’s (Did Not Attend)

A DNA is defined as a new or review patient that has been issued with an appointment but has failed to attend the clinic or did not respond to correspondence issued via a Partial Booking process (No Response) or a review patient that rang in and cancelled themselves from the clinic and did
not request a further booking (Self Discharge).

The DNA policy is that every patient will be allowed a maximum of 2 DNA’s in
succession and will then be discharged back to their GP.

The Consultant may veto this policy and offer further appointments where there are clear clinical risks or other risks (e.g. vulnerable patient).

On the first DNA:
- The patient will be offered another appointment
- The Consultant will write to the referring clinician outlining that the patient did not attend and highlighting any concerns that the consultant has around non attendance. The letter will ask the GP Practice to confirm the patient’s contact details back to the Appointments Office.
On the second DNA:
- The patient will be discharged on the Hospital Information System
- A letter indicating the reason for the discharge will be sent to the referring clinician by the consultant. The letter will highlight any concerns that the Consultant has around non attendance. The letter will state that the patient will be re-instated at the referring clinician’s request.
- A letter will be sent to the patient/GP stating that they are discharged and the reason why and pointing out that they should go back to their GP for further care.

If this is still the current policy, it's clear that they did not even comply with their own policy. If they had, your child would not have been discharged until there were two "DNAs".

They appear to be treating you as a DNA however, I would argue that you did not cancel the appointment unilaterally. You cancelled the appointment with the agreement of the consultant's staff and therefore, discharging you should not arise. Furthermore, putting you onto a waiting list again is not appropriate, particularly as you were not aware that this would arise.

I would be pointing out to the them that you are not a DNA and therefore the policy does not apply. I would request an early appointment as the appointment was postponed (not cancelled) with the agreement of hospital staff.

I would consider a complaint to the IMO if this is not progressed to your satisfaction. These consultants are public servants and should be held to account.

Sligo1

churchview wrote: »

Sari,

A quick google came up with this document

SLIGO GENERAL HOSPITAL
Outpatient Department Management Policy
Information for General Practitioners Issued April 2009

You'd need to check if it's the up to date version.

That policy refers to "Did Not Attends"

DNA’s (Did Not Attend)

A DNA is defined as a new or review patient that has been issued with an appointment but has failed to attend the clinic or did not respond to correspondence issued via a Partial Booking process (No Response) or a review patient that rang in and cancelled themselves from the clinic and did
not request a further booking (Self Discharge).

The DNA policy is that every patient will be allowed a maximum of 2 DNA’s in
succession and will then be discharged back to their GP.

The Consultant may veto this policy and offer further appointments where there are clear clinical risks or other risks (e.g. vulnerable patient).

On the first DNA:
- The patient will be offered another appointment
- The Consultant will write to the referring clinician outlining that the patient did not attend and highlighting any concerns that the consultant has around non attendance. The letter will ask the GP Practice to confirm the patient’s contact details back to the Appointments Office.
On the second DNA:
- The patient will be discharged on the Hospital Information System
- A letter indicating the reason for the discharge will be sent to the referring clinician by the consultant. The letter will highlight any concerns that the Consultant has around non attendance. The letter will state that the patient will be re-instated at the referring clinician’s request.
- A letter will be sent to the patient/GP stating that they are discharged and the reason why and pointing out that they should go back to their GP for further care.

If this is still the current policy, it's clear that they did not even comply with their own policy. If they had, your child would not have been discharged until there were two "DNAs".

They appear to be treating you as a DNA however, I would argue that you did not cancel the appointment unilaterally. You cancelled the appointment with the agreement of the consultant's staff and therefore, discharging you should not arise. Furthermore, putting you onto a waiting list again is not appropriate, particularly as you were not aware that this would arise.

I would be pointing out to the them that you are not a DNA and therefore the policy does not apply. I would request an early appointment as the appointment was postponed (not cancelled) with the agreement of hospital staff.

I would consider a complaint to the IMO if this is not progressed to your satisfaction. These consultants are public servants and should be held to account.

+1 to this! Good researching! I didn't believe there would be a policy allowing for the discharge of a patient after only 1 cancelled appointment!... Unless of course they self discharged which obviously wasn't the case here.

sari

Thanks very much churchview that really helps. I have family visiting from abroad so ill be writing my complaint when they leave.
It's crazy that the patient liaison person for Sligo was unable to give me this info. This was the info I specifically asked her about.
I will go further with this for sure, I've heard so very negative things about this particular peads consultant since talking with some other parents at some of the toddler groups I go.

sari

Would you be able to post a link to this document? Thanks

?Cee?view

Sligo1 wrote: »

+1 to this! Good researching!

I'm in a job where I write a lot of internal policies. It's all too common for people to blame policies or claim they've some power under policies when it's blatantly clear that they've never even read the damn things!

?Cee?view

sari wrote: »

Would you be able to post a link to this document? Thanks

http://www.hse.ie/eng/services/list/3/hospitals/sligo/gpinfo/OPD_Management_Policy_Information_for_GP's.pdf


Here you go. Check it's up to date. Even if it's not I imagine the designation of DNA will remain, but I would not accept that you fit within the category. You postponed with an acceptable medical explanation, which was accepted by a member of staff at the hospital. You did not cancel.

Sligo1

churchview wrote: »

I'm in a job where I write a lot of internal policies. It's all too common for people to blame policies or claim they've some power under policies when it's blatantly clear that they've never even read the damn things!

I concur!

sari

Thanks for all the help. I'll keep you all updated

nicowa

sari wrote: »

Thanks for all the help. I'll keep you all updated

Spotted this in my hse clinic today - if you're looking for a higher authority to complain to.

tigerblob

Maybe you should innocently ask the patient liaison lady whether it was normal for sick toddlers to be dragged, miserable, into the hospital to pass their germs onto other vulnerable people.

I can only imagine how much more unimpressed they would have been if you had brought him, it's ridiculous that you can't cancel/reschedule an appointment, anything could have happened for all they knew.

sari

To be fair she was nice and agreed I did the right thing and it was very "strange" he was discharged.
The thing that annoys me about her is she is patient liaison, she said her job was to liase between patients and staff when problems occurred and to represent the patient yet she has no idea about hospital policies in regard to this, how many other policies has she no idea about? How are we suppose to get the service we are entitled to when the people employed to ensure we do haven't a clue?

sari

Just thought I'd give an update on this.
Firstly my boy is fine he got an appointment with a different peads dr, he referred him to physio, she said he's fine it's within normal range for a toddler, she said he movements were excellent and not to worry.

I made a complaint, asking how was it that drs can make their own rules on rescheduling of appointments when it goes against HSE and Sligo hospital policy. They said they would be reviewing the hospital policy and the 'policy' drs had implemented. Also did they find it acceptable that a child who had not been seen was taken off the waiting list, they said that they were deeply regretted this happened and wil be taking steps to make sure it does not happen in the further.
Pretty standard, limited reply but hope it doesn't happen in the further to anyone else

wolfpawnat

sari wrote: »

Just thought I'd give an update on this.
Firstly my boy is fine he got an appointment with a different peads dr, he referred him to physio, she said he's fine it's within normal range for a toddler, she said he movements were excellent and not to worry.

I made a complaint, asking how was it that drs can make their own rules on rescheduling of appointments when it goes against HSE and Sligo hospital policy. They said they would be reviewing the hospital policy and the 'policy' drs had implemented. Also did they find it acceptable that a child who had not been seen was taken off the waiting list, they said that they were deeply regretted this happened and wil be taking steps to make sure it does not happen in the further.
Pretty standard, limited reply but hope it doesn't happen in the further to anyone else

They may do nothing, or they may take further action. Had you not made the complaint, it would be guaranteed nothing would have been done. Glad you got answers in the end Sari

sari

Yes I'm glad I complained and followed it up, i got no reply for a month and a half!! They don't make it easy

nicowa

Well done for complaining. On another note, my little girl had similar. I had said it to the PHN and she said it would correct itself. Once she started walking it did. I had even forgotten about it til now. Both my mum and my mil were worried about it which didn't help but she is fine now. Good luck.