IOM DHSC & MANX CARE

[John Wright]

2 hours ago, Max Power said:

Well now I’m the victim of a botched op. Came in for a day procedure and been here since last week! Off to Liverpool by air ambulance to sort it out!

Friends have been warning me of the high chance of Nobles getting it wrong, would I listen?

I came in feeling fine, now I feel awful with the prospect of feeling a lot worse. 

 Bugger!

Good luck, get well soon. Keep us updated.

[WTF]

2 hours ago, Max Power said:

That’s the thing, when you feel this bad, advocates are the last things on your mind!

there is a time limit to begin litigation, don't miss it.

[Moghrey Mie]

On 2/15/2023 at 6:36 PM, cissolt said:

Manx care to ask for even more money to clear backlogs.  I thought they still had a significant chunk left from their last backlog funding request?

Note from their mandate:

https://www.three.fm/news/isle-of-man-news/manx-cares-mandate-to-be-laid-before-tynwald/?fbclid=IwAR3XUDlCv3b2EqPzfMUafCI5keSheWp_9s_MCRdLGiUT_OLn3c-1pm3zMc8

They like to 'slice and dice' so they don't ask for everything at once.

[Gladys]

"Could I just remind everyone that it is up to you to cancel an appointment that you cannot keep?"

FFS. Has any analysis of why appointments are being missed been undertaken?  Even if it is an analysis of any a correlation between the length of time before the appointment the letter is sent and the number of those longer booked  appointments being missed?  Why there seems to be a delay between some letters being produced and actually sent? Etc. 

Then, only when you have identified the issues in your own systems can you start to tackle the behavioural issues of patients. 

[wrighty]

1 hour ago, Gladys said:

"Could I just remind everyone that it is up to you to cancel an appointment that you cannot keep?"

FFS. Has any analysis of why appointments are being missed been undertaken?  Even if it is an analysis of any a correlation between the length of time before the appointment the letter is sent and the number of those longer booked  appointments being missed?  Why there seems to be a delay between some letters being produced and actually sent? Etc. 

Then, only when you have identified the issues in your own systems can you start to tackle the behavioural issues of patients. 

There are many reasons why patients don't attend appointments, including

• Didn't know about it
• Forgot about it
• Got the date wrong (we occasionally get people turning up a week early, for example)
• Transport issues
• Confused with multiple cancellations/rebookings
• Got better
• Had other priorities (eg take the dog to the vet instead, get a haircut)
• Ill with something else
• Off island for long periods of time

We need to do better, admin wise - only sending appointments out a few weeks in advance followed up by text reminders the day before may alleviate a lot of the don't know/forgot/confused issues. The letters, if that's what we're going to do, need to have contact details with a number to phone to let us know if the appointment can't be made, or if it is no longer required because whatever they were referred with has got better.

Only then can we start berating or penalising the few who don't show because they couldn't be bothered, or had an appointment for their nails instead.

[Gladys]

5 minutes ago, wrighty said:

There are many reasons why patients don't attend appointments, including

• Didn't know about it
• Forgot about it
• Got the date wrong (we occasionally get people turning up a week early, for example)
• Transport issues
• Confused with multiple cancellations/rebookings
• Got better
• Had other priorities (eg take the dog to the vet instead, get a haircut)
• Ill with something else
• Off island for long periods of time

We need to do better, admin wise - only sending appointments out a few weeks in advance followed up by text reminders the day before may alleviate a lot of the don't know/forgot/confused issues. The letters, if that's what we're going to do, need to have contact details with a number to phone to let us know if the appointment can't be made, or if it is no longer required because whatever they were referred with has got better.

Only then can we start berating or penalising the few who don't show because they couldn't be bothered, or had an appointment for their nails instead.

Indeed, but that analysis does not seem to have happened.  Instead we have the Minister alluding to the only issue they seem to have identified - people not cancelling.

I have a letter dated 27 October 22 for an appointment on 8 September 23.  I have to have certain blood tests for which I was given the paperwork at the previous appointment in early September 22.  I have to have these taken 2 days prior to the appointment in September this year.  Fortunately, I keep this with the record of the treatments I receive throughout the year  but without that record you can bet your bottom dollar I would not be able to find it in early October this year. 

Why not send the letter a month before the appointment with the blood test stuff?

I know they probably want to book clinics early to manage them, but they do not have to send out the letters when they first book them.  People would be able to remember the appointment and are also in a better position to cancel if it conflicts. 

[Gladys]

PS the letter does have a number to call to cancel. 

[Two-lane]

32 minutes ago, wrighty said:

We need to do better, admin wise - only sending appointments out a few weeks in advance followed up by text reminders the day before may alleviate a lot of the don't know/forgot/confused issues

To take a simplified view, this is not *the* problem, it one symptom of *the* problem - which is poor management.

What is being discussed here is not how to fix the destruction caused by an act of God or similar, but just a situation that has been allowed to be created by some (highly paid) managers.

[The Voice of Reason]

51 minutes ago, wrighty said:

There are many reasons why patients don't attend appointments, including

• Didn't know about it
• Forgot about it
• Got the date wrong (we occasionally get people turning up a week early, for example)
• Transport issues
• Confused with multiple cancellations/rebookings
• Got better
• Had other priorities (eg take the dog to the vet instead, get a haircut)
• Ill with something else
• Off island for long periods of time

We need to do better, admin wise - only sending appointments out a few weeks in advance followed up by text reminders the day before may alleviate a lot of the don't know/forgot/confused issues. The letters, if that's what we're going to do, need to have contact details with a number to phone to let us know if the appointment can't be made, or if it is no longer required because whatever they were referred with has got better.

Only then can we start berating or penalising the few who don't show because they couldn't be bothered, or had an appointment for their nails instead.

Well it may seem a bit harsh but could I suggest an alternative way.

An automatic penalty for a missed appointment, refundable or not charged upon a successful appeal (for a reasonable excuse)

But yes make it as easy as possible to cancel an appointment.

[Gladys]

5 minutes ago, The Voice of Reason said:

Well it may seem a bit harsh but could I suggest an alternative way.

An automatic penalty for a missed appointment, refundable or not charged upon a successful appeal (for a reasonable excuse)

But yes make it as easy as possible to cancel an appointment.

Penalties should only be considered once all other issues, including those of their own making, are solved.  Even then, I am not sure it would do much to deal with the behavioural aspects and would be a nightmare to administer including having some sort of appeal process.  It may also unfairly penalise the more vulnerable.

Let them get their own house in order before flinging fines around. 

[The Voice of Reason]

5 minutes ago, Gladys said:

Penalties should only be considered once all other issues, including those of their own making, are solved.  Even then, I am not sure it would do much to deal with the behavioural aspects and would be a nightmare to administer including having some sort of appeal process.  It may also unfairly penalise the more vulnerable.

Let them get their own house in order before flinging fines around. 

I’m not thinking of a particularly formal appeals procedure, more just the application of common sense (I know, I know).

Obviously if the appointment was missed by virtue of a Manx Care/ DHSC cock up then this would constitute reasonable excuse. And it may lead to such failings being uncovered and the attendant bad publicity give rise to fixing such failings.

I am not sure why you say it may also unfairly penalize the more vulnerable. Do you mean those less likely to be able to afford such a penalty, or due to some underlying physical or mental condition? ( in which case again reasonable excuse would apply)

I would rather this issue didn’t have to be considered but at a time when getting an appointment in itself is a Herculean effort,  or merely a matter of chance then any initiative that may lead to a reduction in missed appointments has to be considered.
If administration costs can be kept to a minimum it may also raise some badly needed revenue from the likes of those who would rather have their nails painted without cancelling their appointment.

[Gladys]

I would rather see them overhaul the appointment system than try to generate a relatively insignificant amount of revenue which will, I can almost guarantee, have disproportionate administration involved.  You cannot use 'common sense' as an appeals process, it has to be clear, fair and objective.  Common sense varies.  You would also end up with an exemption system which will introduce even more bureaucracy. 

It would unfairly penalise the vulnerable, both those who can ill-afford a couple of quid penalty as well as those with health issues, would they have to be certified as unable to attend?

Get the system right, then look at behaviours, not the other way round. 

 

Edited February 19, 2023 by Gladys

[Omobono]

1 hour ago, Gladys said:

Indeed, but that analysis does not seem to have happened.  Instead we have the Minister alluding to the only issue they seem to have identified - people not cancelling.

I have a letter dated 27 October 22 for an appointment on 8 September 23.  I have to have certain blood tests for which I was given the paperwork at the previous appointment in early September 22.  I have to have these taken 2 days prior to the appointment in September this year.  Fortunately, I keep this with the record of the treatments I receive throughout the year  but without that record you can bet your bottom dollar I would not be able to find it in early October this year. 

Why not send the letter a month before the appointment with the blood test stuff?

I know they probably want to book clinics early to manage them, but they do not have to send out the letters when they first book them.  People would be able to remember the appointment and are also in a better position to cancel if it conflicts. 

they send all this stuff out in advance so they can claim there is no one on the waiting list ,  then over the months you are bombarded with new appointment  changed  times and dates ,   the appointments come out from a secretarial pool  ,and often without input from the particular department or consultant , not the best way to run an appointments section , and no wonder the patients get confused , 

[mad_manx]

21 minutes ago, Omobono said:

they send all this stuff out in advance so they can claim there is no one on the waiting list ,  then over the months you are bombarded with new appointment  changed  times and dates ,   the appointments come out from a secretarial pool  ,and often without input from the particular department or consultant , not the best way to run an appointments section , and no wonder the patients get confused , 

Spoke to my consultant ..Things used to be better in the old days when each consultant had their own secretary and the department  handled the appointments. 

Then for "cost savings" they made it all in in some central appointments section and things have all been berserk since then..

[WTF]

2 hours ago, wrighty said:

There are many reasons why patients don't attend appointments, including

• Didn't know about it
• Forgot about it
• Got the date wrong (we occasionally get people turning up a week early, for example)
• Transport issues
• Confused with multiple cancellations/rebookings
• Got better
• Had other priorities (eg take the dog to the vet instead, get a haircut)
• Ill with something else
• Off island for long periods of time

We need to do better, admin wise - only sending appointments out a few weeks in advance followed up by text reminders the day before may alleviate a lot of the don't know/forgot/confused issues. The letters, if that's what we're going to do, need to have contact details with a number to phone to let us know if the appointment can't be made, or if it is no longer required because whatever they were referred with has got better.

Only then can we start berating or penalising the few who don't show because they couldn't be bothered, or had an appointment for their nails instead.

you forgot 'died whilst waiting for numerous years' from your list