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Our Hospital

The James Paget University Hospital in Gorleston is our local hospital - not strictly speaking ‘local’ as it’s 13 miles away on the coast but it is the nearest.

I went to the JPUH (unfortunate homophone) Annual General Meeting last week. Give it its due - it’s in the lead for infection controls and is doing some fine work in terms of patient dignity and single gender wards. At the AGM there were excellent presentations on some pioneering deep vein thrombosis risk detection and prevention; a new breast cancer suite and leading edge equipment with digitalised mobile services and some nationally praised breast cancer reconstruction surgery; brand new IT equipment for patient feedback before and after care and treatment; and plans for a purpose built hospice in the grounds.

But I’ve just had cause to make a formal complaint about my own awful treatment at the JPUG Pain Clinic - led by Dr Willy Notcutt, once at the forefront of pain treatment in the UK (I understand Dr Notcutt is now retired).

In short: I was seen last April after a wait of 10 weeks from referral by my GP. The doctor I saw made a precursory examination, did nothing about pain relief and referred me to physio and told me I would have to go back to my GP for a referral to someone else for the pains in my legs. After three sessions of physio I found myself completely immobile and in unrelievable acute pain for three days. There was no follow up by the doctor and no copy of his letter to my GP. I contacted PALS (in July) and was subsequently given choices to see other doctors or that doctor again I decided the fairest thing would be to give the first doctor chance to explain. All the Pain Clinic doctors were away for the whole of August. I was put on the first doctor’s ‘cancellation list.’ Effectively, having heard nothing, I am still waiting for proper treatment and that is since my GP made the referral in February of this year.

I was puzzled about the Pain Clinic doctor I saw telling me he could not do anything about the pain in my legs and I would have to go back to my GP for a referral to someone else.

At the recent JPH AGM I asked (taken verbatim from an audio recording): “Is there, in the hospital, an internal commissioning system?” Asked to expand on what I mean I said: “If a consultant wants to refer to another department, does that consultant have to commission the other department to do that work?” The answer came: “Well effectively that is a consultant to consultant referral..” I interjected: “But there’s no finance involved?” The reply was: “Well yes there is because the actual consultant to consultant may result in additional activity associated with that patient so that it may be actually associated with coming out of the final tariff for the patient - the final price for the patient…” I asked further: “The referring consultant - does he have to make a payment?” “No” was the reply. I said: “Perhaps I could explain: I’ve been involved with one of the departments of the hospital where I’ve been told I would have to go back to my GP to get that GP to refer to another part of the hospital and I’m wondering why that’s happened.”

I then went on to my second (unrelated) question but after that had been aired, the trust’s new Financial Officer chipped in with: “Just in terms of the service pathway and consultant referral for every service path or service pathway there will be different agreements in terms of what stage. Obviously a patient can be referred back to their GP rather than a consultant because obviously the PCT is very interested in being able to know what demand there is and make sure they can actually see the demand for their services coming from the GPs into the trust as opposed from actually going from consultant to consultant. So in terms of that there will be patient pathways whereby consultant consultant will actually happen and there will be some where for certain conditions at a point in time the decision will be to push back to the GP and ask him to re-refer back into the piece if that’s agreed with the PCT.”

I think if this latter process is accurately described it not only holds implications for serious delays in my own problems being dealt with but also possible national ramifications for the efficacy of the ‘patient pathway.’

Has anyone else heard about or experienced this seeming anomaly?



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