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[Christine]

Bloody Charing Cross. I've just received a letter informing me that I've been discharged from their counselling service for not attending an appointment they never informed me about. Well sorry for not being psychic.

This follows a previous and unnecessarily aggressively-worded letter also criticising me for not attending an appointment and not informing them, even though I had informed them in advance and was assured the message would be passed on. As it was, that day had a travel advisory of essential journeys only because of the snow, a situation where I'm used to the clinicians themselves not turning up. The appointment before that I did attend having only been given a couple of days notice by post.

It seems that my letter in reply to that where I informed them that I wouldn't be requesting further counselling appointments was also lost.

So there we have it:
* phones are usually not answered.
* when they are answered, the person is often rude and unhelpful.
* phone messages are not passed on.
* letters sent to clinicians are usually lost.
* faxes sent to clinicians are often lost.
* there is no means of contacting them via email.
* letters sent from clinicians take months to be typed.
* sometimes they are not typed at all or lost before they go in the post.

Why is nobody doing anything about this? I don't think I've ever encountered an organisation with anywhere near as many communication problems as CX. They are in essence impossible to contact, unless you turn up in person. But even then, on my first visit I discovered that the buzzer on the door was broken so I couldn't get in.



Sigh, and there was me feeling excited, thinking the letter might actually be something useful and relevant, not expecting to instead be castigated for failing to attend an appointment I knew nothing about. I thought it was a nice touch to copy my GP on all my supposed failings just to ensure I get a bad reputation.

[Ice Maiden]

When I studied my degree in Health and Social Care one thing was clear from public services was that the way we as individuals think and feel and our expectations are often far in excess to what can be provided.

This is the first mistake - a parent screaming at a social worker who has a case-load of 50 clients desperate for help that week, is bound to result in errors. They are not intentional.

Non-attendance to any appointments in the NHS is a big non-no. They are inundated with demand and clinical time is precious!

Their view would likely be that you did not attend last time (for whatever reason) and a second time on the trot suggests you may well not be that determined to deal with this issue and they gave your slot (no pun intended) to another patient who is desperate!

Solutions

Any meeting with clinicians is kinda like if you speak to a police officer, they tend to be stressed and have a lot on their mind. They just want to deal with often a minor issue, but the patient or member of the public feels victimised and lashes out. Overly critical, threatening behaviour, projective identification pouring into someone who is trying to help results in the walking away and moving on and the do not absorb the issue.

The first thing to do here is to write a civil and calm letter make sure you have your address and hospital/NHS Number on it at the top. Be polite, and most important of all is to send a few copies everytime. Send one to the Head of clinic, send one to the counsellor (if it is Charing Cross that would be Dr Barrett) at the top/Bottom of the letter type CC... names of recipients...

So send on to the person who you were supposed to see, send an identical one to the Head of clinic and another to your GP. Send them ALL recorded delivery or hand deliver them if you are near the GP for example.

Make sure you use large A4 Envelopes do not fold the envelopes. It is common sense that it is harder to lose something big than something small.

Legally you also have evidence - you have the Recorded delivery slips that you retain and store in case you need evidence for legal action. You can also trace if they were signed for print the post office page (track and trace) to show that it arrived.

This all now becomes a very different animal.

1. It shows you are determined as you are going to a lot of trouble and the clinicians can see that sending copies out.
2. They cannot fudge or bullsh*t you that they never got it. You can contact the Health Service Ombudsman with evidence and have the issue overturned. You can sue if need be.
3. Practitioners do not like having colleagues looking over their shoulders that they do not actually work with. You GP watching the farce unfold before them is a good ally to have as they can see that you did this and that and the other, and you can speak to your GP and then say - LOOK! LOOK AT WHAT THEY ARE SAYING! And they will look at your records and see this is nonsense! As they can see what you have sent. This makes them look incompetent on an official level, and not just hearsay.

I experienced similar problems about a decade ago, suffice it to say I followed these rules, although in my case the culprit was the Health Authority not wanting to fund a referral. Well they soon were served with legal action (Judicial Review) and within 24 hours the Head of clinical practice and public policy had phoned me personally and aplogised and it was settled I had what I wanted.

This was because he had been also added to the loop. So at that time I was wring to 4 people each time CC'ing it. All the practitioners could clearly see their failing. And a lawyer had all the evidence he needed to stop it in a finger click as it was indisputable.

This is the end of a very long process. To begin with remain polite, amicable and understanding of the pressures they are under. As time goes on then it becomes their problem, you have done your best. But they need TIME to respond and deliver. I recently felt similar to you, and was impatient, but time flies and I was examined in line with my request.

Of course medical records are retained so if you are unreasonable they have proof too! So think about what you write, I am happy to proof read any letter privately for you to see if the tone is acceptable. And run you through how to best manage this issue on Skype maybe?.

But if you have a history of legal action - I guess I have from the very first attendance, it can make practitioners 'twitchy' as they may think they will be next. So this can also be counter-productive as they don't really wanna spend too much time with you around - COURT ORDER! RUN!

So for you I think this is rectifiable, but you maybe need a fresh approach :)x

[Christine]

Thanks very much for the advice: I'll take heed. The original letter I sent in response to their nastygram nearly was a bit cross (though not rude) but I did think better of it and sent something that was significantly toned down and just stuck to the facts. I'll endeavour to do so again.

It's not really a matter of impatience on this particular occasion, just that I do feel rather upset that I'm getting a bad reputation for messages not being passed on, the first time from me to the clinician, the second time failing to notify me of an appointment. I've actually quite a history of being unreasonably maligned and it's caused me a lot of problems; I'm sure there's some irony in what should be productive counselling ending up doing the same thing...

I understand that the clinicians' resources are precious, but the problem is the layer between the clinicians and their patients. I'm sure Dr Barrett is already aware of this, but perhaps as more people copy him on letters outlining the problems that are being caused, he may stand more chance of being able to address it successfully.

[Ice Maiden]

Well if you need any help you know where I am
ucp.php?i=pm&mode=compose&u=53

and you can always join us for the Skype Group on a Monday - even if it is a one off drop-in issue ;)Px
http://beaumontsociety.transgenderzone.com/live.htm

[Christine]

I'm much too nervous to do interactive stuff! But thanks for the encouragement.