The second letter...

... is actually an email.

"Dear Christine and Nicola,

After our meeting in December, I had hopes that the treatment provided by your services would be more satisfactory. Unfortunately, I have to inform you that I will be writing another letter of complaint after my appointment with Dr O's replacement this morning. Dr S was a perfectly pleasant doctor; however, he not only had not read my notes, he had not realised that they were not in the room until I was with him. The notes could not be located so the entire appointment was conducted on the basis of a print-out of the summary written by Dr O in November. As you can imagine, I am very upset and disappointed that an appointment in which I had invested much hope received such inadequate preparation that it was not even worth me making the trip to Addenbrookes.

When I feel a little calmer, I will write a letter to outline exactly what happened. It is a shame that your excellent efficiency in dealing with complaints is not matched by even an averagely good clinical service.

Best wishes,

Linda Bates"

The letter did not materialise because the complaints director asked me not to make another formal complaint. Instead, she (Christine) and Nicola (PALS rep) met with me again.

The complaint was saved until the third appointment in this sequence:

Dear Christine,

Thank you for your letter dated 26^th February, which responded to my email of 25^th January. You agreed that it was unacceptable that my notes were missing when I was seen on 25^th January by another temporary doctor. You explained that my next appointment would be with Dr D and that the move to a new building would enable you  ‘to manage paper records more effectively’. Your letter arrived after I had been offered an appointment with Dr D on 29^th March.

However, I received another letter, dated 15^th February, from the outpatients department explaining that the existing appointment had ‘been cancelled and replaced by the following:

Clinician Dr Claire D

Date/Time: Monday, 22 March 2010 11:00 AM

Location: Union House, 37 Union Lane, Chesterton, Cambridge CB4 1PR”

Therefore I arrived at Union House at 10.50 am today and notified the receptionist that I had an appointment with Dr D at 11 am. She took my name and asked me to take a seat. Other patients arrived as 11 am approached and, one by one, their names were called by different clinicians. A female doctor, whom I later learned was Dr D, called in a male patient. Soon I was the only patient left in the waiting area. I was already feeling anxious but tried not to overreact because one can’t expect always to be seen on time. However, when 11.25 am came and the waiting room was filled once more with patients awaiting 11.30 am appointments, I approached the desk, showed the receptionist my appointment letter and asked if there was any reason why I was experiencing a long wait. She told me that ‘they are running a bit late’. This explanation did not seem to fit with the timely manner in which every other patient was being called through but I accepted her words and took my seat again. By 11.45 am, most of the other patients in the waiting room had been called through. At 11.50 am, Dr D came out and told the woman sitting next to me that she would be with her in a moment but that she ‘just needed to explain something to this lady’. She turned to me and said that an administrative error had occurred, that my appointment letter showed an incorrect time and I was not on her list until 3.00 pm. She explained that another doctor was willing to see me. Unfortunately, the anxiety of waiting for an hour without knowing what was happening meant that I was very distressed by this point and I was not willing to wait further to see a man whom I did not know. I therefore left the building in tears and feeling incredibly anxious and panicky.

I now do not know when or whether I will receive another appointment and it is very hard for me to trust that any letter I receive in future will be giving me correct information. I also am struggling to understand why staff (whether receptionist or clinicians) did not notify me of the error in my appointment letter either when I registered my arrival at 10.50 am or when I approached the receptionist at 11.25 am or at any other point in the hour when I was sitting waiting in reception. As I am sure you are aware, an hour of waiting without understanding the situation caused me a great deal of anxiety and distress. I understand that mistakes are sometimes made in letters; however had I been told straightaway that an error had been made, I could perhaps have organised to come back at 3 pm rather than wasting the entire morning on a fool’s errand.

Please could you clarify whether I will be able to see Dr D on another day and explain to me why my experience of contact with your services has so far been a catalogue of distressing mishaps?"

"I therefore left the building in tears and feeling incredibly anxious and panicky" is a bit of an understatement. When Dr D came out to speak to me, I went into full-blown sobbing panic attack. In the middle of a crowded waiting room. It was horrible. I then sat sobbing the car for an hour. I think I rang my dad and he tried to calm me down so that I was safe enough to drive home. Since this was the bazillionth time he'd had to do this after appointments with CPFT, he travelled down from Bham to accompany me to the next appointment, purely so that I'd have someone with me to help me cope with whatever shit was thrown at me the next time.

In fairness, Dr D herself was awesomesauce when I eventually got to see her. But unfortunately my therapeutic relationship with her came to an abrupt end when she was moved to another area of the trust after my second appointment.