Experiences of Camden patients attending the Royal Free Hospital or University College Hospital for outpatient appointments

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Summary of report content

Healthwatch Camden undertook research about the patient experience starting with a GP referral right up to the day of the hospital appointment. Over three weeks in spring 2019, they interviewed 153 Camden patients in the outpatient clinic waiting areas at both the Royal Free Hospital (RFH) and University College Hospital (UCH). The largest numbers or responses were from patients in orthopaedics, rheumatology and dermatology clinics.

The great majority of the patients had a straightforward experience of referral from their GP to a specialist hospital outpatient appointment. Most patients were offered an appointment which was not cancelled or changed, were content with the communication about the appointment and were pleased with the appointment itself. In the minority of cases where complications had arisen, these had often been serious and were highly frustrating with potential impact on patient wellbeing.

Most patients reported that communication around their outpatient appointment was clear and simple. However, in the cases where communication had gone wrong, patients reported that things had gone very wrong.

It is easy for those who are familiar with a system and the environment in which they are working to assume this understanding in others. Patients, on the other hand, are often unfamiliar with how things work and are stressed by the hospital experience which further hinders their capacity to understand and act on information given. This failure of “information prescribing” by hospital doctors creates stress for patients and inefficiencies for the hospital following the appointment.

The research indicated that patients place very high value on direct contact with a senior clinician and the reassurance this provides.  Although reports of complications around outpatient appointments usually appear to relate to administrative functions, there was some evidence of the contribution clinicians can make to poor patient experience and to system errors.

Follow up appointments represent a large proportion of available hospital outpatient appointments. Pressure on outpatient appointments could be eased by reducing the number or regularity of follow up appointments with consultants and registrars.

There are six recommendations all designed to improve the patient experience of referrals. 

The report includes responses from each of the 3 providers.

 

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General details

Report title 
Experiences of Camden patients attending the Royal Free Hospital or University College Hospital for outpatient appointments
Local Healthwatch 
Healthwatch Camden
Date of publication 
Wednesday, 4 March, 2020
Date evidence capture began 
Monday, 1 April, 2019
Date evidence capture finished 
Monday, 22 April, 2019
Type of report 
Report
Key themes 
Administration
Booking appointments
Communication between staff and patients
Information providing
Quality of appointment
Quality of care
Quality of staffing
Service delivery organisation and staffing
Staff attitudes
Waiting time to be seen once arrived at appointment
Waiting times and lists for treatment
Healthwatch reference number 
Rep-5261

Methodology and approach

Was the work undertaken at the request of another organisation? 
No
Primary research method used 
Structured interview
User stories
How was the information collected? 
Visit to provider
If an Enter and View methodology was applied, was the visit announced or unannounced? 
N/A

Details of health and care services included in the report

Secondary care services 
Appointments
Orthopaedics
Rheumatology

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
 
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
 
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.