A health warning: I am about to have a winge at a group of fellow professionals, and if you are working hard, and giving a good service then I don't mean you.
People with psychiatric problems have a pretty raw deal out of life. Their conditions are poorly understood by the professionals, and they are frequently demonised by the general public and the media. I spend a lot of my time with psychiatric patients, and I enjoy it. In 95% of cases I can deal with them by myself in General Practice.
We have a system locally where all referrals are chanelled through a single route and this has caused untold delays. There is a panel that apparently vets all my referrals and decides if they should go through and who sees them.
All this does is ties up a group of trained mental health professionals sitting around a table, pontificating on my referral based on the letter. The delays that this produces in the system (sometimes 6 weeks) is utterly unacceptable, and frankly I've had enough.
- If I want a patient to see a consultant psychiatrist, they need to see a consultant psychiatrist.
- If I want a patient to have CBT, I want them to have CBT [Cognitive Behavioural Therapy]
- If I want them to see a counsellor, I want them to see a counsellor.
- If I want them to see a Community Psychiatric Nurse [CPN], I want them to see a CPN.
They should get off their bottoms and see some patients.
This is not just me, read an excellent post from geepeemum about a similar thing.
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6 comments:
We had this nonsense within the hospital. A bunch of people from the PCT around a table deciding that a respiratory consultant asking an ENT consultant to see a patient with Wegener's was inappropriate because they were too ignorant to understand why the referral was necessary. After subjecting them to ridicule they stopped.
I can think of a few reasons why referrals are 'triaged'.
* too many poor GP referrals in the past ?
* resource mismatch - too many patients, not enough psychiatrists [ony the specialty doctors can see the bigger picture] ?
* dwindling bed base - only the very disturbed tend to be hospitalised nowadays.
* the emergence of the ubiquitous health care professional [dumbing down as Dr Crippen calls it].
Anyway, the NHS did not get where it is today without one kind of panel, or other, pontificating on the quality of referrals from other professionals ?
Would I be wrong in thinking that GP receptionists occasionally 'triage' paients.......I've heard it said that waits can be up to x2 weeks ?
Speaking as one of those patients with psychiatric problems I would like to say thank you to geepeemum and yourself, JD, for highlighting this problem. My problems are minor in comparison to many, but I too cannot understand how someone without the training that a psychiatrist receives can decide whether or not I should see a consultant psychiatrist. If my GP considers it necessary for such a referral to be made then no-one other than the consultant psychiatrist should be making any decisions about whether I am ill enough to warrant such a consultation.
It is no wonder that so many people with psychiatric problems are unable to work when they are not able to get the sort of help that they need. We suffer enough discrimination without the services that ought to be helping us, discriminating against us even further.
Completely off topic - but if Zaruthustra & Co [over at mental nurse] see the iconic checked-shirt-man, who seems to crop up with alarming regularity, it may start them all off again.
I seem to recall at least one thread on their site devoted to the inner world of this serotonin depleted, and apparently window obsessed character ?
Having given myself a headache in the early part of the afternoon trying to help someone who is embroiled in the NHS complaints process, I read your post and geepeemum's and went for a walk around the block. The walk seems to have scrambled the two issues in my head, making me wonder...why don't you complain? Is the complaints process not available to GPs?
Around here, at least some of the panels seem happy enough to be bypassed by more direct referrals (even from a private therapist). So they only sit around and wonder what to do when the referral letter is not specific, and I have not heard reports of long delays caused by the panels themselves. I guess there are GPs who feel the panels take some pressure off them.
I can only assume that it is an allocations meeting. These are supervised by a consultant. They then decide if it's most appropriate for them to see them or if someone else can pick it up. Too many patients and not enough consultants. Way of the world I'm afraid.
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