Reasoning and cost involved for sending a patient back to see a GP.

The request was successful.

Dear Barts Health NHS Trust,

After attending Hospital a few years back with a relative who was complaining of chest pains and stomach upset over a 2 year period, i noted the following:

In the 3 emergency visits i attended with the patient each time (who was in agonizing pain) we were told that the patient needed to have an endoscopic procedure of putting a camera down the throat into the stomach to check for problems.

Each time in the Accident Emergency, we were given a letter to give to the GP to book the appointment with the department within the same Trust to carry out the procedure. Each time we questioned why this is the case, and why they could not book the appointment for us as they were giving the instruction for the procedure after a diagnosis.

Each time we were told that this is just the way it is now. Each time the patient went to the GP with a letter, the request letter was refused by the GP, until the patient had an extremely bad episode and was rushed by ambulance to the hospital. Yet again they were given another letter to give to the GP. After the GP apologized for refusing the first couple, he finally requested the endoscopy as instructed in the letter. As it turned out, the patient had multiple ulcers in the stomach and oesophagus. The patient was finally treated after two years of back and forth between the hospital and the GP.

My questions are:

1. Why in cases like this after a request is made by the A&E Doctors for an endoscopic procedure to be carried out, does the A&E not book the appointment directly with the relevant department?

2. Why is it that a letter is asked to be delivered by the patient to the GP requesting the procedure?

3. How did situations like this upon attending A&E get resolved before this system of sending the patient with a request for further treatment/analysis back to their GP?

4. How was it handled before this system of sending the patient back to the GP, and when was this system brought in?

5. What was the reasoning behind changing to the current system?

6. Please list all ailments/treatments that fall under this system of sending the patient back to the GP with a letter for further treatment/analysis?

7. What are the costs benefits of this new system?

8. What are the charges to the GP or GP surgery for accepting this letter and requesting the requested treatment from the hospital? What does this financially cost the GP?

Yours faithfully,

Muhammed Iqbal

FAO Mr Muhammed Iqbal

Dear Mr Iqbal

Your Request for Information [FOI-078-14]

I am writing to acknowledge receipt of your recent FOI request. It will be processed in accordance with the requirements of the Freedom of Information Act and you will receive a request within the stipulated timescale.

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If you have any queries then please contact us at [Barts Health NHS Trust request email]

If you are dissatisfied on how your request has been handled, you can complain in writing to: The Head of Information Governance, Barts Health NHS Trust Email: [Barts Health NHS Trust request email]
Postal Address: The Head of Information Governance, c/o Archives and Records Centre, Barts Health NHS Trust, Lower ground Floor, 9 Prescot Street, Aldgate, London E1 8PR

If, after we have addressed your complaint, you remain dissatisfied with how we have responded, you are entitled to appeal to the Information Commissioner (Tel: 01625 545 745). Details are shown at www.ico.org.uk

Yours sincerely,

Pamela Wood

Corporate Records
Barts Health NHS Trust

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FAO Mr Muhammed Iqbal

 

Dear Mr Iqbal

 

Your Request for Information [FOI-078-14] 

 

I am writing in response to your FOI request below.  In respect of the
questions you have raised, we can advise you as follows:

 

Your Question 1:  Why in cases like this after a request is made by the
A&E Doctors for an endoscopic procedure to be carried out, does the A&E
not book the appointment directly with the relevant department?

Our response:   This is a policy of the North and East London
Commissioning Support Unit, set on behalf of all of our local Clinical
Commissioning Groups, relating to "Consultant to Consultant Referrals" and
with which the Trust has to conform.

 

Your Question 2:      Why is it that a letter is asked to be delivered by
the patient to the GP requesting the procedure?

Our response:    It is the GPs who control access to non-emergency
tests.   It is your GP, and not the Hospital, who is responsible for
deciding when a non-emergency test will be carried out and where the test
will be carried out.

 

Your Question 3:    How did situations like this upon attending A&E get
resolved before this system of sending the patient with a request for
further treatment/analysis back to their GP?     

Our response:  Prior to the refinement of the contracting process by
Primary Care Trusts (and latterly Clinical Commissioning Groups) Hospitals
could book these tests directly

 

Your Question 4   How was it handled before this system of sending the
patient back to the GP, and when was this system brought in?

Our response:    As per our response to Question 3  above

 

Your Question 5:   What was the reasoning behind changing to the current
system?

Our response: This question should be addressed to the North and East
London Commissioning Support Unit  ([1]www.nelondoncsu.nhs.uk/about-us)

 

Your Question 6:  Please list all ailments/treatments that fall under this
system of sending the patient back to the GP with a letter for further
treatment/analysis?

Our response:   This policy applies in respect of all non-emergency
ailments and treatments

 

Your Question 7:   What are the costs benefits of this new system?

Our response:  As per our response to Question 5 above

 

Your Question 8:  What are the charges to the GP or GP surgery for
accepting this letter and requesting the requested treatment from the
hospital? What does this financially cost the GP?

Our response:  As per our response to Question 5 above

 

I hope that this information will be of value to you.  However, if  you
have any queries please contact us at [2][email address]

 

If you are dissatisfied on how your request has been handled, you can
complain in writing to:  The Head of Information Governance, Barts Health
NHS Trust

Email: [3][Barts Health NHS Trust request email]

 

Postal address:

The Head of Information Governance, 

c/o Archives & Records Centre,

Barts Health NHS Trust,

Lower Ground Floor,

9 Prescot St,

Aldgate,

E1 8PR

 

If, after we have addressed your complaint, you remain dissatisfied with
how we have responded, you are entitled to appeal to the Information
Commissioner (Tel: 01625 545 745);    Details are shown at
[4]www.ico.org.uk  

 

Yours sincerely,

 

Pamela Wood

 

Corporate Records

Barts Health NHS Trust

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