"Waiting for an appointment"

About: Bentley Hospital / Older Adult & Falls & Memory Clinics & Day Therapy Unit Fremantle Hospital and Health Service

(as a relative),

Back in end of February my dad’s doctor did a referral to the Gerontology Department because at 91 years of age he was becoming forgetful and maybe he could be a candidate for a medication that might slow down the progression of his loss of memory. We were warned it may take up to three months to get an appointment. On 21st June we received two letters (in separate envelopes) advising us that he had an appointment at Fremantle Hospital on Wednesday 18th July at 1.00pm to see the nurse and 1.30pm to see the doctor. Then on 27th June we received two more letters advising that the appointment had been rescheduled to Tuesday 7th August at 2.30pm to see the nurse and 3.00pm to see the doctor. On the 3rd August Dad received a phone call to confirm the appointment. Because he is hard of hearing and has memory/thinking issues he didn’t understand what they wanted and asked me to check it.  Which I did and confirmed the appointment. On the morning of the 7th August I received a phone call saying the appointment had been cancelled as the doctor was sick, and that we would receive a letter advising the new reschedule date.  Whoever I found this person to be rude and advised that they were a temp and just filling in. On the 9th August we received a letter advising that the appointment had been rescheduled to 9th October at 12.30 to see the nurse and 1.00pm to see the doctor. Note: the letter states to allow up to three hours for the clinic appointment and my Dad lives 40-45 minutes from the hospital.  Because of his age my Dad is set in his ways and he needs to eat and take tablets in the middle of the day and also has his regular scheduled respite trip Tuesday mornings, I felt that this time (12.30 pm) was not optimal for him. I phoned Outpatient Direct and spoke to a person who I felt was the rudest person. She advised that she couldn’t change the appointment and that all she could do was send a message to the clinic to change it and we would be advised by mail. During our exchange I explained the reason for the change request and that an earlier or later time would be better for him. On 13th August we received a letter advising that the appointment had been rescheduled to Tuesday 30th October at 12.30pm the exact time I requested it not to be. I rang Outpatient Direct and spoke to a lovely lady who tried to reschedule the appointment for me even ringing back twice in an effort to find an appointment that was not months away and not in the middle of the day.  She explained the issue was that it was difficult to schedule the doctor and nurse half an hour apart as the doctor seemed to have more appointments that the nurse.  After much effort I advised that it was all too hard and that we would keep the appointment on the 30th October at 12.30 and I would pack a lunch for Dad and deal with the emotional fall out. On the 17th August we received two new letters. One stating the appointment of the 30th October had been rescheduled to the 30th October at 12.30pm and the other one advising that it had been rescheduled to 30th October at 3.00pm.  I am assuming that these were generated when the lovely lady I spoke with was trying to reschedule for a later time for me. 

Meanwhile, while all this has been happening Dad has had several appointments at the Bentley Hospital aged care clinic where the doctor administered a short memory tests and prescribed Donepezil to my Dad. 

Now part of my frustration is that the letters state that if you ‘defer your appointment for a period exceeding 90 days without good reason, you may not be allocated a further appointment and your referral may be removed from the system’, yet the hospital can keep rescheduling ad nauseam. My frustration also includes what I felt was the rudeness of the person I spoke to at Outpatient Direct, as well as the fact that no one can explain to me what the difference is between the Bentley Aged Care Clinic and the Gerontology Department at Fremantle Hospital.  

Responses

Response from Janet Zagari, Executive Director Transformation, South Metropolitan Health Service, South Metropolitan Health Service

picture of Janet Zagari

Dear sambarb38

I am sorry to hear about the cancellations that your father experienced. I understand that this is stressful for patients and their families waiting for appointments. Cancellation of appointments on the day is a situation that we try very hard to avoid, although in this case the unplanned illness of the doctor resulted in the cancellation. We are working hard to reduce rescheduling of appointments as we know this is frustrating and difficult for our patients and will use your feedback in improving our processes.

From what you have written, it looks like your father was referred to both Bentley and Fremantle Hospital Gerontology Departments. Because we are not able to see the referrals to other health services, staff at Fremantle Hospital would not have been aware that your father was being seen at Bentley Hospital. I recommend that your dad speaks to his GP to understand whether there was a specific reason that he would need to be seen at two sites, as it is often best to see one service so that your dad has better continuity of care particularly as he is already receiving treatment through Bentley Hospital. I encourage you and your father to speak to the treating team at Bentley Hospital, and to call Lorna Hardy at Fremantle Hospital on Tuesday, Wednesday or Thursday on 94313659. Lorna is the manager of the outpatient area where your dad will be seen and can assist you in deciding whether to keep the appointment in October or not.

I am sorry that you found our staff member to be rude when they rang you about the cancellation. We expect that all our staff will treat our patients and families with respect and courtesy, including when they are filling in and will continue to emphasise this in our training and recruitment. We will pass on your comments about Outpatient Direct, and thank you on their behalf for your positive feedback about the lady who helped you the second time.

Kind regards

Janet Zagari

Executive Director Fiona Stanley Fremantle Hospitals Group

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Response from Lesley Bennett, Executive Director, Royal Perth Bentley Group

picture of Lesley Bennett

Dear "sambarb38",

I’m really sorry to hear of your frustrating experience overall securing a gerontology appointment for your father and of the delays that have ensued. I am glad however that Bentley Hospital has been able to progress your dad’s treatment. With Fremantle and Bentley both providing a range of similar Geriatric services, as previously suggested, it may be helpful to speak with your dad and his GP together to decide if still requires the input of both hospitals. Continuing his care at Bentley Hospital might be the best option for him.
Thank you for taking the time to share your experience and provide us the opportunity to use this feedback to improve the service we provide to our patients and their families.

Kind regards

Dr Lesley Bennett
Acting Executive Director
Royal Perth Bentley Group

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Update posted by sambarb38 (a relative)

Both responses imply that the doctor did a referral to both Fremantle and Bentley. But he only sent it to the Fiona Stanley Gerontology Department, I know this as I saw the referral. I don't understand how it also ended up at Bentley. I will contact the appropriate staff member at Fremantle Hospital to get assistance in deciding whether to keep the appointment in October or not. Thank you for your responses.

Response from Lesley Bennett, Executive Director, Royal Perth Bentley Group

picture of Lesley Bennett

Dear Sambarb38,

I am glad that you have been provided with a way forward and encourage you to contact Fremantle Hospital. Without more information, I cannot answer why you have been referred to the two services.

However, if you are not able to get clarity on this after your conversation with the Fiona Stanley/ Fremantle Gerontology Department, we are happy to look into it further. If you wish to, please contact Sue Kent, Acting Community Rehabilitation Manager & Site Outpatient Manager at Bentley Hospital on 9416 3773.

With best wishes

Dr Lesley Bennett

Acting Executive Director

Royal Perth Bentley Group

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