In my last few posts I’ve mentioned all is not well with my referral to ‘Healthier You’ the not so early intervention diabetes programme. I’ve written before about the shambolic performance from Ingeus, the outsourced provider delivering the programme in my area, but having given it the benefit of the doubt several times I found thing only ever got worse.
A short summary of events: in late 2017 my GP referred me to this programme, he thought it would be helpful given my health issues and weight management difficulties. I didn’t hear anything for several months, I mentioned this to the practice nurse during a routine appointment, she did a little digging and uncovered I’d been rejected. But Ingeus hadn’t bothered to inform me, and nobody at the surgery had picked up on it. So, she helpfully got the referral raised again, a month or so later I got the letter inviting me to join and a few weeks later a phone call to arrange times.
According to the bumf, the programme would be delivered as group sessions around two hours long, starting with four weeks of weekly sessions and then nine months of monthly sessions. Sounded like a clinically charged-up version of Weight Watchers. The first advisor offered me sessions on a Tuesday afternoon, but I had to decline as they were nowhere near work and taking thirteen half days off was a bit of a stretch. But it was okay, they would find me an evening session, after all there will be loads of people like me who work during the day, people who could benefit from early intervention but find appointments during the day a challenge.
About eight months goes by without word, then I get a second call offering me a later afternoon slot, a little bit further away. I decline again, tell the advisor I’m waiting for an evening slot, they tell me they class late afternoon as an evening slot. I tell them it’s still not helpful as I need an actual evening slot, they confirm they can see this from my previous contact. I’m told they’ll have another go at finding me a genuine evening slot and someone will get back to me in a few weeks.
Two months later a third advisor calls and admits that evening slots don’t exist and they think it’s best if I’m discharged from the programme so my GP can try to find something more appropriate. We have a slightly awkward conversation where he tactfully acknowledges the programme isn’t designed to support people who work during the day, without presenting this as a bit of a fuck up.
A few weeks after that I get a gratuitously inappropriate letter from Ingeus, packed with glib platitudes about how serious diabetes is, and expressing how sorry it is I’ve decided to leave the programme. What the fuck!
Now, maybe the warning signs were always there, the failure to communicate the initial rejection, the extended wait for the non-existent evening slots being pretty clear indicators. But, perhaps the biggest warning sign was in the promotional bumf, the brochure is plastered with a diverse range of stock photos, but go to the patient case studies on the website and they are overwhelmingly older people, the type who are likely to be retired or semi-retired, not so much in the way of people who work full time and have young families to juggle.
I decided to complain to NHS England, firstly about the piss poor communications which meant it took a year and a half to get to the point where Ingeus, grudgingly, admitted it wasn’t able to support people who work during the day, and secondly about the stupidity of commissioning delivery from a provider unable to support a large chunk of the population for whom an early intervention programme could bring major benefits. Unfortunately, NHS England claims it didn’t commission the programme, which was a surprising given its website says it did (here and here). Maybe the NHS website has been hacked with fake news?
So now I’ve raised the same complaint with East Surrey Clinical Commissioning Group. I sent the letter over a week ago and haven’t heard anything back yet. I don’t have high expectations. I’m betting on a letter with some waffle about budgets being tight, brushing over why a small portion of it couldn’t be put towards people who need evening appointments, especially given the long-term cost saving to the NHS from doing early intervention properly. Or perhaps it’s deliberate, and it was always intended as early intervention for older people, but Ingeus just forgot to mention this when put together communications material?
However, I’ll end on a positive note. I had my annual check-up last week and my blood sugar levels are stable, even if they are still in the pre-diabetes range. I also have an appointment lined up next week with the diabetes lead nurse to discuss possible ways forward.