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.
