Anna’s Experience: "You’ll have to start the referral process all over again.”
Anna lives with a long-standing musculoskeletal condition and faces daily challenges. She is reliant on her partner, who doubles as her carer. Her health has got worse over recent months, leaving her in pain and with limited mobility, restricting her ability to carry out daily living tasks leaving her feeling helpless and frustrated. “I can't move, I can't even lift to cross my arms. I can't do nothing, I’ve got hands like claws.”
When I inquired weeks later, calling my GP at Eltham Palace, they told me the musculoskeletal department hadn't even sent the referral to the neurosurgeon.
After a long wait, Anna was contacted by Circle MSK to say she’d missed her appointment. Anna said she never received the appointment letter and had no idea she had an appointment. "I've been stuck here, stuck indoors, and they said, 'Well, I'm sorry, but you've missed your appointment. You’ll have to start the referral process all over again.'"
After a CAT scan and an MRI, Anna was told she’d be referred to a neurosurgeon for further evaluation. "When I inquired weeks later, calling my GP at Eltham Palace, they told me the musculoskeletal department hadn't even sent the referral to the neurosurgeon," Anna says she’s been left with no diagnosis, no support, and no explanations. "I feel like I am being strangled; I am afraid I will choke while eating. My muscles don't work, and nobody cares about me.”
Read Circle MSK's response below:
We were unable to respond before the initial Healthwatch report was published because we had been given incorrect contact details, but have now been able to review this case and make contact with Anna.
We are very sorry that Anna felt so uncared for, but would like to give reassurance both to Anna, and to other patients in the area, that she was not left in the lurch, and to explain what happened in this particular case.
Anna had previously been referred to Circle in June 2019, but she hadn’t responded to the letter we sent to her which invited her to contact us to make an appointment; she was then discharged in November 2019 and we sent a letter to her GP explaining this (which is our standard protocol). It is not clear exactly when Anna tried to contact Circle again but, unfortunately, if it has been several months or even years since her previous referral was closed, we couldn’t simply reopen it, as a lot could have changed over that time (changes in symptoms, different management strategies tried etc.) which would mean that a different care pathway would be appropriate. We did, then, receive a new referral from her GP in April 2023 and she saw one of our clinicians at the end of June, after which an MRI spine scan was arranged. The report came back to us and, in response to that, she was referred on to the neurosurgery team at King’s College Hospital in mid-July for their opinion on whether or not surgery might help. It is not clear why her GP surgery told her that we hadn’t sent the referral on to neurosurgery.
At the time this case was raised to us via Healthwatch we had not received a response from King’s, but when chased by us it transpired that King’s had discussed this lady’s case in their multidisciplinary (MDT) team meeting at the end of July, but unfortunately the outcome letter had not been sent to Circle (we are addressing this issue with King’s). The King’s neurosurgery MDT advised that no surgery was indicated, but instead recommended a referral to the Pain clinic. Based on this advice, we have now referred her on to the local pain team.
All of this was explained to Anna on the phone, and she understood that we would be making that referral to the Pain team, who would hopefully be able to help her manage her symptoms, which she understood. However, on speaking with her, she explained that one of her most significant problems was her hands: we have arranged an appointment for her to see one of our clinicians in our community MSK clinic, to see if anything can be done to help specifically with her hands. We very much hope that that appointment, and input from the Pain team, will help her going forward.
If any patients need to check what is happening with their care with us, we urge them to contact our admin team on 020 3893 8382. However, if any patients feel their care is not up to standard, they can contact our PALS team – the easiest way to do this is via email: circle.integratedcare.pals@circlehealthgroup.co.uk or via telephone: 020 3893 8382.
