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Post by roland on Jul 28, 2011 16:08:16 GMT
It has come to my attention that NHS Bristol Primary Care Trust and Avon and Wiltshire Mental Health Partnership NHS Trust (AWP) are disgracefully locked in a funding dispute which is impacting the ADHD Clinic. It seems the funding dispute has meant that some things have had to be put on hold and therefore for the time being while the clinic is still accepting referrals for assessments it is not setting up any new appointments. As of today the ADHD Clinic does not know if there is an end date for the dispute. I have contacted NHS Bristol to get their take on this situation and will keep you updated. In the meantime, if anyone has been affected by this and/or has been left waiting indefinitely for an appointment please ring the Patient Advice and Liaison Service (PALS) Officers for NHS Bristol at 0117 900 3433 and ask them to urge the funding decision makers to restore the funding. You can also contact the Patient Advice and Liaison Service (PALS) Officers for AWP at 01249 468 261. Remember under the NHS Constitution you have the right to access the services that you need. NHS Bristol is conducting a survey about the mental health services they commission so if you like you can also take part in it (as well as contacting PALS) here is a link to the survey: www.avon.nhs.uk/mhsurvey/
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kreate
Member posts quite a bit
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Post by kreate on Jul 28, 2011 21:46:07 GMT
maybe the dispute is deliberate...
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Post by Deleted on Aug 1, 2011 14:23:12 GMT
Well i have been funded by local Welsh PCT for 4 apts between May 2011 and 2012. I have had 1 already. I am in middle of transfer to a "pilot" ADHD service in Caerphilly. (see my other post today).
You may like to know if you do not know already, that i was told how recently the Bristol clinic discovered how 60+ out of area refferal patients being seen at clinic funded by other PCTs, had "not been paying" Bristol AWP for services for OVER 1.5yrs! They only spotted it recently. So they sent letters out to all patiants whos local PCT had not paid (like mine) saying they would no longer see them as of immediatly, and to speak to local PCT if any questions.
Pretty awful they were so badly managed in Bristol that whoever is in charge had not spotted that their finances were out of order and had not been paid for so long. And to cut of seeing patiants all of a sudden, when people like me were on powerful medications and had no other way of getting meds nor alternative arrangements for treatment elsewhere - is pretty bad. What a mess and farce!
Not sure if this is related to your comments here?
D
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Post by roland on Sept 6, 2011 10:41:24 GMT
Here is a link to a needs assessment done for Bristol this last July (2011) that concludes that 80% of adults screened positive for ADHD in Bristol do not receive treatment and that only 6% of adults with ADHD nationally receive both medication and counselling: bit.ly/p52Hcr
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Post by addam on Nov 18, 2011 18:14:24 GMT
I got my GP to refer me to the Bristol clinic in December 2010. The referral letter stated a waiting time of 12 months. I phoned them recently to discover that Bristol PCT is not funding me. Then phoned Bristol PALS, who told me about some changes that are being put in place to better manage demand. The first is that prescribing will be transferred to GPs after stabilising so that patients do not have to return every 3 months - I was surprised that this was not in place already. The second is that some kind of 'triage' system is going to be used so that not all referrals result in an assessment at the clinic. I found this quite worrying as it is impossible to know if someone has ADHD without a thourough assessment with an experienced specialist. The clinic told me they have a positive diagnosis rate of 98% - meaning triage is completely unnecessary. I fear this will be just an excuse to refuse treatment. It seems that funding is the main issue, and the PCT will begin this triage process when funding is in place, no info on when this will be yet. I would encourage anyone else who is waiting to contact PALS too. I will continue to post updates as i get them.
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Post by Deleted on Nov 18, 2011 18:31:04 GMT
This 'triage' system appears to be the M.O. of all PCTs - it's standard to be referred to secondary care (hopefully a consultant psychiatrist) rather than directly to tertiary care (ADHD specialist).
Considering the very high numbers of referrals that result in diagnosis it looks like the PCTs are shooting themselves in the foot - but the chance of saving money by not having a referral seems irresistible to them...so they spend more in a futile gesture.
As long as the triage you refer to is this then it's nothing much to worry about - it delays you and might end up with a refusal to fund that they should have mentioned before - the end result should be the same.
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Post by addam on Nov 25, 2011 14:48:42 GMT
After speaking to PALS again it seems the triage is for new referrals and will not be applied to the existing waiting list. I also asked if Bristol PCT could fund me to go to the Maudlsey in London instead - the answer was no. Looks like the waiting continues ...
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Post by addam on Dec 9, 2011 13:30:53 GMT
I wrote to my MP, who in turn wrote to Bristol PCT. The trust is carrying out an investigation and I will receive a letter from the Chief Executive Officer with the outcome by 6th Jan 2012.
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Post by Deleted on Jan 6, 2012 23:48:20 GMT
Very interesting. I've just asked my GP to refer me to the Bristol centre so this news is troubling to say the least. Shall be very interested to hear the contents of that letter if you're willing to share them, addam.
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Post by addam on Jan 13, 2012 13:24:39 GMT
Still waiting for the letter. It was sent on Monday 9th Jan to my MP, so a short delay before he sends me a copy. Will post the letter in full when I get it garibaldi, and for anyone else who's interested. The trust seemed to take the complaint seriously, so hopefully the outcome will be a good one. I've got ICAS on standby in case it turns out to be a load of empty words and no action. Waiting time so far: 13 months and counting.
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Post by Deleted on Jan 13, 2012 15:30:16 GMT
Got to say the new doctor running the clinic is very good
The funding situ will be the next issue for some time
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Post by addam on Jan 19, 2012 8:53:05 GMT
Here's the letter then, and have to say really not impressed. It's just the same script I've been getting from PALS and is really no help to me at all. I am being triaged as 'urgent', although if they're still not setting up new appointments this makes no difference at all. Really don't feel they're being straight with me. They are claiming it's a capacity problem, but it's not, it's a funding problem. I feel like they are using delaying tactics to hide this fact. Could be wrong.
Not going to let it rest here.
I am sorry that Mr has had to wait such a long time in order to receive services regarding Adult ADHD. NHS Bristol is aware of the complexities of the recent guidelines published in 2008 regarding the treatment and assessment of ADHD. The PCT has recognised that the disorder does not only affect children but can also cause significant impairment into adulthood.
The PCT has therefore invested in an Adult ADHD service that Avon and Wiltshire Mental Health Partnership NHS Trust provides on our behalf. Unfortunately the unmet need has meant that the clinic currently has more referrals than it has capacity for, in order to resolve this issue we have put several processes in place.
1. Waiting list initiative.
The PCT has commissioned extra capacity from Avon and Wiltshire Mental Health Partnership NHS Trust, running waiting list initiatives to address the backlog starting with cases that are recognised clinically as urgent cases. This waiting list initiative is being triaged by a PCT clinical expert with the clinical team within the service.
2. Shared care agreement
The PCT is working closely with GPs and the ADHD clinic to develop a shared care agreement between the Consultant and GP to manage ADHD care. This will mean that in the long term once this is completed the service will have more capacity to see new referrals. It is hoped that this work will be completed in draft by the end of January 2012 and be in operation by the end of this financial year.
3.Service specification
The PCT has completed a new service specification for ADHD services for 2012-2013, this service specification will divide the service into two components those service users that are new to services and require longer assessments and service users that are in transition from children’s services who require a shorter transition assessment. This means that the service will then have more capacity to see new referrals.
4. Screening tools
The PCT is also working with GPs to develop screening tools to ensure that we are able to identify the service users who require assessment and treatment and ensure that the right information is available to make a diagnosis when they attend an appointment for this service.
Whilst I appreciate that some of these initiatives will take time and that your constituent has been waiting longer than a year for services, I hope that the information provided in this letter reassures you that we are trying to address the situation as effectively and appropriately as possible. I will request that within the triaging for the waiting list initiative that Mr circumstances are considered and his referral is triaged as a matter of urgency. However, if he does have any health related concerns I suggest that he contacts his GP who will be able to offer further advice.
I hope this letter addresses the concerns that have been raised, however, if there are any other issues which have not been addressed, please contact the Complaints Department on 0117 900 2494, with details of Mr outstanding concerns and any additional information he requires, and we will be very happy to respond.
Alternatively, if Mr remains dissatisfied with the response provided, he has the option of contacting the Parliamentary and Health Service Ombudsman to ask them to independently review the complaint he has made. Ideally this will be done within two months of receipt of this letter. The Parliamentary and Health Service Ombudsman is an independent body established to promote improvements in healthcare through the assessment of the performance of those who provide services. Mr can contact the Parliamentary and Health Service Ombudsman by writing to them at:
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Post by Jase on Jan 22, 2012 11:09:09 GMT
It is a capacity and funding issue. Bristol PCT only gave a certain amount of money to the sservice which means they can only see so many people. I know their trying to sort it out but the pct wont give them more money, is not the clinics fault - their very good and want to see more people but the pct wont let them. i know the clinic has capacity to clear theyre waiting list but the pct is withholding the money. If everyone on the list compleins to pals then the more compleints the pct gets the more likely they are to give them more funding.
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Post by addam on Feb 24, 2012 13:50:44 GMT
Looks like things are starting to move now, slowly. Just rang the clinc and while they couldn't give me an exact time it looks like I should be getting an appointment within the next few months. Just sent a complaint to the Health Service Ombudsman, for what its worth. I would encourage anyone else waiting to make as much noise as possible.
At the last meeting Susan said the Dr that runs the clinic might be at the next one, Bristol Mind Friday 9th March 7-9pm.
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Post by Deleted on Feb 24, 2012 20:16:19 GMT
I have been with Bristol ADHD centre since diagnosis as an out of area refferal in 2007.
I have now had a letter from my local GP in Caerphilly saying is seeking transfer of service from Bristol to Dr Bridget Craddock in Bridgend as he thinks its closer for me. Its not much closer really and only a bit cheaper in petrol and bridge toll costs. I have been settled on meds for years now and only go Bristol once a year with a few GP check ups for my blood pressure and weight etc.
I am on 20mg per day of Dexedrine which i get sent as a 3 mthly prescription from Bristol on request.
Anyone know much about Dr Craddock?
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Post by addam on Apr 2, 2012 12:21:32 GMT
Sounds like Bristol PCT are dragging their heels. I would repeat what I said in my last post, I encourage eveyone else waiting to make as much noise as possible. My MP was very helpful, so I can recommend that. I've done just about eveything I can now.
The NHS 'efficiency savings' are resulting in cuts to frontline services, and this is an exmaple. ADHD is an easy target for cuts, as it's such an invisible disability. It's up to us to make things better, no one else will do it for us because no one else understands.
15 months and counting ...
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Post by annie on Apr 2, 2012 21:22:25 GMT
Really pleased you're not giving up on this - sometimes we can be very determined!!
annie
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Post by addam on Apr 13, 2012 11:31:06 GMT
Just had a phone call from PALS to say my appointment will be at the end of May. I had recently chased it up with the NHS Bristol complaints manager, so I don't know if that made any difference. About a year and a half of waiting, endless phone calls to PALS, ICAS and the clinic, letters to my MP, and emails to the complaints manager, it really shouldn't have been this difficult. Feeling a bit nervous about it now after all that...
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Post by addam on May 6, 2012 12:24:49 GMT
Update from Bristol PCT...
1. Waiting List Initiative
The PCT has commissioned extra capacity from AWP, running waiting list initiatives to address the backlog starting with cases that are recognised clinically as urgent. This initiative has started and the clinical team are in the process of contacting all patients on the list to book appointments.
2. Shared care agreement
The PCT has worked cloesly with GPs and the ADHD clinic to develop a shared care agreement between the consultant and GP to manage ADHD care. This has been agreed and is in place.
3. Service specification
The PCT has completed a new service specification for ADHD services for 2012-2013, this service specification is now in place. As described in the letter 6th January 2012, by dividing the service into two components this means that the service will have more capacity to see new referrals.
4. Screening tools
The PCT is continuing to work with GPs to develop screening tools to ensure that we are able to identify the service users who require assessment and treatment. Also ensuring that the right information is available to make a diagnosis when they attend an appointment for this service.
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Post by lambylottie on Jul 18, 2012 20:31:53 GMT
Does the above apply to Wiltshire also? I am awaiting a referral from gp but she was unsure whether she would be able to get a referral for me or not.
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Post by goosey on Dec 1, 2012 10:56:08 GMT
Having returned home to Gloucestershire after finishing Uni at Nottingham, I am now in the process of being referred to Bristol for continuation of my prescriptions. Has to be Bristol as Glos Clinic is not taking any new referrals Am currently awaiting a decision from Glos PCT re funding, but as I can show (via letters from Prof Hollis) that meds make a difference I am hoping this journey will be relatively 'painless'. So.....standby for a miracle.....and a speedy referral !! *ThinkingPositiveThoughts
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