Poor communication about waiting times for surgery

What happened

Mr J needed hernia repair surgery. He was assessed at the Treatment Centre, and staff found he was a suitable candidate for surgery. The Treatment Centre told him there was a problem with its booking system and it could not confirm a date. It said it would confirm a date at a later time, but did not say when that would be.

Mr J rang the Treatment Centre many times but it did not give him a date. Ten days after his assessment, Mr J went to see his GP to ask about having the surgery done privately, as the hernia was causing him a great deal of pain. The Treatment Centre then removed Mr J from its waiting list. Just over a week later, Mr J had surgery at a private hospital.

Mr J complained to the CCG. It said the Treatment Centre's communication with him could have been better. However, it said that he would have been treated within the national 18–week rule guideline had he waited and not had the treatment done privately. The NHS Constitution states that patients have the right to start their consultant–led treatment within 18 weeks of referral. The CCG said that because of this, the Treatment Centre could not refund the cost of the private treatment.

What we found

All the patients who had their preoperative assessments at the same time as Mr J had their surgery the following month. The Treatment Centre said it was safe to assume that, had Mr J remained on its list, he would also have had his surgery then. We agreed that this seemed likely.

However the Treatment Centre's communication with Mr J was poor. It did not tell him how long he could have expected to wait, even though he contacted it repeatedly for information. Mr J did not know about the 18–week waiting rule. The CCG argued that this information was 'in the public domain'. We decided it was not fair for it to expect Mr J to have known about this without telling him.

There were seven working days between Mr J's preoperative assessment and when he sought a private referral. We appreciate that he was in a great deal of pain during this time. The uncertainty about when he would have the operation would not have been helpful. However, there was no evidence to say the surgery should have been carried out urgently. Therefore, if the Treatment Centre had operated within 18 weeks, this would have been in line with national standards.

Mr J would have been in a better position to make decisions about his treatment options if the Treatment Centre had given him clear information. However, we could not say with certainty that he would not have chosen the private route if the Treatment Centre had given him a firm date. For that reason, we decided not to recommend that the Treatment Centre reimburse Mr J for the cost of the private surgery.

Putting it right

The Treatment Centre took steps to improve its communication about waiting times, so that other patients do not have a similar experience.

The CCG apologised to Mr J for delays in responding to him, and took steps to improve its complaint handling.