I am sorry you had such a horrid experience with your recent service appointments. At the risk of being lynched
, may I give you a possible version of the other side of the story? Just really so that you might see that it is not people but the system that may be at fault.
Your previous consultant may have had health or other problems, which is may be why 2 clinics ended up being cancelled in a row. Most NHS clinicians would try to avoid cancelling an appointment for a patient on two consecutive occasions. And it would certainly not be in your consultants power to ensure that there are appointments available for the following week. This is to do with resources rather than individual neglect.
Similarly, I know that in an ideal world, patients with chronic conditions would be informed of a change in consultant. But the NHS does not have the resources to write to everyone to inform them of that. There may, of course be exceptions but I have never known it happen.
If it was her first clinic, your new consultant would not have known any of the patients, and she would have run late trying to catch up with reading notes, building a rapport with patients and ensuring that she's not missing anything. Hence, her stating the obvious e.g. the nurse, etc. to ensure that the system is running well. A good clinician would do that. But the NHS system does not, like in the private system, allow new consultants the luxury of making longer appointments the first time they take over the running of an outpatient clinic.
The operational responsibility for finding clinical notes is not hers but the admin staff that serve the clinic. It is possible that your old consultant had a non-standard way of transferring notes between the clinic and his/her medical secretary and possibly even the Medical Records Department. A new consultant, particularly if they have a new secretary at the same time, may not know about it. Obvious teething troubles you might say, but you would be surprised at the administrative glitches of this type that occur in any large organisation. If she is good, she will have raised her concerns about the missing notes and in future it will be less likely to happen.
As for the advice about an anti-TNF and MTX, if she is a newly qualified consultant, she would be up to date with the scientific literature i.e. the evidence base for medical treatments, without necessarily having accumulated the experience of consultants who have been using these drugs since they were released. I have read a lot of the original scientific literature on anti-TNF and all the drug trials I have come across for etanercept, for example, have shown that it doesn't work as well without methotrexate. Not that it doesn't work without methotrexate but that it works better if given
with methotrexate.
Finally, re. discussion about coming off and on anti-TNFs, I totally agree with you but this is something she may have got from local PCT managers. As you probably know, there is post code lottery in the country about how quickly, and for how long it seems, people get on to anti-TNFs.
And finally, finally, I have just realised I have been able to type this extremely long post and that my hands must be getting better because they only ache a little and it hasn't built up.
Sorry about the long post.
Alice
PS So, I would say, give her the benefit of the doubt and see how you get on.
