A response from SEPT: When sorry seems to be the hardest word

Today I received a response from SEPT, the organisation that provides local health services in relation to the complaint I made about my psychiatrist appointment last month.

A response that is very business-like, devoid of compassion and empathy.

A response where ‘sorry’ seems to be the hardest word.

The response opens with “I am pleased to confirm that we have completed our investigation in to your concerns and I can now reply in full.” It explains who has investigated the complaint.

Am I unreasonable to expect somewhere in the opening paragraph words to the effect of “I am sorry you have had cause to complain”? Or any words expressing contrition?

Patients are human beings with emotions and feelings. We are not just another complaint to strike off the list, to add to the Board report.

The letter does acknowledge that there are many aspects of the appointment that should have been conducted better. It says the doctor has been reminded of the importance of introducing herself properly, and taking the time to help settle the patient, which is heartening. They apologise for the ‘negative experience’ as a result of the lack of continuity of care because of seeing three different psychiatrists. The Deputy Medical Director has apparently written to all doctors reminding them of the importance of reading a patient’s notes before seeing them to help ensure that continuity of care. One would think reading notes before seeing a patient for the first time would be a professional standard.

There are also acknowledgements that being told to ‘remain positive’ was perceived as ‘glib and superficial’. The doctor has also apparently asked the letter’s author to ‘convey her apology’ for telling me ‘God will give me another child’ – they agree it was an inappropriate remark to make.

Being as there is nothing that can change what occurred during that appointment, I have little choice but to accept what they say about ‘apologies’ and staff being reminded about how to speak to patients.

However, there are greater concerns:

In respect to the wait for psychology, the doctor was apparently reading from the psychologist’s letter in my clinical record. The psychologist’s recommendation, according to the response is “that you initially had bereavement support rather than longer term psychological therapy from mental health services in the first instance.” This reference in the response letter is the first I have heard of the psychologist’s letter, or the recommendation. Another issue resulting from the lack of continuity of care, no doubt.

Evidently, the doctor should have explained about the number of talking therapies and IAPT services that are available to me. Well, perhaps she should. The trouble is, it is immaterial because as the author of the letter should be aware once you are in secondary mental health services, IAPT services refuse to accept you – as I discovered to my frustration back in June. Perhaps I should not be in secondary mental health services: this seems to be implied by a separate letter I received today, a record of the appointment in question. This letter includes a changed diagnosis that is news to me; says I “feel disconnected from my dead baby Hugo” – yes, it really does say ‘dead baby’ and incorrectly states the month Hugo died. It also appears to have a different recollection of the appointment on many points.

Anyway, back to the complaint response. If I do not belong in secondary mental health, they should discharge me. There is a long waiting list for IAPT, and it would mean starting all over again because of the mess the pathways are in which is of course, less than ideal. Thankfully, I am now seeing a clinical psychologist, which will be explained in more detail below.

The icing on the cake of the response letter is in reference to the doctor’s refusal to give me a prescription. The response outlines the protocol for prescribing, but that exceptions are sometimes made, as happened in my previous appointments.

My favourite part is “I wish to assure you that Dr x would not have ‘got into trouble’ for writing a prescription…” Phew! It is such a relief to know the doctor would not have got in to trouble for not doing something for me. Frankly, I could not give two hoots about whether or not the doctor would have got into trouble. What I do care about is the distress I was in, as was clear in my original complaint.

There is no reference to whether the doctor raising her voice is considered acceptable, and whether it is practice to follow a patient who has fled in frustration to check they are ok. Such a disappointingly business-like and inhuman way to respond to a patient who had so clearly articulated her distress.

Thankfully, as outlined above, I have now started psychotherapy sessions, which I am incredibly grateful for. I have spoken to one on the phone, and met a consultant clinical psychologist and clinical psychologist in person. Each one was kind, compassionate, empathetic and listened. The relief at such positive progress is huge for me. I remain disappointed that it took the last blog to expedite it, and I continue to worry for other patients who feel unable to fight back.

SEPT, your psychology service is a credit to you. I understand there are circumstances beyond your control, with psychiatrist vacancies and general NHS resources. However, to speak to a patient in the way that doctor spoke to me is wholly unacceptable. While there are two references in the letter to ‘apology’, it is incredibly disheartening that you have failed to acknowledge that in your letter, to be human.

To say sorry.

(Note: I shall be emailing this to SEPT. I redacted the doctor’s name, but will be including it in my response to SEPT).