Editor—At least one anomaly still exists in the NHS (there may be others). It results from a bureaucratic requirement to follow strict communication pathways. That these are detrimental is shown by the example of an elderly woman who developed sight problems from a detached retina.
She first saw an optician. Immediate treatment was recommended. She was told that a letter would be sent to her general practitioner so that this could be done. An appointment to see an eye specialist was eventually (because of omissions and other factors) arranged and took place nine months later. The patient, aware of long hospital waiting times, accepted the wait philosophically, which partly added to the delay.
It is absurd that trained opticians cannot communicate directly with an eye clinic. If they could the eye would have been treated immediately. A general practitioner receiving an optician's request for further referral is not likely to refuse to make the arrangement. In addition, provided that information flows both ways, the general practitioner will be aware of what is happening if a duplicate of the optician's referral request is added to the patient's notes.
Since the patient is going to be seen at a hospital clinic anyway, it does not alter the clinical load. Delays in treatment do, as well as causing unnecessary suffering and sight loss. The system requires change, and freeing up.