The state of the NHS - you wouldn't believe it (well actually you would)

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Dennison — Thu, 05 Sep 2013 12:32:42 GMT

[quote user="Thomas Johnson"]The NHS is so big that no one can take that sort of individual responsibility, even a GP consulting for 6 hours a day, 4 days a week will see getting on for 150 people a week, I couldn't keep track in my head of all the lab reports, referrals, etc. The NHS has to rely on systems and processes, and you just get the feeling that they're not coping with the volume of work.[/quote]

Totally agree with you there. This is the main thing that has been annoying me about my experiences in the past month. GP was great, Radiographer was fine, but the bureaucracy in between each department (Radiologist reporting on xrays, someone typing up report, secretary passing report back to GP) is where the problem is, hence the high risk of getting lost in the system. If you don't ring up repeatedly to find out what's going on and chase things up, it doesn't get done.

Essentially, you have to be a pain in the arse. Which isn't fun and the people you have to deal with start to resent you, which could be counter-productive. After speaking to the GP yesterday I'll be ringing up this afternoon to see if I've been referred yet

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Thomas Johnson — Thu, 05 Sep 2013 12:18:09 GMT

I was musing on the difference between vets and the NHS as I read this thread, and the thought that crosses my mind is that the much smaller scale of veterinary practice allows us to take personal responsibility for our cases. We are involved at every stage of our patients' care and are much more likely to remember individual cases, spot when there's been some sort of delay or problem, and follow it up.

The NHS is so big that no one can take that sort of individual responsibility, even a GP consulting for 6 hours a day, 4 days a week will see getting on for 150 people a week, I couldn't keep track in my head of all the lab reports, referrals, etc. The NHS has to rely on systems and processes, and you just get the feeling that they're not coping with the volume of work.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Dennison — Thu, 05 Sep 2013 11:54:48 GMT

I told the radiology department when they said there was no report or it was 'lost in the system' that if I take xrays, the owner gets a full report the same day and is shown them on discharge.

I still haven't seen mine, I asked for a copy, secretary got quite stroppy, asked her 'Are they not technically my property as they are images of me?'. Got even stroppier, got told I could do but there is a charge.

Phone consult with the GP was entertaining. Apparently my supra-acromial space has been 'obliterated' (the actual word on the report). Could be a projection, but they don't know, so next step is an MRI. I can feel more phone calls coming.

GP gave a list of differentials, but wrote most of them off because I can move my shoulder without pain. Told her the opposite; it's pretty sore and even more so when I move it, I just don't complain about it. 'Oh, that means it could be many things...'

2/10

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Michael Woodhouse — Wed, 04 Sep 2013 23:39:14 GMT

[quote user="Sammy82"]I was trapped in the crash between her and the solid steel side of the crush, pinning me to the wall by my pelvis (luckily the cow had quite a low abdomen so my ribcage didn't get crushed).[/quote]

Since we got Naxcel I get properly squashed by a cow most weeks!

I went to local GP for a couple of sutures after I sliced my hand doing a PM on a nicely dead cow. He wanted to give me local but I refused. No nurse on a Wednesday afternoon so doc had to look in every cupboard to find the kit. I was dabbing my own blood with a swab as he sutured. At the end of the first stitch he held the ends up. I enquired if he wanted me to put the swab down and cut the ends for him, he muttered about lack of a nurse and coped himself. Did break down and I ended up gluing it back together myself 2 further times.

5/10

(breakdown was partly my own fault for going back to PDs rather too quickly as so weird with my other hand).

Sprained ankle Friday before starting rotations. My only ever trip to A&E. Examined, radiographed and discharged in under an hour. Was quite happy. The other bonus was not having to trot up a single horse during equine rotation...

8/10

(not sure how long Doc had been here, but couldn't understand a single word he said. Radiograph was film, when the vet college was digital!)

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Julie Innes — Wed, 04 Sep 2013 23:33:15 GMT

As my poor mum was ill for many years (SLE), I have had many experiences with the NHS, some good, some bad, some downright shocking.

It sometimes seemed to me like the more "serious" illnesses were more proficiently treated- eg, dad had chest pains, called me. I muttered a bit (he had pulse 70, seemed ok), but decided to take him to A+E, expecting a long wait. He was whisked in within 10 minutes, and 10 minutes later I was called through to be told he was having a heart attack (although still seemed ok, apart from bit of pain!) He was immediately taken in, had 2 stents placed within a few hours and has made a completely unevenful recovery.

On the other hand, poor mum was trailed around so many departments that noone seemed able to read her notes- got fed up telling doctors that she was on drugs contraindicatory to the ones they were proposing, sending them scuttling off to read her notes. The worst case was when she developed arrhythmia, and they decided to digitalise her. I was told to collect her from hospital 3 days later, and found her vomiting, as she had apparently been doing for the past 2 days (!) they tried to tell me it was a "bug" and to take her home. I asked if they had checked her digoxin levels, given that she was renally compromised and had been started on digoxin just prior to the vomiting. they hadn't and said they had no intention of doing so. I refused to take her home until the levels were checked, so they very huffily agreed. they never did tell me what the levels were (those notes went "missing"), but they wheeched her off the digoxin immediately....and the vomiting bug miraculously went away.... Now, had I not been a vet, I may have just taken my mum home and watched her die of digoxin toxicity. Scary thought.

However, despite her dodgy heart, fibrosed lungs and compromised kidneys, the neurology team managed to successfully operate on 2 brain aneurysms!

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Sammy82 — Wed, 04 Sep 2013 17:59:56 GMT

Had similar experience to Clive's a couple of years ago. While taking BS from cow the cow waiting in the race behind burst through gate and and I was trapped in the crash between her and the solid steel side of the crush, pinning me to the wall by my pelvis (luckily the cow had quite a low abdomen so my ribcage didn't get crushed). Went to local hospital minor injury unit (next "proper" A&E is 30miles away), where I got examined by a nurse/nurse practitioner. Did she bother to get a doctor to see me, considering the severity of the accident cow vs. human? You guessed right.... Luckily I just had the most colourful bruises across the prominent parts of my pelvis and some bruised arms, but I was surprised by the laid back attitude. I didn't feel that the nurse (or the GP receptionist) had even a vague idea of the weight of a cow.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Utlendigur — Wed, 04 Sep 2013 17:40:20 GMT

2 more recent but opposite experiences ..

Head on crash with another car - both of us only doing 20mph but on sunken winding single track road - car was a write off. Got a lift home but started to get neck pain so went to local A+E, which was empty. Immediately put in neck collar, examined by doctior and straight to xray. Just soft tissue so discharged with pain killers. Total <30min start to finish. But one of the nurses was one of our nicest clients, and the other was the mother of one of our ANAs 10/10

Bitten by GSD. 10minute wait. Wound cleaned, steristripped and dressed. Tetanus booster and antibiotics. Back at work within 30minutes. Nurse was another of our clients. 10/10

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Clive Ansell — Wed, 04 Sep 2013 17:22:21 GMT

2 recent personal experiences:

I had a cycle accident 3 weeks ago, I was hit head on by a car who was turning right on the wrong side of the road. No serious injuries, but badly battered and bruised. I was taken by my partner to local A&E, and the information given at reception was cyclist hits moving car, not wearing helmet, injury to head among others. Despite only 4 other people in front of me I waited nearly 3 hours before seeing a triage nurse who cleaned (not very well, I had to do it properly when I got home) and glued some of the wounds. No neurological assessment however basic, whatsoever and didn't even see a doctor!! rating 0/10. My shoulder is still painful following the accident, so it is anyone's guess how long that will take to be assessed, think I need to arrange it privately?

My partner saw her GP back in May and a referral to a consultant was agreed. The GP forgot to arrange the referral, and yesterday she was informed the receptionist who types the letters is not back in until Monday. again, 0/10.

As an aside I've just been looking at BUPA health assessments, their "advanced" one is £752. And people moan about our prices.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Dennison — Wed, 04 Sep 2013 13:33:40 GMT

[quote user="Sammy82"]Going private seems tempting, but they will probably exclude most of my body by now.[/quote]

Damn, didn't think of that part... I'd probably have a few exclusions too!

Update - chased up the Hospital Xray department and my GP surgery and miraculously the report has appeared. Having a 'phone appointment' with a GP this afternoon

Re: The state of the NHS - you wouldn't believe it (well actually you would)

James Allsop — Wed, 04 Sep 2013 13:27:59 GMT

I generally have a poor regard for the level of service from the NHS based on experience. However 3 weeks ago I managed to cut my arm (badly enough to warrant sutures) whilst gardening. Fully expecting a 4-5hr wait at A&E, I turned up at 1pm and there were only 5 people waiting (and no police presence). I was seen within 30mins, sutured and discharged within 1hour of arrival. Sutures were very tidy, done by a pleasant doctor who treated me respectfully. Only downfall was the dressing - after very carefully placing steri-strips between sutures the doctor slapped on a paraffin dressing (before I realised), the result of which all of the steri-strip's adhesive failed. Had to sort it once I got home but all healed now and overall I was impressed by the service. Cant help feeling that I was lucky to injure myself at a quiet time.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Sammy82 — Wed, 04 Sep 2013 13:06:20 GMT

The delay in treatment is terrifying and endangering patients health (or even lives). We all know how much more difficult it is to cure conditons that have become chronic, which could have been treated much easier last year when it first started, had the owner presented the animal in time (or the specialist seen the patient when the condition was still acute) . The otitis that lead to narrowing of the aural canal, arthritic stiffles after cruciate rupture ect.... With the NHS the primary care seems to be ok (here anyway), but by the time you eventually get to see a referral doctor the damage is done. I bet doctors get frustrated about this as well, it can't be nice to be presented with only chronic cases.

Going private seems tempting, but they will probably exclude most of my body by now.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

KMurphy — Wed, 04 Sep 2013 09:33:39 GMT

Don't get me started!! Recent experiences have left me jaded. Private healthcare is not all that expensive - I think I pay about £25 a month for mine, reasonable cover. It's a tenner less than my dog's insurance. Obviously, your shoulder condition won't be covered :(

I've had torn rotator cuffs and chronic shoulder pain. I don't know if you've tried it or if it's relevant to you but physio and changing my sleeping position were the two most useful things I've done. You can self-refer for physio and it's not that expensive (about £40 an hour up our way). Hope you feel a lot better soon!

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Dennison — Wed, 04 Sep 2013 08:51:25 GMT

Sorry to drag up an old thread, but my experience has left me a little fuming.

Saw my GP beginning of August, referred for 'urgent' radiographs of my shoulder. Had to wait 2 weeks for appointment at local radiology department. Radiographer sends me away with 'all done, you'll get a report in 10 days'.

Rang my GP in 10 days, nothing. They said can take up to 14 days. Rang TWO AND A HALF weeks after the radiographs were taken, still nothing. Not even in the system. Rang the radiology department. Nope, nothing there. Tried to have a moan, they passed me on to the radiology department secretary.

'Oh no there hasn't been a report written yet, it may be on tape, it's just we had a few people off last week so not as much was done'.

As soon as I can afford private healthcare I'm off.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Bob Russell — Mon, 05 Aug 2013 09:13:49 GMT

i was under the impression that smoking was good for the NHS. Probably the Daily Mail but smokers tend to die young before the really expensive illnesses such as dementia kick in.

Some expert was doing the sums and reckoned smokers are good value. Best value are motor cyclists as they are less likely to survive long and are mobile organ donors apparently!

Statistics just get you in a mess!

(all )

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Clive Ansell — Mon, 05 Aug 2013 07:46:11 GMT

[quote user="Braden Collins"]

I hope they don't penalise smokers too much, because they'll really start to hammer alcohol then, and I like a drink.

[/quote]

They already do through taxation. In addition to VAT duty is roughly, £3.50 per 20 cigarettes, £2 per bottle or wine, £8 per bottle of spirits, and about 45p per pint of beer.

Whether the tax raised covers the increased costs to the NHS, and the cost of policing drunken fighting idiots I don't know.

Maybe a tax on soft drinks would be a good idea?

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Braden Collins — Mon, 05 Aug 2013 06:53:43 GMT

I hope they don't penalise smokers too much, because they'll really start to hammer alcohol then, and I like a drink.

As for sports and relative risk: I row surfboats and reckon on average 1 in 10 of the people I row with each year breaks a bone or needs hospital treatment (I've seen broken ribs, backs, pelvis, noses, jaws, etc) but it's bloody good fun. I would hate to have to stop because the NHS decided it was too risky. It's hard enough with insurance already. See attached video for a rough idea what it can be like.

http://www.youtube.com/watch?v=RvOWnfxtaOo

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Malcolm Ness — Sat, 03 Aug 2013 15:07:53 GMT

[quote user="Utlendigur"]that you consider [/quote]

Don't take things personally and please don't personalise this.

[quote user="Utlendigur"]Smoking, binge drinking and unhealthy eating have no health benefits[/quote]

No physical benefits, but many would claim a benefit to their mental well-being - especially those on limited incomes. Similarly, I am not sure that an annual ski week or an occasional jaunt on a horse is obviously net physically benefiicial (they certainly aren't when practiced with my degree of ineptitude)

[quote user="Utlendigur"]small risk of injury (which is in most cases short duration[/quote]

But it could be argued that the risk of lung cancer is not that great compared with the decades of pleasure your average smoker claims to have benefitted from, and not all fat folk become diabetic. On the other side of the coin, we bought a Highland pony from a lady who fell from her horse and broke her neck 30 years ago - she is still paralysed.

[quote user="Utlendigur"]

If you suggest that doing anything risky should be considered a drain on the NHS, we should stop driving cars , lock ourselves in our houses (but not undertake any DIY or gardening), not have children, not play with any children or pets....

BTW sports are not a middle class preserve - that's a bit of a predjudiced generalisation seeming (to me anyway) to imply that you consider anyone not middle class is likely to be a fat lazy couch potato.

[/quote]

I don't think I "suggested" anything, I certainly didn't mean to - it was just an idle thought that we (perhaps that should just be "I") might be being a little unfair, a little inconsistent and even a little disingenuous in feeling able and justified to criticise others with self-inflicted lifestyle diseases while promoting some of our own lifestyle diseases with pride. I struggle to see how anyone could reasonably read what I wrote and come to the conclusion in your last sentence.

Sport certainly isn't a middle preserve but, very sadly, it is becoming increasingly difficult for urban kids to get involved and stay involved in meaningful physical activity. Fewer and fewer state schools play cricket or rugby and increasingly few play competitive soccer or athletics so unless a kid has interested parents with time and money to spare to cultivate an interest in sport, then you will probably end up buying trainers as a fashion statement rather than as a sports accessory and I think that that is a shame. But it isn't prejudice.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Utlendigur — Sat, 03 Aug 2013 13:41:24 GMT

[quote user="Malcolm Ness"]Then there are the sports injuries: Several of this group have sustained fractures and worse through falling off bikes, falling off skis, falling off horses. Some idiots, including yours truly, have managed all three. All my fractures and other similar injuries were treated (very competently though without finesse) by the NHS. Nobody, I think, is even dreaming of putting pictures of smashed skulls on bicycles, blown cruciates on skis or smashed shoulders on horse saddles and it got me to wondering whether it is fair to be critical of, and even marginalise, fat folk, lazy folk and smokers because their guilty pleasure drains the NHS when it seems that our own smug, middle-class guilty pleasures are having a similar effect.[/quote]

This argument gets me pretty annoyed, because it is a false comparison. Smoking, binge drinking and unhealthy eating have no health benefits and an almost guaranteed negative effect on health. Participating in sports, although carrying a small risk of injury (which is in most cases short duration - compared to decades of ill health associated with smoking/drinking/overeating), improves physical and mental health and reduces the likelihood of needing NHS treatment for weight-related, cardivascular and some mental health problems. You are comparing something that has a high risk of needing NHS rescources and no positive benefits with something that has a low risk and many positive benefits.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Malcolm Ness — Sat, 03 Aug 2013 11:20:04 GMT

[quote user="Hanna Bennett"]to those of us who are not fat lazy smokers [/quote]

Perceptions are interesting aren't they?

Devils advocate:

Smokes with lung cancer = self-inflicted. Perhaps sad but it's your own fault. A life-style disease deserving of no sympathy. It is even considered socially acceptable, even desirable, to put gory pictures of your forthcoming demise on the cigarette packets.

Diabetes is sort of in between at the moment. A lot of fat people get diabetes. A lot of very fat people are very fat because they eat too much. Therefore a lot of diabetes happens because people eat too much. Like smoking, it is a lifestyle disease and that realisation is just starting to take hold but not yet to the extent that you see pictures of dropping-off fingers on a McDonalds packet or a dissection of a furred-up artery on a chocolate bar wrapper but who knows what the next ten years will bring.

Then there are the sports injuries: Several of this group have sustained fractures and worse through falling off bikes, falling off skis, falling off horses. Some idiots, including yours truly, have managed all three. All my fractures and other similar injuries were treated (very competently though without finesse) by the NHS. Nobody, I think, is even dreaming of putting pictures of smashed skulls on bicycles, blown cruciates on skis or smashed shoulders on horse saddles and it got me to wondering whether it is fair to be critical of, and even marginalise, fat folk, lazy folk and smokers because their guilty pleasure drains the NHS when it seems that our own smug, middle-class guilty pleasures are having a similar effect.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Hanna Bennett — Sat, 03 Aug 2013 00:11:26 GMT

[quote user="Martin Atkinson"]

[quote user="Clive Ansell"]Maybe it would be more efficient with a good business brain in charge. Who would you choose; Alan Sugar, Richard Branson, Michael O'Leary perhaps ??[/quote] Not Alan Sugar he ruined a company (Amstrad) with potentially the best computer at the time by under-investment in research, how they have him as a business guru on reality TV is beyond me. Michael O'Leary would have a cheap service but charge you extra for the beds and drugs, Richard Branson would not be a multi-millionaire at all if it wasn't for Mike Oldfield so he'd need a bit of luck for things to fall the right way but the best choice of those three. I do resent paying for a service I hardly ever use because I live a healthy lifestyle and thereby I am subsidising a load of fat, lazy smokers when I will use private medical insurance anyway for something serious.

[/quote]

what happens to those of us who are not fat lazy smokers who are unlucky enough to have chronic diseases - I reckon I've paid enough taxes to earn my own care but it has not been cheap this last 18 mths - and I am 'young and healthy' enough to not consider that I needed private medical insurance. too late now.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Todd — Fri, 02 Aug 2013 15:58:25 GMT

[quote user="Utlendigur"]www.youtube.com/watch[/quote]

Obviously a case for the Department of "MSPDTG" or another one "TMSPDTGT", and a Director, office, car, secretary, PA etc....

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Utlendigur — Fri, 02 Aug 2013 14:42:57 GMT

[quote user="Anthony Dennison"]Ring the number to book. Next appointment is in 2 weeks. Told the receptionist that the urgent box had been ticked and the Doctor had said she wanted it done quickly. 'Oh no, the urgent box is only for the radiologist so they know to write the report more quickly[/quote]

www.youtube.com/watch

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Todd — Fri, 02 Aug 2013 12:47:33 GMT

Solution is so obvious I'm surprised nobody has suggested it.

You need a new Department of "MSPDTG". You'll need a Director of MSPDTG and a secretary , and obviously a PA and an office, with washroom and catering on site.

The Director will need a car and driver, not too expensive, a Jag would be fine.

And the Dept will need to be audited and an annual report with graphs, cake charts, sausage charts and bar charts so there'll need to be a separate Audit Dept., no sorry outsource that, the Director needs a career path [and a pension obviously].

Simple really.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Bob Russell — Fri, 02 Aug 2013 12:33:27 GMT

Pretty sure that 'Urgent' box just means they do actually send a report.

Re: The state of the NHS - you wouldn't believe it (well actually you would)

Anthony Dennison — Fri, 02 Aug 2013 10:08:08 GMT

Just to add the the thread with my recent experience of the NHS:

I've been having problems with my shoulder for a while, it aches and keeps clunking when I'm pretty sure it's not supposed to. Saw a physio who thought I might have a rotator cuff tear, but could only feel a lot of scar tissue which he attempted to break down. Saw a Doctor later that day, who was concerned about how swollen it was (I hadn't noticed) and gave me a radiography referral card and ticked the urgent box because she wanted it doing ASAP.

Ring the number to book. Next appointment is in 2 weeks. Told the receptionist that the urgent box had been ticked and the Doctor had said she wanted it done quickly. 'Oh no, the urgent box is only for the radiologist so they know to write the report more quickly''.

Chuffing ridiculous!