What to do about the NHS?

[underneaththeash]

So my DS(14) fell out of a tree yesterday evening and broke his arm - it was obviously broken and he was in a lot of pain. I put it in a sling and rung 111 and we were 30mins late for minor injuries, so A&E it was.

So, I wasn't expecting Saturday evening to be great, but when we got there at 9pm, there were 5 patients in the first waiting room, all with someone with them.

He was triaged within an hour and x-rayed within the next 20 minutes. Then sent to the next waiting area which had 10 patients in it including him. Some people also had a helper with them, including a. After a couple of hours, most of us had started chatting and I looked at the eye of px (f) and been to reception to say that was the likely diagnosis and they'd asked an ophthalmologist to come down to have a look.

2 (a&b) were having obvious mental health crises, one poor guy had a towel covering his head as he clearly couldn't manage seeing anyone/anything.
The other woman started banging her head on the wall and was actually taken though quickly - although they didn't clean the blood off the wall - I did after an hour.

2 (c&d) had back issues, the man had been waiting for a discectomy for 2 years and was disabled and the woman had been told to attend a&E by 111 - she had slight pins and needles in one of her hands consistent with a disc prolapse. She was perfectly mobile.

There was lady with a baby who had a suspect DVT. (e)

The man with uveitis (f)

Someone with a suspected broken toe. (g)

someone who had a chesty cough and couldn't get an appointment with their doctor (h)

A (very overweight) woman with swollen calves, who did actually leave after 2.5 hours (i)

DS was taken through to a cubicle at 3am, having arrived at 9pm. He was exhausted and in pain. We finally left at 5am. There was no transport to get us anywhere and no taxis available and we had to walk to the nearest hotel.

So what is the answer?
(a) and (b) shouldn't have been there in the first place, mental health services need to improve massively and there needs to be specialist support.
(c) should have had his op. (d) shouldn't have been told to go to A&E in the first place - (g) &(h) should have been turned away from A&E
(e) should have been seen preferentially.

The other major issue when we actually went through to a cubicle was the utter lack of urgency by any of the healthcare staff. No-one seemed that bothered about doing their job quickly. There was lots of chatting, wandering. Our cubicle was filthy. I did pop round to take sure there hadn't been a massive emergency, but everything was really quiet in the trauma part. I also know that August is rotation time for junior doctors and they need to learn.

I really think there needs to be a complete overhaul of the NHS - higher earners like me need to pay more, but something felt fundamentally wrong.

"Raising tax on booze would probably help, a lot of drunk people end up in A&E"

The vast majority of people who buy alcohol don't end up in A&E. Do you also think that women who have children should pay more tax because some will suffer PND, or that people who drive should pay more tax because some will be involved in an RTC?

well, obviously the answer is for you to single handedly run the A&E department. I mean you seem able to almost instantaneously diagnose others people and decide on the severity of their illnesses so why bother with other staff such as doctors and nurses hey? I mean well done on rulinng out possible quada equina in the back injuries, or a PE or cancer or interstital fibrosis in the person with chest difficulties. Impressive to manage all that without scans and x rays etc..... And you can clearly also manage to keep the place clean as well so could also do away with all the domestic staff too.Brilliant.
What a very odd thread!!

This has to one of the weirdest written NHS bashing threads in a long time. So much detail! I’m particularly invested in big fat (i) (Irene) and her enormous legs. Why no differential diagnosis for her? Crashing heart failure or dependency oedema? We shall never know…

Honestly OP just popping round to major trauma to have a butchers is wild. Stop that now and get back to heroically washing bloody walls and diagnosing uveitis in patients who haven’t asked for your opinion. Weirdo

How very odd. The op could sort out all of the NHS problems and save money by the sound of it. Perhaps get rid of the lazy gossiping staff first though hey. You seem to know very little about how the NHS runs.This is one for the classics.

If only we all had your ability to instantly diagnose things in a waiting room OP 🙄

Do NOT overhaul nhs. There have been lots of big overhauls - changing organisations - PCTs, CCGs, GP points system, foundation trusts, blah blah. Personally I think they are a waste of money - because it takes more resources to enact the change, train people in the new organisational structure etc - too removed from the clinical effect.

you need more funding and for it to be targeted in small (but important) ways - that actually impact clinical care. For example - increase the number of regular out of hours GPs (so every a&e has 1 every evening/night). Fund community placements and social care (increase salaries) to reduce ‘bed blocking’.

Also - stop PFI. The nhs is big enough fund buildings on its own (even if it does take longer). In the long term this will be better financially.

My thoughts exactly - very weird OP knew each person’s medical condition. Very odd thread.
For those with severe mental health issues, this may be their only lifeline.

There was a TV programme or Internet feature once that I particularly remember.
It was based in a foreign country.
A young lady fell down a hole & broke both her legs
Her family took days to transport her from a rural village to their nearest hospital
At the hospital, they could not afford her treatment
They took her home to die

This story always makes me appreciate the NHS, because nobody expects to die from a broken leg/so.

I know the NHS is not perfect

I know people who have had excellent care
Some people arrive at A&E unconscious, bleeding, no heart beat or multiple injuries. These will always take priority over walk in patients at A&E

I hope your child makes a full recovery