Dying and the NHS

[TheAmusedQuail]

This week, my elderly neighbour (history of heart problems) needed an ambulance. His wife called 999 and they told him the wait was 5 hours. The operator advised him to go to the local GP surgery which is a 5 minute walk away (2 min drive).

He died in the waiting room. The horror of the lack of help available to us in emergencies is like that of an undeveloped country. Today, I read about a man having a heart attack in A&E in the UK. He was left, rolling on the floor in agony, turning blue in the face and frothing at the mouth, in front of his family.

I'm not young, although not yet elderly. I'm terrified that there will be no help available, given that I'm getting older. I know it isn't just my neighbour, or the man I read about, or me. It's all of us. But I'm very scared.

It’s not functioning. I can’t even get an appointment at my GP

i also work in social care in a service aimed at speeding up discharge and preventing readmissions - I work closely with a hospital discharge team in social care and bed management on the NHS side.

Bed blocking is a systemic problem that involves multiple agencies/private companies. If you think it’s social care that’s the problem, you’re mistaken.

Yes I think this is highly unlikely. What is a GP meant to do for chest pain apart from advise A&E.

The Bill being proposed is not for situations like this.

It may not be the purpose, but anyone who thinks it won’t be the outcome is naive.

You only have to look at Canada to see how the shift happens, and if reform come to power they will think nothing of amending legislation to enable killing off the elderly and disabled.

Not true. My DP and I both see this all the time in the NHS

@Cheese55 I thought it was for the terminally I'll?

It doesn't cover frailty and older ages alone , there should be an identifiable condition. The person must also have full capacity, which your relative could have but some ill older people don't.

Agree.

Yet.

There’ll obviously be an exception for people who’ve been on the telly (UK only) for more than 6 hours (not including repeats) in the last 5 years 🙄.

This and a lack of step up care options for the elderly, so the only.place people can go is emergency departments, as well as reduced community support and no wonder the hospitals are overwhelmed and under staffed. Demographics were entirely predictable for the last 40 years and not one government planned appropriately.

I’d make sure elderly people had excellent pain relief and were kept comfortable. Not left lying waiting transport or denied basic care

But not treated for illnesses, particularly when the treatment itself, such as surgery, can cause more pain and suffering than the original symptoms

Call handlers may or may not be better trained now, but years ago my dad phoned during the night with classic heart attack symptoms ( I asked for transcript of call). Call handler assessed as non urgent and when GP called in the morning dad was found dead in his armchair. It breaks my heart he did not phone me.

I think people need to understand that GPs can only do so much. We don’t have the equipment to manage a lot of things, nor are GPs specialists.

I agree that the sacred cow is not in need of the slaughterhouse.
But to deny any form of help for the sick beast amounts to gross neglect.
Despite the amazing progress in the treatments available, the way the NHS is run must remain as it was in its beginning.
It seems to be thought preferable to wring the hands and not ring the changes.

When I arrived in CCU after my angiogram and stent, I was telling the nurse about the 999 call. She said " If you had been a man with those symptoms you would have got an ambulance with no argument".
Looking at the sorry state of services that affect women - gynaecology, maternity for example, I think she had a point.
I was labelled as a silly woman having a panic attack, in spite of very obvious symptoms. I am only in my 60s and I really thought I was going to die. I have never experienced such pain and terror. Once the paramedics came they were absolutely wonderful, as were the hospital staff. One of the paramedics said I was the only patient who actually needed an ambulance so far on his shift.
There needs to be some changes for sure.

That is not to denigrate the experiences of anyone else on here who lost much loved fathers/ sons/ husbands, but the prejudices and attitudes of call handlers, the state of the hospitals and services generally, show that the nhs is not fit for purpose and resources are stretched and sometimes not allocated appropriately.

It’s the other way round imo - my elderly relative was sent off to hospital many many times against their wishes for treatment that only really prolonged a very poor quality of life. They’d had a respect form, and a DNAR for many years.
The care home and medical professionals were most reluctant to stop antibiotics etc. it was awful for all involved and would have been much kinder if they’d been allowed to die a good 18mths earlier. They’re worried about being sued imo.

But our NHS is the envy of the world 🙄

This.

I would also say that a lot of mental health and addiction problems need a separate service - generally a more social services type of treatment. Particularly the 1 in 4 young people who claim "mental health" problems so they can't (don't want to?) work. That's a vicious cycle of regression that needs snipping in the bud. We cannot afford for 25% of the next generation to be economically inactive, and often it's a combination of social & medical problems which makes them so (oh, and having 3 generations of family benefit-dependent)

And we need - as a society - to agree that doctors can give short shrift to the "worried well." It's this category which - according to the experienced GPs in my family, are big suckers up of GPs' resource of time. No, don't come seeking antibiotics for a viral cold etc etc etc. I see it all on the time here on MN - lack of common sense & just getting on with it.

But the current state of the NHS is also a demonstration of what 15 years of austerity can do. And it's complicated - austerity made poor people far more dependent on welfare/benefits/misusing the NHS because they can't get treatment & needs met any other way.

I think the problem lies with the fact that there are only three routes to treatment: GP, 101 or A and E. GPs here are Monday to Friday, the last time I called 101 and was told I would receive a call back within three hours I rang them after six hours and was then sent to A and E.

The NHS most certainly needs reorganisation but no political party will be brave enough to undertake it.

There are urgent care centres. I'm not sure what else the NHS can do.

Emergencies should be directed to A&E, non emergencies are the GP, if worried or unsure then 101 for advice. Given most of us use the NHS more than the taxation we put in I think we are very fortunate.

COVID put enormous strain on the system and staff and it's taken a while to recover from. Add in the increase in population then no one it creaks at times.

An example of increasing care needs, an neighbour in her late 80s had a pace maker fitted, she has significant mobility needs but the NHS still had the ability to improve her quality of life. In the 1990s she wouldn't have been around but medical advances means she is still here and having regular care...that's expensive and the tax she paid from working 30 odd years ago won't have touched the costs of her care.

If a patient is in a GP practice the ambulance control will/may downgrade the call saying they are safe.
Believe me it is terrifying being with a really sick patient in a GP surgery as all we have is oxygen, a defibrillator and some adrenaline and atropine.
We don't have a full resus team and I have heard many stories of GPs trying to argue with ambulance control that they should still be priority. Must be horrendous for the patient and relatives too.

Your not wrong, that’s exactly the plan.

I think austerity followed by covid on a service which was already stretched and running hot, hasn’t helped. There’s the double whammy of catching up on health issues when the NHS was overwhelmed, increasing sickness in NHS staff since covid arrived and all the health issues caused by covid (re)infections themselves. It doesn’t help that infection control is not great in healthcare settings either which leads to poorer outcomes or that covid is framed as being in the past/doesn’t affect children/only get long covid if unhealthy/had it severely/old etc. Healthy qaly were relatively stable for years, but have decreased by several years in the last few years.

You can make an appointment at our GP if you have an “urgent” on the day appointment. The implication is it has to be urgent before even GP is contacted.

My aunt worked in the NHS for decades. It gave her mesothelioma (asbestos related cancer).

“With capital spending, NHS Confederation analysis has demonstrated that had the UK kept pace with the average across the EU-14 between 2010 and 2019, the UK would have invested an additional £33 billion in healthcare capital. “