to think if a business operated like the NHS...

[hairytriangle]

then it would quickly go out of business

Just in terms of client communication and customer service.

Today I've been

1. kept waiting for one hour past my appointment time

1. had a snooty receptionist tell me I'll 'just have to wait' when I asked (nicely) whether I'd been forgotten about

1. Had to push for investigations that their own NICE guidelines say I 'should' be offered

1. Been given advice contrary to what another department of the same Trust gave, about a potentially life threatening action.

1. Been examined yet again when they could easily have got the results of the exams I had six weeks ago by lifting the phone.

I know if we treated our clients like this, then we'd quickly lose them.

The first couple of links I get for alcohol and smoking costs are 3 and 5 billion respectively. So the net cost, after accounting for tax, to the NHS could be as much as £6 Billion.

Whoops! I missed 5 Billion of wine and spirit duty.

So - 15 Billion in total, 2.7 Billion to NHS, so about 2.5% and a net cost of 5.3 Billion.

mamadoc - thanks for all you and your collegues do in the NHS

"I think on reflection that if I had announced to the waiting room that we were one Dr down and that there would be unavoidable delay it would have made it easier for them to bear and stopped them thinking it was because I was slow. The reason I didn't do it is that the reason wasn't exactly unavoidable in the sense of sickness."

Yes - definitely - that would have made a wonderful difference in my opinion.

Tensions in the waiting room would have eased with an explanation and you would have felt less stressed.

It is always information that people want in these situations.

No need for you to explain that it was holiday - a simple "we are one doctor short today" - I would be so impressed if a doctor in clinic came and said that.

The other very very easy thing to do in these circumstances is for the receptionist/admin to work out a conservative estimate of when each person might be seen.

So - eg 17 people waiting for a 10am appointment. Let's say working at 5 mins each - ok massively understimated but it means that you can say to person # 17 - "there is no way you will be seen before 11:30am" - then there is a choice to go back to your car/listen to the radio/go for a walk/go to the cafe/or even stay there but have some idea about the wait.

tabouleh it is probably always best to wait as it is possible to be seen earlier than estimated. Being the NHS, ie a service that people do not have to directly pay for, it is very likely that at least one of those 16 people before you will either turn up late or not turn up at all

The NHS's problem is that it is a top-down organisation, with money allocated from above and then put to use in ways that either do or do not meet the needs of the patients.

Money should follow the patient.

BootyMum - I'm not suggesting that individual patients decide to leave and come back later - just that the receptionist/admin person should/could be in control of such a process!

Hammy, it has always taken 3 years to train a nurse. I did my training 30 years ago. It took 3 years to do my SRN (state registered nurse) training, then 18 months to do midwifery training.

Don't know who your 'nurse' friends are, but if they did less than 3 years training they are not registered nurses.

"I have been the person causing the delay and coming out of the surgery and having everyone glaring at me as I went back through the waiting room was pretty horrendous. Felt like yelling "Sorry everyone, the doctor has just signed me off work for 8 weeks and referred me to 2 consultants, I'm walking past you in floods of tears and you are glaring and muttering about time wasters."

Actually, I don't think anyone has suggested anything of the sort. we're talking about poor admin and customer service, not having a go at those who need more than the 'standard' appointment time.

Politeness and respect for patients by giving information costs nothing and clinic staff should manage this. I have friends who did this work in between travelling and naturally worked inthis way and had happy patients.

The NHS should not be private it's too important. We work our consultants to a higher cApacity, hence the wait. It's cheaper to make use of their skills in this way.

I have had variable experiences. But as I've sad before, when things are really shit health wise the NHS swinging into action ( and it may take a while to get there) is bloody impressive and I can't fault the care and compassion I have received.

agedknees - when was that crash?? reason i ask is that many years ago I worked at Watford general in theatre and we didn't get any patients from the crash...

My daughter (adult) had palpitations for a few days, worse this morning.

She got a call back from NHS Direct within 15 minutes - advised to see GP.
Saw GP 20 minutes after surgery opened. Had bloods taken and physically checked. ECG booked.
Felt worse later that afternoon.
Went to A&E was seen immediately. Had ECG and checked over.

The upshot is probable anxiety. She has had a very stressful 2 years but appeared to be coping.. She will be followed up with counselling.
To me that is an excellent service.

What would you prefer the US model? where insurance companies try to skip out on paying anything. And basically people who are poor had (until recently) no access to their services.

The NHS is not a business, it's also not a free service either but it is constantly under strain as so much money is wasted due to time wasters, drug exploiters and self inflicted problems. Obesity related problems costs the NHS around 5 billion every year. This is something that does not need to happen. Smoking accounts for around 22% of adult hospital admission costs, over £235m every year. There are many problems with the NHS but one good thing is that it is not like a business if it was it would quickly avoid the masses which cause it to lose money.

Sorry statistic for the smoking one is £5.17 billion every year.

My contacts with local health services - my GP Practice and the hospital (A&E, Paed ward and cardiology) have all been positive. I can't think of any flaws (and I am not easily pleased!)

Watford crash would have been about 2000 or 2001 I think.

This is what happens when you get old, years merge into one. The rail disaster would have been in the 90's - so I am thinking about 96 -98 (I think).

What bugs me is the fact that some of the ocnsultants and surgeons seem to do very little indeed for a lot of money.

I needed an appointment for my long running illness and was sent a letter telling me that in 4 monts I would be added to the waiting list!!!! SO I rang the hospital and said "what if I pay and go private to see the consultant?" "Oh, then come in on Tuesday" was the reply. So I saw the same man whom I would have seen on the NHS privately, within 4 days, in a different wing of the same hospital in a slightly nicer waiting room (free biscuits). It cost £120. I got my treatment then, that on the NHS I would have waited at least 4 months for.

Luckily, I can afford that £120 as I (now) belong to a private medical scheme.

It also happened when DD was ill, even as an "urgent" she was given 2 weeks wait so I went private and she was seen the next day.

So when I went both times, there was no wait, no bursting at the seams waiting rooms (I was the only one there)but the consultants were spending an entire day seeing about 6 people (yes, nosey me, I looked at the appointment schedule) while NHS patients waited months to see the same consultant!!!!!!!!

No wonder the consultants and my GP who does 3 days a week private all drive porsches!!!!!!

...far too many exclaimation marks there...

"What bugs me is the fact that some of the ocnsultants and surgeons seem to do very little indeed for a lot of money."

You are paying for their skills and knowledge not their day to day work load, they are worth every penny IMO.
I couldn't do it so they can have their Porche in return for saving lives.

see i went to see my gp - was refered within 4 weeks, the op was agreed and then I was telephoned and asked when I would like to be seen? I agreed a date of my choice and went in - was seen, operated on and home in under 5 hours...

Never paid an extra penny - just my NI contributions

whoever said that consultants and surgeons don't work hard for their money doesn't know what they are talking about.

Smokers and drinkers do pay a lot of tax in duty on booze and fags, but the total they pay is nothing like as much as the NHS spends treating them.

I don't agree with the original question. Just recently my dad was treated terribly by BT and Virgin and all 5 points applied (as closely as possible).

Lots of private companies conduct themselves in a shoddy manner on occasion.

Miggsie - I don't see how that shows that they are doing not very much for a lot of money.

We are paying them for the NHS work. So, say they are paid £100,000 pounds and do 1 days private work a week then they are being paid for £100,000 for a 4 day week. It's up to the NHS then to keep them supplied with work for those 4 days. That's why you have crowded waiting rooms - to get as many patients as possible seen by them. Private work is much less efficient - which is one reason it is expensive.