AIB to ask why people expect/feel entitled to 'first class' treatment by the NHS?

[depressedhealthprofessional]

I ask because, having worked frontline in the NHS for nearly 20 years it feels like peoples expectations are becoming more and more unrealistic and out of step with the reality of what can atuially be achieved within the resources available (limited and shrinking in real terms each week)

I can honestly, hand on heart say that I have yet to meet any health professional who has 'survived' more than a few years in direct patient care who does not give more than 100% each and every day. yet all I hear is people grumbling and complaining that the NHS did not get this or that 100% right. I am not saying that we get it right absolutely all the time but for gods sake, if I have to hear about someone moaning about the quality of the mashed potato on the ward , the fact that the home help (provided by the NHS/social services) is refusing to wash the net curtains, or that it took (gasp) more than one investigation to find out what was wrong with them (they don't know what they are on about'/they are incompetent/ they are wasting my time') I am going to scream. It isi just so soul destroying that the nhs saves and improves the lives of countless millions each and every day yet all we get (in the main) is negative pres and individuals having no idea of what we are up against and just how damn hard we work.

I bloody challenge them to get on and step into our shoes!!

Rant over!!

We pay about 11% for NI don't we? which includes state pension. For an average earner on 25K £230 rough is paid towards these two things.

If you wanted to buy a pension and healthcare it would almost certainly be more than this wouldn't it? That's before you take into account adding children to the policy.

That's the great thing about NHS, those who get paid more subsidise those who pay less. However, it does mean generally those on average to lower incomes would be unlikely to be able to afford private heath insurance.

Sorry that's £230 a month

But most of us are only to realistic at what to expect from the NHS.

I know if I go to A&E I can expect a wait of at least 3 hours. I'm not complaining about that, I understand only too well the pressure the staff are under and the financial constraints of the hospital. I know that every medical test, scans etc have to be financially justified.

But, where as once it was not common place to hear of bad treatment from the NHS it is now becoming a depressingly common story. How many times recently have we heard on the news some appalling care being highlighted at certain hospitals, with patients being left for hours unattended, having no way of getting to the toilet themselves or buzzers being ignored and not answered.

I take offence with OP starting this thread with her 'woe me' attitude. I certainly don't think it's asking too much for a certain standard of care, very different to first class treatment.

I understand why you may have a wait of 3 hours in A&E as they don't know what's coming in, but I never understood why, when i was given at 8.45 app at ante-natal, I would turn up at 8.40 to find no-one on reception until 8.55, when they wandered in with coffee, ignored me until I went to the desk (having walked right past me) and then said the MW didn't come in until 9.00. Needless to say, I got seen at about 9.30. 45 mins is not a lot in the grand scheme of things but this was a fortnightly app, always had to be on the same day so I would always miss the same class I was teaching (a 6th form). The attitude I encountered when I complained about the timekeeping was that I just had to fit in with them and whatever I might be doing couldn't possibly be as important as these routine apps where they would check the numbers I had written down and tell me they were ok (which I knew because they'd told the parameters and I'm not an idiot). Maybe if they didn't insist on pointless apps, they would have more time for really necessary ones. By DC2, I was much more confident to say I was refusing to come in as regularly and they could like it or lump it.

I think the problems with the NHS are not the fault (in the main, although where you have humans you have errors) of the frontline staff. The problems are systemic. It's just such a huge, unwieldy, badly run organisation. That's not to say that every cog is not doing it's job but it doesn't take much to throw things into disarray. The difficulty is that it is the people at the front end who patients see and deal with so when there are issues it's natural that they assume it's the fault of the people they are dealing with.

For example on the maternity ward where I recently gave birth. I had the baby at 7.30am but didn't get moved to a bed on the ward until 4.30pm because all the beds were full. I found out why all the beds were full the next day. I was due to leave in the morning but didn't get out until 4pm because they "didn't have time" to process me out. To me that is very clearly a management issue. Getting people out should absolutely be a priority early in the day (rather than at 4 in the afternoon when they suddenly realise they have run out of room). Not only because people don't want to be sat there when they're ready to go home. Not only because sitting on the delivery bed all day after giving birth was agonising. But mainly because having people sat in those beds unnecessarily all day was using up resources, food, medication, medical staff doing rounds etc. etc. and wasting goodness only knows how much money when added up over all the beds day in day out.

No doubt management felt their hands were tied on the issue due to some directive from higher up about where the priorities lay as well. The whole thing is a farce!

On the plus side my baby was delivered safe and sound and all the staff I dealt with were perfectly lovely.

The complaints in your op are a bit ott, but I've been in our local hospital 3 times recently on 3 different wards ( maternity, paediatrics and a&e) and found blood ( not from any of the patients I was with) on the floor and walls all 3 times. I'm sorry but that's just disgusting!

I assume you complained both at the time and in writing afterwards?

I know perfectly well what it is to care for a sick person day and night. I have cared for one my entire adult life. I have not had a three hour block of sleep now for three years, and never had a break or day off or holiday. Before the DWP stopped my CA, I was "paid" £0.32 an hour for this labour and have no union and no sick days. There is never a break. I must continually strive to learn more and do more and try harder, and one thing this has taught me is that, yes, I could step into your shoes.

I do not expect care from the NHS. I do not expect water. I hope! But it doesn't always happen. Sometimes we get lucky, and we cherish those people; but mostly you can expect abuse, neglect, scorn, and this same sort of thing about my GOD, don't you know how HARD we work????? We must constantly tiptoe around the affronted feelings of NHS workers with a martyr complex.

Yes, I know hard work. It should not compromise compassion. I work hard, but it harder to be paralysed from the neck down. I am lucky to be able to work this hard. Don't you see how lucky you are?

I'm a midwife. I do my best, it's not a first class service and never will be. My image of first class is like a bupa hospital, nice food, pretty much one to one care, ensuite rooms, etc.

However I don't think people do expect that.

But it does bug me when people are very rude and aggressive to me if they've had to wait a few hours to be discharged, seen by a dr, etc. try to explain that they can't be discharged till their meds are back from pharmacy, baby has had a paed check and that the paeds cover scbu as well, meds don't come back from pharmacy till mid afternoon and some people are furious. They don't seem to get that the system can't provide the indivualised care they want to the extent of having a paed on standby to come running for each paed check, to do individual pharmacy runs, etc.

Oh and if you EVER want to be discharged before 4pm you need to do these things:

1. organise transport (if ambulance is necessary find out where the discharge team is and go down yourself and speak to them)
2. waive pharmacy
3. tell them you have a care package and you manage it yourself if applicable
4. say to the sister that your transport is coming an hour before it is and you need to be signed off and you have WAIVED PHARMACY

Pharmacy is the killer, the absolute killer. We have lost up to three days (Friday morning discharge attempt) in hospital waiting for pharmacy, but it's just a prescription--you can go to Boots on the way home.

Coming from the US system, I'm amazed by the high standard of care in the NHS. Like most Americans my level of care in the US has been patchy - I couldn't always afford insurance so avoided the doctor, or my insurance wouldn't pay anything towards a cancer screening, so as a student I avoided being screened.

The basic level of health here is SO much better. To me it's amazing to go to the doctor or the hospital and not pay anything. What my DH pays in tax TOTAL is actually way less than what you'd pay just for basic health insurance per month - let alone copays, insurance, surgery, etc. - in the US. (I get the sense that private medical insurance is amazingly cheap here in the UK - it's unaffordable in the US for most.)

I'm so grateful to be in this system and grateful for any care I can get. I do see the problems that the NHS has though - like any large system - and when I can vote in a few years, I will vote for the party that most supports the NHS. It's crucially important.

By the way... in the US, you will still wait in any A&E for at least three hours, but you will be handed a bill of thousands of dollars at the end. The care isn't any faster in a private system.

In fact I'm always amazed that I don't have to wait an hour in the waiting room for the GP like every doctor I've ever seen in the US. It's surprisingly efficient.

*sorry, I meant copays, PRESCRIPTIONS, surgery in the first post there.

I have an acquaintance who is ..let's say...not at all streetwise. She went to New York and had a pleasant evening drinking cocktails and inevitably got rather drunk.

Woke in middle of night vomiting, sweating, horrific headache. In panic went to nearest hospital. After running god knows how many tests, she was presented with a glass if water, told she was dehydrated from drinking and then given a bill for $2000 which later had to be paid by daddy.

^yup. I had outpatient surgery with "excellent" employer-based insurance once and still had to pay $3000 out of pocket (insurance covered 70% of it, but costs are so inflated).

Haven't read the whole thread, but that's got to be the most offensive OP I have ever read on MN.

There is a big difference between expecting first class treatment, and expecting a decent standard of care to be delivered within a reasonable time frame. The former is consultant led care for the majority of illnesses, delivered at a convenient time, without having to wait more than a week, in clean and hygienic surroundings, enough time to talk about options and oncerns with quality advice and aftercare. No one expects that from the NHS and if they do they are clearly in cuckoo land.

It is not too much to feel entitled a decent level of care within a reasonable time frame, but that's not what we get from the NHS that we pay for.

I'd much rather be able to withhold a portion of tax and be able to pay for private pension and health insurance instead, but we are forced to pay for a substandard service. It's almost criminal.

This thread has prompted me to write a review on the website of the hospital where DD was born three weeks ago. I have nothing but praise for the care we received from the staff that took care of us, even though they were absolutely rushed off their feet. There are clearly people who have experienced substandard care on the NHS but there are also many amazing men and women who work their backsides off for their patients. Thank you to all of you who work so hard.

Well, I think what the OP meant - and should have said - is that "SOME people's expectations of the NHS are unrealistic." Anyone who works with the public, whether they're shop assistants, police officers, teachers, whatever, will tell you that members of the public can be rude and unpleasant.

But just saying "people's expectations", as if it's everybody, is bound to get the backs up of those of us who are consistently polite and deferential to health professionals but who feel as if we've been shat on numerous times. When you think of what happened, for example, in Stafford General Hospital, where patients were left for hours lying in their own urine because the nurses were too idle to change the sheets, it really sticks in the throat to be told that you have no right to expect a first-class service. I don't expect a first-class service from the NHS, but I do expect to be treated with some courtesy and respect for my human dignity.

I wouldn't be in the position of recieving the beyond 1st class treatment I currently get if someone had been halfway competent in the years before I started needing quite specialised help.

Oh and not trying over and over to prescribe a MH drug that has nearly killed me in the past for a PH problem would be nice also. That's not asking for 1st class treatment that's just asking for treatment.

I never made a formal complaint about any of the near misses, mistreatments or horrible staff.
The majority of nursing staff were lovely
Some of the doctors were delightful
The majority of the auxcillary staff were fucking horrible. Cleaners who charged into our room turning all the lights on and using mops that had been in every other germ ridden cubicle, clerks who fucked about being self important while my DD waited in terrible pain for treatment to begin, ditto sonographers and phlebotomist etc,
There were a few who stand out as lovely but they were in the minority.

THAT is what makes me avoid hospitals unless I absolutely have to go.
The memories trigger flashbacks and panic attacks.

But next time you think someone is being demanding because they are insisting on that cross match NOW and not in two hours, maybe wonder if it's because they know by the time the blood arrives their child will have to be transfused overnight, with 15 min obs, with a depleted staff and no consultant available when they go into anaphylaxis.

So another night of intense stress (the rates of PTSD in oncology parents is high) with no sleep at all and an extra day in hospital.

same thing if you think someone is being lairy about anti bs. A few hours delay can mean a whole extra day in hospital.

I worked in a&e for 6 years my oh was a paramedic for 10. I want all my boys to be medics.
I LOVE the NHS.
Doesn't mean I Haven't been battered and damaged by my experiences.

helloclitty

We pay about 11% for NI don't we? which includes state pension. For an average earner on 25K £230 rough is paid towards these two things.

NI doesn't pay for healthcare. All NI goes in to the same pot as all the other tax. NI isn't hypothecated, it's just another income tax.

If you wanted to buy a pension and healthcare it would almost certainly be more than this wouldn't it? That's before you take into account adding children to the policy.

I pay £90 a month for my comprehensive private healthcare. My salary is very low, but my experience with the NHS has convinced me that I can't risk my life with the public sector option.

That's the great thing about NHS, those who get paid more subsidise those who pay less.

The great thing for those who pay less.

However, it does mean generally those on average to lower incomes would be unlikely to be able to afford private heath insurance.

If we weren't all paying such epic amounts of tax we'd have plenty left over for private healthcare.

depressed I think we're all depressed.
I agree care in the Nhs is not what it should be but this isn't due to "lazy HCP" as seems to be a common complaint.

The NHS is going to ruin due to cuts right left and centre to frontline staff and services. Staff freezes and redundancies and ward closures.

90% of qualified staff are not above cleaning patients but have to prioritise between the crashing patient or assisting in a bed bath due to chronic unsafe staffing.

I agree with SirChrisHoy'sThighs in that some staff just should not be there. When my husband was in hospital - in an acute ward - there was one nurse who was to give an injection occasionally to other patients (she would not have got near my husband after I'd seen here). Usually, a nurse would approach a patient and say something like, "I'm just going to give you an inejction in your arm for ..... Please lift it up for me." This one (and I could name her) just marched up to the patient, lifted his arm and stuck in the needle without saying a word. Wiped the skin and moved away.

My experience of the NHS can certainly be compared and contrasted. I was lucky enough to be admitted to a dermatology ward a few years ago. The standard was superb, I was always spoken to with respect, the food was absolutely fine, fresh, tasty and filling. My treatment was timely and appropriate. The ward was clean and greasy, if a little dated.

Fast forward to two years ago when I had pregnancy complications. The optomitrist requested never showed up despite me being onward for six days. My room (in a new build wing) was never cleaned. The hot trolley food was tinned, pre-prepared, portions were tiny and leftovers from the delivery suite (so incredibly poor choice) no information was given at all regarding special diets (I found a menu in my room after delivery- looked nice, nothing like what we got though). It certainly wasn't sufficient Igor of a decent standard to sustain a well person, never mind an ill one. Olli realise this is due to food being contracted out, but the hospital should be overseeing the standard.

While in for the actual birth, and recovering from an EMCS, my baby was nearly frozen to death (the paeds words not mine) by midwives who didn't notice it was cold in my room (I had had lots of drugs) my catheter was bent and therefore not draining. The warmer room I was moved to was dirty, amniotic fluid, blood and used urine sticks on the floor, and a dirty shower. Staff were condescending towards me, when I said there were problems with my wound, I was told, without examination that I must be dirty as it was obviously lochia not fluid from a wound. As a result I said no more and major infection was found four days later at point of discharge.

This cost the NHS a day of bedspace and three weeks of nurse and GP time plus an extra course of ABs. My suggestions of jaundice were ignored, baby had jaundice which could have been treated sooner.

My baby didn't sleep, I was regularly told off by midwives saying I should leave her to cry while I slept, on one occasion a midwife offered to watch her, or at least keep popping in while i slept. I woke two hours later to a baby covered in sh*t and screaming.

Antenatal scans ran permanently late by several hours, compounded by a lack of info, so we were sat for hours with no idea when we'd be seen. One time a 3pm app was seen at 6pm on a Friday night. No problem waiting, but no-one would tell us (by us i mean a full waiting room) when we would be seen at all, until all the onsite shops had closed after five. No clues were available at all. Even being told it wouldn't be in the next half hour would have helped!

This time, I've opted for a different hospital and it couldn't be more different, its only four miles, but I've been seen on time everytime, in fact, last app I was early and seen early! The facilities are old, but clean. I'm not asking for much, and I'm not a demanding person, preferring to quietly seethe than make a noise, but so far my two pregnancies couldn't be more different, and that is 100% to do with the staff, nothing else.

PeanutButterCupCake

depressed I think we're all depressed.
I agree care in the Nhs is not what it should be but this isn't due to "lazy HCP" as seems to be a common complaint.

The NHS is going to ruin due to cuts right left and centre to frontline staff and services. Staff freezes and redundancies and ward closures.

NHS spending has risen every year for the last 10 years and is predicted to continue to rise throughout the lifetime of this parliament.

Cuts? What cuts?