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!!

Obviously, not clean and greasy lol, clean and squeaky was what I meant!

I have had fantastic treatment on the NHS. I consider myself incredibly fortunate to have crossed paths with some of the MW / consultants / doctors over time.

However I find this black & white approach to NHS unhelpful. Not all NHS workers are saints / angels. People are flawed and people work for the NHS, ergo.... Let's not pretend all health care workers are perfect and simply hard pressed so sometimes forced to under perform. Making this point does not make me a hater of the NHS. There are bad apples everywhere who might be better off in a different job.

I had my DS in 2004. The consultant and emergency team were brilliant. My care (7 days in a London maternity unit) was at best neglectful. I would describe one MW as cruel. I wouldn't treat an animal the way she treated me. I discharged myself against advice and was lucky to have a fantastic HV and recovered at home. You can't blame the Tories and cuts for that. Tony Blair was still in charge.

Nearly 8 years on and I'm due to have baby number 3 and I'm scared about going into hospital and giving birth because of my experience first time round. I feel there is no guarantee I'll be well cared for when I'm at my most vulnerable. That's not me demanding first class service - that's me hoping someone I depend on won't actually make me feel worse.

Anyway, as I understand it the real damage to NHS has been thanks to PFI (and this will get worse). PFI initiated by John Major but really expanded by Gordon Brown and Ed Balls. No party is blame free when it comes to NHS.

To all those who would like to take their NI contribution back to pay for their own private care- what about those who don't work or pay NI? The elderly, the sick, children? Who is going to pay for their care? The nhs is funded to cover care of everyone, even those who don't and can't contribute themselves. So while the working population would be ok, everyone else can just rot?
I'm alright Jack.
That attitude stinks. We are supposed to be a civilised society providing care for the vulnerable, it's not just about getting 'your share' of what you pay in.

I'm sorry to all those who have had bad experiences. Despite increased funding the cost of healthcare for this nation continues to increase at a far greater rate due to more chronic disease, people living longer etc. The reality is continuing cuts to services, and this impacts on patient care. It doesn't excuse lack of empathy and humanity but I don't believe that most doctors and nurses are lacking in either of these. Unfortunately there are unkind people in every walk of life, if we could rid the nhs of them that would be great. But there are just not enough resources to go round, and expectations are (often) too high.
Op yanbu

I've worked in the NHS for 24 years.
I've sat with patients while they've told me about personal/health problems. Sometimes they need help to point them in the right direction. Sometimes just an independant person to listen to them ( sometimes they say their family don't listen)
I help people with their shoes,socks,stockings, tights.
I'm very careful to be tidy and hygiene is vital.
I've gone out and bought a pint of milk for a patient who had none indoors and his carer wasn't due for a couple of hours (diabetic patient, hadn't had breakfast)
I've made a drink and a sandwhich and waited (writing up my notes) while a diabetic patient ate them, because his blood sugars were so low.
I've waited over a hour for a (non emergency) ambulance after a lady had a tumble.
I've posted important letters.

I regularly go without a full lunchbreak.Patients turn up late and I very rarely refuse to see a late patient (but only at the end of the session unless they are late due to transport and have to be picked up).
I endeavour to be polite and friendly.
I'm always there early, but my clinic runs late because some patients take longer. I'm not off having coffee.

What bugs me is the ones who say "I don't get anything else free on the NHS" .They are not grateful that they are well, they are annoyed at having "paid in all my life" they think they are due something back.
(BTW do they think their GP is free? They are all registered with a Dr)

When they trot out the "only people who have paid in should get NHS treatment"
I ask them
"So a premature, newborn baby who needs to have intensive,specialised care in SCBU. ?They haven't paid in. The mother may or may not have if she's working/paying tax.But that goes for her care".
That usually makes them reconsider their Daily Mail views.

First Class Service- impossible in the currant climate.
Second Classs isn't good enough IMO.
But the NHS could and should do better.

flatpackhamster my trust have to save/reduce spend by 94 million by 2015!

Staff recruitment frozen and people debanded, wards closed in a bid to save money.

That's a cut is it not

I have yet to meet any health professional... ...who does not give more than 100% each and every day

Then you must have your eyes closed or work on a very small unit somewhere. As a patient and employee I've met very many who are giving seriously substandard 'care'. Its really common, I' astonished that you've not experienced it. So yes YABU. Of course there are some great staff, but sometimes a few rotten apples can really ruin a ward/dept.

ime (I've spent the last 8-9 years in close contact with the NHS due to DD1's complex health issues) the main issue is admin.

The mantra is "no cuts to front-line services". What that means in practice is that although they will cut the numbers of doctors and nurses (or at least fail to increase staff when they increase the number of patients) the real cuts come to admin staff. And we all think of them as a bureaucratic overhead, so that's OK then. That's "efficiency".

The NHS is a vast, creaking behemoth. It makes mistakes constantly because it's just too complex to work without errors. The thing that used to hold it all together was admin staff. The consultant's secretary who worked through her lunch hour and into the evening sorting out the faxes that fell down the back of the fax machine and turned out to be half-a-dozen missed referrals. The appointments staff who spotted that these 3 appointments actually needed to be booked together not on different days, cancelled them and rebooked them. The surgery managers who realised that a child had been booked into a theatre which only does adult surgery and moved them into the right place before re-issuing the letter.

Increasingly, these anonymous but dedicated staff are replaced by agency workers on minimum rates who will leave as soon as they get a proper job and in the meantime, tell you "computer says no" - if they tell you anything at all, because generally whatever you want to know was arranged by someone who has left/is on mat leave/is on holiday.

DD1 has just (yesterday) had a critical operation. Before this it was cancelled FOUR times, and each and every time it was not a shortage of beds or absent surgeon or any other "real" medical reason. Every single time it was an admin cockup and the last time it took 3 different departments a week of infighting before they could decide whose job it was to inform the family. The sad thing is, none of this surprised me, this is peak efficiency from the NHS in my experience. Great Ormond Street once lost a critical MRI for DD1, while passing it from one department to the next. The two departments are in the same corridor. They share some admin staff. They lost the MRI for SIX MONTHS (I get my own copies of everything now; DD1's operation only went ahead in the end because although the hospital had lost a critical letter, I was copied on it and had already scanned it in and forwarded it to them expecting this to happen). I could go on. And on. And on.

I'm OK with it, because I expect it now. I've been trained by the NHS to expect that anything that can go wrong, will go wrong, and I need to prepare for it in advance - so I do. I'm not surprised that people encountering the "system" (in the loosest sense of the word) for the first time are a little grouchy, and take it out unfairly on the medical staff who are as much victims of the system as the patients are.

I agree with the previous poster who said that admin has become the whipping boy of the system, to it's detriment.

The world hates GP receptionists - but has anyone on here ever, ever seen their surgery shut through lack of staff? It might not be easy to get the phone answered, but there is always someone there to answer it, to give you your prescription - always. Same with hospitals. It isn't just the medical staff who pull overtime with no notice, who work through breaks to finish jobs etc.

I once spent three hours (of my own time) straightening the repeat scripts of a single patient out, so that they all ran together. She complained that I'd set the repeat day for one she couldn't make (and completely missed that I'd saved her six other trips) but that three hours saved 4 of GP time on a regular basis and the NHS 6 sets of prescription costs.

I've left the NHS now, thank God, but the person who replaced has been redundant - cost saving - and there's no-one else there who can do stuff like that now.

IMO, that's going to be the next big scandal. As GP receptionists retire or are made redundant and replaced with cheaper, newer staff, the attitude I saw so much - that the desks had to be manned, that the paperwork had to be done, that the results had to be notified, no matter what - will go, in favour of staff who treat it just as a job and go home at 6pm, whether or not the last patient has been seen.

Why shouldn't we expect a first class service? We are a developed country and many of us pay an enormous amount in tax and NI in exchange for he service we receive from the NHS. Frankly the admin n the NHS and some other aspects of the service are an absolute disgrace.

Because we pay for it through NI

Because there are too many high up overpaid managers micromanaging and not enough good friontline staff.

Because there's too much unnecessary bureaucracy

Because there are many jobsworths high up in the NHS making choices-such as Tenders for suppliers- who are rubbish and contrinute more to a place overspending and more to stress of staff.

And i too work for the NHS

Urgh posted to soon

I too work for the NHS, give over 100% and get frustrated when people say my pension is gold plated, that I'm well paid (i'm not i got more in the private sector), I work less hours then they do (i'm contracted 37.5 but do closer to 50, i don't get paid for the excess), I can't take time off in the olympics despite it being school summer holidays.

So i agree with you sometimes people expect to much, sometimes they assume but quite often experience is what pushes those expectations and there is a lot wrong with the NHS-so much right but so much wrong that the whole PHE thing isn't going to fix

Thinkingof4, I am probably one of the posters you are referring to as I would rather be able to pay less tax to help me be able to afford private healthcare.

It is very much NOT a case of 'I'm alright Jack'. If everything was alright, I would happily pay tax to help others recieve healthcare. But it's not alright, in fact it was that bad that we had to use every penny we had ever saved and more to pay privately for decent healthcare. If we hadn't, there is a very good chance our lives would be completely fucked by now. I do resent having to pay twice and I make no apology for that. I believe most people would put their own loved ones first when push comes to shove, and I am no exception.

I feel that we are lied to, people don't realise how crap the MHD can be until they are forced to use it. It can be great for life threatening conditions, but those that are drastically life changing don't get a look in. If I'd have known years ago how dire the nhs could be, I would have saved much harder and paid into a plan. My dc don't pay tax, but then I see that its my responsibility to make sure they get the care they need. Again, if I'd have known how bad the Nhs could be, id have made different choices for them a long time ago.

You might think it sounds selfish, but I don't see why anyone should be forced to pay for the care of others when they themselves can't get what they need.

To all those who would like to take their NI contribution back to pay for their own private care- what about those who don't work or pay NI? The elderly, the sick, children? Who is going to pay for their care? The nhs is funded to cover care of everyone, even those who don't and can't contribute themselves. So while the working population would be ok, everyone else can just rot?

Why not ask the French?! Gov subsidises healthcare and pays insurance contributions for the poorest. Providers are private. Similar arrangements exist in most other Western European countries. It's hard to find objective comparisons, but their cancer outcomes (a subject close to my heart!) are markedly superior.

If the way in which the NHS is funded is so great, why are we the only country to have healthcare funded and provided by government, when said government (of all stripes) has proved time and time again that it can't run a whelk stall??

My experience - 3 local NHS hospitals. First took months to diagnose my cancer but DID diagnose me as having "an anxiety disorder". (Too bloody right I was anxious - I knew damn well I had a tumour and no fucker would listen until I played the BUPA card!) Second - no investigations carried out for suspected recurrence of cancer after presenting with pain/bleeding in A&E. Doctor hadn't read my notes and refused to admit me "for pain". I was aghast and left my OH to handle it - he is an NHS consultant. Complete change of attitude, people running in with IV morphine and ordering investigations left right and centre. Still ended up in scummy shared ward with a stinking toilet (also used by visitors) and never cleaned. Third - lost blood test results checking for evidence of ovarian Ca, delayed follow-up appointment by 4 months, took 5 years to carry out genetic tests on my tumours, countless letters "lost", surgeon did not turn up for most recent colonoscopy and they were going to send me home (despite having fasted for 2 days) and "allocate me another appointment". Again, OH saved the day by asking the sister to explain who the on-call surgeon was, and why my surgeon had an elective list if he was on-call, and if so, did he need to speak to the Medical Director about the rota etc. Magically, a consultant was found immediately. I have still made a formal complaint.

The NHS is the worst possible example of a socailist organisation - it is badly-managed and uses Orewellian tactics to decide who gets seen when. It is absolutely who you know that decides. (My OH is appalled by the expedited procedure they have to use when a "VIP" presents for treatment - it stinks.) My local private hospital (which, incidentally, has an A&E AND and ICU!) could not be more different, and I am absurdly grateful for their wonderful care and compassion, which restored my faith in humanity after repeated bruising experiences with NHS staff and bureaucracy. I think EVERYONE should be entitled to expect that kind of treatment.

OP - YABVU. But part of the problem is the lack of clarity over what people are entitled to expect from the NHS. If we had a contract that explained what was covered, it would be clearer for everyone. However, it would also lead to a call for an "opt out" provision for those (like me) who would prefer NOT to throw their lot in with the NHS and to get decent health cover elsewhere. I would support a system that paid or subsidised insurance for the very poorest, but allowed the rest of us to pay contributions to an insurer of our chouce through gross income.

I think there is a lot of misconception about insurers. Yes, we hear lots of horror stories from the US (hardly the nearest example!) but despite having had cancer and a genetic predisposition to it, I still have comprehensive policy with BUPA that costs significantly less than my NI.

I had shocking care from an emotionally abusive midwife that left me with ptsd and pnd which had a profound impact on the kids. It was nothing to do with understaffing.. She was a vindictive bully. A gp dismissed my grandma,s worries about a lump in her neck. She wasn,t diagnosed til he retired and new gp took over. By then too late.. Terminal. Yes, the principle of nhs is good. But we do pay for itr and are shd expect to get competent and caring care not be grateful

PeanutButterCupCake*

flatpackhamster my trust have to save/reduce spend by 94 million by 2015!

Staff recruitment frozen and people debanded, wards closed in a bid to save money.

That's a cut is it not

Which rather makes me wonder where the money's going. It's clearly not going on care. Where's it going? Managers? Pensions? Diversity Outreach Facilitation Target Delivery Managers?

Haven't read whole thread yet BUT it honestly seems to me like a lot of the mismatch between patient expectations and staff ability to deliver could be solved by communication.......

HCPs on here, I would honestly be interested in your opinion of this: I have a kidney condition which has required 3 x ops this last year and which, IMO, is getting worse - more, severer episodes of pain. I recently had a scan for this - early July - have never had the results or a letter saying when I will have an appt with the consultant. Last week I rang up the consultant's secretary to be told, snappishly, 'Mr X is seeing cancer patients and clinic appts are very thin on the ground, you'll need to wait.'

I am totally sure that that secretary thinks I am an entitled diva. And I don't want to put myself before cancer patients! But I am in pain and scared. Would it be too much to ask that where a patient's results or appt is going to be delayed, you phone them up and tell them this, and not wait for them to chase?

I understand that NHS staff work with scant resources and I am grateful for the good care I've received. But I think HCPs don't often 'see' that patients aren't being arsey for the sake of it, but because they are frightened and in pain and feel that if they don't shout they won't get heard.

^flatpackhamster my trust have to save/reduce spend by 94 million by 2015!

Staff recruitment frozen and people debanded, wards closed in a bid to save money.

That's a cut is it not^

It's not about the amount of money you pour into the NHS - it's about the outcomes you obtain.

You could pour infinite amounts of money in but the system is so inefficient and top heavy with management no amount of money will secure an efficient system.

Revoltingpeasant, that's very worrying-in some postcodes (mine included) if you don't chase up an appointment they figure you don't actually need it after 4 months and you go to the back of the pile. My nan's GP told her this when she waited 6 months for her double hernia to be removed-and apparently she was classed as urgent.

However most of them really don't have time to do the chasing up and informing you of delays because they either are to busy or are dealing with so many different delays that things get royally backlogged and often temps are working too so communication-which is shockingly shite in some places anyway- gets lost. This is why I have so many concerns over PHE-same shit, same face, different name and millions to do it.

Your best bet is to write an email, citing how you feel but better still to go to your GP and get them on the case to. Sometimes it's the only way. OR try again tomorrow and if you get the same response-which is rude, there's no need for it and it's blatantly trying to shame you into not calling back, she should have just said 'i'm sorry things are very hectic right now, could you call back in X and someone will chase it up'- then make sure you complain in your email because that response isn't on and is highly unprofessional. This is why we bloody get training so we are professional and know how to talk to worried patients without upsetting them further. Or even if she's rude again, ask to speak to her line manager instead.

When my Mum had cancer last year she was admitted to a large hospital where some of the care was below par. The nurses would move her bedside phone and call button when they examined her and not put them back within her reach when they'd finished. This meant she was not always able to answer the phone when I called. My daily chats with her were very important as she was a 3 hour + drive away so I wasn't able to visit as often as we would've liked. She also developed bed sores there as they neglected to put her on the right sort of bed. The food was unappetising; she wasn't a fussy eater but she was nauseous and was having difficulty swallowiong too, so serving such an ill patient the sort of pap they did was counter productive IMO. However, she did like the staff bar one, and did realise they were very busy. Luckily she was moved to a wonderful little NHS cottage hospital, where the staff had the time to chat with patients, where she had the most lovely view of the countryside, and where she was served food she could get down her. If she missed the tea trolley or her drink got cold the nurses would make her a cuppa, and when I took her out for the day they made sure she still got her dinner. I am very greatful she died there and not in the big hospital.