Please or to access all these features

Add post

Watch this thread

Save thread

Start a new thread

Flip thread

Hide thread

My feed

Active Unanswered threads

Getting started FAQ's

Unanswered threads Acronyms Talk guidelines

Hide shortcut buttons

Talk

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Flip

1 2 3

Original poster

To think the fracture clinic should be staffed all the time

52 replies

Queeltie · 31/08/2015 20:01

I have spent the afternoon in A&E with my sister. She has had a temporary plaster put on her broken leg. But she has to go back tomorrow to see an orthopaedic consultant as the fracture clinic was closed.
There were lots of people in A&E being sent to the fracture clinic. It seems a waste of money and time to have nurses giving temporary treatment, and then the next day the consultant having to see them and give them treatment.

OP posts:

Original poster

Queeltie · 31/08/2015 20:48

Yes I understand some jobs mean working anti social hours. Like my DP who does evening appointments for people who work. So I do get it.
I simply expressed surprise that evening appointments at the fracture clinic were not more popular.

OP posts:

lougle · 31/08/2015 20:53

I think you need to be able to see the bigger picture. It's not just the consultant in the clinic, it's the consultant that has to cover the clinic consultant's work. Plus the radiologists, care assistants, nurses. The extra beds, operating staff. The admin staff. The clinical coders.

At my local hospital they have an entire theatre dedicated to orthopaedic surgery and they open a theatre every afternoon for emergencies (such as bone fractures).

Fluffy24 · 31/08/2015 21:02

I wish those initiated among us wouldn't assume that when someone says they think their GP should open for longer or a clinic be open that the poster is suggesting that an individual GP or consultant is supposed to work 24/7. As one of the uninitiated I genuinely don't understand why some hospital staff and services operate 24/7 on a shift system but this is apparently an appalling idea for other parts of the service.

Smutlins · 31/08/2015 21:10

Where would the money for this come from Fluffy? You wouldn't just need extra consultants, you would also need extra theatres and associated staff, extra doctors, nurses, health care assistants, extra receptionists, extra staff working in the records department to deal with patients files, extra people working in clinical coding, extra cleaners, extra security, extra secretaries for the increase in administration work, extra resources such as electricity and heating. The cost would run into millions of pounds.

And, in this particular situation, it would be pointless anyway as nothing further can be done with the injury until a proper amount of time has passed.

The departments that need to be 24/7 are already 24/7.

Sidge · 31/08/2015 21:12

Very generally speaking, if you need to be in fracture clinic you're unlikely to be at work...

BumWad · 31/08/2015 21:14

Can you tell us what the fracture is?

parallax80 · 31/08/2015 21:18

I don't think it's an appalling idea as such, but I think you have to be a bit practical. For some departments the need for a service 24/7 would outweigh the cost of staffing and running it. A lot of imaging relies on there being a specialist to either acquire or interpret the images - if you had one of all of these specialists routinely available 24/7 the cost would be astronomical, when each type of imaging might only get used once every few hours or less. Or another example is elective surgery - say you had a surgical / anaesthetic team who were able to do bunion surgery. It would be far more costly to do 2 operations on Saturday morning and 2 on Sunday morning than to do 4 (or probably 5 or 6) in one session on a Saturday.

Health services need to be more creative with how they use resources to meet demand, but equally, as users we have to be realistic about what we demand.

DoctorDonnaNoble · 31/08/2015 21:21

Most importantly, it's normal to have a back slab put on to start with to allow the injury to settle. I broke my 5th metatarsal in my left foot last September. I was in temporary plaster for 5 days before being seen at the fracture clinic.

WorldsBiggestGrotbag · 31/08/2015 21:23

My 19 month old fractured her leg on a Friday afternoon (tiny toddler fracture), was put in a temp cast on Friday evening in a&e and then seen in the fracture clinic the following Tuesday and had a proper cast put on. It didn't really occur to me to be annoyed by it.

NobodyLivesHere · 31/08/2015 21:25

we took my son home for the night with his finger hanging off. they temporarily strapped it and we went back the following day for surgery. its often the way.

WandaFuca · 31/08/2015 22:05

I think that one of the problems is that the term "fracture" is a bit of a catch-all term. Not everyone realises that there are different types, and therefore different approaches to treatment.

sashh · 31/08/2015 22:12

I simply expressed surprise that evening appointments at the fracture clinic were not more popular.

Appointments on sunny days are not popular.

People have all sorts of reasons for not attending, one of my favorites was, "well any fool can see it's my birthday the day after, who gose to hospital the day before their birthday?"

*As one of the uninitiated I genuinely don't understand why some hospital staff and services operate 24/7 on a shift system but this is apparently an appalling idea for other parts of the service.8

Some departments are tiny in respect to numbers of staff. I worked in a district general in cardiology (cont to be confused with CCU) we had 4 full time and 3 part time staff. There was no cath lab at that hospital at that time so no real need for on call or out of hours. The only test done out of hours would be an ECG.

To have someone there 24/7 would have seriously cut down on services offered during the week because people do need time off

When you get in to needing on call staff you sometimes have restrictions on things like how near the hospital you have to live, it is common to be asked to live within 30mins. That means moving job necessitates moving house. At that particular hospital only the manager and one cardiographer lived within that distance.

I'm sure it is the same in any 24 hour business. If I shop at 5am often there is only the self serve checkout open, petrol stations may open 24 hours but with fewer staff, police stations are staffed differently at night, fire fighters get to sleep at work at night.

I'm fairly sure the people who pay wages or do the accounts at supermarkets, police stations etc don't work nights.

m1nniedriver · 31/08/2015 22:34

We don't know how lucky we are in this country! It's very easy to start taking things for granted, this will be the downfall of the NHS

We should be standing together to save it, instead we focus on the negatives. I work for the NHS and have recently needed it oersonally. I see its flaws but for every terrible story we hear there are thousands of good ones. The NHS is being squeezed to the limit, we need to realise that and focus our anger on the real culprits not the staff. Unfortunately it's easier to blame the selfish uncaring nurse or the lazy doctors. It is unconvienient having to go home to come back the next day. It is less convenient to decide whether you can afford to pay for plaster or painkillers, that's where it's heading.

Original poster

Queeltie · 31/08/2015 22:56

I highly value the NHS. This just seemed a waste of resources to me. But I didn't understand how fractures were dealt with.
Although of course you can go to some jobs and go to a fracture clinic on the same day. Plenty of people work with broken limbs, although it obviously depends on your job.

OP posts:

hibbleddible · 31/08/2015 22:59

Where do you propose all the extra funds come from to staff the fracture clinic 24/7?

TheFairyCaravan · 31/08/2015 23:08

There aren't enough consultants, doctors, nurses, radiographers, physios, plasterers etc to keep fracture clinics open all the time. Not only that the consultants have other clinics, theatre lists, ward rounds etc to do. And they need to go home...

BeaufortBelle · 31/08/2015 23:11

I think perhaps the OP wouldn't have had to pose the question if the communication in A&E had been clearer about the following up appointment and why the back slab was necessary. It's good the appointment was only a day or two later - I've had to wait much longer in similar circumstances.

In response to the point about people with fractures not being at work so not need appointments out of hours - might I just venture that I broke my foot quite recently. I did it on a Monday night - went to A&E the following morning, was given a boot and crutches and went straight to work afterwards. I had a follow up appointment five days later. The nurse in A&E was exceedingly helpful; the consultant at the fracture clinic was exceedingly helpful. The organisation of the clinic and the attitude of the support staff and their lack of respect for people and their dignity was mind blowing.

Fluffy24 · 01/09/2015 04:18

Considering the NHS is funded by taxes, I.e. mostly from the everyday people who go out to work in the morning and pay tax and NI, surely it's in the long term interest of the NHS to try to keep us at work, earning and paying our taxes, as much as possible - particularly as we start to live increasingly longer.

Mistigri · 01/09/2015 05:30

Even in properly funded health services, it's normal for a fracture to be reassessed a couple of days (or longer) after the injury and the cast replaced. Some other things in this thread are worrying though, like a four hour wait for an ambulance for a child with a seriously broken limb.

DoctorDonnaNoble · 01/09/2015 06:31

The people with fractures not being at work is a total red herring. I had one day off with mine. The cover supervisor was very grateful that I came in as otherwise she'd have been covering my classes for 6 weeks!

Groovee · 01/09/2015 06:45

The fracture clinic at our local hospital is the out of hours clinic come 6pm. So the actual wards and rooms are used 24/7 but for different services.

Youarentkiddingme · 01/09/2015 07:03

When my dad had an X-ray he was told he would be called with an appointment time as the x Rays were emailed somewhere (Australia iirc) so be looked at and then they give a diagnosis and the hospital decide what treatment to give.

Turns out no fracture but he had torn a ligament in his hand in 2. He was told he needed an operation.

My dad didn't complain and in fact asked for Op under local as he felt it was a waste or staff resources to aneasatise him when he was happy to be awake.

ginmakesitallok · 01/09/2015 07:38

When my dd broke her elbow, she was put in a temporary cast and sent home that evening. Then we got a call at about 10 to take her back so she could be observed overnight and had an op in the morning. So, apart from the whole being let home then called back, if it is a serious break there are on call consultants who will review films etc out of hours if needed. It's just that most fractures don't need that sort of service.

AnUtterIdiot · 01/09/2015 07:48

This reply has been deleted

Message withdrawn at poster's request.

easterlywinds · 01/09/2015 07:55

In agreement with gin, when dd broke her elbow she had an emergency operation performed by the consultant as soon as there was a free trauma theatre and she had been starved. She was in theatre between 7.30 and 9pm and then had 20 minute observations for the next few hours. The consultant came up to the ward to check she was ok and let us know the extent of the injury. The 24 hour care is there when needed! The only thing I can fault with her care is the fact that I hadn't eaten and all the nearby coffee shops were closed. She still had a temporary cast put on but was given a proper cast before she was allowed home.

Flip

1 2 3