To ask what YOU would do to help save the NHS?

[TamiTayorismyparentingguru]

I don’t care if you’re an HCP or not, I don’t care who you vote for, I don’t care what you think about Brexit - all opinions welcome.

Opinions on practical suggestions on how to save the NHS only though.

Our local hospital is getting worse and worse with regards to staff shortages and waiting lists getting longer and longer. I will say that our GP is really great and we’ve never really had a problem with getting appointments etc, but as soon as you are referred to the hospital things go massively downhill. (We did have a GP misdiagnose/miss DH’s cancer which was pretty shit - but I wouldn’t say that was a particular problem with the system - more just one of those unfortunate things that happens, that really shouldn’t happen, but that are just a matter of course.)

The hospital is a different story though - wait lists for some departments are insane (current wait time for an initial cataracts appointment is 42 weeks and then up to 18m for treatment, paediatric dermatology is a min of 30weeks, paediatric podiatry is approx 30weeks also. I have been on a wait list for max fax for 14mths so far. I also had an 8week wait for an appointment at the breast clinic after seeing the GP with a noticeable lump.)

DH has also had to fight for every single appointment since his cancer treatment last year - instead of the 4-weekly appointments he’s meant to have had, most of his appointments have been 7-8 weeks apart and have been cancelled at the last minute (sometimes just an hour before) at least 4 times in the last year.

It’s awful and yet I do trust that the doctors, nurses, receptionists etc etc are all doing everything they possibly can.

What’s the solution?

The individually wrapped biscuits we have now got these as normal biscuits are classed as unhygenic

Then stop giving biscuits

Don't need them

Our post-op patient's in theatre recovery most certainly do need the biscuits as there are no cooking or storage facilities for other food stuffs..

Shouldidoitspoilt. Who the f** opens a new cannula pack for a bung? Don't they have separately packed bungs at your place? 

Bluelady

By the way, who do you think does the tax return for a chip shop or a local electrician or plumber or window cleaner? Accountants do! Do you really think all these people are rich; accountants make them richer, and accountants are making mega bucks out of them? It's like saying every GP works at Queen Sq, doing world class neurosurgery!

Somebody doing that kind of work can barely dignify it as accountancy, anyone with a basic knowledge of book keeping can do that - and do. A GP's work is just as valuable as a neurosurgeon's, it's just different.

This thread stopped being about the NHS being cost effective a long time ago.

bluelady You say you have 30 years working in a hospital. Your posts highlight the problem facing the NHS. Being a medic doesn't make you some sort of magical creature. It's a job that is just as stressful as a lot of other careers. You are making decisions which affect others, typical of pretty much any job which enables entry into the upper middle class.

It's a job that is just as stressful as a lot of other careers. You are making decisions which affect others, typical of pretty much any job which enables entry into the upper middle class
I don't agree with this.

@Iused2BanOptimist Not in the trusts here where I live??
I am shocked to hear they have them separately packed.
After being really unwell for a few years and in hospital more then 50 times with IV access i honestly go nuts about this issue. It's actually fairly identifying because I always bang on about it

Also the lack of inter agency communication between the hospitals at home team and the consultants at hospital who twice doubled up on a very expensive anti biotic for IV admin at home.
I couldn't even give it back to the chemist it had to go in the bin.

More then £80 a dose.

Bring back the student nurse bursary. Pay them better. (This attracting high quality people to the job, and retaining them which improves quality and saves on extortionate agency costs).

I do not believe my family is in anyway unique or special. Given that, with the below tales of everything that has happened to my mother, I refuse to believe she is an isolated case. Therefore, if you multiply the amount of inefficiency, waste and general mis management as detailed below across the whole NHS community, I refuse to believe chucking any more money at it will solve the problem unless you fix the whole system.

6 years ago mum needed 2 new knees and 2 new hips due to arthritis. She was meant to have the process started in the mid 00s but dad was diagnosed with terminal cancer so it was put on hold. Since then, the following has taken place – I’m doing it in bullet points:

1. September 2012 – first new knee done and was told she’d have one operation every six months. Spent an extra week in hospital as the physios’s would not discharge her due to her going down stairs backwards – she’d done that for nearly 10 years and wasn’t about to change now.
2. District nurse took the stitches out too early – knee burst its stitches
3. Because she couldn’t have the required physio at the right time she was not referred back to her surgeon to go onto the list for the next one as in her trust, the physios were responsible for saying yes, ok to go ahead with the next one
4. Finally got back onto the list only to be told that because she had to have a general anaesthetic not an epidural due to fused spine, she could only have one operation a year.
5. August 2013 – sent for pre-op – operation cancelled
6. November 2013 – sent for pre-op – found a “heart murmur” – referred to cardiologist and operation cancelled
7. Jan 2014 – saw cardiologist – absolutely nothing wrong that needed treatment – wrote strongly worded note for her file – back on the list
8. Asked would she consider seeing a different surgeon – she said she didn’t care who did it. Consultations and appintments needed for new surgeon to learn her case.
9. July 2015 – sent for pre-op with new surgeon – pass for surgery – before she’d even got home, voice message left – operation cancelled. New surgeon didnt want to do surgery because of BMI as he wasn’t that experienced. Put back on original surgeons list.
10. September 2015 – called for pre-op – turned up – they had the wrong Jane Doe’s file. RE-assured her they would still do the op. Passed for surgery on the Thursday – 7pm on the Friday night before the surgery was being done on the Saturday – operation cancelled by telephone.
11. Asked would she see a different surgeon – she referred them to what had happened previously but they insisted she now go onto a different new surgeon. Queue another round of appointments and consultations for the new surgeon to learn her case.
12. November 2015 – pre-op – refused surgery because of high BMI even though she weighs exactly the same as when she had her op in 2012. Its because she’d shrunk 2 inches due to her discs collapsing in her spine and it reduced her height. Told she had to loose weight. Considering she has to eat with most of her tablets and she was taking 6 lots a day and could barely walk 20 yards it was a tall order. Referred to a nutritionist.
13. September 2016 – knee that had been replaced in 2012 was now falling apart as being the only working joint for four years it had taken a lots of strain.
14. December 2016 - reached acceptable weight. Back on list.
15. January 2017 – called for pre-op. Found heart murmer again. Note written by cardiologist was “lost” so referred back. This time he put her on tablets because although her condition was exactly the same as in 2013, guidelines had changed and the risk was regarded as too high now for “elective” surgery. By this point it can be argued her surgery was not elective and bloody necessary.
16. July 2017 – called for pre-op – irons levels were low. Hospital insisted there was “something untoward going on” (read convinced she had advanced cancer) due to her weightloss and cancelled op. Refused to believe her when she said she had no bleeding, symptoms or anything. CT and MRI’s every inch of her. Found nothing. Turned out it was a reaction between a pain killer and a the hear medication causing her to be anaemic. Meds changed.
17. December 2017 – called for pre-op. Decided right hip needed doing as a matter of urgency. Had right hip replaced. Surgeon was gobsmacked at how bad her hip was – she had no hip left at all. Spent Christmas in hospital. Reported that at least two people on her ward were ok to go home, the doctors and physios were telling her they were ok to go home, but patient was refusing until they got a care package “they were entitled to” despite they didn’t need it.
18. Jan 2018 – signed forms for left hip to be done.
19. June 2018 – had pre-op and op on left hip. Looking good at this point. Left hip was almost non existant as well. However, this is two major ops in six months so goes against what she was told in 2012/13 about can only do one a year.
20. June 2018 – unexpected bleeding from wound – five times she went back to the ward to get the dressing looked at and five times she was dismissed.
21. July 2018 – Wound burst open – house looked like a scene from Dexter. Turns out massive infection. Had second hip replacement on left hip.
22. Summer 2018 – spent 8 weeks in hospital. Stay was extended by her surgeon going on holiday for three weeks and no one taking responsibility for discharging her until her came back. When he cleared her medically, phyio’s assessed what she could do and were gobsmacked that she could do 99% of things herself. Ready for discharge – physios were adamant she needed a care package put in place (despite there being nothing she could do) and council wouldn’t put one in. Tried to insist my mum refuse to be discharged until a package was in place. Mother didn’t want or need a package. Refused to sign anything off for her release so she signed herself out with the support of her surgeon. That was a bed they were trying to block for a week with a patient who didn’t need or want to be there just so they could cover their backsides and tick a box.
23. The extended stay in hospital whilst being well did however allow my mum and us to make numerous observations about how the whole set up (at least in her ward) was grossly inefficient. Things like: i. They ask the patient to being in all their medication with them – then proceed to throw them away, give them different ones and issue them with a whole new set on discharge which in my mums case were exactly the same as the ones she’d brought in. Apparently it is in case the instructions change they can’t risk her “getting confused”. ii. Eventually sending a whole load of mobility aids out to her house that she didn’t need or want because they thing she needs them. E.g. a zimmer frame when she already has a trolley that does the same thing! And now refuse to take them back because they’ve been in a house were there was an infectious patient and there might be cross contamination.

In the middle of all this, she has received:

a. 53 letters relating to her operations and appointments
a. 10 arrived after the appointment date
b. 5 of them arrived at the same time as a letter cancelling the same apoointment
c. 11 times she was asked to go for an appointment in one clinic at the same day and time as another appointment at another clinic.

Sorry for the lack of paragraphs - there were when I wrote it in word!

Bluelady

Some of you need a reality check.

If you don't know the difference between book-keeping and tax, then stop spouting off, when you don't even know the basics of what you are talking about!

I have pointed out how I know exactly what the stress of making life or death decisions is - and I had to do it 24/7, about my own child not some random stranger, I might never see again!

My family have been doctors since time immemorial, and none of them showed the arrogance and God complex you do - that is precisely why so many people are sick of health care professionals!

As for what GPs do, being important - its a pity some of them don't take it more seriously then:

1. DH's aunt - two years, complaining of stomach pains. GP told her it was the menopause. Actually cancer of the stomach killed her.
2. DH's father - complaining best part of a year of pain on micturition. GP gave him anti-biotics for UTIs, without apparently bothering to do MSUs. Actually, cancer of the bladder. Dead!
3. DD2 - five years, complaining of painful periods, pain on sex, pain on ovulation, chronic tiredness...20 odd GPs told her all women have painful periods, and all the rest was down to anxiety! I had to go with her, and insist on a referral to a gynaecologist. Consultant gynaecologist said at 1st appointment - all the classic symptoms of pelvic endometriosis, and it was! Five years of rolling around on the floor with pain, vomiting every time she moved during a period.
4. DD2 also complained of loss of appetite, nausea, vomiting and abdominal pain. She used to have to run out of work to be sick in the high street, in the middle of serving a customer. Numerous GPs at our practice and student health told her it was anxiety. Her boyfriend, a doctor had to go with her and insist on a referral to gastro-enterology. Consultant gastro-enterologist told her, her transverse colon looked like the corkscrew rollercoaster at Alton Towers, and he could see the right faecal loading, due to adhesions, caused by the endometriosis. Symptoms would be loss of appetite, nausea, vomiting, wind, constipation and pain.
5. DH told the GP for 2 years he fainted if he had to stand up on trains. She said it was stress. We think the stenosis of 90% in his LAD, and 60% in two other coronary arteries was more likely to blame! Only diagnosed when eventually he went and said he felt like he was dying, because of his breathlessness!
6. Two weeks ago, I asked DD1's GP for the pneumococcal vaccine for her. The GP refused on the basis, she had it when she was 8 weeks old. I told her twice DD had not had it. The GP insisted she had. If DD gets flu, and then pneumonia and dies in status epilepticus (which a high temperature will cause), because she has not had the flu jab either yet, we will hold her negligent. I went home and checked on Google. Sure enough the pneumoccocal vaccination was only approved for use in the UK on babies, when DD1 was 12 - so she can't have had it at 8 weeks, can she?
7. Best friend - went for 6 months, complaining of pain in her thigh, and was told it was a side effect of the Mirena coil. I told her to get a MRI scan to find out why she was in so much pain in her back too. Actually, it was stage 4 non-Hodgkins lymphoma eating her bones to the point, they said if she got out of bed, her femur would snap; she also had a broken vertebra in her neck and another lower down! She's dead, leaving two young children!
8. I asked my GP for a prescription for DD1, as per her care plan laid down by her Professor of Neurology - she told me the CCG had banned them from prescribing it, when actually it was on the CCG's own website that it was the recommended product of choice in the county, as it also was on the websites of the other CCG and the mental health trust! The community epilepsy nurse told me they had already written to every practice in the county, telling them to prescribe this drug to patients; but she would write to them again!

(DH's client, a senior consultant oncologist told him all his patients died, because GPs sent them to him, too late!)

Is lying to patients part of medical ethics? Isn't all this called healthcare gaslighting?

I have had this in my family, too - big time.

But, to be fair to GPs, they probably have 20 people a day in their surgery complaining of "pain". 19 out of 20 will be exaggerating, or have nothing really wrong at at all. This of course impacts most seriously on those who genuinely have an illness. If the GP sends everyone who comes in through the door for a scan/further investigations etc, then waiting times will be a hundred thousand times worse than they are already.

I read an interesting article on pain research, and pain is almost impossible to qualify or quantify, because it is often about perception. Someone whose leg is hanging off may complain less than someone with a splinter, and in fact actually not feel the pain as much (obviously bit of an exaggeration there).

I guess it would help if for serious conditions there could be a quick "insta-scan" to fast track those who were really ill.

For example, mil went to the GP every single week for one thing or another. In fact she used to say, "Oh, Dr Green will be wondering how I am!" (Yeah, right.)

Anyway, she was admitted to a care home with dementia, and had a full medical. She had absolutely nothing wrong with her. All her medication for numerous ailments was completely unnecessary. I removed approximately 20 carrier bags of medicines from her house, all unopened.

Loving the assumption that everyone who works in a hospital is a medic. Not in my case, never assume.

www.theguardian.com/politics/2018/oct/23/brexit-patients-may-need-own-drug-stockpiles-pharma-execs-tell-commons-committee

blue Never assumed you were a medic. You said you work in a hospital and you are defending doctors as if they are untouchable. They aren't. If that is how managers and admin see doctors then that is a problem.

Who said that? Not me.

I have said they do an incredibly demanding job which carries greater responsibility than any other. They do years of rigorous training, endure long hours and huge stress as juniors and are constantly open to criticism and the threat of litigation. There's absolutely no problem in recognising that.

Yes and plenty of us are saying other professions carry as much responsibility as doctors.

And you can keep on saying it, it still won't be true.

Exactly. Your attitude stinks IMO. Others here are being very clear giving examples and you just don't want to hear it. That's the problem with the NHS, the people working for the entity think they are somehow different to everyone else. They aren't.

Bluelady we've agreed and disagreed on various matters. I have to agree with others here blind faith in medics is not helpful to anybody and not to the nhs as a whole.

Medics are no better or worse, no less likely to make mistakes than anyone else.

Luangwa how old is your DD1?

PCV7 was introduced routinely for babies in 2006 but was given to children at risk from 2002.

PCV13 was introduced in 2010.