AIBU to to really disheartened at how it seem most view the NHS

[Loubielouslonglegs]

I'm a medical secretary to a breast/plastic surgery consult in the NHS. I've seen the decline of services in the last few years and absolutely disagree with it, yet understand budget.

I've been on a thread where a poster's parent could drive herself to hospital and was kicking up a stink because she wasn't 'taxied home'.

My consultant came back from clinic shocked that one of his patients started throwing chairs and hurling abuse because he wouldn't perfom surgery unless she'd seen a psychologist.

The only time I ever get any feedback is complaints - I've been offered a post in the private sector almost 2x my 23,000 nhs wage . Now finally thinking I should put myself first x

Save yourself the time Helena - If I were you and my elderly husband had received so much from the NHS I absolutely would be putting threads up praising them, praising the 'nice' nurses, praising the sympathetic doctor etc

All I ever see from you is negativity - If it's really so bad why not go private? Surely your husband's health is top priority?

That's fine Helena - I wish you well - But I will call you out when you're hypocritical. Fund your healthcare if the NHS is so lacking.

Goodnight.

HelenaDove Wed 17-Oct-18 22:31:13

Where i can praise the NHS enough is when DH had his heart attack Emergency care is exemplary

They were brill with DH at the hospital. Ive never complained about his care there so i dont know why you think i have.

I did post about how i was left in excrutiating pain for nearly a year after taking personal responsibility and losing ten stone.

Pain that was so bad i considered suicide.

And the benefits attitude will not go down particularly well with the carers that are on £64 a week (im talking about the MNers who are on it) the carers who help to keep their relatives out of hospital. Because you would soon notice if they stopped.

sorry i dont see where ive been hypocritical.

DH was attending a rehabilitation course to help his heart in the winter of 2006. He couldnt finish it because we could no longer afford to attend. WHY? because i had been put on a "work placement" (i had to sign on back then) if i didnt attend i would be sanctioned. How would no money or food have helped DHs health. I also needed to pay the fares UPFRONT so we had no choice but to take the money we were using to go to the hospital and use it so i could attend the work placement instead..

You brought up a correlation between health and benefits so i posted about this experience.

And from page 5 of THIS very thread.................

HelenaDove Wed 31-Oct-18 21:32:10

And yet the emergency care DH got after his heart attack was second to none. Everyone was fantastic the paramedics the doctors the nurses the consultants.

LoubieLou . If one list orovides for 6 cancer oatients and 14 need to be seen, a better system would have 2.4 lists not 1. Similarly, Mrs Smith's results belong to Mrs Smith not the consultant and she shouldn't have to cry for them whilst you seek the consultant's permission to disclose. They should have been sent already ir at the least a waiver signed at consent to the procedure so there is no protracted nonsense about their release. Do you really not see that?

Good luck with your new job. I hope it works out for you. The orivate sector is all about customer service and being better than the competitors.

You were very rude to honeyroar at the beginning of this thread when you totally misinterpreted her thread and have more recently been very rude to HelenaDove dragging up previous posting history and criticising her lifestyle.

Final thought Loubie it's 6 11 I'll be out if the house in less than 20 mins and back at about 8.45pm. This private sectors pays well but by golly if 14 clients need something you jolly well make sure they get it even if it means workng harder to make sure they do.

Roses, us admin people are very firmly told not to give out results. No matter how much a patient may beg for them it is simply not allowed. We aren't clinical, many secretaries and receptionists won't understand the meaning of them, won't have the context and could end up giving a completely wrong impression which would do a lot more harm than good.

Likewise as someone who has had to help manage clinics with far to many active patients for the time slots available, we can't change this, the Drs have to put a case to management, money has to be found for the staff hours, space has to be found for the extra appointments to take place, many hospitals are also short on space.

Me and dh was coming out of our hospital a couple of years ago. We went out the main gates (A&E is about a minutes walk from the gate) and elderly lady fell over right outside the gate. I stayed with the lady while DH ran in to get someone to come out to her they told him to call an ambulance as it wasn't on hospital grounds. She was literally laying right outside the gate. We called an ambulance like we were told and waited 30 mins for them to come to her. She was 83 years old and in agony would have taken 1 minute for someone to come out to her to make sure she was ok and get her inside. It was near Xmas too so very cold. DH went in twice more to try and get a jrse out and was told to wait for the ambulance

The reason for box ticking and bureaucracy is two fold.

Firstly to make people’s care safer and more pleasant. As an example, the WHO Safer Surgery Checklist (very much a routine, box ticking exercise) used correctly reduces the risk of Never Events such as wrong side surgery or the incorrect implant. Counting swabs, likewise.

The second reason is to be able to reduce funding on medical negligence. In 2017 the NHS in England paid 1.7 billion pounds on negligence claims - often not negligence and often settled early to reduce costs. The costs associated with addressing these and unsuccessful claims rockets to over 5 billion pounds. Good records are the only way to defend a legal challenge. It is the ambulance chaser, no win no fee legal, firms who have, in part, driven the extreme bureaucracy. The vast majority of claims are unsuccessful.

Non clinical staff cannot share medical records. Information should not be passed on by telephone unless ward staff or GPs know who they are talking to. The reason consultants usually give out results face to face is to enable assessment of how the patient will cope, their understanding and to answer questions. It wouldn’t be acceptable to many for a secretary to ring and say “ Hi Mrs Pavlova, Yes definitely cancer, have a good day”, would it? If you develop a reasonable, trusting, relationship with your GP and medical team you can often ask them to ring or email them to sort out issues that can’t really wait.

No us blaming administrators or receptionists who are simply trying their best to juggle large numbers.

OhTheRoses - where are the additional who are the additional 2.4 consultant oncologists? Where are they coming from?

It’s most UK hospitals people with cancers are on very clear pathways with set frequency of appointments and tight timelines. Most are referred under 2 week wait rule to initial appointment. Most are seen within this time (currently sitting around 92% nationally).

The clinics are full of people without cancers because GPs over refer based on the referral guidelines. This is to avoid missing people. From a single one stop clinic of eight people, it might be only one with cancer.

Rare cancers are different because they are so rare and inevitably aren’t at the forefront of everyone’s mind. They do tend to present later because they have vague symptoms and mimic less serious conditions. Nobody’s fault - it’s like more people recognising French words than Flemish.

Cancer services in the independent sector are not well developed and outcomes are worse overall with out of hours and emergency care reliant on the NHS. Support services are generally not available within independent sector and level of nursing expertise is lower. They do usually follow NHS network clinical pathways though and offer same treatment plans.

The NHS is struggling dueto the fact we all think we should have 24 hours access to a GP, admin should have a crystal ball to know we have moved, and we neglect our bodies and health and expect the NHS to fix it.

Crap. I work in patient advocacy, have a disabled child and am disabled myself.

Most people have incredibly low expectations of the NHS, and the service frequently lives down to them.

As for neglecting health, a far bigger issue is GPs having their hands tied behind their back, not being able to refer in a timely fashion, which costs the NHS far more in the long run.

Took a decade to diagnose my endometriosis so I’ve needed six surgeries, years of treatment and now need a hysterectomy. I have been telling GPs for years that there’s something wrong with my hormone levels which has been utterly ignored, but after private testing I’ve discovered I was right and now it seems my constant chronic pain might be due to bone density loss (which should have been monitored, but never has been). My mums cancer could have been cured if detected earlier, when she was first complaining of symptoms - she’s now dead. Guidelines for the type of cancer she had actually say not to refer unless patient has symptoms x,y and z - those symptoms mean that if they do have cancer, it’s inoperable and most likely y

You have no idea how much time I have to spend liaising between consultants for my son, chasing up missing appointments, or just trying to get the truth. We saw a consultant after my son had an MRI and were told it was normal which was a huge relief - we were seeing another consultant the next day who actually showed me the report and pointed out they’d found my son had brain damage.

I am incredibly grateful that the NHS exists but that doesn’t mean we should accept poor care.

So e specialties work better privately than others but cancer tends to need a whole team which as Cherry says isnt always possible in the private sector.

Interestingly the admin side of things can be worse in the private sector, I'm guessing the lower number of patients means you can be more slapdash. Our hearts always sink when we get a new referral from the private sector as chasing the information needed like results and scan images can be a nightmare.

“Our hearts always sink when we get a new referral from the private sector as chasing the information needed like results and scan images can be a nightmare”.

This isn’t a private problem in itself though, it’s more that your system isn’t really set up for concomitant private work and isn’t encouraging of it.

No it's that with an NHS referral you just need to phone the secretary, confirm the patient details, give a contact and fax number or email address and request what additional information is needed. If the specific secretary is off it's not too hard to find a colleague who can access the relevant information. Either way it's usually printed and sent over quickly. A lot of the time they send over all the results with the referral anyway.

With private if the secretary is part time there is often no alternative contact. They often don't seem to have access to results and will refer to some other company which is virtually impossible to get hold of.

I'm guessing the customer service side is good otherwise they wouldn't attract customers but when it comes to liaising with them from our side it's hard work.

“With private if the secretary is part time there is often no alternative contact. They often don't seem to have access to results and will refer to some other company which is virtually impossible to get hold of. “

But that’s because in the U.K. there’s not the same set up as in Australia. Here there’re loads of private clinics and private hospitals but a fairly free flow between public and public. It’s not unusual for people to pay to see a specialist in public for outpatients (so they see the same person) but have arranged admissions for the same problem in public. This is not discouraged and communication is fairly free between the two settings. The private labs are prompt and very good and forwarding any older results if necessary. Most radiology is reported and sent back with 24 hours and again, easily accessed from other locations. The labs have dedicated help lines to get assistance with accessing results.

I’m just pointing out that just because the public/private communication is done poorly in the U.K. doesn’t mean it’s not streamlined elsewhere.

*obviously the flow is between public and private.

Australia does have a “free” (Medicare) public hospital system though, it’s nothing like the US. But the private system does take the strain off the public one.

I've been reading this thread with interest. I and my family have been very lucky in that, so far, any help which we have needed from the NHS has been problem free. The service have had relation to DS2's severe allergies has been excellent.

However, I was interested to read the comments further up the thread about some bias against patients who appear to be middle-class. The only encounter I've had with the NHS which left me scratching my head was, I think, caused by this.

DS2 used to suffer from recurrent eczema. When it began to flare up, it was quite easy to get it back in line by using 1% hydrocortisone cream; however, if it was not caught early, it would deteriorate quickly and become infected.

On one of these occasions, when we were running out of the cream, the pharmacist told me that I was not allowed to buy it over-the-counter, because DS to was too young (I think he was under 10 at the time). She said I needed to go to the GP and get a prescription, as she would be breaking the law by selling it to me.

I duly made an appointment and saw a young female GP who we had not seen before. I explained, somewhat apologetically, that I would not have bothered her except that the pharmacist said that I could get the cream only on prescription for a child of that age. The GP did not deny that this was the case, but was clearly not prepared to write a prescription. She asked me how much of the cream I had left and I explained that we had a quarter of a small tube, which would have lasted no more than two days (DS's eczema was quite extensive). She simply kept repeating "well, use that then".

Whilst I was not in the least combative, we had clearly reached a stalemate. I I did say to her, "So think what you are saying to me is that you are not prepared to prescribe it, and I'm not allowed to buy it, so does that mean that my only option is to go to another pharmacist and lie and say that the cream is not for my son?" She shrugged. I was so shocked that I did not say anything although I wish I had now.

When I relayed this tale to DH, on returning home, he said, "Well, look at you". I had gone to the doctor's straight from work. I am a lawyer and had been presenting to clients that day and so was fully suited, with a smart coat and bag. DS was wearing his very obviously private school uniform. I am not forcibly "posh", but I do not have a local accent and I did look very "shiny" on that day. It would appear that I was being judged for that.

There isn't much interaction between public and private in the UK. I get the impression private is good for being seen quicker and works better for single issue stuff. A common tactic is to get an initial consultation or operation done private then get transferred to the NHS clinic for follow up once the necessary treatment has been initiated.

The difficulty is with patients who need a multidisciplinary approach and input from different specialists especially when it's only available in the NHS. I'm guessing that many private secretaries simply don't have much experience of referring and liaising with other teams whereas the NHS departments do it all the time.

Often private patients bring their own CD copies of scans for us to upload and keep their own medical records which they can bring to appointments because they know this is a problem.

Morbidly, I too was carrying a Mulberry bag and I had on a certain notoriously e pensive brand of mac! DSs reckon I look and sound like a newsreader!

Note to self: don't look too polished when trying to access essential services.

If acute and life-threatening public in Australia is best. But the private system can and does cater for complicated chronic illnesses.

There are loads of private therapists (OT, physio, clinical psychologists, educational psychologists, speech) and ways to access them more cheaply but most of the time people still pay a gap. With a psychologist under a particular referral type people pay about 60 dollars per session, with the other 170 paid by the government. This obviously doesn’t fit some people’s budget and therapists can be accessed in public, but there’s a wait. Where I live they’re about 100 private paeds speech pathologists, for example.

Sorry, that’s the other 120 paid for by the government for psychology referrals. I need to proof read!

I should add that there is access to fully government funded private psychologists for children under 12 if the family is of lower income. And for adults with selected issues.