To think the NHS is beyond repair?

[NHSisfallingapart]

DS has been unwell with chickenpox. A couple of the blisters looked like they might be infected. It’s a Sunday and the GP is closed, when I rand their after hours line it just goes dead. I rang 111 for advice at noon and have been waiting for a return pcall ever since. Someone rang me a few hours ago to ask whether I stil want to speak with someone. They could not provide an estimate of when I will receive a return call and told me it’s a 24 hour service and I may be called at any hour.

AIBU to think the standard of care provided by the NHS is inadequate? I suspect DS needs antibiotics and I can’t do anything about it.

You could have googled the nearest out of hours pharmacy and gone there. Somethings these things respond better to topical antibiotic cream you can buy over the counter.

What do you means by funding being badly managed? Any examples? (And not T&T which wasn't procured by the NHS). Sure there's some, but they have to adhere to PCR 2015 just like all other public sector spending- so what examples?

Yes. A mix of underfunding and an aging u healthy population. I know people who have gone to a&e for a black finger nail when it was shut in a door! Stuff like that needs no more than a GP or pharmacy visit.

This.
And I can only assume that 111 have assessed your situation as not being urgent which is why they haven't called back.

But people will be calling 111 on a Sunday because they've got a baby with a sky high temperature, a painful ear infection that is not responding to painkillers and in excruciating pain or if their asthma is playing up and they're struggling to breathe. These are the people they are dealing with and that's why you were waiting so long.

A slightly more red chicken pox spot does not need seen on a Sunday. It's not a weekend GP service.

A slightly more red chicken pox spot does not need seen on a Sunday. It's not a weekend GP service.

It doesn’t need to be seen at all. It needs extra calamine lotion.

The waste and inefficiency is the problem, not lack of money (although more money is also needed).

My son has finally got an appointment for a scan of a growth on his neck. He first consulted his GP about it a year ago. GP "referred" him for a scan but said it may be a long wait! After six months, he contacted surgery to chase it up, only to be told that the referral had been rejected, but the receptionist didn't know why. A few days later, a GP rang back to say it had been rejected because the GP hadn't done a blood test and for him to book a blood test! (how long would the GP have left it before they bothered telling DS!). Once blood test done, referred again, another 6 months, still nothing heard, so DS phoned GP surgery again, only to be told it had been rejected again (apparently not even sent to scan dept, both times were "rejected" within the GP surgery by a more senior GP! A few weeks ago, he went for his annual dental check up and the dentist mentioned the growth - DS told her he'd been trying to get it checked out via the GP, but without success - dentist said she'd refer him herself to the maxillofacial dept, he got an appointment quickly and now he's got a scan appointment next month. So finally getting somewhere by going via a different route, not via the GP! The GPs do seem to be the problem by just "fobbing" off which causes more GP appointments needed in the long run!

But the problem is that you can't get a GP visit and a lot of the time, pharmacists aren't helpful either and they just refer you to the GP!

In 2019 WHO judged the NHS the most efficient healthcare system in the world. The Conservatives then decided they would make the NHS more efficient and would cut "pen pushers". So they decimated the NHS admin staff which has caused it to be inefficient. Appointments do not get sent out in time, paperwork does not happen when it should, results of tests are delayed.
Its as if the government thought the admin staff were sitting around doing nothing, instead of being crucial to the NHS.

My DH has cancer and will be on a package of Chemo tablets until they stop controlling it which could (hopefully) be several more years, he's already been on them over 3 years! He has, literally, thousands of pounds of tablets that he's not taken because he has no control over the prescriptions issued by his oncologist. The oncologist knows he doesn't take all the meds prescribed (literally a carrier bag full every 4 weeks), but won't change the prescription because it's a "package" and he glibly says "it's funded so doesn't come out of my budget!". He gets 3 of one particular chemo tablet that costs over £1k per tablet, but only takes 2 per month (can't tolerate all 3 and it's working anyway). Same with another cancer drug where he gets 21 (3 weeks out of 4 week cycle), but only takes 1 every other day (so 10 or 11 per cycle), and those are around £300 per tablet. Oncologist knows all this as he's the one who suggested cutting down to reduce side effects etc. There's also other drugs he never takes which are a lot cheaper, i.e. anti sickness, anti diarrhoea etc. Oncologist says that if he reduces the numbers prescribed, he may not get "authorisation" to increase them again if needed hence why he wants to keep to the standard "package" which he has authorisation for. But OH had probably £20k of tablets in his cupboard and it's getting fuller!

I'm sure all that is more the fault of "the system" rather than individual doctors or managers, but it's still waste! That kind of thing shouldn't happen, but, ironically, it's probably because of trying to be efficient that it does happen, i.e. oncologists having to get "committee" approval for expensive treatments is fair enough, but not when it has adverse side effects such as oncologists not wanting to change things when they have specific approval for a specific course of treatment!

Sorry should say 2010 not 2019.

@Kazzyhoward That sounds like the oncologist is at fault. I have found Drs and consultants quick to remove medication from prescriptions. But your DH does not need to get the medication. He can give the pharmacist the prescription and say what he needs and not to give him anything else. My DP did this when a repeat prescription had an old medicine wrongly on it that he no longer used.

Do you think he hasn't tried handing the meds back to the pharmacist? That was the first thing he tried before asking the oncologist to stop issuing the ones he doesn't use. The pharmacists (he's tried several times) insists that because it's a package containing restricted chemo tablets), he has to "hand over" the complete sealed bag, and if OH opens it and hands anything back, then it'll be destroyed as it's been "officially handed over" and they can't reuse anything handed back! Rather than having it destroyed in the pharmacy, OH thinks it's better to keep it just in case he needs to take it in future if the "approval" gets stopped in the future (he'd only do that if the oncologist agrees of course!).

@Kazzyhoward That is strange. Sounds like it is to do with how the drugs are packaged by companies. Maybe the NHS does not have a choice then?

Anyway, he doesn't "give" the pharmacist the prescription. He has no control. The oncology dept send the prescription to the hospital pharmacy (he's not allowed to pick it up anywhere else due to the controlled chemo drugs), and the pharmacy pick/pack it. All OH does is go in to collect it from the hospital pharmacy (or sometimes, it's handed over by the oncology nurse if he has to go to the oncology dept for blood tests, BP checks etc that month). It's not a case like a GP where you tick to ask for the meds you need and pick up from your local pharmacy!

It didn't need urgent care last night unless the child was not drinking and dehydrated or showing signs of sepsis. Chicken pox can look awful but it's rarely a serious issue

Really? Our pharmacist does not prescribe anything that you couldn't get over the counter. It's all done through the GP, which also does not have appointments - you have to phone every day at 8:30am sharp on the hope of getting a call back.

But YANBU to expect a call back in a timely manner

Most efficient in 2010 but not the best. That didn't happen til 2014. 😉

No, it's the pharmacy who "package" them. All individual drugs are separately packed, and the most expensive chemo drug comes in individual tablet packs, so he gets 3 separate packs of a single tablet, so they "could" easily just prescribe 1 or 2, rather than 3 if there was a will to do so.

YANBU to this the NHS is beyond repair [without significant reform and overhaul], because it is.

But YABU if you think that based purely on this one experience that you don't find satisfactorily convenient.

Then I would contact your MP maybe to ask if this can be changed.
I have never heard anyone talk about this before and I have had friends and relatives with cancer, including my mother. So it may be a very specific issue that needs tackling.

6 weeks ago I’d have agreed with you

I suddenly became unwell 5.5 weeks ago. Was able to see my gp same day after they triaged me online. Referred immediately to hospital seen the next day by a consultant and then every 48 hours for another 10 days even at weekends with a consultant and not made to wait at all . Scanned etc quickly at weekends then given open access to a ward if needed till the issue was resolved. The level of care was amazing and not at all what I was expecting

The NHS is great at urgent care, but the issue is a lot of the other longer term or emergency issues- the diagnoses and management of is lacking as well as for lesser things but that also effect quality of life. I suspect this is the way we are heading- free at point of use for emergencies etc but for anything else pay a fee.

@Pastadanca It is what the Tories want. Because people dying in the streets from road traffic accidents for example is not a great look. But people dying from untreated long term conditions is more hidden.

I, my DC and my DH all have long term conditions. We have had brilliant treatment. DH and DC are under a top specialist and get great long-term management of their care. Under your scheme they would just die.