AIBU to ask you not to take your frustrations out at the system failures of the NHS on the clinician?

[IncognitoPanda]

It’s been a long week. I loved my job but honestly it’s got so tiring being moaned at about things I cannot control. I want to help you with your problem, that’s why I am here. But the sad truth is that in an over stretched service under immense pressure the limited time I have to help you is not best used with you complaining.
I know how many months you have waited for this appointment, I have your referral letter. I know you’re unhappy about it. I am too, I would much rather have seen you when it first occurred rather than you suffering and worrying until now.
I know how long you’ve sat in the waiting area, I can see your check in time. If we don’t have enough staff we will be delayed in seeing you. I will always apologise if the delay is excessive but please don’t delay me even further by spending ten minutes complaining about it.
I know you’re scared, I really do and I completely empathise. But if I tell you it’s a three month wait for a given test, it’s not because I want you to wait 3 months, it’s because that’s how long the queue is. Getting angry at me doesn’t help, and doesn’t give me any ability to speed up that time frame. I could be evasive and not give any clue as to how long your wait is but that wouldn’t help and would just put more pressure on my administrative colleagues when you are chasing for an appointment that they cannot provide.
I know you may have seen the last patient leave my room ten minutes before I call you through, that’s because I have had to complete their paperwork and take time to read your referral and relevant history. I look rude if I have my back to you to read my screens, so it’s important I take a few minutes to understand why you are here before I invite you through. The systems are so disjointed I may have to view multiple software platforms (all of which are slow to open due to the poor it infrastructure). Even doing this I won’t know your full history so please understand if I ask questions that you may have had to answer before.
I know you may have seen me disappear from clinic for 10 minutes. I can assure you I won’t have been off to the coffee shop. Instead I am probably addressing a critical issue that would further delay the clinic if not remedied.
I know you would like to see the clinician each visit. I get it, as I like to see the progress of patients. However if we all had individual waiting lists, the system would become even more unfair as the wait times would vary between clinician. We do talk, we do leave good notes for each other and you will be looked after. Sadly I cannot promise I will see you myself next time.

It’s the desire to help people that keeps most of us in the profession, it’s certainly not the salary or working conditions. Please believe me that I am just as fed up of the system as you.
YABU - it’s a British right to moan
YANBU- I get it

@ToffeePennie you said further up about health care assistants prescribing......they may hand you the script but that's it - same as a receptionist might but it doesn't mean they've prescribed it

If you have mono it's a virus - taking antibiotics won't help. Your body needs to fight it itself. Taking antibiotics when not needed does much more harm in the long run

Again, I have no clue beyond they keep saying “mono” and giving me the antibiotics it’s a really sucky situation

And that’s the attitude towards the public that drives the NHS…

Quite.

I appreciate working for the NHS must be a living hell at the present moment as it's less fit for purpose than ever IMO.

However, I find in the vast majority of appointments I have the workers are only ever in fobbing off mode or misdirection mode. Sometimes they're even openly sarcastic or verbally aggressive, it's not acceptable. I record all appointments.

But I have total sympathy. It's like everyone's given up the ghost. The only people I know who were working for the NHS have quit. Things are getting worse.

When people have only limited time to discuss the history of failings or previous issues, they're going to want to recap it with the first person they get to see so as to describe how it all came to 'this' and ask for corrective action or the right referral.

So I guess plenty of people are going to whinge but there's a lot to whinge about and it seems to be getting worse. It's a vicious circle.

No just you @Haydenn and the small minority of patients who are vile.
Fortunately the overwhelming majority of patients are nothing like you.

I understand. I'm a community NHS professional. I cried all the way to work today, I felt myself becoming teary on a visit, and I cried all the way home. The pressures and expectations being put on us are horrific and it's dangerous.

I’m not sure how much more of a ‘real world’ NHS staff could live in, you know, dealing with life/ death/ illness etc for less than great pay.
yes, some staff are awful, but so are some staff in other sectors.

Hopefully you enjoy your private healthcare.

Do you think working for the NHS altered any way in which you were treated ?

I've heard many say it's a closed shop these days.

I've certainly seen preferencial treatment given to NHS staff who turn up at A and E, and day case surgery settings, I wonder of others have seen this.

Respectfully, in the past six months, during several stays as an in-patient, I have been lied to by porters, HCAs, nurses, sisters and doctors.
There is a common theme to each of these lies - each individual recognises that there have been flaws in my healthcare journey (multiple days in chairs, medication delivered 8 hours late, wrong doses, capsules instead of drips, sepsis ignored, cannulas inserted incorrectly or in one case torn out ...) BUT they cling to an assumption that some unknown person is going to come to the rescue and that every future step will take place without error.

There seems to be a prevalent feeling that treating people badly when they are at their most vulnerable will not reflect badly on colleagues - it does and while I am grateful to those who have given me excellent care, I will not forget the arrogant individuals who have placed me at unnecessary risk.
Public messaging could be more considered, while the number of sepsis posters has been reduced at my local hospital, no consideration seems to be made for it and when a relative waited 18 hours to be admitted with acute appendicitis, a woman with the stroke symptoms shown on TV and the sides of buses had still not been seen despite being in A&E for 6 hours.
There are undoubtedly hundreds of thousands of committed and excellent NHS staff in the country, but equally tens of thousands who will remain in our memories and socials for all the wrong reasons.

@LemonPeonies

I'm not saying this to be pedantic, it's just that I've done health and safety training specific to staff personal safety and staff wellbeing and morale. One of the first things we were taught is that your personal bodily needs must always come first - you must always eat and drink when you're hungry and have a scheduled food break.

To not do so is failing yourself, your employer, and ultimately the patients as one day you'll get ground down and ill from skipping meals, not resting when needed, and working extra hours. That's why these things are enshrined in law. You're very kind and caring, that is clear but you have to put your own oxygen mask on first as the saying goes. There's no prizes for being the hero who burnt out or got too sick to carry on themself.

I don’t think there is hatred for NHS staff. I think the vast majority of people are incredibly grateful that we have such a system and I know
i certainly appreciate my GP and the staff there very much, along with the majority of medical staff I come into contact with - not to mention
my local pharmacist and team, who are saints!

It’s the feeling from some NHS staff, which comes across very strongly at times, as in LemonPeonies post above, that they are special and different, doing a job more important than anyone else’s and uniquely self-sacrificing. Other people are under pressure too!

Have you thought about working for a competent employer to gain warm feedback?

I'm so sorry to hear this. What I wonder is what action NHS workers themselves are taking to push back against all this?

I myself, as a patient, always put an appropriate complaint to the appropriate authority when there's been a clear error or failing that could have or did cause harm / injury. Unfortunately in my case that's been quite a lot in the last few years. In my life, I've been severely physically injured twice by the NHS in surgical situations that should have never arisen ie 'never events' and my mother (who was vulnerable) died because of a blatant and shocking NHS failing. So, I'm kind of jaded.

But the reason I complain, appropriately, and politely, is because I think wow if they're doing this to me who has mental capacity and english as a first language and knows how to navigate the complaints system, what the heck are they doing to everyone who doesn't / cant?

I can see that NHS staff are overwhelmed and the more senior they are the more unprofessional and angry they get in my observation, I suppose nurses and tech staff can't be so free with their rage and frustrations or they'd simply lose their job but consultants (and quite a lot of GPs) are in a league of their own lately. It's a bit terrifying.

I welcome an intermediate 'private' healthcare system where those who can pay towards treatment do so. I can't afford to go private but I would be willing to pay towards costs. People say 'why should I pay?' and I agree, we already pay in our taxes and generations before us did so too. But something's got to give.

Some of these posts honestly fill me with utter despair.

Firstly, the public need to stop turning up at A&E or calling an ambulance for simple things like colds, nosebleeds or UTI's in women. People also needs to consider whether they can make their own way to hospital or a minor injuries unit instead of calling an ambulance. Have you seen some of the ambulance reality programmes?! Makes me want to scream, people calling an ambulance over a minor cut or headache! Less staff time taken up with silly nonsense = more emotional and physical time to attend to those who seriously need it.

I've had some awful care, I've also had some brilliant care. Sadly some NHS trusts are far better than others, read the cqc ratings if you want a more in depth report. Ours is incredible, but I have lived in some where they were awful. A lot of it does come down to management, which as we all know poor management lead to unhappy and disgruntled employees.

A private system would not guarantee us happy chirpy staff. The system in the US is under a lot of pressure too and is no guarantee and worse you have to pay for it.

Be grateful nobody is going medically bankrupt.

@JFT @LemonPeonies
In my most recent stay as an in-patient, 'presenteeism' caused more problems than it fixed. Three staff (nurse and HCAs) were moaning loudly about wanting to take their break because they were 'starving'.
Ten feet away, a man in urgent need of an operation requiring general anaesthetic, who had spent three days in a chair in the Emergency Department and who had been 'nil by mouth' for more than 12 hours and was two hours overdue for his op, didn't appreciate the continual reminders of food - or the request to remain nil by mouth until the following day when the postponed op might be able to take place.
None of the three were doing anything, other than waiting for someone to send them on their break. They could have been collating details of the prescriptions for their dozen patients, they didn't with the consequence that we all received our meds late.

I hear you. A lot of the systems don't seem to work. If they can even be called systems.

One thing that could help is that the average person is keen to gain agency over their own healthcare and putting some systems in place that help people gain direct access to the care they need could probably save time / money, as opposed to being the most terrifying concept in the world according to GPs who are constantly gate-keeping us.

If you feel private would be better...

https://www.google.co.uk/amp/s/www.dailymail.co.uk/health/article-12702277/amp/Scandal-NHS-never-events-Bungling-hospital-medics-wrongly-removing-ovaries-leaving-drill-bits-INSIDE-patients-day-shocking-audit-reveals-trust-one-worst-offenders.html

Ramsey Healthcare 9th in the UK for never events, despite carrying out far less procedures than any other trust.

This is the problem isn't it? I'm having major surgery next week. My surgeon did something horrific and unspeakable in her private clinic to the point she must have paid millions to settle the lawsuit. It's a sh*tshow whichever way up.

I think there is a real problem with the perception that private healthcare can step in and fix things as a viable alternative to the NHS.

There are not enough clinicians in this country. If the NHS was abolished tomorrow that wouldn't change, the pool of available clinicians (including the irresponsible, callous, rude, inept ones etc) would remain exactly the same.

The discrepancy between demand to see a given clinician or service and the capacity / availability of that clinician or service would remain more or less exactly the same. Waiting times on average, would remain exactly the same. Provision of emergency services, exactly the same. Additional qualified staff would not spring up from the earth the moment private finance was available to pay (presumably more) for them.

And that would be the case for the foreseeable long term. The difference would be solely as to the balance of funding from the public purse, insurers and private pockets.

Regardless of how you feel about public vs private, healthcare provision is in a state of precipitous decline with no quick solutions available.

The same is broadly true in many other nations because of the inflationary nature of social and healthcare costs. To address this adequately required long term planning and funding provision, not only within healthcare itself but much more broadly in public services and social care - which hasn't happened. This needed to start decades ago, and instead the reverse has happened (a shrinking of the social state, collapse of social care, rise in inequality, and long term attrition of qualified staff whilst demand has continued to rise).

Even the best government right now would have a very hard time fixing where we are, even over the course of decades. Attempts at top down reorganisation of the NHS to address it's many failures and inefficiencies have largely made things worse.

We're in a right state and I personally do not think a public funding structure is really the root cause nor would moving away from this solve much. I think we would have many of the same problems, of not worse problems with a privately funded healthcare service - only it would additionally cost a lot more per capita and this is bourne out both in 1) per capita comparisons of cost between the NHS and comparable private healthcare models and 2) comparisons of how NHS funded services perform and how much they cost before and after they are handed over to private enterprise (largely much worse and at greater expense - has happened to many NHS services including many ambulance services).

It's widely considered the Labour Party will win the next election and they've made no promises or commitments to 'save' the NHS so I guess we can be assured that it's going to be heavily deconstructed into different 'pay for' services at some point.

Agree. The one and only time I've needed the NHS, I encountered staff who frankly couldn't have given less of a shit. Without health insurance, I would have been totally fucked (that's an understatement!).

And I hear what you say about being 'retraumatised', I was thinking just today that I should have put in a complaint about one establishment (that I can't believe has the audacity to call itself a hospital!) But if I'm honest, I don't want to relive the experience.

If you're going to complain, do it quickly, and effectively to the correct body (usually a Stage 1 complaint to the complaints dept of the relevant hospital).

Reason I say this is because they will then either not reply -or- reply absolute garbage. At this point you can go up a stage to Stage 2, ditto. That leaves you free to approach the Ombudsman (who in the history of time to not uphold complaints, however they are obliged to log and record them, forever!). If you don't do all that within a reasonable time, your complaint is dismissed as being out of time.

Other idea is ring around no win no fee medical injury solicitors.

@JFT If anyone listened to me on arrival at A&E, I wouldn't have needed to be admitted at all on the last three occasions. Finally, someone has approved a significant stock of antibiotics, so that I can self-administer when a flare-up next occurs.
My work involves designing and implementing process flows to save money and avoid risk. It is very demoralising to find nobody interested in simple things that would keep patients safer and help shorten patient stays - particularly when the costs would be no more than £5-£10 per room or ward and would last for years and the savings could be enormous - in human and financial terms.
It seems bizarre that in Formula 1, yacht racing and professional cycling, enormous sums are invested to improve efficiency by tiny percentages toward a greater goal, but in an organisation with an initial budget this financial year amounting to £5,500 per second, it's not viewed as worthwhile.

@KidsDr Thank you for your comments. Across Europe, every country seems to have reduced its number of beds. Whether this is by mothballing establishments, or as we have done, selling off large parts of the estate, I don't know. I do know that the hospital my DC was born in (now flats), built as an isolation hospital for Scarlet Fever would have been very useful for Covid patients had it not already been flogged off.
As I understand it, Holland has a very low waste system, with a single, monopoly provider that negotiates a flat rate paid by all of the population based upon their income and which is scrutinised and approved in much the same way as DHSC gets its funding.
I was in a position to propose a Dutch approach to care homes to a large number of public sector leaders - they were not receptive. My experience came from seeing my father, a dementia patient in Holland treated exceptionally well in essentially an office block, seven floors, each with communal areas and thirty individual bedrooms. The grounds were adequate but far smaller than three private or six council-owned facilities would have been and in addition to 24/7 doctors and nurses on-site, it was within sight of the local general hospital.