To think this waste of NHS resources is abhorrent?

[TootYourOwnHorn]

My little boy woke up in the middle of the night with severe croup, struggling to get a breath. This has happened before and we were told to call an ambulance if it happens again. So we did. We were told several hours wait and to take him in ourselves. Not ideal as the hospital is 30 minutes away but luckily we do drive, although it was a rather scary drive. Would've thought that a child with severe breathing difficulties would've been a priority but there you go.

Anyway, the issue is that as soon as we arrived at the hospital we got a phone call to say there was an ambulance outside our house. We told them we'd taken him in as advised, then they said "well next time you need to cancel the ambulance". As far as we knew they hadn't sent one as we'd agreed to take him in ourselves. So due to the lack of communication they've wasted an ambulance, the cost of that ambulance and the waiting time for someone else who needed it! This is insane to me. The call handler also didn't know the difference between a rash and mottled skin. Surely more training is needed here, this isn't ok? I would never waste an ambulance like this, and I'm a bit offended that she suggested so! But more offended at the absolute waste of resources.

I genuinely think the issue isn't lack of resources, but how they're managed! Not sure if I should bring this to someone's attention so it doesn't keep happening.

The sickness is horrendous. The money spent on people off sick is awful. I worked in teams where 40 percent are off sick!

No idea! I think the idea of “flow managers” sounds on paper like someone is doing something to free up beds for people in A&E so that waiting times can be met.

But just to reinforce again….there are already bed managers doing this! These flow manager posts are over and above that.

At the end of the day, there are simply not enough beds to cope with demand. You have people getting brought in from care homes because old folk are no longer allowed to just get old and die; people with mental health problems who should be treated at home but there’s no community mental health support available; migrants who need a translator so a 10 minute consultation takes 2 hours …..everything is bursting at the seams and no amount of “flow management” is going to change that.

@Ponderingwindow see my experience, as an IT expert engaged to try to build a functioning system, above.

Systems are only as good as the people behind them and if the people can't sort their shit out, then the systems won't work.

@SleepyRich You still don’t have Dex? We’ve had it for a good few years now.

Because they'll keep the ambulance coming despite the wait time. They would only cancel if you actually told them to cancel it. Otherwise they'd assume you'd wait. Surely they would have cancelled if you had been explicit. I appreciate though it must have been a scary and stressful time , so I'm sorry for stressing you with my response.

I've been left in so many ridiculously time and money wasting situation it's unbelievable.

Because those matrons ruled their wards and everything seemed to go like clockwork. No diversity zahs costing over £100k each needed.

I know!! It's just a cost thing since it's £50ish a dose.

Do you have a process for administering and discharging at scene if appropriate or must all patients administered to be transferred to A&E for monitoring??

It makes me so cross that I keep getting texts calling me for a NHS health check, yet NHS can’t cope with those it currently has on the wait lists. Why try to find even more ailments to add to it?
And today on This Morning there was a doctor advising people to go to A&E if they had certain symptoms and that they need treatment within 4 hours… well good luck with that! In my local hospital you’d still be in the waiting room 12 hours later. Even ambulances are queued up outside for whole days.
The NHS should have a campaign to discourage people to go for treatment unless there’s a real severe emergency, not looking for more people to add to the lists.

And had you phoned your GP, they’d likely have received the information about your fracture and then been able to refer you to the fracture clinic.

Well it didn't always work quite like that.

Example 1. I had my first baby 50 years ago, sister was a tartar and preferred mothers to bottle feed so she knew what baby was getting. The food in the hospital was awful and the only decent meal was breakfast which was good, cereal, fruit, bacon, sausage, eggs, beans, toast all help yourself except if you were breast feeding you weren't allowed to go to the dining room until she gave permission and breastfeeding mums weren't allowed to go until most food was gone and what was left was cold. I also had fluid on one leg, blew up like a balloon and young doctor prescribed an injection to get rid of it but she shook her head and said not on her ward. Doctor slunk away and came back after she went off shift and I got the jab.

Example 2. One of my children, 3 years old, was having surgery 40 years ago. I was allowed to stay with him till he went to theatre and then sister told me, and other mothers, that we could come back tomorrow, no point staying as children would be sleeping. I argued but she told me if I didn't leave the ward she'd call the police, I was a civilian police worker and knew officers at the local station so it didn't frighten me and I told her to go ahead but the staff nurse behind her was indicating to stop arguing. When sister left she told me the sister was going off shift at x o'clock and to give it half an hour and come back and she was happy to have me on the ward.

Yes those power mad sisters were great but not always as powerful as they thought.

@indianwoman they told me they weren't sending one, that was pretty explicit. DH said he was taking him in, also pretty explicit. I'm really not sure what more could've been said in that phone call to make it obvious what was happening. If I had any clue they were sending one immediately I'd have waited. If she'd have said we're sending one but it'll be hours we'd have said cancel it while we were still on the phone in the first place. I can't cancel something that I've been told isn't happening. I don't know how much clearer I can make it for you.

I didn't hand them out, she did.

I genuinely think the issue isn't lack of resources, but how they're managed!

Perhaps there are some areas of waste - but economies of scale means NHS get good prices - and most importantly figures clearly show the NHS had the lowest annual increases in funding above inflation between 2010 and 2018 since its inception 75 years ago, around 1% annually during these years when the average has been 3%. There has been higher increases than 1% annually since 2018 but not enough to make up for those 8 years of v low funding. This underfunding happened at a time when more of the population is older which means higher costs for the NHS as older people need more healthcare and modern equipment is more expensive. So I would argue insufficient funding since 2010 is the NHS’s biggest problem.

Yes, I was reading a post by Sam Freedman, a fellow at the Institute of Government - who said that a current problem the NHS is having is insufficient managers. Just as you may be able to have too many, you can have not enough. With such an huge organisation as the NHS, good management is important as well as good clinical care.

This absolutely nails it. Multiply this by a million and that explains perfectly what is wrong with the whole benighted organisation.

This sort of thing is pretty much a regular occurrence for people with a chronic condition, particularly if they have co-morbidities. Different departments don't seem to talk to each other and the only thing that anyone knows for certain is that whatever you are asking them about is 'not my job'.

Complete and utter fucking shambles.

Underfunding is definitely the issue and, unfortunately, it’s the older generations who aren’t paying into it so it’s difficult to increase funding, unless the current working generations pay more tax. Catch 22 really.

Yep, you've nailed it. You clearly have experienced the same as my OH. He has a little black book of names and direct line phone numbers after being on chemo for five years and every sodding month there's some cock up or another that he has to sort out as no staff are remotely interested. He'd be dead if he wasn't on top of it himself.

As for the departments not talking to eachother, another yes! When he was first diagnosed, he had all kinds of tests, bone marrow, skeletal x-rays, MRI and CT scans, etc. They referred him to a different hospital in the next town, and the consultant there glibly ordered the whole lot again, same NHS trust, same county, but apparently "he wanted his own" and wouldn't wait for them to come through from the first hospital. (I can only assume he wasn't confident they'd ever appear after all his referral "file" was a single typed A4 sheet with no test results, just a generic, "this patient is xyz, please could you review" or something similar - how hard would it have been to ping over some actual detail???

Over the past five years, he's had other issues, i.e. a broken foot and a need for dental treatment. No one gives any real information - the oncologist glibly says ask the dentist, the dentist says ask your oncologist, he's constantly left in limbo trying to actually get advice/direction as he's just fobbed off.

Even with things like iron deficiencies that pop up on oncology blood tests, the oncologist won't just issue a prescription or give the data to the GP to issue, OH has to get a GP appointment, then a GP blood test, then the GP will say something like "not low enough to prescribe", so he tells the oncologist who says it IS too low due to the chemo effects, and back he has to go to the GP to tell them, and they then very reluctantly agree to issue the iron supplements. It's all so time wasting and maddening that they just won't communicate directly with eachother and leave the patient as piggy in the middle, which means more appointments, delays etc all wasting NHS time as well as his own.

@karriecreamer

Im so sorry, but not surprised, that your DH has to deal with all that crap, but I'm glad he's standing up for himself. You hate to be that patient, but frankly if you're not you will just be shoved in the corner to die. A friend who had cancer said it took weeks for any change of prescription to happen, when contacts on her internet support group who had private treatment would have these changes implemented straight away. Another friend who had lost his lower leg in an accident said they asked if they could amputate a bit more of his leg, to mid thigh, because they had messed up the measurements for his artificial limb and they didn't have the budget for a new one. I'm not making that up!

We had to deal with MIL, who went into hospital for a heart valve replacement, but she also had Alzheimer's, so she desperately needed to be out of hospital but wasn't safe to go home straight away. We were dealing with the discharge team and physios (who seemed to work completely different hours), our GP (3 different doctors seemed to be dealing with it, plus the pharmacist), occupational therapy teams (the hospital team, the community hospital team and the home visiting team - all different), the adult social care team and the community dementia care team who were the best of the lot. Then there were the two unsafe discharges, the long ambulance waits, finishing off with the final ambulance that was called by the lifeline service (we were away for a few days) and then cancelled. MIL spent all night on the floor alone. I won't describe the complaints process, but it was set up from the outset to prove no one had done anything wrong, so the same thing will just go on happening to other people, again and again.

I'd never really understood what being triggered meant, but there are a lot of ads for dementia and Alzheimer's charities at the moment and seeing them has brought a lot of bad memories back.