I know this isn’t the first thread, but the NHS is close to collapse

[Adropintheocean1]

I don’t want to be to outting, but basically I have some symptoms. GP suspected a condition due to these symptoms, and referred me to the hospital.

My hospital (large city) said we don’t test for this condition, please refer to x London hospital. London hospital said we are the only hospital dealing with this diagnosis, we are overwhelmed, we can’t see her. Suspected illness is not life threatening or limiting however does cause horrible chronic symptoms that need to be managed. So that’s it… GP seemed genuinely embarrassed. Basically if I want a diagnosis I need to go privately (can’t afford it.) GP said for a relatively poor area, his making as many private referrals as NHS ones.

Is it not time we got angry about this?

Yes you can ask to be referred to any hospital - it’s about patient choice now (can’t remember the actual technical term).

uou can also find the wiring time for each hospital trust by department online

I highly rate the neuro team at Chelsea and Westminster who work with wider teams in imperial nhs

they have a specialist neuro auto immune consultant there who is absolutely amazing!

We've been through worse times. And the NHS has been through worse times. YABU to be scaremongering like this!

I think you're right about this, the privatisation of the NHS has slowly happened by stealth. I say this as someone who has worked in it for 20 years and witnessed the deliberate underfunding and stripping of services first hand. I work in A+E and spend most of my day patching up non emergency problems that people have got to the end of their tether trying to deal with in the community. As other posters have pointed out bed waits are often over a day now, we end up juggling the sickest people, shuffling beds about as people in the waiting room deteriorate, we don't really have space but have to kick someone else out who is less poorly back to a hard plastic seat. I'd like to think we are good at the real life threatening stuff but everything else just gets a band aid shoved on it and go back to your GP because there isn't much else we can do. I'm sorry for anyone who has had to experience this, it makes the staff sad and frustrated to be delivering this sort of care.

Why would you feel hearing evidence of other experiences as you lying. All of this exists at the same time. I work in the NHS and know just how badlyly it was crushed by Tory cuts. I’m sorry you have had this rubbish experience and how it has effected you.
However the private system will be even worse for most.
You had a bad experience this time. I agree it shoypuld not be like this. 20 yrs ago it was not like this. But do not believe private is this answer, it really really isn’t for oh so many reasons.

@advarksnoutstronaut It is just called 'Right to Choose' I think and essentially means you can choose any GP surgery / Hospital / even particularl consultant to be referred to for non emergency care. It might help you to look at other hospitals and their estimated waiting times for routine appointments for your particular issue and go elsewhere.

www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/

Aging population.

Complex and multiple conditions.

More expensive and longer treatments or hospital stays

Lack of fitness and health in the population, contributing to generally lower physicals and mental health

Inefficiency management of nhs and investment badly managed eg in IT.

Ageing stock of hospitals

Vastly increased sense of entitlement to a long and healthy life - this is a good thing in many ways! - but means people don’t just put up, shut up, and suffer like they might have in past decades. For example menopause, mental health, cancer symptoms.

there are thousands of problems and the only solution is money

We all saw it coming and the nhs cannot pay for it all.

Think she can get access to a neurologist?

my dh had a seizure last year. The proper NHS pathway is to be seen by a neurologist within 2 weeks; there is a special referral process, to be Triggered by GP who should offer some basic advice such as ‘Don’t drive, don’t exercise alone, don’t have a bath on your own’.

we got a GP telephone appointment 4 weeks after the event (none of the above advice was given) and were refused a referral after the GP tried to make one. Some tests were offered at the GP surgery, but when he got there they hadn’t been specified on the system - just the appointment - so nurse couldn’t do them.

this seems to be to be incompetence from the GP; incompetence from the GP’s administrative office; and also from the ‘referral team’ , whatever and wherever they might be.

we have gone private

https://www.england.nhs.uk/wp-content/uploads/2017/03/patient-leaflet-digital.pdf

here you go OP:)

A single seizure actually doesn’t lead to a 2WW referral unless he had something on his imaging.

the vast majority of the population will have one seizure in their lifetime.

just to reassure you :)

Thanks advark, but in the meantime we are in a complete limbo. Dare he exercise? He has voluntarily stopped driving but does he have to stop for life in the absence of a doctor willing to take this forward? What if driving was his profession? We won’t be able to get travel insurance, will we?

he has to get some imaging before he can get the referral but in the absence of the referral he can’t get the imaging

(I should add, this happened abroad, and we have imaging from there, and it does show something - but no-one here will look at it )

Fair enough, but the lifestyle induced ailments are a huge reason NHS is overwhelmed. People need to start talking responsibility for their choices and not expect the NHS to sort it out!

We have a guest seizure referral pathway done on admission/ discharge to the neurologist

But that kind of thinking leads to denial that there are real problems and people not taking the problems seriously. It's just one step up from victim blaming. It's clear the NHS has major problems, and it's not just a recent thing. My experiences is that it was just as crap back in the noughties when my FIL and mother were effectively killed by NHS blunders, than it is today, after seeing my MIL killed by NHS blunders over Christmas/New Year just gone. The longer we hail the NHS as something wonderful (which it isn't), the more likely it will collapse completely and we'll end up sleep walking into the US system. Far better to accept it's no longer viable and start transitioning to a European style of healthcare before it's too late.

And the NHS needs to grow a pair and start saying "no", i.e. to people presenting at A&E with a cut finger, or with a headache, etc. Also needs to start telling patients if their lifestyle is contributing to their health problems, and yes, refusing treatment for patients who won't change their poor lifestyle choices.

And in his NHS health record it says ‘Seizure. Significance: significant’

@beelzebud If we see a patient with a first ever seizure in ED they normally get referred to 'first fit' clinic to see an outpatient neurologist which used to be 2 weeks but now is unfortunately months and months. The advice we normally give is to avoid driving and baths / swimming and general known triggers such as alcohol / stress. We wouldn't normally advise avoiding exercise, that is fine, I probably wouldn't do riskier things like climbing/horse riding for the obvious reasons that if you were to have another seizure you'd be in a more dangerous situation but otherwise you can go about your life as normal. We don't normally do CT/MRI in a healthy fully recovered patient so you've done well to get some imaging already. I'd hope if there was anything worrying or urgent on the scan they would have told you when it was done. Every single radiology report has tiny incidental findings and comments that often don't need further investigation. I'm saying this in the hope it is reassuring and hope the wait is not too much longer for you.

I am having excellent specialist treatment for my condition on the NHS and it sounds a lot like your condition @Adropintheocean1

I would seek to connect with other people with your condition,.they may be able to advise you

Agree 👍!

Thanks for your kind words, Leaf.

As a matter of interest , do you think it is poor that (a) none of this advice about driving, etc was offered by the GP and (b) that we were refused an NHS referral? (It isn’t just a matter of being on a longer waiting list than two weeks - we aren’t on one at all. Yet the advice we got from ‘forrin’ was that an operation is necessary. This was all available to the NHS two days after the event and we copied and hand-delivered it to the GP the day after we returned)

it seems unconscionable to me.

It's underfunding . Our hands are tied in the NHS as we have no resources to treat people the way we want to and there is a shortage of doctors training posts which the government are unwilling to tackle

It’s not just underfunding, although that is an issue, but it’s huge amounts of money being wasted. And private companies making a lot of money from the NHS.

For example, we have to order supplies from particular companies that have an NHS contract. Want a stapler? That’s £25 for the same thing you could buy for less than £5 in any stationary shop. Need a new examination bed? £2000 for the most basic one. It’s sickening when you see first hand what these companies charge but we are forced to use these companies as they have the contracts.

You believe evidence-based thinking leads to denial and that your case-study emotion-based rationale is superior? That’s curious.
My clinical experience is that I see the best and worst, and lots in between, of NHS healthcare everyday. I advocate for those having challenges and celebrate when it goes well.
Having a binary approach like yours does not help. European models - which one do you prefer. The French system definitely has its pros and cons but would’t touch the German system. Which of the very different models are you advocating? Which of these models would be safe from a current or future government de-funding them to argue for privatisation and selling us to US companies for huge profit? None of them is the answer. The central problem is not the model but what those with unhelpful intentions have done to it.

Well that’s not what happens in my Trust. I’d suggest that’s an issue with your specific senior leadership team NOT the NHS as a whole.

I find that hard to believe. I’ve worked in several trusts and all have had the same issue of being tied into a particular supplier and not able to shop around. Maybe not all suppliers are charging silly amounts but if they suddenly decided to you will still be locked into a contact with them.