NHS/GP rant - serious but with a laugh

[chellewillnotbebeaten]

Disclaimer I work in healthcare, I know there is a lot of red tape and systems are frustrating but there for a reason, i know how overworked we all are and that being asked to do another ‘one little job’ can lead to finishing late, added stress etc…..
HOWEVER, I’m am going for planned bloods as per GP clinical assessment, following my last lit of bloods, been planned 2 weeks. Since then I’ve had terrible chesty cough and temperatures, saw a GP who said viral and no antibiotic needed - fine, that was their assessment and conclusion. But i have had a cough of some sort - started as tickly dry cough, then a bit chesty which went, back to dry cough, then chesty again with high temps for about a week and a half, but cough originally started mid October and I’m exhausted by it, it’s waking me up every night and I ache from the coughing be it a wet cough or a tickly dry cough. Bloods I have planned were arranged for something else not chest, just U+E’s but I’d like to ask if my white cell count and CRP can be added (indicators of infection). Tried online requests which is how we are expected to communicate with surgery but couldn’t really fit this request into any of the sections as I dont feel I need a f2f appointment for it and phone appointments would be way after I go for these bloods. Rang surgery and very kind receptionist said she was unable to message or ask for a phone call I had to go through the triage system, which she did for me on the phone but she also was unable to get me a phone call earlier than 2 weeks post my appointment for bloods - she then advise I try the online request system again and ‘fiddle about with it’. Which I have and now have a f2f appointment again for chest and to ask my question - really I feel like a time waster as all I needed was a GP to listen to my simple request and either say yes or no. So I either time waste going to this appointment to ask and then go for my bloods OR it will be another time waste waiting for a telephone appointment and then another appointment potentially for another lot of bloods.
This was just a rant - I work for this completely unhinged healthcare system in this county, we are lucky to have it but my god 🤦🏻‍♀️🤣

The sooner the system starys to value patient time as much as doctors' time the better imo. Too much of it is "make work".

Definitely go to the appointment. You should probably have your chest listened to for a potential chest infection at this stage

I could not combine a smear test with bloods that were already booked. It was pointed out blood test appointments are only 5 minutes, smears take longer. I know this. I meant cancel the blood test and do it as part of the longer smear test appointment. But they couldn't understand at all, so I gave up and had two separate appointments with the same nurse in the same room...

@EBearhug but this makes sense as each appointment is only times for how long it will take- so did you just expect the nurse to run late to fit your needs? If smears are 15mins and bloods 5 then you were booked a 20min slot?

they always advise double appointment if more than one query for the sole reason that it takes time to discuss/document/do the related admin for each concern.

if a beautician asked me to book 2 separate slots for nails and eyebrows (with the same person) I wouldn’t even blink. Sometimes I wonder if expectations of the nhs are too high in this country just because it is free

(but yes, OP i agree that there should be a system to send messages to the duty doctor or a care coordinator for simple requests like adding on bloods which can be dealt with quickly and most (good) GP practices would have this option available.

Even two adjacent appointments would have been more efficient for us both, but they didn't seem to understand the concept at all. (Blood test appointments with us are 5 minutes, and I think smears are longer than 10; but I am usually out before the official end of appointment time, so it shouldn't have taken longer.)

I do agree. I have to have annual bloods relating to my osteoporosis and consultant led treatment. I also have to have annual bloods (not time sensitive) for my thyroid ordered by my GP. I asked the secretary if the TSH coukd be added to the annual bloods (all taken at the same hospital trust)

Evidently it could be done but my GP needed to write to the consultant to request it. The NHS makes work for itself and then the staff whine they are overloaded.

Meanwhile my time has so little value that I can have something that needs doing once, twice, because the computah sez. Next time I see the consultant in 18 months I'll ask her to add the TSH. I bet she does.

You are trying to make an assessment yourself of what is needed and so no, that is not ok. That is the doctor's job. You have new symptoms so you need to see the doctor.

If you are unwell you need a clinical review by a doctor. A one off CRP /WCC will not add anything. Both are likely to be raised because of your recent infection.

It sounds like they secretary is being obstructive, but can you not see that without there is a risk that patients phone up requesting any number of tests? Some may be appropriate - like your TSH, others may not. 'Can you add on my testosterone, adrenal function, vit D, tumour markersetc'. Aside from funding (running a blood test does cost), the person who requests a test or investigation is responsible for the result. This is one of the reason why GPs are reluctant to request bloods on behalf on hospital specialists. If they receive an abnormal result, they then spend ages having to chase the hospital team.

Agree system needs an overhaul in many ways, but I think the secretary was in the right there.

DOI - hospital consultant who does add on tests if they sound reasonable .

It doesn't seem like time wasting at all to have a face to face appointment if the cough is as bad as you describe and has been going on since October.

The systems being used throughout the NHS instead of human judgement and are too rigid to cope with the huge range of possibilities providing healthcare brings.
It’s ridiculous, infuriating and wastes both time and money.

Yes but all the secretary needed to do was look at the previous letters that note I take levothyroxine, or to drop a note to the consultant who is reasonable and very very good.

One of the issues I have is the assumption that every patient is a scummy ingrate. It's far less so when dealing with a consultant to be fair.

The system needs to refocus away from what the behemoth needs to what the patient needs.

Add wasted patient time to GDPR investment and it would rocket upwards. There is a huge hidden cost to the economy and individuals arising from the utter lack of respect for patient time.

To be be clear following a couple of comments regarding being seen for the worsening cough I was seen last Thursday for it and advised it was viral, I respect that clinicians assessment but the same symptoms continued and i will go for a chest xray as she advised if the symptoms continue I just thought seen as I was already planned to have bloods anyway I may as well get my infection marker bloods checked also. I’m not trying to self diagnose, and I do respect that decision that it’s viral but I am, and yes because I am also a healthcare worker so it’s what I’d suggest but I appreciate that is my clinical opinion, wanting those bloods added seen as I’m already having bloods as I don’t think it would do any harm and sometimes infection does need bloods to be detected. But if the GP I see today (not the PA who assessed my chest last week) says no, I will also respect that. I just want the chance to ask!

And I don’t ask last week, it’s something I’ve thought since

The issue with blood tests is "computer says NO". Everything is held on the computer system and nothing can be added to a request form except by the person who created it. GP blood forms and consultant blood forms are different, created in different systems and cannot be altered or combined under any circumstances. If you manage to talk to right person, you might get another form added to your record, but it is nearly impossible to do.
I had a ridiculous telephone appointment with a consultant last year who asked why I hadn't had the relevant blood test done before the appointment. Because despite my best efforts with phone calls and emails, nobody had ordered the test.
I had to go for 3 separate blood test appointments (and have a needle stuck in me 3 times) in a 3 week period, at 2 different hospitals. Not only could they have been collected at the same time, but the tests could have been done on the same tube. No wonder the NHS wastes so much money.

On the other hand, it's not a good use of 'expensive' consultant time to be dealing with queries like that. Responding to an email or note about your unrelated health condition takes time and distracts me from the work that I am meant to be doing.

You may say that it only takes a minute, but you are not the only person who will be asking for similar and it all adds up. Your result then comes back as abnormal and I need to then spend more time sorting it out.

I completely agree a sensible secretary is worth their weight in gold. Sadly the system is moving to call centres and email helpdesks staffed by v junior admin staff. We have 5 secretaries between 70 consultants.

And no I don't think everyone is a scummy waster, but believe me some are.

But this isn't a hidden infection. You have symptoms suggestive of infection, so confirming with a WCC or CRP is not going to add that much. You still need to be seen.

I guess if both were normal it would suggest something weird is going on, but then you would need a face to face clinical review anyway.

The appointment isn't done when you walk out of the room. The nurse still needs to document the examination, request the test, package your sample, and clean the room, before she can start to set up for the next patient.

If they didn't offer you two adjacent appointments, there was probably already a patient booked into the next slot. Asking for an extra to be squeezed in cuts into that patient's time.

Sometimes it's easier to combine your procedures if you offer to be rebooked into a day further in the future, which isn't already so full.

OP, a face- to- face for worsening cough is appropriate and more efficient than a couple of random blood tests without examination or trends. I hope you feel better soon, there are some dreadful coughs around at the minute.

Agreed!
I had 4 med reviews due, but 1 of them not due until a later date, contacted the surgery to suggest we combine them, instead I was spoken down to, and had "not due" repeated at me.
Fine. Waste your time then IDGAF, I get paid for medical appointments, was trying to save our precious NHS some time and money

I hear you.

However, I had no expectation that the consultant needed to deal with the result. That was my responsibility. Adding the test on may have taken a minute or two, and I hadn't appreciated how many such requests might be received.

It's interesting you note such requests aren't the best use of an expensive consultant's time. Have you ever reflected that the time of some patients may be as expensive and as valuable as yours?

My consultant often runs 60 to 90 minutes late; there is never clarity about the delays and rarely an apology. A 10.30 appointment that runs 60/90 minutes late takes out my entire morning and it's all the more irritating when there is no wifi and I can't even catch-up on emails. That time has to be made up. Ditto, for example, the apt made by the hospital for 8th June, which on 1st May is changed to 1st June. Rearranging my diary takes me 40 minutes and then two weeks later, it's moved back to 8th June, which I then can't accommodate. It takes me an hour to get through on the outpatient line to be met by huffing. Evidently Consultants are entitled to leave and to change it.

As there is clearly very little respect for patient time, I hope you may appreciate it when we try to save ourselves an hour. Particularly when we too are expensive, tjme poor and do work that makes a difference and has purpose.

I see both sides to this as a healthcare professional. It has to work both ways doesn’t it? As patients we take precious time out of work to ensure we are caring/looking after ourselves as we would be no use to our patients/clients/customers/family if we don’t, but multiple appointments, time spent on phone to acquire said appointments etc….. DOES impact OUR working and personal lives massively often.

UPDATE attended appointment, had bloods I requested added, bloods done….. Result?? Sample lost/unsusable !!! - at this point I have to 🤣🤣🤣🤣 also attended xray for those who made reference to this, awaiting results of that.
Cough?? I’m still chesty and spluttering, seems I’m going to just have to accept it as a way of life now 🤣🤦🏻‍♀️🤣

Seems my username is massively impacted too - more like chellemustaccpetshehasbeenbeaten 🤦🏻‍♀️🤣