What’s the point in the NHS?

[younknow]

I fell over at work today. My ankle was immediately black and blue and swollen, so I hobbled off to urgent care in a taxi.

I waited for four hours, I was x-rayed and told there were no breaks and a severe sprain. The doctor told me I’ve likely torn ligaments in my ankle and will be sore for three months.

I asked what sort of follow up would be given and she all but laughed at me, saying that I could get myself a support on Amazon if I wanted. I said I couldn’t even weight bear and she said I could also pick up crutches if needed. She then said I could refer to physio but “ChatGPT would give me a plan”. I asked if I’d be scanned to find out how badly damaged it is and she said there was no chance.

What is the point? Genuinely, what are we paying for when even things like this are being directed to Amazon and A.I?! I can’t believe it.

I remember 15 years ago my mum tore ligaments in her ankle and she was scanned the same day it happened, put in a boot and on crutches for six weeks, had a course of physio and consultations with an orthopaedic surgeon to discuss a plan if it didn’t improve.

What’s going on?!

Haven't read the whole thread but - why would you need a scan? You had an xray - it wasn't broken. What difference would a scan have made to any treatment plan??

You don’t know your sprain is exactly the same as your mum’s. If they refused to scan you I’d feel differently but you had an x ray! And just because you didn’t get the exact treatment as your mum doesn’t mean there is no point in the NHS.

So has my DH, but he is the exception rather than the rule!!!

Mine was until he had an operation that had a conservative cost of around £300k. He’ll be in deficit for the rest of his life now.

Urgent care is just that I am afraid. If it’s not fractured, you will simply be asked to rest and ice it (RICE). There is nothing they can do and they would not scan it in urgent care.

if you truly cannot weight bare, they probably should of provided some crutches.

in most areas now it’s self refferal to a muscular sketetal team for a physio assessment. But you cannot do that until the swelling is down, so they won’t see you straight away.

Did they not give you any advise on resting it etc for now? That is literally all that can be done, and then it’s back to GP if it’s not healed in a few months time.

you can of course see a private physio too.

I am glad for you both. However that is not the point of the nhs, all ailments deserve to be treated not only life threatening. The level of care at the moment is alarming

I got hands on physio, naproxen and a couple of steroid injections and then hydrodilation for my frozen shoulder. All NHS

I completely agree that the NHS is struggling right now. But it's naive to think that you'd be better off directly paying for services unless you're banking on being fit and well indefinitely. About 20% of the average person's tax goes towards the NHS and the NHS as a whole spends about £300 per person per month.

This is broad brush maths, but there are fun calculators out there where you can work out if you're a net beneficiary or contributor based on how much tax you're paying. Look up "where does my tax go calculator".

It's shit when you're paying tax but feel you also need to top up privately. The NHS does need radical change but I don't know what that will look like.

It feels anecdotally, from seeing complaints on here and elsewhere that the first place everything breaks down is at the local level - the GP’s surgery.

So many people not being able to get appointments within a reasonable timeframe.

In the OP’s example best practice taking into account triage and resources would be do the x-ray - establish not broken - advice on RICE given for the next 48 hours and to see GP in five days if no significant improvement.

The GP would then be able to assess - advise on ankle supports, boots, crutches or not, refer to PT.

But if the follow up care is not likely to be available the OP is left feeling that something may be missed / worried etc.

What’s going on at so many GP surgeries?

I left the UK over ten years ago but it wasn’t hard to get a that week appointment or even a same day appointment if it was serious.

That’s the trouble with the NHS, it’s a lottery..what happens with one person on one day might not be the same for the next person on another day. It feels like it’s down to chance which is scary when it comes to health.

A young woman I know who has been nursing for about 4 years now was attacked by a patient last week and has a torn rotator cuff. There needs to be serious changes all around. Quite honestly you couldn't pay me enough to do their job!

So the problem starts at a local authority level?

My DF is in the UK and he gets appointments and referrals very easily. He’s in a small Cumbrian town and his GP surgery is fantastic. The downside is he does have to travel 40-50 miles for any specialists such as cardiology or dermatology. He’s still a good driver at 85 so okay so far but I can see that being difficult when he can’t drive any more.

You sprained your ankle, get a grip

No it isn't. It's a sprained ankle. The advice is RICE, rest, ice, compression, elevate.its a very basic low scale injury.

Oh well next time just pay and go to a private hospital then.
Plenty of people would have been very thankful just to be seen at all.
Urgent care is exactly that. They see you, patch you up and then you follow up with your GP if it's not life threatening.
I hope your ankle feels less painful soon.

That’s good that you got physio. I didn’t. I also didn’t get pain relief as they refused to allow me to see a gp. Anything which is muscular skeletal you’re now only allowed to see the physio for. Who wears a suit and doesn’t touch you and can’t prescribe anything. 🤷‍♀️. I argued on more than one occasion that I wanted to see a dr not a physio and was told i couldn’t. I told the physio I wanted pain relief and he said over the counter stuff would be sufficient.

So you were seen, X-rayed and given advice. But you are pissed off because someone else with a similar injury years ago got different treatment?

It is a sprain. Yes a sprain can be nasty and painful but it doesn't need a follow up appointment.

I’m sorry you hurt your little ankle. You must be very sad. I suggest you pay privately for your treatment and let the NHS take care of people who are actually ill. The money you pay does not mean you’re entitled to absolutely everything for free, it’s not a savings account.

Same experience. Nasty fall. GP instructed straight to A & E. X-rayed - no breaks but ligament damage from hip to toes: Told it’ll take 6-8 weeks and self-refer for physio at GP if required. Asked GP after 3 months, seeing physio in 2 weeks - 9 months later. Still in pain. Only just getting back to normal.

Decades of under-funding.

Partner stumbled a little dec 2023, thought just sprained something in his knee but it didn’t improve, docs sent for x-ray feb 2024, nothing broke so ‘must be’ tendon told to rest it for 6-8 weeks, still no improvement, he also lost job in this time as according to docs notes it was a tendon and he ‘should’ve’ been back to work, had an MRI after having to repeatedly go back to the doctors to say it wasn’t improving, this was then June 2024 which shown full acl tear, meniscus tear and cruciate ligament tear, November 2024 for eventual consultant appointment to review, waiting list for surgery to rebuild knee, October 2025 surgery!! Gotta love the nhs 🤬

Well, no, and you know perfectly well that is not all that it provides. The NHS saved my nephew's life when his heart stopped suddenly and gave him fantastic care in Intensive Care. It diagnosed and treated my shingles and has been working to prevent glaucoma damaging my eyesight. It investigated my husband's anaemia, discovered and treated an ulcer and took action to prevent a repetition, replaced his knee, and is regularly monitoring for possible cancer. It is looking after my niece who has gestational diabetes. It is about to give me free vaccinations against flu and pneumonia.

The simple fact is that there is not a great deal they can do for a sprain.

Just worked it out and over the last ten years I've paid about £7.5k per annum towards rhe NHS. Definitely a net contributor. I pay an additional £3k per annum in private insurance.

Now here's a good example of where the NHS lets people down in relation to non acute issues.

For the last four years, I've had to replace my glasses every year. High myopia, plus long sight and astigmatism which extrapolates to about £900. At the last optician appointment, I was told if my vision could be corrected with a prescription I coukdn't be referred for cataract surgery but did need driving glasses and occupational lenses as well.

For reference, I am struggling at work with three screens, struggling to read, feel unbalanced, have lost contrast when driving and the lights arw blinding and fracturing and arcing. So work/reading is difficult and night driving is a no no. I need tondrive home from work and it's almost winter. Also my 90 year old mother is 80 miles away, there coukd be an emergency and if she has a late afternoon hospital appointment, it's 15 miles across country roads.

In summary I am having difficulty at work and can't drive at night when it's essential. My GP advised if the optician won't refer neither can he. I ended up paying him £40 for a private referral for my insurance.

I saw an ophthalmologist privately who described the cataract in my right eye as "ripe" in old money terms; in my left as earlier but due to the high presription both eyes must be done. Booked in in a couple of weeks. My insurance will fund what the NHS won't.

Without the surgery, I'd have to work less and pay less tax and I woukdn't be able to care for my mother and that would cost the NHS more. And that's quite apart from the fact that I have been able to afford very expensive glasses every 12 months for four years.

That’s the insurance coverage that’s lacking, not private healthcare. Admittedly, you can’t get private A&E but private dentistry, mental health services and maternity absolutely exist, your plan just isn’t comprehensive enough to cover it. I had private maternity care - all scans, consultations, C section, nice recovery in private room etc.

You get scans in the US because it's a way for hospitals to make money out of insurance companies. Not because you need them.

Nail on the head