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?!

A client of mine who is a nurse told me that people go to A&E for things like when they’ve broken up with their boyfriend /girlfriend.

I agree with the main thrust of your post.

The NHS is brilliant at emergency medicine type things.

I'm afraid my experience suggests that's not a given any more.

Well the mental health crisis team is based in my local A &E
If its a bad break up then potentially they could be in crisis.

Someone being truly suicidal, having a serious breakdown, being psychotic etc needs to go to a and e. Someone who is very sad needs to go to a friend or supportive relative.

They might not have one.

That's superficial. The REAL problem is A&E being a dumping ground from other parts of the NHS. Ours is clogged up with admissions, people on trolleys in corridors waiting a couple of days before a bed comes free on a ward. They're not "timewasters". My MIL was in a corridor 48 hours before they moved her to a ward!

Not just admissions, though. It's also a dumping ground for discharges. We were aghast to find DH was being moved from a discharge lounge to be "parked" overnight in A&E because there wasn't an ambulance available to take him home after discharge. The discharge lounge closed at 8pm so everyone who was still there was going to be moved over to the A&E to stay overnight, then moved back to the discharge lounge the next morning!

We need to challenge the NHS "patient blaming" narrative as to why A&E is so busy!

The real problem is social care and it clogs UK the NHS. Which is why the prime minister is finally trying to implement a national social care system.
Private firms and insurance cannot solve this issue. At the moment approximately 1 in 7 NHS beds are occupied by people who are medically fit to be discharged but waiting for a social care place. Without solving that issue the NHS will always struggle.

Local authorities are going bankrupt because of the enormously high prices being paid to private social care providers, particularly for children and disabled people. Again this issue needs to be solved.

Then phone a helpline.
People do need to take some responsibility for themselves.

Stop griping about the NHS struggling to provide a decent service after 50 years of cuts to funding. And start putting pressure on politicians to increase funding. Even if that means you may have to pay a little bit more tax yourself instead. If you would rather not pay for an adequately funded service, you have no right to complain.

A friend of mine who is a nurse says that people go to A&E for a huge variety of reasons, and that many of them are so ill they get admitted to the already overcrowded hospital as soon as there are beds available. The last time I went there I was hospitalised for three weeks with life-threatening bleeding in the lungs-drowning in my own blood-and suffered two strokes because they had to stop my blood thinners to staunch the bleeding. Waited in A&E with a huge variety of people suffering serious ailments for 18 hours, before a bed opened up on the Acute Respiratory Ward. Most people in there that night were suffering from more than a breakup. Pretty certain there was an absolute lack of heartbroken patients occupying beds in the Resuscitation Unit for the four hours I was in that one.

Unfortunately "a little bit more tax" falls disproportionately on a relatively small number of people, i.e. usually middle earning workers. That's the problem. Far too many people have been "excused" from tax rises.

But we also have to appreciate that the overall tax burden in the UK is the highest it has been in over 50 years, so more than ever tax revenue is being raised, but it's being spent faster, hence the billions we need to borrow every year, putting the country into ever increasing debt.

I agree and as I said upthread, "patient blaming" by the NHS. People lying on beds in corridors with drips aren't time wasters and aren't there for a broken finger nail or a relationship break up. They're there because they're waiting for a bed on a ward!

Not helped by A&E being the default route for admissions, i.e. non emergencies, but urgent admissions needed as lots of wards don't have any other means of admission, so patients are directed to admit themselves via A&E.

I think the A&E is being "dumped on" by the rest of the NHS, i.e. GPs, 111, admissions via consultants/out patients, lack of alternative urgent treatment centres, etc. It's NOT always time wasting patients!

I work as an MRI radiographer, and can confirm that the scans are very expensive, and that there is a quite a wait (although it's going down where I am at least). We do scan ankles for things like this, but it only tends to be after they've rested it and seen no improvement. It is simply not possible to scan every patient immediately, so if there is nothing concerning on the x-ray, it makes sense to give it some time

People do, but in many cases (maybe not the breakup thing) if you aren't medically trained it can be hard to know for certain what is wrong. That's why the helpline is useful but also triaging by nurses when people get to A and E. In the case of the original post she was right to go because her ankle could have been broken not just sprained. The only problem is that even when correctly triaged/correctly diagnosed people can end up feeling disgruntled if thet don't get the full treatment they want/think they should have.

Op, as a nurse, I can tell you that there is nothing that can be done for a torn ligament. Its easier if you break a bone, that can be fixed with metal work. Yes they could of sent you for a scan, but that would have the same result so why put yourself through the radiation. If you are young and fit, then you shouldnt need crutches.

I didn't think there was any radiation in an MRI scan??

My DH has been sent three appointments for a non-urgent, routine test in an outpatient unit.

We are away from home frequently for both business and personal reasons. I am sure in common with many busy people with complicated schedules, we cannot just drop everything and appear at hospital on any random day chosen for us.

The first time he was sent an appointment letter and he realised it was when he was away, he either phoned up or went online (can't remember which) to cancel it. He was not given the option to pick another date from a list of available dates. Only to cancel the appointment he'd already been allocated.

We went away for a few weeks and when we came home we found a letter informing him of a second appointment, which had already been and gone while we were away. That was the only notice he had, a letter by post. No email or text. So he was one of these time-waster 'no shows' the NHS keeps complaining about, because he had no idea the appointment had been made.

Then, the other day we received a THIRD letter with a third appointment date for this test. Again, we are going to be away from home that week on business. He can cancel the appointment this time, but not re-book himself another one at a time he can actually bloody well be there. 😤Of course there is no-one to speak to to explain this, so we just keep going round the houses with it.

How hard can it be for the NHS to set up a self-booking appointment system for routine testing? I know it will be labour intensive and expensive to set up, but surely so is endlessly paying someone to make appointments and post out letters to people who may not receive them in time, or can't make that date anyway. Why not just do it the logical way and ask people when they are able to attend, for crying out loud?

If I want to book lunch at our local pub I can go online and it gives me a list of times and dates they can fit me in, for months in advance. It takes my details and phone number and confirms by email. Why is this totally beyond the wit of the NHS, with all the billions it spends on administrative staff and IT systems?

Don't you have the nhs app? Letters appear immediately in there.

I'm a MRI radiographer and we do scan ankles for things like this, but it only tends to be if rest and things like physio haven't helped. That's simply because they usually do, and if we scanned every single person who sprained their ankle like this, it would not only cost the NHS millions and push up waiting times, but in the majority of cases, it would make no difference to the treatment plan for the patient. Depending on the type of scan, it could also expose the patient to unnecessary radiation.

Whilst the attitude of the doctor and the advice to consult ChatGPT don't sound very professional and may be something you wish to register a complaint about, the rest of the advice was technically correct. If the pain persists after rest and physio, you can always go to your GP and they may refer you for a scan, as it would indicate that a different treatment might be needed, and they would actually need more information to decide on a next step. You say about the actual treatment your mum had, but the majority of it is the same, minus the boot (which may have helped, but I have no way of knowing why they didn't give one), and the consultations with an orthopaedic surgeon, which honestly seems like a waste of time and money.

Not always and not everywhere.

@Badbadbunny what letters don't appear in the NHS?

NHS app is just for England, having just tried to get it on the app store

Well then, you’ve learned something here.

Good god if you think the American system is better than ours then go and live there and find out for yourself.
Honestly, just go and get a second opinion and put your dummy back in. The NHS is a wonderful service. If you don't like it then don't use it. 👍🏼