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?!

You are right but not all scans are MRI. CAT scan has radiation, MRI scan is magnetism.

Any that your particular ology doesn't upload to the NHS app. Tests too. None of my rheumatology or opthalmology test results are loaded.

I have to refer to 3 apps to get the full picture, Accuryx, NHS and Patient Knows Best.

Not sure whether he has the app or not (I do) but if he does have it he obviously wasn't receiving notifications on it. And again, unless it gave him the ability to schedule his own appointment time then it wouldn't solve the problem.

I am confused. Patients get test results through accuryx as it is used to send texts to patients personal phones. You don't log on to get results. You can use it to send messages saying I haven't had my test results when will I get them? But any reply is a text to your personal phone.

You get to patient knows best through the NHS app. It's integrated.

If you are in England just get the NHS app.

@Imdunfer are you in England? Because as I said above your comment makes zero sense and doesn't reflect the facts.

I’m in England and have never had test results sent to my phone. And for hospital tests I get an email through Patients Know Best - I can get to that through the NHS app, but still need to log in separately. Hospital tests and letters don’t go on to the NHS app itself unless the surgery chooses to a) download the results and make a note or b) upload the letter.

The nhs save lives everyday and all we do is pay our tax towards it. It is an amazing service. You don’t need a&e this is why the nhs is how it is.
when do was diagnosed with cancer and they treated it I cannot fault the nhs absolutely amazing service and they continue to be for him now

Likewise nothing from dh’s oncology dept - no letters not even blood test results. Even his gp says he can’t see the blood test results done by the oncology dept.

We’re in England and use the nhs app. Very little ever appears on the app from our hospital.

Which comment, I've made tons. If you mean getting my results it reflects the facts of my own situation. Hell, even my optometrist the other day was saying they can't share results with other NHS hospital departments who they work with because they can't access the same systems! My own GP can't see my rheumatology blood results.

Whereas my bloke’s MyChart shows the result of every test, every note the consultant writes and every prescription. Once again, if one hospital can be so efficient why can’t they all? It’s not the NHS that’s at fault, it’s the hospital.

I've never had any of my many test results sent to my phone. I've never been notified that test results have been updated, I've always had to go looking for them and twice in the last year I've had to threaten an FOI request to get hold of them.

I had a test done 2 months ago that should have taken a maximum of a month to run which I am still waiting for after one prompt and a promise to sort it.

The standard statement is "we'll let you know if there's a problem otherwise you won't here from us".

I'll trust that when someone tells me how to tell the difference between "there's nothing wrong" and "we lost the test/we lost the results/we forgot to contact you".

I would suggest that your area is the one that's out of the ordinary, given what other people are experiencing? I'm north west, my SiL is the south east has the same.

Also when you deal with different departments in the same hospital, it's dependant on the ology. For me, opthalmology and rheumatology in the same hospital don't use the same system. My opthalmology appointments come through Patient Knows Best, my Rheumatology ones don't.

And why in the names of gods are they still sending paper letters with postage and production costs? Don't anybody talk to me about the NHS needing more funds until they work out how email works!

I think the reason it’s so efficient is because it’s a well known teaching hospital. I repeat - if one hospital can do it why can’t they all?

I agree!

And the contrast with the private sector is even more stark. Most of the private sector consultants we've seen have recorded the initial information gathering session and AI then produces the notes and letters necessary, the doctor does a quick check and presses a button and it all gets recorded and delivered to the right places.

My local district hospital and a huge teaching hospital we also go to still have consultants dictating letters which go into a typing pool which can have a backlog of a month or more, to produce a physical letter on paper which is then posted to me and to my GP. Last month I even got exactly the same letter twice. it's ludicrous.

And it's extraordinarily frustrating when you can see how badly the NHS needs money spent in the right places, and watch your own savings disappear in huge chunks (yes I know I'm lucky I've had it in the first place) to get essential care in a reasonable time, knowing that other people are being left as invalids and some are dying.

The hospital is funded and controlled by the NHS.

Funded yes. Controlled no, there wouldn’t be such stark differences if that was the case.

A huge yes to that. The inefficiency is unbelievable.

Last two appointments with DH....

First an x-ray. Gave details to receptionist, who then proceeded to print off a sheet of A4 paper, get scissors to cut it in half, stuck it with a pritt-stick to a piece of thin cardboard, then printed off a sheet of small labels with his name/address/dob/rtx number, stuck one of those to the sheet stuck on the cardboard, and seemed to throw the rest of the sheet away, then left the cardboard sheet in a box on the counter. In between answering the phone a couple of times, going into her back room to make a coffee, and checking in another patient, that all took 15 minutes. During this time, no one came out of the x-ray room itself. Then the receptionist pressed a button which rang a bell in the x-ray room, and the HCA came out, picked up the cardboard sheet from the box and called DH into the x-ray room. Where she then proceeded to type all the details from the cardboard sheet into her computer! Don't they know that you can "Ping" data from one computer to another these days? Or even email the details from one PC to another. It must just be "jobs for the boys" to give the receptionist something to do.

Yesterday, orthopaedic appointment, similar set up with receptionist creating a sheet of paper, left in a box on the counter, which eventually got collected by a HCA who had a workstation outside the 3 consulting rooms containing the 3 orthopaedic surgeons/consultants. She had several "piles" of these sheets, presumably all meaning different things to her. We watched her type the details by hand into her computer. As patients were called in, and then sent for x-rays, scans, plaster room, treatment room, etc., she put the sheets from one pile to another, presumably showing where the patients were within the department. As patients came back from wherever they'd been sent, they had pieces of paper with them which were handed to the receptionist, who then printed a different sheet of paper which she put in the box, again, eventually collected by the HCA and put into her different piles again. It just seemed that all the staff were each entering data on to their respective computers based on pieces of paper being moved around and fuelling lots of different admin/HCA staff giving them work to do.

At one point, we were sat in a waiting area outside the orthopaedic clinic's x-ray room for around an hour. Over that time, only two patients went in, and both were in/out within around 5 minutes. For the other 50 minutes, it was unused - that's an enormous waste of resources as there was the radiologist and HCA and expensive x-ray machine, plus the rooms, all unused. Same with the plaster room next door - two staff visibly sat at their desks and we only saw one person go in to have a pot removed in that hour.

When we've gone anywhere private, it's been paperless. Receptionist clicks on her screen, and when we go through, whether to the dentist, optician, audiologist, MRI scan, etc., details are on the screen and they're ready to go. No small army of staff walking around with bits of paper and re-typing the same details several times! No nonsense of dozens of people all given the same appointment time and forced to wait for an hour or two like the orthopaedic clinic where the waiting room was full and standing at 9.30 and literally no one else came in after 10am, with the final patients (us) finally being seen at 12.30 called through from an empty waiting room.

When he's had his private MRI scans for his cancer, his haematologist has has the scans and report in her email "in box" the next day, as did we as they email copies to the patient too.

I think the NHS could benefit enormously from the old style "time and motion" studies where someone shadows staff and shadows a service user to follow-through the working practice end to end. The NHS is too fragmented and "silo-d" with staff not knowing what other staff do nor other departments - it probably makes sense on an individual staff member level, but when you look at it across different staff/departments, it's crazy.

There are national guidelines. They're either inadequate or not being properly enforced.

Look at franchise business models - most branches of Specsavers, McDonalds, Costa Coffee, etc., are privately/individually owned, but there is consistency across the brand. The difference is that such highly successful franchises police/enforce their policies/standards.

Nothing to stop the NHS being the same.

I find it very hit and miss what appears on the NHS app. Or at least I did. I got a new phone last month and now can't log into the app at all.

I agree. Thing is they were rigorously enforced by the Blair government then scrapped again. You reap what you sow.

Are you joking? Look at the profit of the private companies and the huge deficit the NHS runs under. You cant do things with barely enough resource.

I agree but there are huge differences between different parts of the NHS, they should be sharing best practice but they’re not.

As an example I live midway between two large hospitals. One uses MyChart so patients can see their records virtually in real time. The other uses paper.

Seriously ill informed stuff on here. GP practices are independent contractors who get a contract from the NHS. Running a hospital is a little bit more complex than running a McDonald's.
Healthcare HAS to respond to regional differences. If your hospital is in an area with a high proportion of smokers, you have to allocate more money to lung screening and detecting lung cancer than in an area with a low prevalence of smoking.

And yes hospitals and other parts of the NHS do share best practice. You don't know what you are talking about.