What to do about the NHS still being shut?

[notevenat20]

My FIL needs knee surgery. The first step to this is to go to the pain clinic. However his GP referral is not going anywhere as the clinic is simply shut because of COVID with no sign it will reopen.

What can we do? It can’t go on like this as it is ruining his life.

I would firstly try to remember that it won't be the staff doing the clinics who have closed up - it'll be redeployment, poor infrastructure, lack of clinic rooms, cleaning time, poor writing areas, one way systems, red zones etc - previously we all crammed in rooms and block booked patients wherever and we can't do that now. Unfortunately cases are rising in hospitals so they are becoming even stricter.

Secondly, I would contact PALS and make a complaint about how the lack of care is affecting him. Has the GP actually sent the referral? They should be re-sending the referral each time you make contact and escalating the urgency if needed. The hospital won't know who is waiting and on what level of need without that.

Is the referral for pain relief advice or as part of the pathway to surgery?

Where abouts in the country ish are you?

A referral to a pain clinic is usually as an alternative to surgery. Are you sure about this ?
Pain clinics are running virtually in my region. Have you contacted them directly ?

I work I the NHS as a medical professional and I'm in the same boat exactly but with spinal problems. I don't know how I get out of bed each day. I get by on tramadol and butec patches. I e been td it will be spring next year now. I'm in Somerset.

This is In Worcestershire.

Must be area by area as I’m taking a relative for her pre op assessment appointment today for a knee replacement on the scheduled waiting list.
She’s in agony but it’s non urgent & the process is moving on.

So not everything is shut down.

@Pockpolly

Which area are you in?

Sorry...@Pickpolly

Sounds like “the NHS” is not shut if you’ve been seeing the GP about this...
However being in pain is horrible, and you should escalate to PALS if only to draw attention to the lack of this service (pain clinic). If the GP has sent the referral then you should contact the appointment line directly - them re-sending a referral as pp suggested will be a waste of everyone’s time as it will just be rejected as a duplication.
Finally, if knee replacement is what’s needed and you have the resources I would consider going privately, as sadly even pre pandemic this procedure has a notoriously long waiting time due to chronic underfunding of the NHS and priority being focused elsewhere.

The NHS is definitely not shut. Our service is almost back to normal, we’re just missing one clinic which was held in a community building so it’s their decision.

Another one chipping in with of course 'the NHS' isn't shut, that is such hyperbole!

Who says he needs surgery? The pain clinic will be to see if it can be managed with analgesia in the hopes of avoiding surgery, it isn't a 'step in the process of getting surgery' like you think. Has he spoken to the GP about trying other forms of analgesia? The GP has some responsibility in this too.

I would also advise him to ring the hospital switchboard and ask to be put through to the actual pain clinic to see what they say.

@treebarking

I would firstly try to remember that it won't be the staff doing the clinics who have closed up - it'll be redeployment, poor infrastructure, lack of clinic rooms, cleaning time, poor writing areas, one way systems, red zones etc - previously we all crammed in rooms and block booked patients wherever and we can't do that now. Unfortunately cases are rising in hospitals so they are becoming even stricter.

Secondly, I would contact PALS and make a complaint about how the lack of care is affecting him. Has the GP actually sent the referral? They should be re-sending the referral each time you make contact and escalating the urgency if needed. The hospital won't know who is waiting and on what level of need without that.

Your GP absolutely should not be resending the referral at every contact!

I would also advise him to ring the hospital switchboard and ask to be put through to the actual pain clinic to see what they say.

I spoke to them directly and they said they were shut due to COVID.

I've got an appointment with my pain clinic. Finally.

The referal was done in December. They did confirm to me when they called me the other month that they had been completely shut down over the peak and have gradually reopened and I have a virtual appointment next week. Inevitably I will then need to see them face to face so this is frustrating as the virtual appointment I feel will be pointless as it's just going to mean I wait again to see someone but it is how it is and at least I have something.

It's been a massively long wait during which I'm I have exhausted all pain relief options and have nothing else left so I don't really sleep. It sucks but I think it's just the way it is. It isn't the NHSs fault they're working within what they've been told they can.

My specialist hospital was completely closed down and turned into a trauma center so I have lost my specialist physios. My main doctors for my illnesses have been absolutely great though and been able to remain open throughout and I've been in contact with them pretty much weekly so that's been fine.

It's a mixed bag but it's not anyone fault and I'm not sure complaining will help as they're doing the best they can really

@OpheliasCrayon

Which area are you in?

The main thing that all of us can do, is to do everything to keep transmission of Covid low.

Because only when NHS is stable can it tackle the backlog.

If it has to divert major effort to infectious diseases again, then the backlog will get worse.

Which is verging on the trite, but it's not meant that way.

As an individual, all he can do is keep on at his GP.

I think surgery is not just a postcode lottery at the moment but also dependent on the specialist area.
I have a dc who had surgery in the summer and has had some, diagnostic tests but definitely at a slower rate than we're used to and some things are taking a lot longer.
I've been waiting over a year now for an operation and recently received a letter acknowledging the fact but giving no time scale, if I ring up everything is blamed on covid (although it's been a big problem for years) and no one can help me. My gp tried experditing (worth a try) the case but they said I and everyone else on the list was in in the same position. My health and many other peoples health is deteriorating with long lasting consequences but because its not covid-19 it doesn't matter unfortunately.
Its frustrating for all involved could he go private for pain clinic then he might manage slightly better till the NHS gets things moving? Not ideal but realistically the NHS is going into winter season so are not going to prioritise anything that is not life threatening /critical till spring (it happens every year and this year they've got a good excuse to do so).
Also can the gp refer to a physiotherapist they can often help with pain and also ways to mobilise without causing more damage /pain.

Can you ask to be referred somewhere where pain clinic is open perhaps? It will still be quite a while until knee operation I would imagine.

If he can afford it, or family club together it might be worth looking at going private.

It is frustrating that services have slowed or temporarily shut down due to Covid 19 but we all have to accept that this is the situation at the moment. Asking the GP to re-refer is pointless as your FIL is on the waiting list already.

Also contacting PALS when there is patently nothing they can do at present is wasting valuable staff time as each enquiry must be replied to and investigated and this costs.

The suggestion re physio is the best option as this can help relieve your FIL's pain in the meantime.

I only said re-refer as OP made it sound like the referral has been sent back - so re-refer with up to date info if the situation has changed like pain etc. No point if they are on a waiting list already but I assumed they weren't holding a list by the way it was worded.

Can the GP refer your FIL to another pain clinic in the region. Are all of these closed?:

        Evesham Community Hospital
        Kidderminster Treatment Centre
        Malvern Community Hospital
        Worcestershire Royal Hospital
        Alexandra Hospital, Redditch

It's a great question. I will phone them to see if they are open. If anyone knows a pain clinic that is open, please let me know.

@Itsabeautifuldayheyhey

No luck with those hospitals but I called some other major hospitals an hour a way and they are seeing patients. Now just need to get a referral.. Thank you!

I don't know about your area but where I live the pain clinic's main aim is to get everyone off of opiate pain clinics and using a website and "pacing" for pain relief.

there have been so many complaints about it

I hate to think of everyone being in pain due to lack of treatment. There must be some other sort of pain relief the GP could prescribe. How absolutely awful.