Loopy knife edged NHS Treatment Model ?

[Clunkclick]

Just now, Wino said:

 

Just thought it made an amusing antidote to excess verbosity about not much.

I'm extremely happy with my treatment at the NHS lately, just this morning I was offered a GP appointment 20 minutes after calling, with no questions about how urgent or otherwise.

A month ago I had a weird falling-down-vomiting thing suddenly at work. My partner called for an emergency appointment and we were offered one 15 mins later. Vestibular neuritis diagnosed within seconds of arrival.

Maybe I'm lucky with my local GP surgery.

I'd say that's pretty good by today's standards.

NW London: Non-urgent for my GP, its usually a fortnight wait (He's now one of the more senior inn the practice and in demand), otherwise its same week for another doctor in the pool. Urgent, don't really know - all my urgents have been ambulances bfrom home. I suspect probably same day, as long as they are in that day.

 

As another poster has said on another post by way of generalisation, seeing the NHS docs is usually good, its the admin bits in between that can sometimes go awry.

 

Nick

[Clunkclick]

Just now, Wino said:

 

Just thought it made an amusing antidote to excess verbosity about not much.

I'm extremely happy with my treatment at the NHS lately, just this morning I was offered a GP appointment 20 minutes after calling, with no questions about how urgent or otherwise.

A month ago I had a weird falling-down-vomiting thing suddenly at work. My partner called for an emergency appointment and we were offered one 15 mins later. Vestibular neuritis diagnosed within seconds of arrival.

Maybe I'm lucky with my local GP surgery.

Not much ? Just imagine it was an OAP with arithitic knees and mild dementia, with no local suppor or hospital transport, being asked to attend a clinic  at 14 miles and 1 hour 40 minutes distant,   by tube and bus. Does your attitude change then ?

 

Nick

Edited 12 May, 2017 by Clunkclick

[gadgetman]

1 hour ago, Clunkclick said:

Not much ? Just imagine it was an OAP with arithitic knees and mild dementia, with no local suppor or hospital transport, being asked to attend a clinic  at 14 miles and 1 hour 40 minutes distant,   by tube and bus. Does your attitude change then ?

 

Nick

There's hospital transport staffed and run by charity/volunteers. 

 

Dad had it for a 25 mile each way trip when he had his chemo sessions. 

 

Ask your hospital or macmillan nurse for details. 

[Clunkclick]

For me to find and book that service in the time available between hospital attendances, not possible. It all happened too quickly - viz  Leave NPH Harrow 02:00 and required to be @ Royal Free Hampstead by 14:00 on the same day (8th May) (The clinical imperative being to get the broken bones aligned before they start to set) - only achievable  if I had Iron Man's suit and boots or . . . . perhaps . . . Theresa's leather trousers . . . do they have Harry Potter style magic properties . . . Thinks . . . .  only if you're in the HP set.

 

The continuous belly laughter continues . . . Despite NPH being reported as hit by the Ransom ware attack (Probably govt), they still managed to squeeze out another letter (arriving this morning) cancelling my forthcoming Haematology follow-up appointment in June, putting it back another month. So, that's each of the last 4 quarterly appointments cancelled and moved to the right . . . with the most recent one cancelled twice !

 

Haematolgy Department at NPH must be in meltdown.

 

So to be a patient in the New Model Health Service (Who said army ?) de rigeur, requires the following super human qualities:-The patience of a saint, the visual acuity of an eagle (When watching the fall of mail from your letter box), the flexibility of a circus or music hall contortionist and the velocity of movement over urban landscapes of Iron Man . . . . not many of the able bodied have this. Edit # . . . . and the Bank account of Mark Carney for the squaring of the circular  debt mountain of travel and parking charges.

 

I think Hunt the **** is going to be getting a letter.

 

40 years of Tory Government, or near equivalent and we've got this . . . ****ERS

 

Nick

Edited 13 May, 2017 by Clunkclick

[Ootohere]

1997-2007 a Labour Government followed by a Con-Dem Government then a Conservative & Unionist Government.

(EDIT, my bad, Labour Government until 2010, Gordon Brown as the Prime Minister, waste of space and money and the one that sorted out those for services rendered.  Spread the wealth among those that deserve it most, so that will be his cronies.)

 

Lots of money spent on paying interest on moneys borrowed over the decades.

Hospitals the Tax Payers do not own and so many Golden Handshakes paid to NHS Employees who leave and become re-employed with the NHS or just Contractors.

 

In Scotland there was a Labour Government, then a Labour-Liberal, then the SNP 

and plenty are making big money from Private Enterprise that was and is not value for money to the tax payers.

(Peerages a plenty to some of those Ex MSP's that were in Government from Labour, Liberal Democrats & Conservatives.)

http://theferret.scot/probe-private-finance-schemes-scotland 

Edited 13 May, 2017 by Awayoffski

[Ootohere]

http://nhap.org/what-you-can-do/facts-fingertips/links-between-mps-lords-and-private-healthcare 

[Clunkclick]

Plagurising Freddie - "Don't start me now" -As an ex-NHS and MOD employee canned on two successive occasions, as a consequence of HMG financial mismanagement (The disastrous exit from the ERM in 1990 and the £36 billion hole in in the MOD budget in 2010) I could wax lyrical.

 

I was thinking the other day, rather than sit here suffering until the ultimate appointment deferral, I could get on my bike, with my EHIC card in my grubby paw, and arrange for everything to be put right frog side. Hmmm ? Might as well before it goes "Pooofh" under BREXIT.

 

Nick

 

 

[gadgetman]

Perhaps it'd be best to write to your MP, Trust CEO and the Health Minister than post here about it? It'd be more productive 

[Clunkclick]

I'll give it a bit of time until after the "People have spoken" - oh gawd !

 

Another classic today, emphasising that there are LITTLE OR NO ADMIN SYSTEMS underpinning the new dispersed patient handling arrangements in the London NHS its all "On-the_Fly", with all the responsibility for ensuring that the batton isn't dropped when its passed between hos;pitals on the patient - if you don't contact them, they wont contact you and you fall out of the system.

 

Had to attend Royal Free Hand Trauma clinic again today (Friday) to have the hand re-examined as the Physiotherpists declined to treat my hand at MV on Thursday because when the strapping was removed my finger pinged back into its uncorrected i.e. damaged position - 35-40 degrees splayed from straight ahead.

MV physios decided to refer me back to RFH so that corrective treatment could take place. No referral back letter was issued by MV for me to present to the Royal Free Hand Trauma Clinic - I just got the place, date and time scribbled on a fragment of paper and an undertaking that a fresh set of X-rays taken at MV on Thursday would be forwarded to RFH.

 

Arrived at 10:40 for 11:20, and as I walked in front of the hospital I spotted a car load of grim-faced nuns waiting outside. I'm not one for omens, but as presages to future events go, this has got to be good. Now read on . . .

 

So get into to see the clinic  doc  at RFH about mid-day. I was quizzed about the full history of this break, which suggested to be that no electronic patient or general notes had been forwarded from MV but I could see that X-rays were available (Whether they were Thursdays, I don't know). So my impression was that the RFH's appoach was to treat you as someone just off the street in A & E, rather than as an outpatient in outpatient clinic, where full notes are available.

 

Anyway, the position of the finger was re-corrected under  anaesthetic and I was told not to use it and to keep the strapping on for 2 weeks. Before leaving clinic , I was told to get the hand x-rayed in the A & E X-ray and the prints would be sent on to MV. No indication was given as to the type or length of treatment that would be given by to me by  MV - can only assume that the doc at RFH was unaware of MV's standard treatment package (Which, again, presumably NPH is paying for under contract/service level agreement - internal or external), no referral back letter issued (and clearly no instructions to MV), and it seemed as if there would be no further contact, even electronically, between RFH and MV. I was told to contact MV by phone on Tuesday. So again, all the responsibility for ensuring that the   "Service" (I use the term loosely) batton isn't dropped between hospitals rests with the patient.

 

This has got the smell of a system designed to sever the links of legal liability between patients passed between hospitals - no doubt with commercialisation in view (If it isn't here already).

 

Progressing the story, pitch-up at  RFH's A & E, where I have to register as a new case (Obviously nothing has been sent down electronically on the intra hospital system to advise them of my X-Ray requirement) . Wait about 30 mins then the A & E Triage nursed calls me in (Said Triage Nurse on the door). What do you want ?(The only info she has before her is what I've already just given the A & E reception clerk, nothing from the Hand Trauma unit where I was just treated). I explain. She tells me that she will have to contact the Hand Trauma Clinic by phone to find out what needs to be done. She asks me to leave the room whilst she does this. Five minutes later, she pops out and tells me to go round to X-ray - I assume X-Ray have been briefed as to what's required. In the X-ray suite, the Radiographer tells me that she needs to remove the strapping in order to get the right shot. This is done and the X-Rays taken.

 

I then return to the Hand Trauma clinic to get it re-strapped only to be admonished by the consultant for allowing someone to remove the strapping - I suggested to her that perhaps the lines between departments could do with clearing properly. At best it appears that even the departments within the same hospital are not communicating with each other. So finger has to be re-set and restrapped, luckily the local anaesthetic is still in effect. Inner city ***** !

 

Lash-up doesn't even get near !

 

Postscript

 

One hour forty minutes later I get back home only to find a inner city London number has called me. Look the number up on interweb, yep, its the RFH hospital with a ****ing telephone survey, "How were you treated ?" Lucky for them I missed the call . . . . .eh readers ?

 

 

Nick

 

 

 

 

Edited 19 May, 2017 by Clunkclick

[Clunkclick]

My concern, is that the first-line treatment, pull and re-align, won't work. Its failed once, apparently. Yet its persisted with a second time.

 

Whereas the book, or at least one of them, says that a surgical fix is the best route to success:-

 

http://www.handtoelbow.com/proximal-phalanx/

 

See 2.3 (E).

 

And whether this is the best solution for someone living on their jack, as an increasing proportion of people are - the advice is to scrupulously avoid using my RH for the next two weeks - if you are on your own, who can do that consistently ? Even feeding out of cans, packet or frozen ready meals requires a second hand as a steady. And, I thought medical solutions were supposed to be tailored to the patient, not the system. Ok, if they want to waste money finding out the pitfalls, so be it. Don't like being used as a lab rat. . .  Bring on the istate-funded mported slavery indentured personal hand maiden.

 

Even more worrying is  the speculative thought that pull and align may be adopted over surgery, under a system lining itself up for privatisation, as the preferred method - because of its "Much cheapness".

 

In the clinic session, I attended yesterday,  the consultant was over seen by an older "Guiding light" on station, at her elbow, advising and approving of the solution adopted. How long before, solution of first resort becomes the only resort and the skills necessary to do the surgery become rarer than . . .

 

N

 

Edited 20 May, 2017 by Clunkclick

[KenONeill]

"the advice is to scrupulously avoid using my RH for the next two weeks - if you are on your own, who can do that consistently ?"

 

Absol-frelling-lutely! Been there, done that...

[skomaz]

Well _ had direct experience of the NHS again yesterday with my daughter and it seems ‘relatively’ easy to see where the issues are.

 

About 09:30 in the morning my 9 year old daughter was having a nasty generalised seizure that was going on a bit too long and getting worse lead us to administering her rescue medication and calling 999.

 

Paramedics and Ambulance with us in a few minutes as she started to come out of it and, as usual they were great – calm, knowledgable, reassuring and just got on with the job in hand.  They took her in and handed her over to A&E staff, checked she was OK again before gong back on call – all as you would want and spot on.

 

Then was the wait – A&E at that time wasn’t busy – maybe half a dozen or so in the main waiting area plus a further half dozen in the triage or whatever, none of whom appeared to have any major trauma (although I accept that is difficult to ascertain from a distance).  No sign of any real urgency in dealing with patients, no major emergencies coming in and, in fact, what seemed to be a fair bit of ‘standing around at the nurses station chatting’ going on – mostly about what to do next and whether there was any wifi connection / phone signal etc..  Bloods, blood pressure, temperature etc. taken regularly for the next few hours until we saw the doctor.  She was fine and thorough but certainly wasn’t going to do anything other than monitor and check all seemed fine and send us home, advising us to speak to my daughters consultant in the morning (today).

 

So…   I guess the crux of the story was 6 hours in total, from an 09:30 call out to getting away from A&E at 15:30, at an A&E that ‘appeared’ pretty quiet.

 

My overall impression (rightly or wrongly) – great staff, quick response from the emergency services (paramedic and ambulance) but a lack of organisation and focus, the latter being where there is apparent room for improvement.

[Clunkclick]

Today, a couple of weekly outpatient appointments later at Mount Vernon, things seem to be getting back on track treatment wise. The finger seems to be healing and physiotherapy (Both clinic based and me doing some at home) seems to be having an effect in ensuring that most of the finger tendons on the damaged finger don't become locked-up with adhesions.

 

Downside, I left yesterdays clinic session and went to the clinic reception to  book the next appointment only to be told that I couldn't as the computers were down - apparently they are still having problems with software re-installations following the recent hacking ??????

 

N