My ileostomy reversal operation was scheduled for Tuesday - a 5 month wait after I was given the "all clear to proceed" scan.
On Saturday, I started the pre op process, which basically means three days of medical goop but no solid food, and no water 6 hours before the op.
Arrived at 11:30 on Tuesday, was prepped, and then sent home at 16:30 - theatre time had run out . so thats 11 hours without water and 16 hours without food.
I drank water overnight till midnight,
Arrive at 07:30 today - was sent home at 16:00 - No beds . so thats now another stint of 16 hours without fluids and and 40 consecutive hours without food.
Funnily enough I kicked up a fuss.
The department head was called, and in trying to placate me thought it would be a good idea to justify it by saying "there is a lady in now who was on her 5th cancelation"
After I told her not to boast about her abject performance, that it was nothing to be proud of and did the opposite of placate me, the PA to the CEO was called.
She is going to try and cancel some other poor schmucks ops next Wednesday and fit me in then
She said that even cancelling someone else and putting me in does not mean there will be a bed so I could still be cancelled after waiting all day - So it could be another large period without eating.
The likely outcome is that my reversal will be deferred till March next year, some 12 months after being given the ileostomy and 8 months after being cleared for a reversal.
|
|
Might be worth going private.
|
|
Could you try another hospital?
|
>> Could you try another hospital?
You need to be referred by your current consultant, and there is no guarantee they are any better. An outside referral just adds further delay, and unless your referred hospital is a specialist centre, your referring and referred hospital have no performance guidelines to try and adhere to.
|
>> I'm investigating it.
>>
SWMBO had both her knees done privately.
I was surprised how widely the prices in the south east varied.
I contacted a lot of hospitals for their deals.
Both ops were performed at Oxford by a John Radcliffe surgeon.
Transport was by me.
|
|
Bowel surgery does not fit as well into the "priced menu" scenario.
|
I read an article about the amount of work carried out by an NHS surgeon. Seems that a USA surgeon works twice as hard (twice the hours?) for four times the pay.
I asked a friend who is an orthopediac surgeon if this assessment was correct and he confirmed it. So I asked him why the NHS couldn't do this? It would be much more efficient if NHS facilities were operational 24/7. The simple reason was that they don't want to work that hard.
There are bound to be more complicated reasons as well, such as other staff needed to support the surgeons who also need to be paid and of course there are not enough of them nor beds. But it could be done, if some element of commercialism was injected into the NHS.
|
If I go private, I shall be using the same consultant surgeon, the same hospital theatre, the same theatre technicians and nurses, That will be at about 19:00 in the evening - I was cancelled at 16;30 because theatre time had run out
Post op will be in the Runnymede BMI which is connected to the NHS hospital by a 200 yard corridor
Last edited by: Zero on Wed 4 Dec 19 at 21:16
|
I'm not close to the detail but I suspect that there are a lot of moving parts to this. I think the US does far more surgeries than the UK for example. Data are hard to compare especially for elective procedures because the US data are skewed towards patients with means or good insurance. Surgeons have every reason to incline to doing more surgery if there is a ready supply of insured patients.
But I suspect you are right to say that NHS surgeons are more likely to be limited by theatre time. Ironically cost may well come into it too. Far more is spent per capita in the US than here I believe, disregarding who spends it.
|
Sorry to hear of your situation Z...
Unfortunately we are probably a week into the annual winter bed crisis, things are only going to get a lot worse until probably March next year, each time we cancel a major procedure because of no bed then it just has a knock on to the next operating list and so on..
Now if you've been cancelled on the day due to No Bed, and you actually attended the hospital then you are a '28 Day' case, there is a legal responsibility for the hospital to carry out your op otherwise they will be fined big time (unless you decide to turn down the new date).
Look up '28 Day patient' on the NHS sites.
I'm not going to comment on some of the other comments as they are total BS.
|
>each time we cancel a major procedure because of no bed then it just has a knock on to the next
>operating list and so on.
Can't you set up a bed sharing scheme in the winter months?
OK, I guess people might be a bit upset having to share a bed with Z but if you kept them under anaesthetic for a bit longer they might not notice.
|
>> OK, I guess people might be a bit upset having to share a bed with
>> Z but if you kept them under anaesthetic for a bit longer they might not
>> notice.
I can assure you that having experienced two fairly recent stays in hospital, my bed would be preferable to some of the drugged, drunk, crazy and mentally unstable rif raf that you find in an NHS ward.
|
>>
>> I can assure you that having experienced two fairly recent stays in hospital, my bed
>> would be preferable to the other drugged, drunk, crazy and mentally unstable rif raf
>> that you find in an NHS ward.
>>
...there, fixed that for you!.....
|
>> >>
>> >> I can assure you that having experienced two fairly recent stays in hospital, my
>> bed
>> >> would be preferable to the other drugged, drunk, crazy and mentally unstable rif raf
>> >> that you find in an NHS ward.
8/10 Well Done Bland Minor, You clearly have a promising career at the Palace of Westminster clown academy.
|
>> But I suspect you are right to say that NHS surgeons are more likely to
>> be limited by theatre time.
Its generally acknowledged that NHS theatres are under utilised. This is for a number reasons, including lack of surgeons, and theatre staff (dont forget you need a trained nurse/ theatre technician or two) anaesthetist, surgeons hours, and somewhere to stuff the stream of patients coming out, be that post op, HDU/IC, hospital bed or discharge lounge.
Just found the 28 day rule
www.nhs.uk/common-health-questions/nhs-services-and-treatments/what-if-my-nhs-surgery-or-operation-is-cancelled-at-the-last-minute/
Going to raise a complaint via PALS
|
|
Sorry to hear about all this, Zeddo; I know from recent, personal experience that delayed surgical procedures can overshadow a whole period of your life. I hope that you get sorted soon.
|
|
Sorry to here about your situation Z, we have had similar experience with Mrs O'Reliant. She needed minor eye surgery a few years ago and we lost count of the number of cancelled appointments with long waits between each one. Her follow up treatment was subbed out to a local optician after we complained about the same thing happening again, and to be fair he was excellent.
|
Hope you get sorted soon Z.
It seems to be crumbling a bit round here. In Tring, referrals in the past have usually been to Stoke Mandeville which is the nearest hospital, but they seem to be struggling and more people are now being sent to Hemel Hempstead and Watford. Whether this is related to Tring being in Herts and SMH being in Bucks, I don't know.
I'm seeing my cardiology consultant next week, I'll ask him what's going on if anything.
|
Spending has fallen significantly behind what is required to maintain the position in 2010.
Added to which the pensions disaster has meant consultants do less overtime as they end up with 5 figure tax bills for breaching Osborne's limits.
When I started around the turn of the millennium, the NHS was is a shocking state - 2year waits for hip replacements were not unusual - Labour started spending a lot more in their second term (~6%/yr increase iirc) and by 2007 it had become an awful lot better - a few weeks was typical for referral-to-appointment for most specialties.
The population is getting older and more morbid, and in addition is living a damn sight longer with ill health - increasing health spending by inflation plus a couple of percent will mean the service stands still at best.
We're a bit behind most of our neighbours with similar GDPs
data.oecd.org/chart/5Mvk
|
|
I wonder what percentage of over 65s are not currently being treated for something or other by NHS. Pretty small I think. Ironic that we no longer make any NHS contribution. Time to change that I think.
|
|
Children don’t have an income do they? You and I have a pretty good income and could well make a contribution to health costs.
|
>> Children don’t have an income do they? You and I have a pretty good income
>> and could well make a contribution to health costs.
Ah - means testing. oooo bad words spoken there ( even tho it is clearly the only way to ensure fair distribution of "free" services) And clearly stopping paying into the NHS on retirement is an anomaly thats wont last.
I think my balance is in credit. I spent so long not going to the doctor they sent me a letter asking if i was still alive, and if i didnt respond i would be taken off the list.
Last edited by: Zero on Thu 5 Dec 19 at 16:00
|
You do make contributions from the income tax on your pensions and VAT on the crap you buy (you know, the Farah slacks from the Express magazine...)
NI is just tax - it isn't hypothecated.
Ditch NI and transfer it all to Income Tax?
Last edited by: Lygonos on Thu 5 Dec 19 at 16:03
|
|
Well yes we do but at the end of the day we are not paying enough tax to support the NHS. I think a hypothecated NHS tax would be a good idea but wealthy pensioners should not be excluded.
|
>> Well yes we do but at the end of the day we are not paying
>> enough tax to support the NHS. I think a hypothecated NHS tax would be a
>> good idea but wealthy pensioners should not be excluded.
I wouldn't welcome paying extra but....
It's a massive anomaly that people like Zero and myself retired on decent pensions some years before our State Pension Age pay less tax than would be case if our pensions were earnings.
|
>>Well yes we do but at the end of the day we are not paying enough tax to support the NHS
I have always paid the approrpiate taxes, but my family and I represent hardly any drain on the NHS. Firstly we're not there much and secondly when we are there we tend to go private, A&E being the exception. Oh and the occaisional GP trip.
I don't mind that, but I wouldn't be instantly thrilled about paying more. Especially when the NHS is the most horrendously inefficient organisation that could be a million times better with no extra money.
It doesn't need commercialisation as such, it just needs to be arranged and managed more proficiently. I did one contract in the NHS. The organisation and structure are laughable.
Removing unions stuck to historic processes and arrangements would significantly help as well.
|
|
That’s all well and good but the NHS needs more funds now. What we have paid in the past is no longer relevant. Those who can pay more will have to pay more one way or another if the NHS is not going to collapse. The NHS was designed for a population that mostly died by the time they were 70, not one that can survive with expensive treatment well into their nineties.
|
It's perhaps a good idea but politically a non starter, no pensioners will vote for it.
Look at the 'dementia tax' a mere toe in the water to some sort of reform, dead in the water before it saw the light of day.
|
|
Well I would but you’re probably right. I’m afraid we’re heading fo ttwo tier system in which those who can afford to will buy private healthcare leaving the majority to suffer at the hands of an increasingly degraded NHS. If we want a decent healthcare system for all we need to pay for it. We currently have a poor to middling system compared to other countries which is relatively cheap to run. I’m no fan of the NHS as it is but whatever system we want will cost us money.
|
>> I’m afraid we’re heading for a two tier system in which those who can afford to will buy private healthcare leaving the majority to suffer at the hands of an increasingly degraded NHS
Going privately doesn't exempt anyone from also paying for the NHS. Surely it also lowers the burden?
Last edited by: No FM2R on Thu 5 Dec 19 at 19:25
|
|
No it doesn't but it does make people who no longer use it less prepared to pay increased taxes to fund it. From a personal point of view I would be happy with a private care but that's not going to be affordable for most and I dont waste particularly want to live in a country where only the wealthy can afford medical care.
|
>>I dont waste particularly want to live in a country where only the wealthy can afford medical care.
So people using private care AND paying paying tax, some of whic goes to the NHS will make the NHS unaffordable for the poor, whereas if everybody used the NHS it would become more affordable?
And this when we're talking about tax in a general tax bill? Because there's not a specific tax bill for the NHS is there?
>> it does make people who no longer use it less prepared to pay increased taxes to fund it
So ban Private Health Care, so all those people become an additional burden on the NHS and then it'll all be ok?
I think you may need to revisit your logic.
Last edited by: No FM2R on Thu 5 Dec 19 at 20:14
|
So people using private care AND paying paying tax, some of which goes to the NHS will make the NHS unaffordable for the poor, whereas if everybody used the NHS it would become more affordable? “
I didn’t say that. Perhaps need to revise your reading skills,
If we have a health system which provides good care for all the wealthier part of the community would not need feel the need to buy private care and would be prepared to pay higher taxes to support it. As it stands at the moment we stand in danger of a two tier system.with the wealthy abandoning the health service much as they have abandoned state schooling.
|
Then how are you relating private care use and the affordability of the NHS?
>> the wealthier part of the community would not need feel the need to buy private care
Utter garbage.
Private medical care is not very much about the quality of medical care. It is really all about convenience and customer service. Not what the NHS should be there to provide.
If you want those people to use the NHS then you will absolutely have to have two tiers of service. Unless you are going to give the whole country private rooms with cable TV, decent meals and facilities, and operations scheduled when it is convenient for them.
>>at the moment we stand in danger of a two tier system.with the wealthy abandoning the health service much as they have abandoned state schooling.
Yet we continue to pay for both systems.
Though in the case of Private Education it is very much about the quality of that education. Private education with the standard of teachers and their approach to teaching, their equipment and facilities, standards of behaviour and all round performance is in a different league to the vast majority of state schools, if not all.
So I don't mind paying for it, but you're not making me use it and I won't ever want to.
So I presume you do not resent people paying for the NHS, you just think they should use it also? And that if they do that would help somehow?
|
>> Ah - means testing. oooo bad words spoken there ( even tho it is clearly
>> the only way to ensure fair distribution of "free" services)
Do you accept that if that were the case you and your wife would both be paying full cost or, at least, the maximum assessed contribution for any GP visit or treatment?
|
>> >> Ah - means testing. oooo bad words spoken there ( even tho it is
>> clearly
>> >> the only way to ensure fair distribution of "free" services)
>>
>> Do you accept that if that were the case you and your wife would both
>> be paying full cost or, at least, the maximum assessed contribution for any GP visit
>> or treatment?
Yes I fully accept that, but ironically it wont come to pass because somehow lefty type people have an idea that means testing is an evil capitalist plot to denigrate the poor - So the real poor dont get the benefits they need, the well off dont pay for their state privileges and all because the pretend poor dont want to be found out.
|
>>Yes I fully accept that, but ironically it wont come to pass because somehow lefty type people have an idea that means testing is an evil capitalist plot to denigrate the poor - So the real poor dont get the benefits they need, the well off dont pay for their state privileges and all because the pretend poor dont want to be found out.
*Who* does object to means testing?
Presumably someone who believes they should have something for free but are told that in fact they must pay for it? Or wants a State Benefit but are told they can't have it.
But surely that's an argument about where the line is drawn, not the philosophy itself?
We seem to believe that somebody getting something they shouldn't have is a greater problem than someone not getting something that they should have.
.**********
I like means testing we just need to think more about where we draw the line and stop trying to be so tight about it. We should work out what the threshold actually is, near as we can calculate, and then move it 10% further in the direction of the possibly needy.(if you see what I mean)
Last edited by: No FM2R on Thu 5 Dec 19 at 21:58
|
I think if you’ve signed a DNR form, thus less likely to be an NHS customer in future, you should get an increased State Pension.
|
>>I think if you've signed a DNR form, thus less likely to be an NHS customer in future, you should get an increased State Pension.
Or free fags for pensioners.
|
That's ironic. After a fast drive across town I am now writing this from a hospital where I am going to be with #1 daughter for a few days.
Honestly, it makes you miss the medical competence of the NHS, if not their customer service and facilities.
|
In the last 18 years I have had 3 operations
2002 - Gall Bladder - Off work & in hospital 3 x 5 days as they could not "fit me in"
Paid £6,500 - saw GP Monday, Consultant Wed, Operated Friday 7pm, out Saturday noon.
2004 - Hernia - 6 months after consultant visit - Pre-op tests etc etc but no dates - Paid £2500.
In Wed pm, out Thursday noon
2010 - Cancer (my GP was 99.9% sure on day 1) not officially found for 7/8 weeks, then surgeon goes on holiday.........waited 5/6 weeks.
When a son knew of the surgery delay he offered to pay but I had already discounted paying for it myself as I knew that the operation was but 1 step in a much longer journey.
Now 9.5 years since diagnosis & hoping to be around for some time to come. My "Surgery and Chemo" pals are no longer with us - I am the last man standing.
The NHS I felt let me down with the gall bladder & the hernia BUT when my problem was very serious they came good - stuttering service before the operation BUT tremendous service & care for the 3 years afterwards.
|
I received two text messages in quick succession yesterday, both from my GP's surgery.
1. Dear Ms X
Please make an appointment with any GP for a cancer care review.
2. Dear Ms X
Please ignore the last message you received this one has been sent in error.
Just as well I'm not awaiting test results and have never yet been investigated for cancer...
|
>>*Who* does object to means testing?
OK I’ll bite.
Firstly, for all Zero’s dismissive comments I suspect it could quite quickly lead to a ‘two tier’ service. Might there be a temptation to cut corners on things like food for those not paying? I don’t mean starvation just restriction to a minimalist menu. I think in time the same ‘economy’ would creep into treatments. The likelihood is that those paying would develop a mentality that they were subsidising those who got free stuff and demand a say. We’ve seen that on here where people demand rights over how ‘their’ taxes are spent.
If you want to see two tier provision look at NHS Glasses on sixties/seventies.
It’s undoubtedly true that some people will run a mile from a means test either from pride or because they can’t manage the questions never mind computerised application process required the 'digital by default' mantra.
Their health will suffer as will that of those who miss the means test but genuinely cannot afford the cost.
Will the means test take account of travel to work costs, real housing costs, child maintenance and all the other stuff that applies in real life? You’ve got a big bill coming up; repair the car so you can get to work or get your mole looked at?
How do you set charges? A fixed fee for a GP appointment is at least easy to work out but where do you set it? Even if it’s ‘only’£10 that’ll be a real burden for those with just a bit too much or who are on a run of bad luck. And frankly £10 goes nowhere near covering the cost. I doubt it would even cover the cost of administering testing never mind recovery of charges due but unpaid.
What about a hospital stay? Do you just levy a ‘hotel’ charge for bed and food? Or will cost depend on treatment so cancer cost lots more a hernia? Rationing of treatments and a second class service for those who cannot pay? - bet.
Debt recovery would be a massive big issue – see problems recovering charges from foreigners treated here. And don’t even consider suggestion of pay in advance. Windrush victims have suffered in pain and probably died because of that policy.
And then devise a means test to separate the free sheep from the paying goats? Is it just those on income based benefits who get in free or would others do so as well?
We means test ‘free’ prescriptions and things like dentistry and eye tests/spectacles; and that’s a mess. If you get Universal Credit (UC) as a Job Seeker or for sickness you get free prescriptions etc. But there’s no space on the form for that you have to pretend you’re on JSA or ESA. Get it wrong and a fine will result – I’ve seen this with my own eyes. If you’re on UC to top up low earnings free prescriptions depend on how much you earned in the last ‘assessment period’. So you get them free in July and September but not August or October.
Is there a policy unit or 'think tank' that come up with a serious/workable model for means testing health care.
It’s simply not a practical proposition.
|
>> lefty type people have an idea that means testing is an evil capitalist plot to denigrate
>> the poor
That's a contentious and rather silly way of putting it.
Obviously some sort of means test is a necessity for the Social Security 'safety net' of cash benefits.
There are both principled and practical objections to means testing for services like health care and education. I've a number of work and domestic issues to deal with right now but I'll try and return to the subject later in the day.
|
>> >> lefty type people have an idea that means testing is an evil capitalist plot
>> to denigrate
>> >> the poor
>>
>> That's a contentious and rather silly way of putting it.
But very accurate
|
Pensions and welfare spending is ~£300bn a year.
Sod benefits and state pensions - just give 5 grand a year to everyone over 16 as a basic income until they're dead or in jail.
No ID card & NI number? No basic income for you.
No spongers as we'd all "sponge", less admin costs, less ££££ going to Capita et al and they're useless assessments...
You want a bigger pension than 5 grand? Save for it.
Last edited by: Lygonos on Fri 6 Dec 19 at 10:36
|
I have an ongoing, minor, health problem. My default hospital is Kingston, but I have been referred to St Georges, Tooting. The journey to Tooting was so awful that I have now referred myself to Royal Surrey at Guildford.
The service that I have had at all three is good. I think I will try to stick with Royal Surrey for this particular problem.
Zero, sorry to hear about your problem. I don't suppose you want to say where you are attending - I might make a guess and say St Peter's?
|
Organising elective surgeries is a piece of cake.
Once you add in the need to deal with emergencies and GP referrals it becomes very difficult. A perforated appendix trumps ileistomy revision.
If private hospitals had to run A&E and accept GP referrals they'd be no better than your local DGH.
If you want exclusive elective surgeries that are never cancelled you then need to have a separate team dealing with emergencies with their own bespoke theatres and clinics.
Oh, and cancelling winter would help too...
I'm always a bit wary that being able to do both NHS and private work is a disincentive to having a short NHS waiting list....
Last edited by: Lygonos on Fri 6 Dec 19 at 11:59
|
Re. The OP, the gaffer is now finished her treatment and all her markers are clear so it's now the waiting game for the next few years.
6 months of chemo, 4 months of which occupying a hospital room.
I'd guesstimate £100k worth of care, which would easily have been double that in the US.
Apparently over half of US debt collection actions include unpaid medical bills.
|
>> ... the gaffer is now finished her treatment and all her markers are
>> clear....
...excellent!...
|
>> Re. The OP, the gaffer is now finished her treatment and all her markers are
>> clear so it's now the waiting game for the next few years.
Excellent. They call our waiting game "the surveillance clinic" I must confess when my first appointment came through I misread it as "the survivors clinic".
£100K? I would guess thats on the low side of estimation. Tho when I had my hip incident in Cuba, that involved an ambulance, nurses, Xray, Cuban version of a consultant, and crutches they presented me with a bill for £55
Last edited by: Zero on Fri 6 Dec 19 at 12:54
|
Interesting year but not one I'd recommend.
A bit like your journey, Z, from "I hate sending poo in the post" to "My ileostomy reversal has been cancelled twice"
Not a big fan of this being a patient malarkey (vicariously in my case I guess)...
|
>> Interesting year but not one I'd recommend.
>>
>> A bit like your journey, Z, from "I hate sending poo in the post" to
>> "My ileostomy reversal has been cancelled twice"
>>
>> Not a big fan of this being a patient malarkey (vicariously in my case I
>> guess)...
Its the mental stress thats the problem, it's a real roller coaster, Bad news, Good news, things work well, things go badly, albeit interspersed with periods of stability.
Having an ileostomy is certainly not a lifestyle choice I would recommend, and its had its moments, but at the end of the day, its a disability that has not actually stopped me mostly doing and achieving stuff I want or need to do. The worse thing is that for the last 5 months its been medically not necessary or required. At that point it becomes a thing of resentment.
Generally speaking my trust has been pretty good with dealing with my issue, and I am aware that now my medical priority is not the highest thing on the planet, but at the end of the day a patient has to take some responsibility, control of care, and I am not prepared to meekly roll over and be a victim of someone else's poor planning, poor management, and entrenched rules.
|
>>...., but I have been referred to St Georges, Tooting.
>> The journey to Tooting was so awful that I have now referred myself to Royal Surrey at Guildford.
>>
I /We have been to St Georges many times and going by car have not had problems at any time.
IIRC The alternative is by train to Wimbledon and a 493 bus ( 19mins) .
The bus uses the same route as I did.
I have done the the trip in a NHS ambulance - no blues and twos from Kingston Hospital to St Georges and they gravitated to Wimbledon route I used.
|
The journey to St George's and the parking there isn't a bundle of fun but you learn ways to make it more bearable when you are a regular and frequent visitor.
Parking at Royal Surrey is apparently even worse though.
|
>> The journey to St George's and the parking there isn't a bundle of fun but
>> you learn ways to make it more bearable when you are a regular and frequent
>> visitor.
>> Parking at Royal Surrey is apparently even worse though.
It is, and its quite a long schlep from the station. There is parking int he side streets of Park Barn estate, if you can ensure your wheels are still there when you get back.
Last edited by: Zero on Fri 6 Dec 19 at 14:01
|
>> No ID card & NI number? No basic income for you.
Appreciate this may be 'tic' but what do you do with those people who genuinely cannot manage/retain even that sort of stuff?
|
images.app.goo.gl/b58BqBnTBnwutAjg7
Legal guardians are how it's done just now, Bromp, for the infirm.
Last edited by: Lygonos on Fri 6 Dec 19 at 12:49
|
>> Legal guardians are how it's done just now, Bromp, for the infirm.
I'm not talking of the infirm but those with chaotic lifestyle and/or multiple misfortune.
I could give examples.
Not large in number but too many to ignore.
|
>>but those with chaotic lifestyle and/or multiple misfortune.
Yeah the current system works great for them too.
|
>> Yeah the current system works great for them too.
Indeed.
No ID = no money doesn't work.
QED.
|
Bromp, you're either capable of looking after your affairs or you are not.
If you are not then a responsible guardian is appropriate.
Not quite sure what your point is.
|
A son works in Texas. His company provides $2m cover for any family member.
A colleague's wife has cancer - they have exhausted the £2m, sold the house and moved into rented. The family car is now a banger rather than what they used to have.
Despite earning some $200K salary he is, after 4 years, effectively bankrupt, and his wife's outlook is very bad.
The NHS has issues for many in the UK but in the UK you would have been treated foc.
With the husband being able to look after the kids and not having this type of money worries he faces everyday.
|
>> Bromp, you're either capable of looking after your affairs or you are not.
In England and Wales, since the Mental Capacity Act, the test is subject etc dependant.
It's not binary.
|
"you're either capable of looking after your affairs or you are not."
I can say from personal and friends' recent experiences that, in order to get the best out of the NHS, you need to be articulate and educated. You have to be aware that any chain of communication is as strong as the weakest link, and that link could be someone with a poor command of English, someone inadequately trained or someone who doesn't really bother.
|
>> "you're either capable of looking after your affairs or you are not."
>>
>> I can say from personal and friends' recent experiences that, in order to get the
>> best out of the NHS, you need to be articulate and educated. You have to
>> be aware that any chain of communication is as strong as the weakest link, and
>> that link could be someone with a poor command of English, someone inadequately trained or
>> someone who doesn't really bother.
Having experience of corporate life is very helpful. Names - Finding out who is who and who they report to, who has the skills sets, who has the clout, what they get measured on, process procedures, what buttons to press.
|
>>>Having experience of corporate life is very helpful. Names - Finding out who is who and who they report to, who has the skills sets, who has the clout, what they get measured on, process procedures, what buttons to press.<<<
Z - do not give away the secrets, otherwise we will loose the benefits. For many years I have used the ' understand the process first' mantra, followed by 'understand the people'. It has served me well in over 20 years of regular NHS contact, with very little to complain about. My experience of private health in that time would leave me to avoid private whenever possible.
Best of wishes, ( I was going to say 'luck'), with your continued interactions with the medical professions.
Last edited by: sherlock47 on Sat 7 Dec 19 at 09:10
|
Same applies in all walks of life when wanting to progress a complaint, whether it be about your new car, your supermarket chicken being off or your train being late.
Get to the one who’s KPIs will be affected and you will get a better result!
|
|
Daughter returned to her home near Bath after a trip to Thailand. She drove to us in Poole on Friday. She said driving had been ok but she had experienced an odd light in her right eye. It became insistent yesterday and her vision blurred. She called our local hospital at about 10:30 but triage referred her to Royal Bournemouth Hospital for 2:15. No consultant was available until 3:15 but then there were two. They diagnosed a torn retina and said she should have an op asap. There were no local facilities but they got on to triage to sift possibilities, to hit on 7:15 this morning – in Bristol. She couldn’t drive but Hubby hot-tyred it in the F type to take her back to Bath last night. The successful op was about 11:00 this morning. She will be kept in overnight but expects to be back home tomorrow mid-morning. The state of the NHS looks good in the southwest.
|
My only experience in that region.
A son of great friends was in a bad car crash in Poole.
Poole hospital treated him but said no more could be done to sort his eyesight.
He had an opague lens in his specs which was far from great.
SWMO was a Moorfields patient and my daughter had a great friend studying there.
I sorted him out an appointment and they solved his problem.
We were all obviously delighted.
They came to me by car and I was taxi driver to Moorfields, hovered/hid and then returned them back to my home.
|
|
In my all to frequent experience, the NHS has always been good at single issue acute (ish) conditions. It got far worse at ‘joined up care’ under Tony Blair’s governments and stil,hasn’t recovered....more money was spent, but it created silos. There was no strategy, or even a plan. Up until he died, the only way Andy got anything like joined up care was by being vocal and by knowing the system. That can’t be right.
|
>> In my all to frequent experience, the NHS has always been good at single issue
>> acute (ish) conditions. It got far worse at ‘joined up care’ under Tony Blair’s governments
I was impressed that my case got good Joined up care, Treatment provided by three trusts, Frimley, Guildford & St Peters, and few home visits by specialist care nurses, all joined up and automatic... I did however have a common issue, with known treatments and outcomes.
Of course, and understandably it all came to a grinding halt when I became non urgent.
>> up care was by being vocal and by knowing the system. That can’t be right.
Funnily enough, my noise making and knowledge of the system place and process, has now got my op moved up a day to Tuesday, with a backup place on the theatre list for Wednesday.
It may not be right, and someone else may be disappointed and displaced, but we do what we have to do.
|
Eldest is currently in A&E on nights and spent quite a while last night dealing with the aftermath of a crash involving a drunk driver (f) with a 7month old baby.
With the police, ambulance service and fire service involved as well the costs of this need to be put squarely on perpetrator - sell your house to make reparations sort of costs - It must have cost thousands to clear up the mess.
Considering a friend of ours was recently killed by a drug driver I think she did well not to "let rip". I probably would have.
|
>>
>> I was impressed that my case got good Joined up care, Treatment provided by three
>> trusts, Frimley, Guildford & St Peters, and few home visits by specialist care nurses, all
>> joined up and automatic... I did however have a common issue, with known treatments and
>> outcomes.
>>
>> Of course, and understandably it all came to a grinding halt when I became non
>> urgent.
>>
The challenge Andy faced was coordinating more than one specialism. Renal by itself was fine, though shockingly inefficient compared to other renal units around the world, without exception. But linking renal with diabetic with general surgery when he broke a leg was an absolute shambles. Even though they were in the same hospital!
In Europe, it seems to me that the French system is considerably better and more efficient / patient centric than here. But that was true of Jamaica as well, which is a sad indictment of the way the NHS is run, not what we spend on it.
|
Well I got admitted, and the deed is done. On water only till they are sure the gasket and bolts are tight, then it's a period of retraining what will be a babies bowel
So for me this cancer journey is coming to an end with a successful conclusion, plenty reading this thread will have similar journeys if they hadn't already
|
Good Luck!
I hope the 'retraining' is at least well enough advanced for you to enjoy Christmas comfortably.
|
"Well I got admitted, and the deed is done"
Well done, Zeddo, that was quick; best wishes for a comfortable recovery.
|
Good luck from here Z.
I not surprised by the retraining. A friend of mine was ventilated for about two months. There was some doubt as to whether he would successfully re-learn to swallow. Not something one might think of if one hadn't already heard of it.
|
Nice one Z, hope you are back to normal soon.
There's plenty for to do, West Ham need a new manager.
|
Best wishes, Z, from me too.
I'm a survivor of rectal cancer (diagnosed one year ago to the day), but I didn't have such a bad time as you.
|
>> So for me this cancer journey is coming to an end with a successful conclusion,
>> plenty reading this thread will have similar journeys if they hadn't already
My brother had a similar story to you. It took him through until he was 86.
Good luck.
|
When I qualified 25ish years ago the stats were "1 in 3 people will get cancer in their lifetime" - now it is "1 in 2 people..."
Ironically I think much of this rise is due to lower smoking rates - far less people dying from heart attack and stroke early gives them more time to brew a tumour!
A decent chunk is also likely diet, exercise and alcohol related - stats show we drink more than 30-40 years ago and the role of alcohol in cancer is better understood now.
Another stat from the past is "prevalence of type 2 diabetes is 1%" - today it is more like 5%.
|
|
Alzheimer’s disease is now the leading cause of death in the UK. I’m not sure if that represents medical progress.
|
>> babies bowel !!
Golly!
Does this mean you're in nappies?
Seriously, Best Wishes
8o)
|
Yeah best wishes for a speedy recovery Zeddo. Hope things improve from hereonin.
Saw a steamer last week powering up the Settle Carlisle line....wasn’t expecting that this time of year
|
>> Saw a steamer last week powering up the Settle Carlisle line....wasn’t expecting that this time
>> of year
>>
This time of year brings the steam trains back out with santa specials and trips to Christmas markets, we are going up to York on Saturday behind Tornado and coming back down behind Union of South Africa
Hope the recovery process goes well Z
|
coming
>> back down behind Union of South Africa
>>
You ain't, it's broke
|
|
It's the third time it's broken in 4 weeks with the same issue
|
|
In fact that link IS the last time it failed, it conked out at kings langley
|
>> You ain't, it's broke
>>
great :-( , it's been a busy few days, I hadn't checked
|
>> >> You ain't, it's broke
>> >>
>> great :-( , it's been a busy few days, I hadn't checked
Tornado is fine, you will get steam one way, but may be class 47 on the way back, which is an experience, 1960 diesel, it's very noisy and smelly
|
>> Tornado is fine, you will get steam one way, but may be class 47 on
>> the way back, which is an experience, 1960 diesel, it's very noisy and smelly
>>
I will let you know my view on Monday
cheers
|
|
Rumour Mill says its tornado both ways
|
|
..thought we were still in your medical thread for a moment.
|
|
And actually equally as accurate
|
>> Rumour Mill says its tornado both ways
And so it was, with a class 47 on the back for shunting, turning, electric carriage heating and insurance
Rumour mill says the 47 was in neutral on the runs with tornado hauling it, and the 11 coaches for a gross train weight of 575 tonnes cruising at 75 mph. It would have used about 8000 gallons of water and about 8 tons of coal
|
>> >> Rumour Mill says its tornado both ways
>>
>> And so it was, with a class 47 on the back for shunting, turning, electric
>> carriage heating and insurance
>>
>> Rumour mill says the 47 was in neutral on the runs with tornado hauling it,
>> and the 11 coaches for a gross train weight of 575 tonnes cruising at 75
>> mph. It would have used about 8000 gallons of water and about 8 tons of
>> coal
>>
Rumour mill pretty accurate on all counts, faultless running, 20 minutes early into York and on the button return to kings cross, warm carriage, fairly reasonable supply of tea/coffee etc.
Only gripe was staff and other passengers who cannot close a door behind them.
Tornado still gets a good crowd at stations and along the line, sadly looks like 60009 has ended its main line steam days
|
"Saw a steamer last week powering up the Settle Carlisle line....wasn't expecting that this time of year"
2 weeks ago I was looking down at the Ribblehead viaduct from the top of Ingleborough. And a tad windy it was too :(
|
|
And best wishes Z. Hope you are firing on all cylinders soon.
|
Fullchat. It’s always a lot windier on the top of Whernside. Just up the road from chez LL gaff in Giggleswick. Hope you made the time to appreciate the Christmas lights in Settle. A good effort by a team of volunteers, of which I used to be one. A thankless task, especially taking them down early January in lashing rain.
Friends tell me that the Flying Scotsman, or some such , came through Settle a few days ago
|
We were staying at a HF Holiday hotel near Airton. They bused us to Clapham for the Ingleborough climb so we by-passed Settle both ways on the 65.
Would have loved to see the Flying Scotsman.
|
>> >> babies bowel !!
>> Golly!
>> Does this mean you're in nappies
Possibly at some point, depends how good I was with my pelvic floor exercises,
Ironic really, I am surrounded by altziemers cases
|
>> Ironic really, I am surrounded by altziemers cases
Just like C4P then?
|
|
I didn't like to say that
|
>> Ironic really, I am surrounded by altziemers cases
>> Just like C4P then?
I object to that, although I do have this condition that makes me forget stuff - can't remember what it's called.
|
>> Ironic really, I am surrounded by altziemers cases
Same when I broke my hip in 2012. Apart from one other bloke who'd been in an accident everybody else was over 80.
|
>> Ironic really, I am surrounded by altziemers cases
>>
A nice variety of ones possible future ?
I hope you get chucked out asap. ( In the nicest possible way. )
Good luck with the exercises and I hope you will be back on the rails.
|
>>
>> Ironic really, I am surrounded by altziemers cases
>>
...that's Christmas for you; I think someone has bought me a case as well.
;-)
|
Medically, it's not going smoothly here and won't be out as soon as I hoped
But a doc came round with proxy voting forms, so wifey is voting for me
|
|
Sorry to here that. Hope things get sorted soon I guess you’ll be following the election coverage through the night
|
|
Zero has been sedated while the election results come in. They will reassess the dosage in the morning.
|
Can you get the exhaust note tuned so it sounds sportier Z?
;-)
|
|
....sounds to me like he'd have been better with twin pipes.....
|
Returning to the OP get ready for a tough winter in the NHS.
I expect the traditional targets will get dumped faster than making the switch from RPI to CPI for austerity.
Corbyn would have been better going for an early Jan election, but no-one can accuse him of having his finger on the pulse of the world outside his bubble.
|
...I don't think Labour had much choice about the timing, did they.
As I remember it, having resisted Boris's call since it started, the LDs and SNP both decided they would support a December election (based on the simple majority "notwithstanding" motion).
Labour were then caught in a position where the election would happen, and they would be accused of being "frit" because they opposed it.
The SNP subsequently "rowed back" somewhat on their stance, but the LDs didn't, and that was still just about enough on the numbers game to get the motion carried regardless.
Got a lot to answer for, those LDs (again).
|
Well I am at that stage where recovery can be managed at home and I am medically fit enough to be discharged with little risk of readmission
So far there has been no doctor or specialist round to sign that off
So here I lay blocking a bed in a way that probably stopped me getting here in the first place
Discharge is chaotic and uncoordinated, I've seen enough in the last 6 days and experienced it last time round myself to realise it's a contributory factor
Last edited by: Zero on Sun 15 Dec 19 at 14:24
|
|
Good luck. Hope it's all improvement from here on.
|
>> So far there has been no doctor or specialist round to sign that off
Could be due to them reducing hours so as not to get a whopping tax bill for breaking pension limits.
My wife's haematology consultant has reduced her hours* at age 41 for the same reason.
*To 10 half-days per week.
Last edited by: Lygonos on Sun 15 Dec 19 at 15:27
|
>> Well I am at that stage where recovery can be managed at home and I
>> am medically fit enough to be discharged with little risk of readmission
If you want owt at home give me a shout.
Who is walking Woofy?
|
|
I have a tracker on the Beemer, so you can forget it
|
|
Excuse me, young man, I operate a Mercedes-Benz.
|
So here in hospital I decided to watch Guy Martin's great escape
He explained what he intends to do, that he is a siiit bike jumper, and looks at the camera and says
" I can smell hospital already"
Tea bed sheets change moment
Embarrassing, it's visiting hour
|
"Discharge is chaotic and uncoordinated,"
Usually you are kept hanging about for the pharmacist to show up.
|
>> "Discharge is chaotic and uncoordinated,"
>>
...oops! I thought he was describing his condition.....
;-)
|
>> Usually you are kept hanging about for the pharmacist to show up.
Not just in NHS. Exactly that at private place where my Mother had her cataracts done.
|
>> ....sounds to me like he'd have been better with twin pipes.....
Unequal length pipes sound a little strange
|
|
I guess right now you'd know that better than the rest of us.
|
|
....I just hope they haven't used exhaust bandage to fix him.....
|
Talking of exhausts, was it Orwell who said “4 pipes good, 2 pipes bad”. Even my girly car has the correct number Zeddo.
Hope you get out soon and make a good recovery.
|
|
4 pipes good 2 pipes better if you take Orwell to conclusion.
Last edited by: Bromptonaut on Sun 15 Dec 19 at 20:16
|
I have 12 types of medication, in single, double or "as and when" doses. To save money wasted on over-ordering, my GP surgery instituted an online ordering service. This lists each item and shows when it can be re-ordered (I have managed to synchronise them so that only one collection every two months is needed).
The orders are passed to the pharmacy in the same building. If for some reason I have enough of particular items in hand I omit then from the list. This happens when a dose is suspended for some medical reason, or items such as inhalers are out of use due to weather conditions. It makes no difference - I get the lot, regardless.
This has happened several times and I can't find out why. The pharmacy apologised. My wife collected the latest order yesterday. Perhaps as a recompense, I found it had added anther two-month supply of an item I had expressly omitted. They had already told me that Items returned had to be destroyed, since their origin could no longer be certified. I now have nearly enough stock to open my own pharmacy.
I wonder how widespread this practice is; it seems an odd way to save money.
|
My repeat medication is also ordered on-line though my GP surgery website, and then gets sent to the pharmacy in the same building.
I only get supplied with what I have requested from the list.
|
Mine wrks fine,, I go on-line, reorder as and when required, pickup at the chemist 4 days later.
If i need to change, delete or add, I phone up the pharmacy co-ordinator at the health centre.
Last edited by: Zero on Tue 17 Dec 19 at 11:40
|
>> Mine wrks fine,, I go on-line, reorder as and when required, pickup at the chemist
>> 4 days later.
That's how mine works too. Only covers two regular meds and one of those is something Alendronic Acid prescribed after I broke my hip. Faff to take and I was somewhat alarmed by possible side effects so in practice I've never ordered it.
I paused the other in summer as anxiety it was for seemed better but I've resumed in last two weeks. Will be interesting to see if I can just repeat or whether I need a consultation.
They won't put some stuff, like codeine for back pain on repeat - I have to to a telephone consultation when problem recurs to get that.
Still, it's all free from now on (60).
|
>>...Alendronic Acid prescribed after I broke my hip. Faff to take and I was somewhat alarmed by possible side effects so in practice I've never ordered it.
You avoid thus another problem with it - it makes tooth extraction harder. The only "Faff" I get with it is the need to remain upright for at least 30 minutes after taking. I haven't experienced any other side effects although reading the leaflets with my dozen medicaments I find several items that should not in theory be taken with others.
|
>> Still, it's all free from now on (60).
Free for diabetics too. Don't have to wait until you're 60.
|
>> My repeat medication is also ordered on-line though my GP surgery website, and then gets
>> sent to the pharmacy in the same building.
>>
>> I only get supplied with what I have requested from the list.
Same here although I have mine sent to a satellite surgery. I have four drugs and for one of them I only take half a tablet, so I omit that every other four week period as they come in 28s.
I can get away with ordering a day or two early which has the effect of bringing forward the next ordering date so I can build up a buffer which I like to maintain at around a month. The system doesn't recognise 'tablet anxiety' - when you take what is for you a life saving drug, getting down to a day or two's supply is actually stressful.
I take mine religiously notwithstanding some bearable side effects, and my recovery has been far better than was expected which is due solely to drug therapy. I was very surprised to discover during the group discussions at cardiac rehab how many people say "I'm on such and such a drug but I don't take them because they make me cough/ache/sleepy/nauseated" or whatever. I imagine some of them build up cupboards full.
|
>> It makes no difference - I get
>> the lot, regardless.
>>
>> This has happened several times and I can't find out why. The pharmacy apologised. My
>> wife collected the latest order yesterday.
Why not get the pharmacy to check the contents of the package before they hand it over?
That's what I do.......
|
My surgery will only give 1 month supply at a time except in special circumstances. If I am ordering early/extra I add a comment to the online form.
Mine are automatically sent to Tesco for dispensing. It used to take a couple of days but the last few times I have had the text from Tesco to say they are ready late ion the same day as the request went it.
Maybe twice in the last year Tesco didn't have the prescribed smaller size of a cream which I intermittently need. Both times they simply gave me the (much) larger size... Also I got some gout tablets and they gave me a small bottle full instead of the 6 which I normally get but that was a mistake on the prescription.
As an aside, I recently saw the locum for something and he reviewed my drugs and was surprised I have been ion Omeprazole for many years. He recommended against it due to side effects and interactions, which I then read about, and as result I'm trying to wean myself off it but it would be good to get something else to relieve the symptoms (quite severe reflux).
|
I go to the doctor and get a printed prescription. Typically a prescription covers 3 - 6 months, and in my case 5 different drugs.
I take that in person with my ID to the insurance company who register it and tell me which pharmacy chain I must use.
The pharmacy's computer computes the daily dosage for each drug, the quantity it is supplied in, and the date that a refill will be due. I must pick it up on that day or within 3 days afterwards. On that day I walk in, show my ID and get handed whatever the computer says I should be handed.
Consequently with the variations in dosage and packet quantities you can be pretty sure that each drug is on a different day and it is almost impossible to synchronise them.
One month before the end of the prescription period I then have to repeat the whole process from the beginning.
If you're leaving the country for a period, tough luck. The drug refill dates wait for no man, and most certainly cannot be moved closer to give you a travel supply.
Last edited by: VxFan on Tue 3 Mar 20 at 12:44
|
|
We've got a pharmacy in the same building as all the Drs. Makes things much easier, we can get upto 6 months supply at a time.
|
>> We've got a pharmacy in the same building as all the Drs. Makes things much
>> easier, we can get upto 6 months supply at a time.
Ours has a village pharmacy attached which provides OTC medicine and stuff like toothbrushes, soap etc you'd expect. It's also more recently provided a home for the Post Office. Prescriptions go straight through and can be collected as soon as you walked round from the consulting rooms.
However for some reason patients from other villages still have to use the dispensary within the surgery which everyone used until the pharmacy was built.
Assume reason is money.
|
I take a couple of drugs, one's supplied in 28 day cycles the other (much more expensive and foreign sourced, in 30 day cycles). Because of brexit I've been ordering both regularly and I now find find I've a 4 month supply of the most expensive, compared to a 2 month supply of the cheaper.
I'm not telling my surgery.
All are well within date.
Last edited by: bathtub tom on Tue 17 Dec 19 at 16:35
|
"We've got a pharmacy in the same building as all the Drs. "
We have that too but it's in the middle of town and I am in Tesco more frequently than I am at the doctor.
There are also now a choice of suppliers who will deliver to your door, for no cost I believe. There must be money in dispensing!!
Last edited by: smokie on Tue 17 Dec 19 at 16:30
|
|
I don’t have any medication for anything, probably because it’s nigh on impossible to get a Doctor’s appointment in these parts. I guess the system is working :-)
|
>> I don’t have any medication for anything, probably because it’s nigh on impossible to get
>> a Doctor’s appointment in these parts. I guess the system is working :-)
Funnily enough i rang up today at around 3pm got in at 9.30 tomorrow morning. Must have been lucky ;-)
|
We have that too but it's in the middle of town and I am in
>> Tesco more frequently than I am at the doctor.
Ah right, I dont have anything on repeat prescription so it's a Drs visit each time first.
>> There are also now a choice of suppliers who will deliver to your door, for
>> no cost I believe. There must be money in dispensing!!
We don't have anything like that.
|
You do, if you have repeats...for instance
tinyurl.com/w2zbbft
tinyurl.com/t4t6ggz
But when writing that I was thinking of a van service I've seen buzzing around here, which may just be the local chemists.
Last edited by: smokie on Tue 17 Dec 19 at 17:27
|
A&E last week:
Case 1- an 85 year old woman presents herself. She has a cold. Temperature normal. Otherwise fit and healthy, even spritely. Wants to be "looked after". Does not live alone. No evidence of abuse.
Social services called. Can they look after her? No, she owns her substantial home and has enough cash for a new BMW in her current account and would need to pay towards accommodation and doesn't want to. Sent home.
Case 2 - A domestic violence case brought in by ambulance, a seriously cut and bruised accountant. After 8ish hours the consultant discharges the patient home despite protests from Miss Z as patient is in fear for their life. Social services manage to find safe accommodation. Police advised. Nothing expected to happen.
Case 3 - Toddler is ill and is rushed to A&E by parents. It doesn't look good and Miss Z is on the phone to London hospitals to find a specialist unit with a bed. At last a place is found and an air ambulance is called but the toddler dies just as it arrives. Consultant, Miss Z and nurses all shaken. Mother collapses and is admitted, understandably. (Parents have done nothing wrong.)
All the staff in the department seem to be constantly "exhausted".
The hospital failed to meet all of its waiting time targets for the last couple of months and just doesn't have enough bays to cope.
Last edited by: zippy on Tue 17 Dec 19 at 19:47
|
Christmas ruined
There is a spate of illness on A&E at the moment and shifts have been re-drawn and the troops are very unhappy.
Daughter is now working 21:00 Christmas Eve to 08:30 Christmas Day, then 21:00 Christmas Day to 08:30 Boxing Day and the same for the rest of next week.
She wont be home for Xmas so we will probably go down to see her on the 27th.
Last edited by: VxFan on Thu 19 Dec 19 at 01:58
|
>> Christmas ruined
>>
>>
>> There is a spate of illness on A&E at the moment and shifts have been
>> re-drawn and the troops are very unhappy.
Norovirus? There's a warning notice in the doctor's although I don't know anybody affected.
|
>> Norovirus? There's a warning notice in the doctor's although I don't know anybody affected.
>>
Yes and flu despite most staff getting the jab!
|
In a good year the flu jag covers about 50% of the influenza strains in the community.
Does hee-haw for colds.
|
Exactly what I was about to say..
The majority of staff/people going off sick in my hospital haven't had flu even though that is the condition hitting the headlines, most have coughs and colds.
The vaccine is being pushed as the silver bullet over basic hygiene... washing hands, covering your mouth when coughing, using tissues and throwing them away, where has the information about 'coughs and sneezes spread diseases' gone?, it's probably easier to push the injection to the public.
The flu vaccine is based on last years strain so will always be an educated 'guess'.
|
|
By all accounts this years vaccine is a pretty good match for the virus currently circulating. It does seem amazing that so many healthcare staff don’t get vaccinated.
|
>> By all accounts this years vaccine is a pretty good match for the virus currently
>> circulating. It does seem amazing that so many healthcare staff don’t get vaccinated.
>>
Daughter said they had a posse armed with the jab and stickers “I’ve been vaccinated” stickers. Getting as many staff as they could.
Work have paid for all of us to get done at a local pharmacies, I need to get mine done!
A few years ago my GP did me when I had my sleeve rolled up after a blood pressure check - without asking! Said he was paid for each one and had a quota! I was too dumbfounded to be annoyed and he was a very good GP otherwise (shame he retired after the local health authority said his practice was too small and the partners weren’t in a position to invest further). We now have a “Virgin” practice and a six week appointment delay and you never get to see the same GP.
|
>> We now
>> have a “Virgin” practice and a six week appointment delay and you never get to
>> see the same GP.
That can't be right. Boris said the NHS would never be privatized.
|
Miss Z knew it would be an interesting night last night in A&E when she arrived at work half an hour early to see a helicopter landing.
Waiting time was 10 hours for all but the most serious patients.
Locums were called to take up the slack and were offered £67 an hour. Not one accepted! The Trust refused to offer more.
Two other junior doctors went home halfway through the shift. One fainting from exhaustion and one started throwing up on patients.
Spoke to her again this morning as she walked back to her car. She was in very high spirits despite two young people dying on her. Puts everything in to perspective.
Still an awful lot of people turning up in the middle of the night for non-emergency treatment.
She thinks she will sleep well today and is coming home later this week for her delayed Christmas!
|
|
How is your recovery going, Zero?
|
Since the New Year, major southern hospital has implemented a new shift rota in A&E.
Two nights on, two days on, eleven hours between shifts, i.e. a change from nights to days without time to reset ones body clock.
The medical staff have been dropping like flies with one junior doctor attempting suicide and another actually referring himself to an A&E department at a nearby hospital because he is so sleep deprived, he keeps "seeing things". Another collapsed in the ward through exhaustion and sick leave is "through the roof".
Miss Z refuses to drive to work at the mo because she is too tired. Her flat mates who have sensible shift patterns drive her to and from work if they are not on shift and she gets a taxi otherwise. She has done similar for them when they have been exhausted after shifts.
Locums currently know better and don't take up offers of about £600 per shift.
The junior doctors have been asking for a week of nights, 2 days off (a weekend - even if its mid week) and a week of days but the hospital refuses.
|
Do you mean two days then two nights? It's not possible to go from nights to days with only an 11 hour rest.
My NHS employer does two days then two nights. For staff who do not follow a set rota (relief staff) there has to be a sleep day then a rest day between finishing nights and starting days.
|
>> Do you mean two days then two nights? It's not possible to go from nights
>> to days with only an 11 hour rest.
>>
>> My NHS employer does two days then two nights. For staff who do not follow
>> a set rota (relief staff) there has to be a sleep day then a rest
>> day between finishing nights and starting days.
>>
The person who manages the rota insists the 11 hours are the sleep day.
As of this morning this is being reviewed by the trust as a number of the team have gone en masse to HR.
|
|
Clearly "the person who manages the rota" does not work these shifts. Perhaps they should.
|
>> Clearly "the person who manages the rota" does not work these shifts. Perhaps they should.
>>
My daughter has been through this mess time and time again over the years.
In the early days, a couple of times, I had to drive her from N Surrey back to Warwick and return home by train/tube/train.
There was no way I would allow her to drive.
I could sleep knowing she would avoid coming to harm on her trip back to the hospital rota.
|
>>Two nights on, two days on, eleven hours between shifts,
I'm sure it's awful, but I don't quite understand how can it be an 11 hour gap? If I finish a night at 6:00am, then 11hrs later would be another night?
My understanding to one side, who sets these shift patterns? Surely it's someone who at least understands how many hours sleep a human being needs?
|
|
HR departments are usually great at doing things by the book when it suits them. I'm sure there'll be a book for this.
|
>> There's probably a law.
I think the NHS got dispensation.
|
|
One of those undesirable EU laws (or directive)...
|
>> How is your recovery going, Zero?
Oh missed this,
My post op wound completely healed just two days before my departure on the cruise. Bowel function is now not bad it just speaks to me now in a different tongue, so its a bit confusing. But life goes on -
|
>> Bowel function is now not bad it just speaks to me now in a different
>> tongue, so its a bit confusing.
Hmm.
|
I worked all manner of shift patterns. They become a compromise between what the employee would like and what the employer needs to cover periods of demand throughout 24 hrs.
Initially I worked a mixture of 8 hour shifts, Nights, Lates and Earlies. 7 nights. 2days off (one of which you were in bed and then a mixture of lates and earlies which were constructed with a couple of quick swings ie 8 hours off between shifts. 28 day rota 8 days off including a floating rest day to make up the 8, on of each day. 3 day long weekend was sacrosanct before nights
The 7 nights were were too long as the body clock turned, and the quick turn rounds no one slept.
4 nights were deemed the maximum for health benefits and 11 hours between shift was something that came from the EU. Other than exigencies of duty.
Modified shifts were introduced but to achieve them some shifts were longer than 8 hours. NO more than 4 days working. The troops loved them and they remained for some time until it was realised that they were detrimental to service delivery and they have been changed a couple of times much to the anger of the troops.
There are no 'good' shifts but there are better rotas to be had.
|
The airline industry has well researched shift patterns although the maximum working hours are now targets to aim at by the employers....
But I would want my health workers being treated in no worse a way than a pilot in this regard.
Last edited by: Netsur on Tue 25 Feb 20 at 06:18
|
Disappointed that young doctors still don't have the c****** to tell their managers/consultants to GTF.
When I worked in A&E there was a weird rolling rota where there were 8 different weeks ranging from 40 to 84 hours (7x12 hour nightshifts).
By arranging it this way the average came down to the max 48 hours (above which much higher overtime payments came into effect.
The way they tried to cheat us was to only allow annual leave on a week where the shift was 40 hours.
Apparently that's how it had been done for years.
Sorted that pretty quick.
|
>> Disappointed that young doctors still don't have the c****** to tell their managers/consultants to GTF.
I must have had a very sheltered life.
What is the c****** word? C followed by 6 asterisks? Cunning?
No. I give up!
|
That wont help him, he disnae speak jock.
round spherical things that dangle. Car hoe ness. YOu need to pay attention to your clint eastward film lessons there Dunc.
(impressed the swear filter covers spanish slang)
Last edited by: Zero on Tue 25 Feb 20 at 09:20
|
>> (impressed the swear filter covers spanish slang)
A certain bloke formerly from RLBS was responsible for that, IIRC.
|
>> (impressed the swear filter covers spanish slang)
Only 'cos we've taught it!!
|
Reminds me of the few months I worked as a private mental "home" (aka Bedlam) attendant.
Staff worked every single day on a 4-day roster. The nearest we got to a day off was a 3-hour shift. Not surprisingly, the staff exhibited more signs of insanity than the patients. I decided to leave both. This was the place:
discovery.nationalarchives.gov.uk/details/r/2b50b779-503e-41b0-abf8-b92744ab6d39
|
I did a survey at this place in the 60s. Wow! How depressing.
en.wikipedia.org/wiki/Cane_Hill_Hospital
|
>> I did a survey at this place in the 60s. Wow! How depressing.
>>
>> en.wikipedia.org/wiki/Cane_Hill_Hospital
Much visited by urban explorers after closure.
Have you seen how Holloway Sanatorium turned out after closure? It became Virginia Park, here is one of the apartments
www.rightmove.co.uk/property-for-sale/property-66854961.html
|
And of course - Cambridge Military hospital, Aldershot. A site I visited many times on business.
www.theurbanexplorer.co.uk/cambridge-military-hospital-aldershot-hampshire/
Aldershot Military Prison (I only went in there once!) was the location for the original film version of 'Porridge'.
en.wikipedia.org/wiki/Aldershot_military_prison
Last edited by: Duncan on Tue 25 Feb 20 at 11:10
|
Loads of these places dotted around the country. Mrs B's sister was bi-polar and spent some time in St Edwards at Leek:
en.wikipedia.org/wiki/St_Edward%27s_Hospital
My Mother, after retirement, worked as a volunteer at High Royds:
en.wikipedia.org/wiki/High_Royds_Hospital
Her speciality was helping those patients who struggled with reading to upskill.
Last edited by: Bromptonaut on Tue 25 Feb 20 at 11:23
|
We had more than our fair share in Surrey.
en.wikipedia.org/wiki/Brookwood_Hospital
Now a large modern housing estate, with a small modern secure unit (very secure - guards, fences, the lot)
With the closure of these places, and it numbers in the hundreds, one wonders what became of the past, present and future inmates.
Of course a percentage should never have been there in the first place, a percentage will be successfully treated at home, but we know a significant portion have fallen through the gaps, ending up in and out of police cells and doing prison time.
|
Another site is Normansfield , Teddington by the banks of the Thames opposite Kingston, where the famed Dr John Langdon Down did so much of his work.
www.google.com/maps/search/normansfield/@51.4198668,-0.3145631,16.75z?hl=en-GB
Not an impressive building but some is preserved including its unique theatre and also contains a museum.
|
Zed sed "a small modern secure unit (very secure - guards, fences, the lot)"
My daughter used to be a nurse in one of the most secure units in Birmingham. I don't think they had outdoor guards a la Stalag 19, and all of the staff in the unit were just trained nurses, with some additional training like restraint etc and a panic alarm.
I don't recall her mentioning any attempted or successful escapes but they regularly had "incidents" and, if any were required, they were dependent on support from the police (about once a month I think), but there seemed to often be reluctance on the part of the police to attend as they thought the place had its own security staff, despite many "lessons learnt" multi agency meetings where it was clearly communicated that they hadn't.
She also did a few months (working, not committed!) in Broadmoor and definitely came into contact with one or two of the Big Names but won't tell us who. That also is apparently staffed with nurses... no "warders" or anything like that.
She now is a mental health nurse in the community. I'd say they are quite brave as she often visits pretty sick people alone, she just has to call in before she goes in and again when she comes out. If anything did happen I imagine there could be quite a time lag before anyone noticed, and even longer before help arrived.
|
>>Secure units...
Miss Z did a stint after she first qualified at a mental health unit in the south.
There was very little protection for staff and some of the female patients were terrifying, in that they plotted action to hurt or injure whilst the males were either violent or not and you could just avoid the violent ones.
Strip panic alarms that go along the walls were not in all rooms and patients knew it.
>>She now is a mental health nurse in the community. I'd say they are quite brave as she often
>>visits pretty sick people alone, she just has to call in before she goes in and again when she
>> comes out. If anything did happen I imagine there could be quite a time lag before anyone
>>noticed, and even longer before help arrived.
Miss Z has done accompanied visits to mental health patients at their homes just after she qualified. One of her trainers had two phones; his smart iPhone and a cheap Nokia on an unlimited SIM. Against all the rules he would make a call before he went in and left the phone on through the visit. He would not say who he called but the reasons as to why were obvious.
|
Miss Z is home for the weekend.
The hospital has been rotating staff out of A&E this week because there has been a bit of a crisis as too many are falling ill / keeling over from exhaustion, including consultants.
She was rotated on to the vascular ward and one of the team there is doing some of her stint in A&E. Other A&E staff have temporarily swapped with other departments.
She said it was so different there, a normal manageable pace where you can give proper care.
She did some counting over coffee this afternoon. Apparently the patients' leg to head ratio on the ward is 3 : 11! It's not quite a 2:1 arm to head ratio either!
Last edited by: zippy on Sat 29 Feb 20 at 01:49
|
>
>> She did some counting over coffee this afternoon. Apparently the patients' leg to head ratio
>> on the ward is 3 : 11! It's not quite a 2:1 arm to head
>> ratio either!
Does that mean that the patients have a total of 11 heads between them? And they share 3 legs?
No. No. I am not paying proper attention. Am I?
|
>>Does that mean that the patients have a total of 11 heads between them? And they share 3 legs?
Either that, or 3 heads share 11 legs!
|
the state of the NHS - CGNorwich
