NHS

[acko22]

Hi,

Honestly @class37025, I do feel your pain when the better half was due they forgot a steroid injection which mean't a dash back to the hospital at 1am to be back there for 8am for a C section.

At the time I was not a happy bunny, but with been there for well a lot in the days after it was only then how I saw just how under pressure the anti natal department was and they are slightly detached from the rest of the hospital and what is going on.
They had a shortage of staff across the board due to what was going on (from the receptionists all the way up) and when we got a chance to speak to some of them not only was there that pressure but all of them receptionists included were staying in isolated accommodation away from their families so they didn't risk bringing the infection into their part of the hospital.
I know how hard that can be having done it for many months and well years on tour it's hard to keep a smile on your face, your head in the game and the patience of a saint. So yes they may have cocked up sadly but a bit of perspective can sometimes explain a lot of what is going on and how hard things are on their side too.

[honestjudge]

I'll add a bit to this conversation for what its worth.

I work for the NHS in a frontline clinical role. From what I see, my colleagues and most NHS workers do excellent work and help a huge number of people. Sometimes things go wrong, and those cases make the headlines, understandably upsetting for those involved. But to dismiss the whole NHS on those grounds is wrong in my eyes.

On some other points; there was a project to unify all the computer systems throughout the uk some years back, but I think cost and complexity and political will stopped that idea. Our region stopped using fax machines internally due to security of data . We either send out appointments reminders with SMS text or letters or both. Most of our patients are elderly and don't do email and like a bit of paper.

[Bealman]

I get SMS reminders for everything medical here, and it's brilliant. I can envisage elderly folk having a problem with that, however. As you say, they like it coming through the mail on paper.

But when I was a kid, I'd most certainly think of me as elderly!

[Railwaygun]

Breakdowns in communication seem to be behind many of the problems.

It all depends on the individual hospital unit/trust . I am a regular customer at Imperial (W London) who offer phone/txt reminders 1w and 1d before an OPD attendance is due, and you can book your next appt on the way out - they also have smartphone apps for all staff to access results from the bedside, and computers in all OPD consulting rooms.

So the NHS can get it right! It also gets things terribly wrong - NHS Direct was the forerunner to the 111 service and was doing video consults and online consults 10 years ago using a national network of linked call centres, call handlers backed by experienced nurses and decision support s/w.
it was replaced by 111, an inferior service not national ( different trusts /999 services were the providers , not linked initially) .

A similar episode occurred with OOH (Out of Hours services). Initially provided personally by GPs supported by  commercial services, the system was improved with formation of  GP coops, providing local GPs manning OOG centres and visiting services.

These coops closed overnight when the NHS changed the GP contract and they were not sustainable as a result. Now GP OOH is provided by commercial providers, and a few ex-Coop organisations. The proverbial one  Doc and a dog service, in the Walk in Centres/ GP units in hospitals,  or patchy visiting services.

( the Doc feeds the dog, and the  dog diagnoses!)

So constant re-invention of the wheel, aided/hindered by the independent trust system, Lansley contracting farce, and the odd epidemic or two!!

NickR (35yrs at the Couchface)

[chrism]

The proverbial one  Doc and a dog service, in the Walk in Centres/ GP units in hospitals,  or patchy visiting services.

( the Doc feeds the dog, and the  dog diagnoses!)

That takes care of the lab test, so who does the cat scan?

[themadhippy]

So constant re-invention of the wheel, aided/hindered by the independent trust system, Lansley contracting farce, and the odd epidemic or two!!

Dont forget  multiple layers of management and office wallahs telling those at the coalface how to do their job,each layer must have some one above telling them what to do and a layer below to pass on the commands .Of course i  could be wrong as im basing my theory  on the practice  of 30 years ago when 4 electricians needed 7 supervisors and managers to run the department,today i expect its closer to 1 multi skilled technician,19 managers and 47  contractors.

[guest311]

I remember years ago when my eldest daughter was in PRH, addressing a woman in a dark blue uniform as "Sister"

you'd have thought I'd suggested a quickie in the linen cupboard 

"I'm not a sister, I'm a nursing manager"

exit stage left in a foul mood. oooopppps

[jpendle]

Just bear in mind that no-one ever asks you for your credit card when you walk in or send you a bill after you leave.

Here in the US the OP's experience would have been a little different.

Go straight to Urgent Care, but only if you have insurance, if not go straight to A&E. Oh and don't forget to make sure the facility you go to is 'In Network' with your insurer.
See the triage nurse and then wait for 3 or 4 hours because the people actively dying take priority.
See the Physicians assistant or sometimes the Doctor and then get sent home with some meds and the prospect of a $1k bill winging your way sometime over the next 3 weeks.

Regards,

John P

[Bealman]

It's a bit like that here, too.

[guest311]

after being 'treated' sunday, daughter had to take him back again on monday as no improvement.

told anti-biotics were working, and given a spray to numb his mouth as in such pain with the ulcers there, then sent home.

tuesday evening, still no better, getting very listless, so son-in-law took him back, for the third time, to the Alex.
admitted, due to have IV and a feeding tube.
update today, apparently not tonsilitis, not thrush, anti-biotics prescribed not correct ones, now think it's a viral infection, but unable to get canula into his veins as now so dehydrated, and unable to get feeding tube in as his throat is now so swollen.
will probably be kept in for 3-4 days, and having a conference as to how to proceed now.

CEO's office now involved and an urgent case raised with PALS by CEO's office.

waiting now for some idea of how they intend to proceed.

[Newportnobby]

Poor little chap. Hope they can get things sorted asap, Alan.

[guest311]

Hi Mick,
many thanks for that.
I did manage, just before taking HB for his evening walk, to get hold of my son-in-law, and things are apparently improving.
Antony has managed to eat some ice cream, and the doctors have managed to get a canula into his arm, so he is now getting fluids and anti-biotics. they have also decided not to try any further with getting the feeding tube in, but he is being fed through the IV.
he is much calmer and more alert, I assume as he is getting the fluids back into him.
they are still waiting for his test results but are pretty certain he has just got a virus infection.
all being well, he will hopefully be discharged late tomorrow afternoon.

speaking of feeding, his dad has not been allowed to leave his room, even to go to the vending machines, which I can understand with the Covid restrictions, but he has been able to get a drink now and then.
he had not however been able to go and get anything to eat since Antony went up to the ward, but just before tea time he was asked if he'd like them to sort him out a meal. 

don't know if someone had realised he'd not been able to get anything to eat, or what, but obviously very much appreciated.
I also checked if he'd got enough cash on him to pay his parking, of course when he went down he was expecting to be there for a couple of hours, not days, but he said he's been told they will sort out his parking charges.

can't help but wonder if someone from the CEOs office may have been on the phone, or am I just being suspicious 

[Newportnobby]

Good news all round but, as you say, it does seem someone's butt has been kicked and a change of attitude has taken place although, as I've oft repeated, the folks at the 'coalface' know far more than the bosses how to treat people like human beings and not 'numbers'.

[Bealman]

You got that right, same in the teaching game too.

[guest311]

should be in the happy thread, but putting here, so there.

grandson discharged this afternoon and on his way home.
test results not back yet, perhaps the lab is out for a walk  , but  they will no doubt be forwarded to their gp so he can do a telephone update.

son-in law offered and had a breakfast, but didn't bother with lunch, though it was offered, and car parking charges waived 

so at least something was communicated.

hopefully he will be back to his normal energetic / annoying / loveable self in a few days.

so, a thank you to the front line staff, and I'm guessing the CEO's office / PALS, but still retain my views of the pen pushers, I'm afraid, but no doubt that will be resolved in due course.

so all in all ....