Computer says no ...

[mc281]

So would a five day gap be OK ? Ten days adrift? Where do you draw the line ?

We don't!

 

[Crazy Dave]

I popped into my surgery to see if they had a chiropodist the reply was "no" I asked if I could book an appointment to see a doctor the receptionist asked why I said that I have an ingrown toenail on my big toe she asked "is it infected?" I replied not at the moment to which she replied "come back when it's infected" I said I'm sorry to be such a nuisance, maybe I'll just go straight for the amputation and save you any bother.

6years on and I still have that darned toenail that bleeds but still hasn't become infected. I'm sure I don't have to tell anyone how sore it is or how difficult to cut, in fact I have to tear my nail as the cutters won't get in deep enough to cut it.

I'm not complaining but just saying how the system is.

 

[mc281]

I popped into my surgery to see if they had a chiropodist the reply was "no" I asked if I could book an appointment to see a doctor the receptionist asked why I said that I have an ingrown toenail on my big toe she asked "is it infected?" I replied not at the moment to which she replied "come back when it's infected" I said I'm sorry to be such a nuisance, maybe I'll just go straight for the amputation and save you any bother.

6years on and I still have that darned toenail that bleeds but still hasn't become infected. I'm sure I don't have to tell anyone how sore it is or how difficult to cut, in fact I have to tear my nail as the cutters won't get in deep enough to cut it.

I'm not complaining but just saying how the system is.

Go to a private Chiropodist!

 

[SammyQ]

Without knowing what the job description required I wouldn’t jump to the conclusion that having the role is poor value for money. PR is a generic label that can cover quite a range of actual tasks. An admittedly extreme (and heart-wrenching) example of where a hospital needs someone who can deal with the press is where parents end up taking doctors to court as they don’t agree with the decision to withdraw medical support for a child. I’d hazard a guess that NHS trusts have a constant flow of press and other enquiries to deal with.

A point well made, Blackswanwood, and I can fully see the necessity. That said, as the young lady in question is a family member, I can say that her job is more prosaic than the dire exremis you refer to; in fact, I get the distinct impression that she is one of a body of such individuals employed on a more mundane, daily basis to comb the press etc and 'spin' for the hospitals they are employed by.

To return to your point re heart-wrenching cases - like the mitochondrial disease one recently - I utterly agree, medics may not have the skills needed to handle the wider publicity and emotional overtones. Yes, a specialist in media is needed to ensure no mis- or dis- information is 'put out there' - whether intentionally (for whatever reason) or via the 'gossip machine' and the establishment and profession are not maligned for circumstances beyond their control and/or the limits of medicine.

Rhetorically, I'd put it to you, that, heavily emotional cases are rare enough to argue more for a specialised team, with a roving commision, operating out of a regional base, to be more effective and suck up fewer funds than the 'bread-and-butter, just-in-case' unit my family member represents, especially when you multiply it up across all major hospitals?

Yes, I run the risk of over-simplifying, but in the tenor of the original 'common sense defied' post by Phil, I think it does no harm to challenge the behemoth that the N.H.S. has become, noting ironically its simulataneous degradation in quality over the last three decades.

 

[worn thumbs]

Does anybody outside the system actually understand how the various trusts,commissions,authorities and colleges all manage to function together as a more or less cohesive whole?

 

[mc281]

Does anybody outside the system actually understand how the various trusts,commissions,authorities and colleges all manage to function together as a more or less cohesive whole?

No..... Just snipe without knowledge, just preconceived notions..... It's so much easier than learning the nitty gritty.... Bare in mind we are only upholding our 'Whinging Pom' reputation though.
There are always issues with any system and as the NHS is the largest, it's bound to have a lot more than most others.

 

[Phil Pascoe]

The assumption that they do is a trifle optimistic.

 

[mc281]

A point well made, Blackswanwood, and I can fully see the necessity. That said, as the young lady in question is a family member, I can say that her job is more prosaic than the dire exremis you refer to; in fact, I get the distinct impression that she is one of a body of such individuals employed on a more mundane, daily basis to comb the press etc and 'spin' for the hospitals they are employed by.

To return to your point re heart-wrenching cases - like the mitochondrial disease one recently - I utterly agree, medics may not have the skills needed to handle the wider publicity and emotional overtones. Yes, a specialist in media is needed to ensure no mis- or dis- information is 'put out there' - whether intentionally (for whatever reason) or via the 'gossip machine' and the establishment and profession are not maligned for circumstances beyond their control and/or the limits of medicine.

Rhetorically, I'd put it to you, that, heavily emotional cases are rare enough to argue more for a specialised team, with a roving commision, operating out of a regional base, to be more effective and suck up fewer funds than the 'bread-and-butter, just-in-case' unit my family member represents, especially when you multiply it up across all major hospitals?

Yes, I run the risk of over-simplifying, but in the tenor of the original 'common sense defied' post by Phil, I think it does no harm to challenge the behemoth that the N.H.S. has become, noting ironically its simulataneous degradation in quality over the last three decades.

How do you define a lowering quality?

 

[Spectric]

to which she replied "come back when it's infected" I said I'm sorry to be such a nuisance, maybe I'll just go straight for the amputation and save you any bother.

There is a hospital in Cumbria that would just remove the foot to make sure that the problem was fixed, then following sepsis they would start shortening your leg !!

 

[ajs]

to many pen pushers and people with daft or pointless jobs who are just like throwing a handful of gravel into a gearbox.

I suppose I would count as a pen pusher in a previous job, sending paper medical records between practice when they move. GPs, nurses etc knew the rules and why they were there. It was support staff - receptionists, practice managers etc that were the problem. They often seemed to be of the impression they could simply say "clinical need" and somehow the rules didn't apply.

The common case was people would move house and not re-register until they needed a consultation. Then they would do both at the same time and the GP would immediately request the notes as a matter of form whether they are needed urgently or not. So far, so fine, but that gets converted by the receptionist as critically urgent. No, you are not getting those notes. You have still not completed the patient registration process. I will not send those notes until you have. Argue all you like, that's the reality.

At first sight that may seem overly beaurocratic, but that's the law. For good reason - you probably don't want you medical records sent to just anyone that asks for them.

 

[SammyQ]

How do you define a lowering quality?

Sorry, sweeping generalism to make the post shorter. Specifically: longer waiting times (with particular impact on cancer patients); failure to sufficiently attract both medics and nursing staff and subsequently, to retain them. This then 'dominoes' into longer admission waits, from A&E to elective procedures and reduces recovery time available in hospital. Deteriorating premises, ergo, aging buildings no longer fit for purpose.

 

[Keith Cocker]

It isn't, it's very badly managed.

It’s hugely short of resources. That’s unarguable. Is it badly managed? That could be argued and probably true in some places and some areas.

 

[Phil Pascoe]

They're not short of resources - money - if they can afford diversity managers.

 

[--Tom--]

It’s as though chronic under investment in health for at least the past 10 yrs has led to issues
https://www.bma.org.uk/advice-and-s...orkforce/funding/health-funding-data-analysis
We should be angry with a Government that’s eroded one of our country’s greatest assets. Look at the issues in the US with healthcare, and then don’t fall in to the trap of blaming the people who are doing their best to keep it running.

How the pandemic hasn’t been a stimulus for massive change in the approach is beyond me.

 

[Blackswanwood]

Most organisations employing and/or providing a service to large numbers of people have dedicated teams dealing with diversity. It's the same point as I made earlier in relation to PR managers - they are unlikely to be spending their time hugging trees and are more likely to be embroiled in keeping their NHS Trust on the right side of the rafts of legislation that did not apply 30 years ago.

The NHS does get things wrong (and sometimes horribly so) but on the whole I feel they do a great job. We overlook the expansion in the demand that they deal with - some of which is driven by a greater sense of entitlement in society.

Another way of looking at the opening issue is perhaps to be grateful that a further vaccination is available at no direct cost and just accept the minor inconvenience of needing to wait a few days to be eligible to book an appointment. IMHO it falls very much into the category of being a first world problem.

 

[Phil Pascoe]

I accept the "minor inconvenience", I merely pointed out how bloody stupid the system is and question why idiocy like this is allowed to persist.
I appreciate they have to keep within the law - I know people who have employed total morons just because they have to meet targets. Personally I'd much rather they employed the best people than worry about said people's colour or sexuality, but my thinking obviously needs correcting.

The NHS does get things wrong? 21/22 it cost us £2,600,000,000 in negligence claims. An estimated £1,290,000,000 lost to fraud and theft.

 

[Phil Pascoe]

How the pandemic hasn’t been a stimulus for massive change in the approach is beyond me.

I believe it costs £800 a day to keep someone in a major hospital. I spent an unnecessary day in hospital waiting twelve hours for prescription to be made up. My friend, a GP, came to pick me up in the evening and said he'd go to the pharmacy for it so I could leave. It was a box of aspirin. I commented to a nurse that that was a day of my time and their bed wasted and she said yes, it happens all the time. You are not going to solve problems like this by throwing more money at them.
They could also sort out their buying. An acquaintance is a buyer in our local hospital, several years ago he told me he was paying £16 for a screwdriver bit (used in hip operations) that he could buy in town for 99p. The 99p one was the same steel as the £16 ones, it would need to be sterilized (not a problem) and was single use so chucked afterwards anyway. I asked why he didn't buy the 99p ones and he said that supplier wasn't on the list of suppliers he was allowed to buy from. The amount the NHS pays for drugs is often ludicrous and seemingly unquestioned. Brown envelopes come to mind.

 

[Jester129]

^^^^Phil, the 'thanks' is because it's nice to know there is someone else thinking exactly the same as me!

 

[--Tom--]

Pretty much all the challenges described will be down to stretched resources focusing on the most critical areas.

If they had more nurses you could have been cared for and left the hospital but as it was nobody had the time to focus on you with seeming a low need for support.
If the procurement team had capacity to worry about screwdrivers costs then it could be looked at- but I imagine they’re focused on bigger ticket items.

Imagine how much more likely you are to make a mistake in the workshop when you’re knackered- if there were more doctors, surgeons, nurses there wouldn’t be a need for massive amounts of overtime to help deal with waiting lists. Add in better equipped hospitals and claims against the nhs for negligence would go down.

All big businesses will fall victim to fraud- but fighting it needs investment in people and processes. Let’s not forget that anti fraud processes introduce steps - like procuring screwdrivers through approved mechanisms which will add in cost.

Easy to be a smelfungus with these things

 

[paulrbarnard]

Sideways, I must concur with Phil, having heard my son, now working 'at the sharp end' in emergency medicine, tell me about the pressures and practices of the N.H.S. The organisation is on its knees, but - for example - a hospital (I won't name it) thinks it is good practice to pay a P.R. salary of £70k?? P.R.?? Hello?!!!?? Who in pluperfect hell 'managed' that decision? What cerebrally deficient, oxygen-stealing, jumped up turdweevil thinks that is "more value" than say, two nurses?

They need the PR to counter the claims of bad management spending. Self fulfilling…