National Health Service

[Fester]

Two reasons for posting this article,

1, The failings of the NHS24 emergency telephone helpline are starkly exposed here, and have caused the premature and needless death of this poor man from Scotland.

2, I couldn't help but notice that the picture of him favoured by his family, has him on the Llandudno Cable Car.

See here..  http://www.bbc.co.uk/news/uk-scotland-24456142

[Ian]

If you read the full account, it's interesting, since it indicates very clearly several things.  The NHS 'helpline' was always doomed to fail, because it intersperses a human being between the patient and the advice. When you ring the helpline they 'tick boxes on (their) computer screen' and - in this case - some of the wrong boxes were ticked. If the human had been removed, then it would have been down to the patient to tick those same boxes.

Secondly, the helpline is designed to ward off the 'imaginatively ill' and direct the really ill to the appropriate (and increasingly overwhelmed) resources. Triage is difficult to do at a distance and still difficult to do in person.

Thirdly, whenever a sick person is face-to-face with any medical professional two discrete skills are brought into play: physical diagnosis through examination and taking history, through communication. The latter is essentially a process whereby the patient has to convince the Doctor of the seriousness of the condition and with some patients (and some Doctors) that's not an easy process.

I'm not sure the failings in this case actually "caused the premature and needless death of this poor man from Scotland.".  That may well have contributed, but Septicaemia isn't something from which you easily walk away and it's noteworthy that 'he concealed the extent of the illness from his family' for 24 hours because he didn't want to spoil their Christmas. Laudable as that was, without prompt medical attention that condition is often fatal.

[born2run]

Has anyone ever used the NHS website for diagnosis? Whenever I have typed my symptons into that it has told me to rin and ambulance straight away

[Fester]

If you read the full account, it's interesting, since it indicates very clearly several things.  The NHS 'helpline' was always doomed to fail, because it intersperses a human being between the patient and the advice. When you ring the helpline they 'tick boxes on (their) computer screen' and - in this case - some of the wrong boxes were ticked. If the human had been removed, then it would have been down to the patient to tick those same boxes.


I'm not sure the failings in this case actually "caused the premature and needless death of this poor man from Scotland.".  That may well have contributed, but Septicaemia isn't something from which you easily walk away and it's noteworthy that 'he concealed the extent of the illness from his family' for 24 hours because he didn't want to spoil their Christmas. Laudable as that was, without prompt medical attention that condition is often fatal.

The first thing to point out, is that (subject to the enquiry) it seem that SEVERAL human beings made critical errors. One is understandable, even foregiveable.  But several???  That smacks of very poor management, training, process, or a combination of all three.

On the point of whether you believe that this case 'caused' his needless death, that will be decided by the enquiry.
All I know is, if that was one of my nearest and dearest, I would be mightily angry about the fact that he laid there, seeking help whilst suffering, and it could have been prevented.

[Ian]

All I know is, if that was one of my nearest and dearest, I would be mightily angry about the fact that he laid there, seeking help whilst suffering, and it could have been prevented.

Well, I wasn't disagreeing with your assessment, F;  I was simply observing that the NHS incongruously named 'helpline' was always going to be an accident waiting to happen.

More seriously, perhaps had he thought to mention to his family how badly he was suffering, then something might have been done. 24 hours with Septicaemia and no treatment isn't recommended.   

Actually, I've long thought we've reached a point where distance treatment could be done.  There are several things that make this viable.

Most people who visit GPs don't need to. Most GPs have no idea what's wrong with their patients most of the time. Most people will (and do) get better by themselves. A small number of people rigorously abuse the system. A self-diagnostic program on your computer will usually do the job as well as or better than your GP.

We could slash NHS spending in three ways: refuse treatment to those with self-inflicted conditions - which includes falling over when drunk, drugged or self-incapacitated.
Institute rigorously-manned Triage points at A&E units.
Make visiting the GP an unpleasant experience by - say, chilling all waiting rooms by having all windows open all the time. That's why dentists aren't as overrun as GPs claim to be. No one enjoys visiting the dentist, so they only go when they have to. But too many local surgeries are simply social clubs for the local over-80s nudist clog dancing and low altitude free fall parachute clubs.

Note:  some of the above is in jest.
 

[Yorkie]

Despite all these problems, I have nought but praise for our NHS.  If it were not due to excellent diagnosis and expert treatment, i would probably have departed this World some years ago.

First open heart surgery in 1990 gave me a new lease of life and then the discovery and repair of an Abdominal Aortic Aneurism in 2000 gave me my second chance.  I live and love every new day and am forever grateful to my Surgeon and the super Hospital Staff who attended me.  ZXZ

[Fester]

This article tells that the MAJORITY of planned surgery in N Wales has been POSTPONED this week.
Another stark example of how badly under pressure the Betsi Cadwalader Authority is.

http://www.bbc.co.uk/news/uk-wales-25830185

What the article DOESN'T say, is how long patients have had to wait to even reach the stage of being allocated surgery, only to see it postponed.
I shall impart my current experiences.

Ophthalmic Surgery (Cataract).  Current waiting list time just for consultation, 52 weeks.   I have been waiting 67 weeks and I reminded them today.  The appointments clerk apologised and said I hear something soon!
I was given a leaflet saying 'Cataracts are a simple thing to deal with in this day and age, and we deal with them very quickly'
Hmmm.

Orthopedic Consultant.  (Knee replacement)  NHS Target just to get the consultation is 36 weeks.   I have been waiting for 50 weeks.
Again, I reminded them today.
The reply was, I should be offered an appointment at Wrexham hospital in the next few weeks,  as there is nothing at all in the foreseeable future at Glan Clwyd or Bangor.
When I mentioned the NHS target, I was simply told that they are nowhere near meeting their own targets, and actually never have!

It's getting a little worrying.

[Yorkie]

I am waiting for an Opthalmic Consultation, but was it not agreed that a Consultation should be a maximum of 18 weeks  after seeing your GP?

I have a letter from the appointments department which says if I have a problem before I get my appointment to go and see my GP or the Opticians.  Fat lot of good as they are the ones who diagnosed the problem!     

[Fester]

I am waiting for an Opthalmic Consultation, but was it not agreed that a Consultation should be a maximum of 18 weeks  after seeing your GP?

I have a letter from the appointments department which says if I have a problem before I get my appointment to go and see my GP or the Opticians.  Fat lot of good as they are the ones who diagnosed the problem!     

Indeed Yorkie, I was told 18 weeks, and I did get aONE initial consultation after waiting about 25 weeks...BUT, I attended 5 appointments, only because the Consultant 'phoned in sick' for 4 of them..... and I was sent home each time!
So, all in all it took ONE YEAR to actually speak to the consultant..... who then fobbed me off with a leaflet, and a promise of a follow up appointment 'in the future'

[DaveR]

Terrible treatment, especially when you consider the many billions pumped into the NHS. 

[Ian]

It seems we're caught in a vicious circle, too: fewer GPs, so A&E is inundated and hospital beds blocked because no suitable alternative provision can be found so with a rapidly ageing population the system looks to be grinding to a halt.

[Fester]

After working all year, (sat on my backside mainly), I have been taking time off recently and giving my already dodgy knees a thorough work out.  Long walks, darts matches, a million stairs at Penrhyn Castle, then the Gym etc...

So today, one of them gave up the ghost and my ligament ruptured when I stepped out of the shower.

The point of posting you this is tell you how impressed I was at Llandudno Hospital today, by the beleaguered staff of the  Minor Injuries Unit
I was seen and processed very quickly, and despite no Doctors being on duty at weekends, the Nurses level of expertise was first class.
The lack of resources was clearly evidenced by the fact that the Radiographer who X-rayed me had to also double up as Porter, as he came to wheel me to and from the X-Ray dept.  Then he also had to do the Admin to discharge me as there was no Clerk on duty.
The Xray dept is actually not open either, it is categorised as being 'On Call'

Nevertheless, I was in and out in about 90 minutes, and I'm really glad Mrs Fester compelled me to go, as due to this injury I will now get fast-tracked to getting some surgery.  Surgery that I have been 'on the list' for, for several years now!

 

[hollins]

Sorry to hear about your injury Fester but I hope you get it sorted quickly now.

[SteveH]

All the best Fester, hope all is well soon.. ££$

[Merddin Emrys]

They are excellent at Llandudno Hospital, hope you improve soon and it's not too painful! 😃