Unbelievable

[otherclive]

1030 this morning we drive by our local church and there was a lady lying in the ground, half her body on the kerb, half on the road. There were three people around her and she was covered in some blankets. Driving home at 1210 she was still there as she was when I drove to the HRC. at 1420. Coming back from the HRC at 1450 an ambulance had just pulled up.

I don’t know the circumstances but nearly 4.5 hours to wait for medical attention tells me there’s a lot more work required to get the NHS back to par.

 

[Mr Plodd]

A while back we we were at a walking group lunch at a pub, one of the members had what appeared to be a stroke. So I rang for an ambulance, explained exactly what the symptoms were and asked how quickly they could get an ambulance to us as we were, at most, a 5 minute car journey from A & E, so if the ambulance was going to take longer I would bundle the lady into my car and take her there to save time.

Despite much cajoling the call handler simply refused to tell me "We cannot give out that sort of information" being the constant reply to my pleas.
Why not asks me, I am trying to do the very best for this patient, just tell me if it's going to be here quicker than me taking her to hospital myself. A simple enough question, or so I thought. But no, I was just met with the same pathetic answer. Whilst attempting to talk some sense into the operator I heard a siren approaching, which happiky turned out to be "my" ambulance (in double quick time I thought)

But what a ludicrous situation to be in, a simple "I cannot get an ambulance to you for 15 minutes" or whatever would have enabled me to make an informed decision and get the lady to A & E with minimum delay as time is critical in regards to treatment for a stroke.

I am glad to say the lhe lady made a 95% recovery from her stroke, but would the end result have been so good if I had waited and the ambulance had taken 20 minutes???

 

[RogerL]

A while back we we were at a walking group lunch at a pub, one of the members had what appeared to be a stroke. So I rang for an ambulance, explained exactly what the symptoms were and asked how quickly they could get an ambulance to us as we were, at most, a 5 minute car journey from A & E, so if the ambulance was going to take longer I would bundle the lady into my car and take her there to save time.

Despite much cajoling the call handler simply refused to tell me "We cannot give out that sort of information" being the constant reply to my pleas.
Why not asks me, I am trying to do the very best for this patient, just tell me if it's going to be here quicker than me taking her to hospital myself. A simple enough question, or so I thought. But no, I was just met with the same pathetic answer. Whilst attempting to talk some sense into the operator I heard a siren approaching, which happiky turned out to be "my" ambulance (in double quick time I thought)

But what a ludicrous situation to be in, a simple "I cannot get an ambulance to you for 15 minutes" or whatever would have enabled me to make an informed decision and get the lady to A & E with minimum delay as time is critical in regards to treatment for a stroke.

I am glad to say the lhe lady made a 95% recovery from her stroke, but would the end result have been so good if I had waited and the ambulance had taken 20 minutes???

I'm surprised they wouldn't give you that information - a couple of years ago I fainted when I stood up too quickly (to chase a cat!) - my wife and a neighbour called for an ambulance and were told they were under extreme pressure so could they take me to hospital themselves, which they did.

 

[Buckman]

When OH had an issue, they were around within the hour however on arrival at A&E she was kept in the ambulance for 8 hours!

 

[Beardy]

When OH had an issue, they were around within the hour however on arrival at A&E she was kept in the ambulance for 8 hours!

So two paramedics and an ambulance unable to respond to emergencies for 8 hours. 🤦‍♂️

 

[Buckman]

So two paramedics and an ambulance unable to respond to emergencies for 8 hours. 🤦‍♂️

If we add up all the occasions in 2022 that she spent trapped in the ambulance we are probably looking at over 30 hours. Every time was a life threatening emergency.

 

[Hutch]

When I thought my wife had a stroke at 08:30, I quickly assessed her and gave her an Aspirin, and called 999. The ambulance was with us withing 10 minutes, I can drive to the hospital in 20 minutes. She spent all day in Hospital having checks. Very grateful.

But when I thought I had a heart attack, at 07:00 ambulance car and Ambulance arrived withing 15 minutes, checked me over, Thankfully Not a heart attack but wanted me to go to A and E, for further check, go under your own transport as we have another call.
Turned out to be Gall Bladder, 3 days in Hospital after surgery next day.
There are reasons our Ambulance services cannot get to us.

 

[Buckman]

When I thought my wife had a stroke at 08:30, I quickly assessed her and gave her an Aspirin, and called 999. The ambulance was with us withing 10 minutes, I can drive to the hospital in 20 minutes. She spent all day in Hospital having checks. Very grateful.

But when I thought I had a heart attack, at 07:00 ambulance car and Ambulance arrived withing 15 minutes, checked me over, Thankfully Not a heart attack but wanted me to go to A and E, for further check, go under your own transport as we have another call.
Turned out to be Gall Bladder, 3 days in Hospital after surgery next day.
There are reasons our Ambulance services cannot get to us.

The main reason is that hospitals were built for a smaller and younger population and can no longer cope with the increase in population and aging people.

Our local hospital spent millions renovating an existing building to increase the size of the A&E. As a walk in patient, you need to go down a long flight of steps equivalent to one floor. If you are disabled you need to go to the far end of the car park to access the ramp.

However they still have the issue of patients stacked up in corridors in A&E because no beds are available hence the ambulance is tied up with a patient in it and cannot go out on calls. Very sad state of affairs!

 

[RogerL]

Last time I was at A&E, ambulances were stacking up outside, unable to admit because A&E couldn't move patients onto wards who in turn couldn't discharge patients who needed care "packages"

We may talk about the NHS being broken but in reality it's the care system that's broken and causing a "log-jam" throughout the NHS.

 

[GaryB]

Being young-ish (55) and quite fit I've never had the NHS experiences that some of you have had. However, today, I tried to make an appointment at the doctors (sinus pain for 2 weeks), the first available appointment is with a nurse, 5 weeks away! I dread to think what the service will be like in a few years when I start to need it more.........

 

[Buckman]

Last time I was at A&E, ambulances were stacking up outside, unable to admit because A&E couldn't move patients onto wards who in turn couldn't discharge patients who needed care "packages"

We may talk about the NHS being broken but in reality it's the care system that's broken and causing a "log-jam" throughout the NHS.

I don't think the NHS is broken at all, it cannot cope with a population that has increased in size since the hospital was first built. Worcester hospital is a fairly recent build, but since it was built the population has increased considerably.

It did not help that they closed down the hospital in Kidderminster which is now mainly used for consultations. That hospital had some very modern facilities that were removed and taken to Worcester hospital in the late nineties and it now no longer has an A&E. A person requiring A&E now has to travel to Worcester a considerable distance when it is an emergency!

 

[otherclive]

Last time I was at A&E, ambulances were stacking up outside, unable to admit because A&E couldn't move patients onto wards who in turn couldn't discharge patients who needed care "packages"

We may talk about the NHS being broken but in reality it's the care system that's broken and causing a "log-jam" throughout the NHS.

Social care is one that since 2010 no one has had the courage to pursue despite grandiose sounding statements.

My daughter is a mental health nurse who has worked with the elderly for many years. She told me that in our trusts area the local authority social care staff are trying to put customised at home care packages in place for people who cannot cope with carers and at best would need a 24 hour live in carers. This is cheaper than a care home placement. So whilst there are places in care homes the patients fit enough to discharge are retained in hospital. The failure rate of in home care is not good unless the patient has close by relatives or friends that can supplement the cares.

So where my BIL is looked after only 28 of 41 rooms are occupied. Nett result is that his annual fee is nearly £80k and rumours are the home (a charity) could close.

I really feel that sorting out social care is a vital step to helping the NHS get back on its feet.

 

[ProfJohnL]

I don't think it's easy to place blame on any single part of the NHS's organisation for the way events and circumstances have evolved and left us with such apparent chaos and long waiting times we seem to be seeing.

The provision of Health Care across all settings is a very complex set of procedures, and successive governments have all failed to fully understand the extent and cost of providing what we have come to expect.

When the NHS was created in the 1940's the population had a very different demographic, to today, and the expectations of the public were also very different. In practice much of the medical knowledge was still fairly primitive, and the Dr's may have had a name for a condition, but they didn't necessarily know how to proactively cure it.

One of the strengths of the NHS was it had the critical size and funding to start more research and to produce better outcomes for many conditions, but it also means it has now identified many more conditions which through developments it can now treat. This has widened the scope of the NHS and as is so often the case these new procedures and medicines all add to the cost burden on the NHS. And it has increased the public's expectations of what the NHS might be able to do.

A&E and Hospitals are just steps in the critical healthcare system,
and they are dependant on systems and procedures outside of their direct control to allow them to function effectively. "Bed blocking" is often cited as being a major restriction for the admission of critically ill patients. This is where the hospital is not satisfied the discharge route for a patient has been properly facilitated to receive the patient with their post discharge needs. This process actually falls on the local authority over which the hospital has no directive control.

We also have to recognise the demographic of the population has changed, partly due to the success of the NHS, the UK population as an increasing number of older people and as anyone ages they are more likely to need medical help so the burden on healthcare is increasing.

As Oc has pointed out the social care system (again local authority based) needs both a massive injection of funding and a more cohesive management that can quickly bring the necessary resources and support to meet post discharged patients short and long term needs.

Whilst these would be great interventions, there are still other needs to be addressed to bring down the pressure on the A&E and hospitals in terms of the numbers of minor conditions that present at the emergency departments rather than being handled more effectively by local service distributed across the population such as GP Surgeries, Pharmacies, heath centers, or even minor injuries facilities. locally, rather than centrally.

 

[Buckman]

A weird abnormality. A doctor coming from South Africa can walk straight into a job in the UK. A GP from the UK going to work in South Africa would not have enough qualification to practice as a doctor and would be required to undergo more training.

A friend of ours from Johannesburg who is a qualified Doctor migrated from SA to the UK to work in the NHS. hHe worked here for 3 months before moving on as his argument was how to can you diagnose a patient properly in 10 minutes which was the time allocated for each patient. The last I heard was that he had a successful practice in the states.

 

[Mel]

There are massive structural issues in the NHS and Social Care that need an expensive root and branch reorganisation.
However, the problem is that no one wants to face the grim reality that demand is always going to be near infinite and resources are finite. We expect more and more from our health and care systems and the realities of a generation ago of illness and death are no longer acceptable.
That is not to say that things could not be very much improved, but until it is accepted that infinite demand is impossible then restructuring will always eventually fail.
Mel

 

[Dustydog]

Last time I was at A&E, ambulances were stacking up outside, unable to admit because A&E couldn't move patients onto wards who in turn couldn't discharge patients who needed care "packages"

We may talk about the NHS being broken but in reality it's the care system that's broken and causing a "log-jam" throughout the NHS.

A decade ago North Devon had a half way house rehabilitation centre where people were sent after a stay in hospital. Not ill enough for hospital but not well enough for home. My Mum ended up in this lovely home , Oakwell, for four weeks where she was retaught how to fend for herself.
It took the burden off the NHS hospital and gave encouragement and hope to their residents.
Sadly it was pulled down by the then Government and sold off for a new housing development 🤬🤬

Let’s reinvent the wheel😵‍💫

 

[RogerL]

A decade ago North Devon had a half way house rehabilitation centre where people were sent after a stay in hospital. Not ill enough for hospital but not well enough for home. My Mum ended up in this lovely home , Oakwell, for four weeks where she was retaught how to fend for herself.
It took the burden off the NHS hospital and gave encouragement and hope to their residents.
Sadly it was pulled down by the then Government and sold off for a new housing development 🤬🤬

Let’s reinvent the wheel😵‍💫

Some of our local hospitals have refurbished and reopened old wards where they do the same - it seems better to operate these wards as short-term care homes as it frees up space on specialist wards.

 

[otherclive]

There used to be places called convalescent homes where people would go after being discharged from hospital but who were not sufficiently well to go straight home. My parents used to go to ones in Filey and Ayr just as paying guests and enjoyed the break. Plus the food was excellent and all were given a free stout in the evenings to aid recovery whether patient or guest. Local Councils or Trades Unions would run them.

 

[Devonisheaven]

When I thought my wife had a stroke at 08:30, I quickly assessed her and gave her an Aspirin, and called 999. The ambulance was with us withing 10 minutes, I can drive to the hospital in 20 minutes. She spent all day in Hospital having checks. Very grateful.

But when I thought I had a heart attack, at 07:00 ambulance car and Ambulance arrived withing 15 minutes, checked me over, Thankfully Not a heart attack but wanted me to go to A and E, for further check, go under your own transport as we have another call.
Turned out to be Gall Bladder, 3 days in Hospital after surgery next day.
There are reasons our Ambulance services cannot get to us.

Hutch, you really should not give aspirin to someone who you believe is having a Stroke. If the cause is a bleed, you will makes things worse. 👍

 

[Hutch]

Hutch, you really should not give aspirin to someone who you believe is having a Stroke. If the cause is a bleed, you will makes things worse. 👍

The 999 responder, agreed to my giving 300 mg of Aspirin and getting her in a sitting position. This was told to myself on a company first aid course. And never contradicted over three incidences.

Edit I have just checked on NHS guide line, and Aspirin is NOT advised.
Thank you for correcting me. Seams like a lot of European health guide lines have changed.
Thanks Devonisheavon.

 

[RogerL]

The 999 responder, agreed to my giving 300 mg of Aspirin and getting her in a sitting position. This was told to myself on a company first aid course. And never contradicted over three incidences.

Edit I have just checked on NHS guide line, and Aspirin is NOT advised.
Thank you for correcting me. Seams like a lot of European health guide lines have changed.
Thanks Devonisheavon.

999 responders sometimes give advice which later proves to be diametrically wrong

I recently collapsed on a day out, my friends called 999 and were told categorically not to give me anything to eat or drink - on admission to hospital I was diagnosed as dehydrated and both doctors who checked me over agreed that advice shouldn't have been given -we'll never know but I suspect that if they'd been told to give me a drink that we could have avoided an ambulance call out and admission to A&E.

 

[Hutch]

Yet again, Never give water, due to internal ruptures. Is advised.

I think I will book myself into the St Johns accident course, I am obviously well out of date. .
Well out of date with my BSAC diving , rescue certificate.

 

[IanB1485]

Two things to add , . 1 if a casualty is conscious then the priority is low for an overworked ambulance service, if the casualty goes unconscious then the priority get 'bumped' up.
2.Once at A & E the ambulance crew can't leave the casualty until A & E staff accept them which stops them responding to new calls . Having worked at several hospitals as a contractor upgrading the Building Management Systems and Blood storage Equipment I have walked past lots of such casualties accompanied by ambulance crews in the corridors into A & E . The worst was a 21 car pile up on the M62 near Leeds. The corridors and outside A & E of Leeds general infirmary were crammed full , lots of blood and gore - not pleasant as they were not being sorted . Having said that, I sooner have an incident in the UK or Europe than in the U.S were they ask for your insurance/credit card before they will put you in the ambulance

 

[ProfJohnL]

A weird abnormality. A doctor coming from South Africa can walk straight into a job in the UK. A GP from the UK going to work in South Africa would not have enough qualification to practice as a doctor and would be required to undergo more training.

A friend of ours from Johannesburg who is a qualified Doctor migrated from SA to the UK to work in the NHS. hHe worked here for 3 months before moving on as his argument was how to can you diagnose a patient properly in 10 minutes which was the time allocated for each patient. The last I heard was that he had a successful practice in the states.

In reality Doctors in the UK also have to be able to demonstrate they partake and learn from Continuing Professional Development (CPD) failure to do so will bring them up in front of the General Medical Council

 

[Buckman]

In reality Doctors in the UK also have to be able to demonstrate they partake and learn from Continuing Professional Development (CPD) failure to do so will bring them up in front of the General Medical Council

Many of the doctors that we used in SA, could diagnose you in the morning with appendicitis and then operate on you in the afternoon. Regarded as "minor" surgery. In the UK our surgery has several docters, but only two can administer injections or do minor surgery