NHS Reform

[Tattie36]

8 minutes ago, welshbairn said:

I've had a similar experience both for myself and family members, when you get a serious diagnosis they don't mess about. I think the problem is in getting the initial diagnosis promptly if you're not in a particularly high risk group, because they have to strictly prioritise scarce resources there are bound to be people who slip through the net. 

Yeah, you’re right.

My problem was getting the initial diagnosis. Even though I had pretty much told multiple GPs (over a period on 5 or 6 years) what I thought the reasons were for my symptoms and my family history, it took one particular GP to take it seriously.

It angers me when I think about it as I reckon I was a heart attack waiting to happen. On the other hand I’m very grateful for the treatment I have had.

[scottsdad]

3 hours ago, Tattie36 said:

There’s no doubt that the NHS is chronically underfunded and creaking at the seams, however my recent experience was very positive.

I was diagnosed with coronary artery disease in late August, within 9 weeks and 6 days of my initial GP appointment, I had had multiple hospital trips (ARI), an x-ray, ultra sound, angiogram, more ecg’s than I could count, blood tests, angioplasty and stent fitted. All done with the utmost care, professionalism and good nature.

To say I feared the worst after my diagnosis is an understatement, especially as my wife works for the NHS, so the reality was a hugely pleasant surprise.

Obviously not everyone’s experiences are as positive and some parts of the NHS sound like an absolute shit show but it’s not all bad.

Hope you are doing well, Tattie. 

My dad is in severe heart failure and has had similar tests. Forth Valley Hospital helpfully put the cardio section miles away from the entrance, so he has to walk for ages to get to it. This is a guy who can barely manage a dozen steps at a time. Not a issue with the state of the NHS but a major annoyance. 

[Tattie36]

Just now, scottsdad said:

Hope you are doing well, Tattie. 

My dad is in severe heart failure and has had similar tests. Forth Valley Hospital helpfully put the cardio section miles away from the entrance, so he has to walk for ages to get to it. This is a guy who can barely manage a dozen steps at a time. Not a issue with the state of the NHS but a major annoyance. 

Yeah I feel great thanks.

That’s not great re your dad. It would be good if they could have the departments for illnesses like this right at the entrance to hospitals, carparks etc but it’s probably not even something they think of as they’re so stretched just providing the service. It’s the same at ARI, probably a 10 minute walk from the car park to the cardio dept, across a busy road, down stairs and along corridors etc. Not a problem for me but I can see how it would be a pretty big deal for someone less mobile or with a more serious condition than me. Luckily my heart is strong and healthy it’s just that an artery was blocked.

If it’s any consolation for you and your dad, I feel better than I have done for years since my procedure. My mum has also lived with a stent for 23 years and she’s a very sprightly 82 year old. Her brother also had a triple bypass 20 years ago and he’s probably the fittest 70 odd year old going.

I’m lucky I think in that I’m generally a fit and active guy and my condition was caused more by hereditary factors as opposed to a bad lifestyle, general I’ll health or age (I’m 54). I was a marathon runner, footballer, walker, golfer etc and generally a very active, sporty person until recently so that’s helped. My fear was that if I continued with pushing myself physically without being diagnosed and treated then things could have ended pretty badly.

[Salt n Vinegar]

I know it's probably a forlorn hope, but the best thing we can do to help our NHS is for the majority of the population to become even just a little healthier than it is now.  I have to confess that so far I have 'wintered well' and from today will be looking to get some weight off. 

We have had relatives staying with us since Christmas Eve, and so haven't been going out much and... the horror... have been having too many boozy meals and evenings. However the relatives leave today so a long walk this afternoon and every day is on the cards.  I know that there appears to be little if any hard science behind the 10,000 steps a day target, (my target was 12,000) but even 10k must be better for the average person than sitting on the couch munching a Greggs. 

It's a long term issue, not just for my waistline but for the country as a whole. 

[Binos]

We have too many old people 

And we will have an even greater percentage in the years to come 

Edited January 3, 2023 by Binos

[BFTD]

21 hours ago, scottsdad said:

Hope you are doing well, Tattie. 

My dad is in severe heart failure and has had similar tests. Forth Valley Hospital helpfully put the cardio section miles away from the entrance, so he has to walk for ages to get to it. This is a guy who can barely manage a dozen steps at a time. Not a issue with the state of the NHS but a major annoyance. 

I had a couple of blood clots in my leg a few years back, and it literally took me half an hour to hobble along the death march corridor for a scan, as it was a wee bit sore. I apologised for being late when I arrived, and the lassie on reception said, "oh, you should've just asked at the front desk to have a porter wheel you along".

Yes, well, it seems obvious now...

1 hour ago, Binos said:

We have too many old people 

And we will have an even greater percentage in the years to come 

They're working on it - average life expectancy has already started falling for the lower classes, and that trend will only increase as things like healthcare and retirement become aspirational goals.

In these trying times, it's reassuring to know the High Heid Yins have a plan.

[Dundee Hibernian]

Recently read an article/thread from a consultant physician who reported that one-third of people in NHS beds are stuck there as local authorities have been short funded to the extent that they cannot provide care at home for the individuals, mainly old people, who are stuck in these beds.

That 33% require care in hospital, taking staff away from A&E and clinics. The article was from a north England physician, but the trend exists in Scotland. Forth Valley Health Board opened a Contingency Ward in a Community Hospital yesterday (Falkirk) in an out patients' unit to move elderly patients out of acute wards to await non existent care packages.

In short, a lack of fund provision for care staff is forseen as a greater issue than more finance being provided directly to the NHS. In any case, a large chunk of cash going to the NHS isn't utilised for patient care, but goes to 'preferred suppliers'

Further, and this wasn't part of the article, the 'early intervention' GP part of the system isn't as accessible or responsive as it was pre-Covid, leading to people possibly getting sicker faster, or trying to access hospitals to cut out the middle man. More people land in hospital because the GP system has become fractured.

[Have some faith in Magic]

It seems to be incredibly disjointed. Lots of people doing their own wee thing to the best of their ability but absolutely no communication between specialisms or departments, that's just within the hospital never mind once you get out and GPs, District Nurses etc get taken into account. 

[parsforlife]

19 minutes ago, Have some faith in Magic said:

It seems to be incredibly disjointed. Lots of people doing their own wee thing to the best of their ability but absolutely no communication between specialisms or departments, that's just within the hospital never mind once you get out and GPs, District Nurses etc get taken into account. 

Getting rid of the trust system surely should be a big help on this, absolute joke having patients punted between hospitals and having administrators argue over which trust should pay for someone’s treatment instead of just placing them the best place for there care is an absolute disgrace.

[Cyclizine]

6 minutes ago, parsforlife said:

Getting rid of the trust system surely should be a big help on this, absolute joke having patients punted between hospitals and having administrators argue over which trust should pay for someone’s treatment instead of just placing them the best place for there care is an absolute disgrace.

We haven't had trusts in Scotland since 2004. There are fourteen regional health boards plus several special health boards that provide national services.

[parsforlife]

1 minute ago, Cyclizine said:

We haven't had trusts in Scotland since 2004. There are fourteen regional health boards plus several special health boards that provide national services.

Different name same problem.    There is no reason to have different departments arguing with each other and wasting time, money and worse of all impacting patient care.  

[Cyclizine]

1 minute ago, parsforlife said:

Different name same problem.    There is no reason to have different departments arguing with each other and wasting time, money and worse of all impacting patient care.  

The situation you describe doesn't really happen though - you're referred to the most appropriate place, which will generally be your local district general hospital, unless you're in need of a specialist service which would be in one of the tertiary centres or one of the national centres if it's super-specialist.

There needs to be some form of organisational structure, the Scottish system of regional health boards (similarly used in Wales and NI) allows services to be tailored to local needs, whilst reducing the bureaucracy associated with multiple quasi-independent trusts. What would you suggest would work better?

[ICTChris]

My dad has had heart problems and any time he's needed to go into hospital the care he's had has been absolutely exemplary - absolutely no way to complain about anything.  He's also had a life saving operation due to the screening for aortic aneurysms.  I think the modern NHS is pretty good at dealing with cardiac problems, although that could obviously change from place to place.  Good luck to the poster dealing with it.

I listen to a podcast about training done by a couple of American doctors, Barbell Medicine, and they recently did an episode on things you can do for your health in 2023 and the final one was about choosing a 'primary care physician', which I think is Yank for GP.  They were talking about how you should select your doctor, whether it's best to go for someone with more years of experience or someone more recently trained, try and find someone still engaged with a teaching hospital or academic institution etc - the whole thing was really bizarre to listen to.  In the rare occasions I go to the doctor I just assume that the person I'm speaking to is a doctor and go with it.

Edited January 3, 2023 by ICTChris

[parsforlife]

6 minutes ago, Cyclizine said:

The situation you describe doesn't really happen though - you're referred to the most appropriate place, which will generally be your local district general hospital, unless you're in need of a specialist service which would be in one of the tertiary centres or one of the national centres if it's super-specialist.

There needs to be some form of organisational structure, the Scottish system of regional health boards (similarly used in Wales and NI) allows services to be tailored to local needs, whilst reducing the bureaucracy associated with multiple quasi-independent trusts. What would you suggest would work better?

The situation does happen,  I’ve experienced it at its worst.

National health Service,  it should be centrally run.   One service,  doesn’t matter a f**k where you are from or where you fall ill you get treated at the best place.   No fucking around moving patients unnecessarily.

Edited January 3, 2023 by parsforlife

[Cyclizine]

6 minutes ago, parsforlife said:

The situation does happen,  I’ve experienced it at its worst.

National health Service,  it should be centrally run.   One service,  doesn’t matter a f**k where you are from or where you fall ill you get treated at the best place.   No fucking around moving patients unnecessarily.

So be constructive and explain how you think it should be structured. What does "centrally run" mean?

[parsforlife]

2 minutes ago, Cyclizine said:

So be constructive and explain how you think it should be structured. What does "centrally run" mean?

One organisation,  you know like the fire service and police have gone to,  dropping the unnecessary divisions.

[welshbairn]

7 minutes ago, parsforlife said:

One organisation,  you know like the fire service and police have gone to,  dropping the unnecessary divisions.

Someone in a call centre in Glasgow deciding where an old lady in Helmsdale who's broken her hip should be treated and if she needs an ambulance and if so from where?

Edited January 3, 2023 by welshbairn

[parsforlife]

1 minute ago, welshbairn said:

Someone in a call centre in Glasgow deciding where an old lady in Helmsdale who's broken her hip should be treated and if she needs an ambulance?

Ambulance service is already National 

[Binos]

1 hour ago, BFTD said:

I had a couple of blood clots in my leg a few years back, and it literally took me half an hour to hobble along the death march corridor for a scan, as it was a wee bit sore. I apologised for being late when I arrived, and the lassie on reception said, "oh, you should've just asked at the front desk to have a porter wheel you along".

Yes, well, it seems obvious now...

They're working on it - average life expectancy has already started falling for the lower classes, and that trend will only increase as things like healthcare and retirement become aspirational goals.

In these trying times, it's reassuring to know the High Heid Yins have a plan.

Retirement certainly becoming an aspirational plan, yes may have many more keeling over 

[carpetmonster]

1 hour ago, ICTChris said:

My dad has had heart problems and any time he's needed to go into hospital the care he's had has been absolutely exemplary - absolutely no way to complain about anything.  He's also had a life saving operation due to the screening for aortic aneurysms.  I think the modern NHS is pretty good at dealing with cardiac problems, although that could obviously change from place to place.  Good luck to the poster dealing with it.

I listen to a podcast about training done by a couple of American doctors, Barbell Medicine, and they recently did an episode on things you can do for your health in 2023 and the final one was about choosing a 'primary care physician', which I think is Yank for GP.  They were talking about how you should select your doctor, whether it's best to go for someone with more years of experience or someone more recently trained, try and find someone still engaged with a teaching hospital or academic institution etc - the whole thing was really bizarre to listen to.  In the rare occasions I go to the doctor I just assume that the person I'm speaking to is a doctor and go with it.

And that’s before you get into TV ads for prescription medication - ‘talk to your doctor about x’ - ehhh, I’m a pleb. If my doctor doesn’t know about this shit, I certainly don’t, and I’m probably fucked.