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Not diabetes related - just a general moan about the postcode (health) lottery

Proud to be erratic said:
I can understand NHS staff burnout, @CliffH.

I had a Urology app't this morning at the Royal Berks Hospital in Reading. I've only been there once before. The waiting area was small, cramped and very busy. Thurs and Fri are the weekly repeat days for the Urology "One Stop" consultations, bringing a lot of extra patients, potentially thee for a series of tests across up to 4 hr duration. These extra patients are amidst the steady flow (no pun intended) of outpatient app'ts.

An older lady waiting for her 0920 slot was still there at 10am and her partner/husband decided to loudly and offensively announce to everyone that "it all wasn't good enough", then went and berated the luckless 2x receptionists. Once he'd got centre stage, he was determined to make his point and in doing so not only offended everyone else, but went on and on, repeating himself and preventing the receptionists from investigating his wife' appointment or dealing with others. All most unreasonable. Bearing in mind the current heat wave, the no of people crammed into a limited space and obvious overload of patients, I would struggle to want to come to work in such circumstances.

Of course it wasn't the fault of the Receptionists - the complaining man felt they should have known his wife was still waiting and seemingly lost in the system. No doubt the booking system had tried to squeeze more out of an overcommitted Dep't; and no doubt patients expectations were not at all well managed (if my appointment letter is representative of what to expect). But there would have been considerable justification to my mind if the receptionists had politely but firmly told him to leave. The lady whose app't this was for, was clearly used to this sort of behaviour by him - but I would have been happier if she had looked more contrite or embarrassed by his dreadful behaviour.

Nobody wins: the NHS overload is worsened; even if affordable there are not sensible policing or control arrangements to deal with a belligerent idiot; the experience of other patients is made more stressful by the misbehaviour of one person. It is a mess and I have no obvious solution to suggest that is helpful.
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I survived my many years in the NHS by setting limits for myself - although I'm not naive enough to believe that being white, male and middle-class didn't make a huge difference! Lower-paid NHS employees tend not to have any one of these three massive privileges that I was lucky enough to be born with. For example, I was able to run a private practice alongside my NHS employment, which of course most NHS employees can't do.

There's work been done recently on the concept of 'Moral Injury' in terms of what the NHS can do to its employees. Also, 'transference' is a key issue: patients sometimes (understandably) convert their feelings of worry, grief and anger ("Why me?") into anger at whichever NHS employee is in front of them.
 
'Moral Injury' - did you mean what the NHS can do to its employees or "for" it's employees. Whatever that answer it's still taking effort and money away from the core business.

Perhaps receptionists should be provided with some form of "red card" that invites beligerent idiots to be polite, courteous and reasonable OR their behaviour will result in them being asked to leave without even being seen.
 
Proud to be erratic said:
'Moral Injury' - did you mean what the NHS can do to its employees or "for" it's employees. Whatever that answer it's still taking effort and money away from the core business.

Perhaps receptionists should be provided with some form of "red card" that invites beligerent idiots to be polite, courteous and reasonable OR their behaviour will result in them being asked to leave without even being seen.
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It's the feeling of being unable to provide good enough care: https://www.bma.org.uk/advice-and-s...l-distress-in-the-nhs-and-other-organisations

I've often done training for NHS colleagues on how to cope with 'challenging' patients. The trouble is, if (for example) an A&E department refuses to treat someone who's drunk and (usually, therefore) obnoxious, how can that person get their head wound stitched?
 
Proud to be erratic said:
'Moral Injury' - did you mean what the NHS can do to its employees or "for" it's employees. Whatever that answer it's still taking effort and money away from the core business.

Perhaps receptionists should be provided with some form of "red card" that invites beligerent idiots to be polite, courteous and reasonable OR their behaviour will result in them being asked to leave without even being seen.
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A temptation for NHS staff is to 'depersonalise' or 'other' patients, so that we don't have to feel so guilty about not being able to help a fellow human as much as we might want to do.

It's been an eye-opener for me seeing things from the perspective of a patient with a long-term health condition (rather than from the perspective of a clinician), since being diagnosed with late-onset Type 1. Depersonalisation can take subtle forms: for example, instead of asking, "What's your address?", NHS staff tend to ask, "What's the address?".
 
It's been an interesting year and a bit for me, with a very mixed bag of experiences within the NHS.

In my experience anything potentially sinister is dealt with efficiently and promptly, often, in my own case, with early morning weekend appointments.

Anything deemed routine is a different story. Having eventually got myself off the gynae oncology waiting list, and onto a list for a specialist combo team of gynae/gastro challenges, I see in the NHS app that the average waiting time is 21 weeks. I joined the list on 21st July, so that's not very satisfactory.

I've also been taking part in another cardiology study as someone with a past diagnosis of T2, but no heart failure. All super-efficient, but I suffered an unexpected, adverse effect of some "homework" involved in the study.

I reported my concerns, by email, around 8:30 and by late morning it was agreed I should be seen, same day, so off I trotted.

No waiting, seen by senior consultant and an action plan agreed. Consultant apologised that I had to come in, but did say if I hadn't been mobile, he'd have done a home visit. Thankfully that wasn't necessary, but how fabulous is that?

Another call back today to ensure I was recovering as hoped and follow up appointment agreed.

So, it seems like the good, that bad and the ugly co-exist in the same areas, hospitals and even specialisms. I've said it a million times, but it has never been more important to self advocate and educate ourselves when it comes to our health care.
 
AndBreathe said:
It's been an interesting year and a bit for me, with a very mixed bag of experiences withing the NHS.

In my experience anything potentially sinister is dealt with efficiently and promptly, often, in my own case, with early morning weekend appointments.

Anything deemed routine is a different story. Having eventually got myself off the gynae oncology waiting list, and onto a list for a specialist combo team of gynae/gastro challenges, I see in the NHS app that the average waiting time is 21 weeks. I joined the list on 21st July, so that's not very satisfactory.

I've also been taking part in another cardiology study as someone with a past diagnosis of T2, but no heart failure. All super-efficient, but I suffered an unexpected, adverse effect of some "homework" involved in the study.

I reported my concerns, by email, around 8:30 and by late morning it was agreed I should be seen, same day, so off I trotted.

No waiting, seen by senior consultant and an action plan agreed. Consultant apologised that I had to come in, but did say if I hadn't been mobile, he'd have done a home visit. Thankfully that wasn't necessary, but how fabulous is that?

Another call back today to ensure I was recovering as hoped and follow up appointment agreed.

So, it seems like the good, that bad and the ugly co-exist in the same areas, hospitals and even specialisms. I've said it a million times, but it has never been more important to self advocate and educate ourselves when it comes to our health care.
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I think your experience points to how difficult it can be in the NHS for people who struggle to "self advocate" or who don't have someone else to do it for them.

It's striking how different things are when I (as a white, male, middle-class clinician) go with my mother to health appointments, compared with whenever she has to go by herself: people are still very friendly towards her when she's by herself but she doesn't come away with as much important information as when I go with her and know 'the right questions' to ask - and am able to ask them in ways that don't lead to us being brushed off.
 
CliffH said:
Are they? I don't know, I'm afraid.
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Did some research - prescription charges were abolished in Wales in 2007, Northern Ireland in 2010 and Scotland in 2011.
 
CliffH said:
I think your experience points to how difficult it can be in the NHS for people who struggle to "self advocate" or who don't have someone else to do it for them.

It's striking how different things are when I (as a white, male, middle-class clinician) go with my mother to health appointments, compared with whenever she has to go by herself: people are still very friendly towards her when she's by herself but she doesn't come away with as much important information as when I go with her and know 'the right questions' to ask - and am able to ask them in ways that don't lead to us being brushed off.
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Yes, I shudder when I think how it must be for those without the ability to ask questions and, in some instances, ask for what they need.
 
Until recently, diabetes has been my main contact with the NHS. Whilst I wouldn't describe the support as "amazing" and have had to advocate for myself a number of times. I have no complaints with the people I see, especially considering the financial limitations they are under.

More recently, I have seen a little more of the local hospital since I broke my elbow. Sadly, there was an initial assumption made based on my age but after telling them I am a climber, they have been very good.
The only issue has been waiting times. I have been on the waiting list to have the metal work removed since February and still do not have an appointment. I appreciate that is not as long as many people have to wait and the urgency is probably not seen as high but I have to deal with the uncertainty of not knowing and the continued discomfort every day. Plus, I was told the ideal time to remove the metal work is once the bone has definitely healed but not grown over the metal plate. This is 8 to 9 months after insertion. Insertion was 9 months ago and I should get 6 weeks notice for the removal. So they will miss that window which will make the removal more complex.
 
I think what people mean about health being more important than money is that if you do not have your health you cannot enjoy things so much in life that other people can. It obviously depends on the person and the illness. I don't think the saying is referring to paying for health care.
 
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