Thursday, 10 July 2014

What Has Happened To The NHS?

Southmead HospitalI have always been very understanding of our Government-run services. I am fully aware that it's a difficult job, with limited budgets that have to be shared out amongst, often equally deserving, candidates, but I am becoming increasingly bemused by the lack of common sense involved in serving the most basic needs of our nation. Take, for example, something as simple as a GP appointment. This is no criticism of the staff I see, they all do their best, but there is something very wrong with the current system at my surgery. I have long term medical needs and these are the hoops I have to jump through, in order to see my doctor;

  • If I know I need an appointment, I have the choice of either telephoning the same day for 'Urgent Care' clinic (five minutes and one problem only) or being allocated an appointment up to six weeks from the day I requested it, if it's something more complicated that requires longer. The trouble is, there is a world of difference between an 'urgent' (same day) problem and one that can wait four to six weeks. 
  • So, even if it isn't urgent enough to require same day treatment, I often have to telephone for an Urgent Care appointment, because it can't wait up to six weeks. This involves getting in a queue with all the poor souls that do require urgent care. And there are lots of them! The line is busy for at least the first hour of surgery and it's a real battle to get through. 
  • With Urgent Care, all you get is an appointment for the clinic, so, after waiting to get through on the 'phone, you then have to troop down to the surgery and wait to be seen. What frustrates me about this, is that I don't want to get in the way of people with urgent problems, if all I've got is something that could wait a few days, but is unlikely to get better without treatment, or, worse still, something that can't be solved with a five minute appointment.
  • So, let's try 'Prebookable Appointments'. It takes so long to get through on the 'phone, I tend to call into the surgery to make these. Average waiting time is a month. A month? Surely you will either have ended up hospitalised by then, or recovered, but that's the tricky part, isn't it? Knowing when it's serious enough to insist on same day (not easy if you don't like to make a fuss) or when it can wait a while. What if, though, you go to your five minute appointment, and something gets missed, because there's not enough time to go into any detail?
  • And so we arrive at the final, and most unjust, hoop of all. After waiting over a month to be seen by my favourite doctor, who I think is pretty brilliant, I am kept waiting so long, by the time I get seen forty minutes later, my back is in agony, and I am worse than when I started! 

On that last point, I don't blame the doctor at all. In my opinion, she has it totally right. Make the appointments fit the patient. If it's an ear infection, toss them a prescription, by all means, but let's remember, patients are people, often sick people, so it stands to reason that it may take a while to get to the bottom of the problem. Surely it makes more sense to spend a bit longer with challenging conditions, rather than make inviduals complete the consultation over several short appointments. With these timescales, that could take a very long time! 

What frustrates me most of all, is that this is pretty fixable. Short term patients and long term patients need to be given equal priority, but treated differently. At the moment, there is no tenable provision for long term care. It is not always possible to see the same doctor and it is hard to have continuity of care when appointments are like gold dust! It's also worth remembering that when you suffer from long term health problems, everything is a challenge. It's not always possible to know, from one day to the next, whether you are going to be able to keep an appointment, never mind a month or so in advance! 

So, what would be wrong with finding a way to identify patients who have ongoing care needs, or conditions that are still under treatment over months or possibly years? Why can't Health Centres and GPs differentiate between a short term case, that just needs antibiotics, and something that is, as yet, unsolved, or in need of further monitoring? I don't profess to have all the answers, but I do know one thing, the GPs and Health Centres in this country are under immense strain. It's not hard to see, that these less than ideal appointment systems are borne out of a need to rob Peter to pay Paul. We are an ageing population. We should be investing more money in our healthcare, not less. I genuinely believe, that if we spent more time taking proper care of patients and giving them the time and attention they actually need, problems would be spotted sooner, dealt with quicker, and everyone would benefit. Let's hope the Powers That Be can start to inject a dose of common sense into this ailing institution, before it becomes too late to save it. 



  1. Very well said. Getting an appointment at our GPs seems harder than getting an audience with the Queen. When you do finally get in there is a 'one problem only' rule - do not discuss more than one medical problem as it keeps other patients waiting. Err - I had multiple injuries from an accident as well as long-standing health problems and having waited almost a month to get an appointment was pretty desperate to discuss all the things wrong with me. Luckily the actual GP I saw was happy for me to do so, but I was aware that I probably was making someone else wait and felt pretty guilty about it.

    As for hospitals, missing and incorrect records, don't even get me started....

  2. Thank you, Heather. I have always tried to be understanding, but it's getting to the point of exasperation now!! I am glad you have an understanding GP, and I totally agree, I am always aware of everyone outside when I've been forced to save up my issues for a few weeks! x

  3. This is so true. On a similar note, my 3wk old son had very mild jaundice, his levels were falling daily and he was feeding, sleeping and otherwise perfectly healthy. The midwife was happy to sign us off, but brand new protocol meant we were sent for him to have a blood test at hospital. Not only that, but an appointment was made with a consultant for the following week for the results, which we all knew would be absolutely fine! Unhappy about wasting NHS and our time like that, I phoned them and cancelled the appointment and said just ring me if anything actually needs discussing because otherwise, we're spending time with a highly paid, in-demand consultant who would surely be of more use to a baby who does have a medical need!x

  4. thank you for joining in with Flashback Friday - you make very valid points and all of which seem to be a problem across the NHS, it's certainly the same where we live. I suffer with anxiety (fluctuates between mild and severe) and although I'm not on medication just the thought of having to wait so long for appointments sets my whole body on edge. As you say sometimes we don't have something that is urgent but certainly can't wait 4 - 6 weeks something has to change but I (and I suspect those in charge) have no idea what that will be x

    1. Sorry to hear about your anxiety, Louise, it must be horrid and I imagine medical appoointments are stressful enough anyway! You are right, we do need change, and I don't really know the answers either, but I do know it wasn't always this bad, so there must be some hope! :-)

  5. The situation certainly hasn't improved around here, I even had the surgery ring me to put my appointment back a week as they were short staffed, I booked the appointment three weeks previously so refused and they somehow managed to squeeze me in then!
    Trying to phone on the day for an urgent appointment can be a joke too, the lines are constantly engaged, by the time they aren't all of the urgents are gone. grrr!

    Leanne - A Slice of My Life Wales

    1. Exactly! And if you are genuinely ill enough to need a same day appointment, how are you going to spend all that time battling for a slot?! Us patients nderstand the problem!


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