• josh1 posted an update 5 months ago

    Can someone please explain to me how the NHS works? Trying to arrange ongoing care for my jigsaw tibia, I logically started with the obvious – call my GP surgery and explain I need a dressing changed every three days, stitches out fairly soon, and a referral to an orthopaedic surgeon. ‘Sorry, we don’t have anything available until some ludicrous time in the future’. Not even to change a dressing over a pretty impressive incision in my leg? ‘No, you could go to a walk-in centre, or try calling the District Nurse’.

    Phone call to the District Nurse: ‘as you’re not housebound you’ll need to contact your GP’. We’ll ignore the fact that I can only just about hop about, with pain, on crutches.

    Decide going to a walk-in centre and making it their problem is the best solution. Talking to a friend who works in the NHS, she suggests they might actually just send me to A&E and that it might be better to go to A&E in the first instance. To have a dressing changed. How is it that my best option for something that is no longer an ‘A’ and certainly isn’t an ‘E’ is to bother A&E? It’s no wonder healthcare in this country is so ‘cked.

    • Don’t you normally get instructions about this kind of follow-on care from whatever part of the organisation did the initial treatment? It sounds like the problem is that you’re entering the system by a route that the bureaucracy isn’t expecting.

      • The people who did the initial treatment are in Sallanches, which I’m sure is the entire problem. It can’t be that uncommon for people to come back from foreign countries with broken bones though, surely?

        • I had my shoulder reconstructed in Sallanches. It was a long time ago now but the follow up was all via the GP.

          • That’s what I was expecting, but even calling while I was still in France to get the ball rolling they couldn’t offer me any semblance of sensible appointment dates. It’s irritating because changing a dressing is a two minute job, I can’t really do it myself and I don’t really want to consider the ramifications of infection in a wound that’s almost the length of my entire leg. But the woman on the other end of the phone didn’t seem to understand why it couldn’t wait until it was convenient for them.

            • You appear to have a tricky receptionist at your GP. My GP have a very good triage system and would just book you in to see one of the nurses. You could say it’s a bit painful and request a doc/nurse callback?

    • Try contacting your local fracture clinic. It’s the follow on from A&E when you’ve broken a bone.

      You should be able to refer your self.

      • You shouldn’t need to. Your end-to-end care should be managed from the point you walk in with an issue (or from the 999 call, if applicable) right through to eventual discharge.

        This is something the NHS is absolutely terrible at. A small number of consultants, including fortunately the one I am seeing at present, are quite good at doing it themselves or having their own secretarial staff do it, but the system doesn’t do it, and it absolutely should.

        I see that this was from an overseas thing – but there really should be a proper feed-in for this kind of thing. But my experience is that there is often a disjoint *where the NHS did the original treatment*!

    • Who undertook the original care/procedure/dressing. They will normally book you into the system for the rest?

    • Bear replied 5 months ago

      1)Exactly my experience when I was discharged from hospital with a dressing over the healing incision wound following surgery (to remove a kidney stone through my back). Instructions to go to my GP’s surgery to have the wound inspected and the dressing changed a couple of days after I got home. Go to surgery. No nurse appointment available for the next week. “But, the hospital told me to come here within 2 days” I said

      Surgery “Sorry, definitely no slots available until end of next week. Try going to A&E, or do it yourself”

      DIY was a problem as it was in my back out of sight and out of reach,

      Finally persuaded my then GF to do it, so why didn’t the hospital suggest that a friend could do it in the first place?

      2) 9 weeks ago told by hospital eye department that I need eye surgery, and told they would contact me within a “week or so” with an appointment.. After about 6 weeks rang “appointments” to find out what was happening? Was told I was on the list, but ring back again in a couple of weeks. Rang again this morning to be told that they can’t give me a date because “they don’t have a consultant” ! So still no date or prospect of one……

    • UPDATE: I’m resigned to going to the Minor Injuries Unit at the A&E at the crack of dawn, and asking them whether they can sort the referral I need for ongoing care. The medical report I have from France has ‘follow-up appointment with orthopaedic surgeon within 3 weeks’ in huge bold letters, so I look forward to trying to make that happen!

      In comparison, getting it changed in France was a case of calling a local nurse to come over and do it for me, having already been given the necessary bits and pieces for it on prescription. Night and day.

      • fred replied 5 months ago

        I suppose as it was an A then A and E may be best placed to make the referrals for ongoing care. Minor injuries attached to A and E is a generally good idea, as long as they don’t bounce you between the two.

        In the meanwhile I suggest you complain to your MP about the lack of appointments at your surgery.

      • burp replied 5 months ago

        Sounds like the receptionist has taken it upon themselves to triage you. You have been put in the same category as ‘has a sniffle’.

        Fracture clinic at your local hospital is a good bet if they let you self-refer. Otherwise put your foot down with the GP surgery, explain clearly that you have a surgical wound down into the bone and you’re worried (sounds like you are) about getting an infection as the surgeon advised that the GP or practice nurse need to check it and change the dressing (you might be asking a bit much every 3 days but a clinician should decide not a receptionist). If they still refuse ask to speak to their manager, take their name and ask how to make a complaint, same as bad service anywhere.

        and don’t blame the NHS blame the lack of resources, doctors, training due to successive Tory governments who stand to make personal gain if the NHS fails

    • http://www.bbc.co.uk/news/health-43143325

      I guess when you are short of a few people if makes it harder to do the jobs sensibly.

      Doesn’t make it easier. I need to chase up being referred back to the consultant about my shoulder . When you’re busy it’s not easy is it?

      The was another story that the user is management consultants has made it less efficient! At a cost of .multiple multiple millions

      Doesn’t surprise me at all.

    • I’m in! Went to the Minor Injuries Unit today, seen within ten minutes, dressing changed, X-ray taken (as I left France without the post-surgery X-ray), and an appointment at the fracture clinic for tomorrow morning, bright and early.

      Once you find a weakness in the impenetrable wall, the system is really quite efficient. It just annoys me that I had to go waste the time of someone who could have been treating someone with a real problem to get in.

      I’ll be making a complaint to my GP in due course.