Yep, private will at a drop of a hat of many thing serious send their patients to an NHS hospital for critical care, seen it happen they literally dump and run
Visiting the UK. Health Coverage ?
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Yep, private will at a drop of a hat of many thing serious send their patients to an NHS hospital for critical care, seen it happen they literally dump and run
No we haven't but evolution has ... let's say we have the following 3:
If someone pitches up all covered in blood and says "I am bleeding" then you can assume three things straight away 1) Their airway is patent 2) They are breathing 3) They are reasonably alert. This one can wait.
If someone else pitches up at the exact same time wheezing and struggling to say "I'm asthmatic" then you can assume 1) Their airway is still patent 2) They are still breathing 3) Both of these are under immediate threat. This one needs to be seen very quickly.
If someone else pitches up at the exact time with a kid in their arms saying the kid was just choking after having a sweet you assume ... actually you get stuck in their straight away as the indicator is their airway is at threat and they are about to die on you. This one is the priority.
People don't really understand what people mean by an emergency which is a life threatening event. And life threatening means airway most important, then breathing, and lastly ones circulation. It is simple when you consider the point of the heart and the circulation system (on a short time scale) is to deliver oxygen and take away carbon dioxide around the body, however, if you aren't breathing then who cares you aren't getting the oxygen and carbon dioxide to and from the blood anyway so the circulation system is redundant anyway till you address this. Likewise what is the point in breathing if you have no way to get air into the lungs in the first place. This is why you go Airway, Breathing, Circulation. Against these broken bones don't really class as an emergency against whatever else has most likely pitched up. People die immediately from asthma attacks then don't from a broken femur.
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I think stating that most people wait more than 4 hours to be seen is pushing it slightly, though I concede that in your case the severity of your injury wasn't appreciated - I can understand why that experience would shake someone's confidence in the system.
I'd like to point out that at no point did I say you were wrong to go to A&E, or that you could have/should have been seen elsewhere. I was simply making the point that those people who are identified as being in an immediately life or limb threatening condition are treated as a priority to others, who will have wait to be seen - a situation I find completely acceptable. Though as I said above, it does seem the severity of your particular injury was missed during triage.
As others have said, the NHS is not perfect, it is overused and under resourced. It needs more money, staff and facilities if it's going to provide the level of care people expect.
Well, from all my experience and others I know currently under treatment the NHS is doing ok, it is certainly better than being in the US and their private insurance system for those without adequate insurance cover...is it perfect, well clearly not, but is it 'shocking' again..clearly not. That isn't to say that it isn't shocking on occasion, all medical organisations worldwide are shocking on occasion, but overall, we are in an envious position in this country to have such a system of medical care, flawed as it is or not.
As a patient of many years, in many hospital I would say that regardless of expertise, I know good care from poor care, for example my primary surgery was quick, efficient and without incident or delay from diagnoses to consult to treatment was all in weeks rather than months, whereas we currently have to travel 110 miles round trip for my sons brace to be adjusted every 6 weeks simply because the waiting list in our local foundation trust is two years long because the only consultant they have keeps taking time off for maternity (three times in five years) with no replacement ...anyone would to one degree or another know whether their care is acceptable with regards to their own care and the results therein. To suggest that you need to be a fully qualified, experienced and time-served medical professional in order to know whether you are receiving good care or not seems rather daft.
And what objective facts can you supply and under which context and comparable to whom?
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it's an interesting time for the NHS atm, i've just starting working for an NHS service provider (social enterprise, providing NHS services into the community arising from the split of commissioning and providing of NHS services). the king's fund have some really good pieces and thinking around the future shape of the NHS, worth reading if you feel like it http://www.kingsfund.org.uk/
in terms of treatment it's down to degrees of risk, kind of what the guy is saying above. in theory if you have life-threatening injuries then you go to A&E, everything else you either use GPs, walk in centres, pharmacists etc. if you're walking wounded, despite the fact that you clearly need to be seen then there will probably people in more urgent need.
mate of mine broke his leg playing football, called an ambulance and they asked 2 questions, is it bleeding and is he conscious. it was no and yes, so he was low priority - an hour later the ambulance came and took him to hospital.
in terms of treatment it's down to degrees of risk, kind of what the guy is saying above. in theory if you have life-threatening injuries then you go to A&E, everything else you either use GPs, walk in centres, pharmacists etc. if you're walking wounded, despite the fact that you clearly need to be seen then there will probably people in more urgent need.
mate of mine broke his leg playing football, called an ambulance and they asked 2 questions, is it bleeding and is he conscious. it was no and yes, so he was low priority - an hour later the ambulance came and took him to hospital.
Maybe you meant to say that all A&E deps are meant to use a triage system. Where I live in South London they don't. They just have a receptionist who takes your details (name and what's your problem) and asks you to wait. It takes hours before you are seen by any doctor in all the cases I've been. Maybe the triage implementation is so bad that the doctor who is supposed to screen you ends up seeing you hours later..don't know, but that's the reality here.
Which is a bit scary as there are so many problems that require specialist treatment and care, not just someone stitching you up or just doing a tracheotomy to keep you simply breathing while you deteriorate over the hours.
I'm not arguing against what you're saying in the sense that you're quoting what is supposed to be happening. Unfortunately, my personal experience has been very-very different and has shaped my appreciation of the NHS. Yours might be totally different. Just because things are supposed to be one way doesn't mean they actually get delivered as such.
Alright, since you are having difficulty of figuring it out I'll make it simple. I was either the partner, actual patient or the accompanying person to all the cases I've described. That is how I know such details. Get it now?
Also, who said I did nothing and just watched? You are making up things. I didn't go into details on what happened and what I did as that was irrelevant to the discussion at hand.
I'm not making up anything and my life is not (that) dull, so please stop arguing this thing.
Strange I know plenty of A+E consultants who work in South London and I would wager they would say otherwise.
So this receptionist you spoke to - as per above - we can assume that a) your airway was patent b) you were breathing c) you were alert enough to give her details about yourself. The fact you were alert enough tells us that there was sufficient oxygen getting to your brain indicating that your circulation system was holding up at that time.
Therefore you was not a priority by your own admission ... and could await formal triage. If however you had been raced in by an ambulance crew or collapsed in the reception you would have been seen in a different timescale.
No it's not scary at all they refer on to the relevant speciality eg gynaecology, orthopaedics, cardiology, etc.
I am not discounting your personal subjective experience that was poor, or Castiels which was good. What I am doing is explaining why your understanding is leading you to the wrong conclusions, clarifying misconceptions, and saying that subjectivity and personal experience aside the NHS has poor results currently and fails people consistently time and time again.
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I work for the NHS, the general rule of thumb is that they treat first and ask questions later.
I would make sure you are well insured to avoid any potential fall out, but the administration side of things is pretty slow in all honesty. The IT is also very dire (my field) so you would not face what you would expect in a US hospital.
They won't confirm citizenship or draw up your NHS number before treatment, although don't expect much help from a GP surgery. I would suggest obtaining a list of Walk In centres in the area you expect to visit for general illness but for hospitals they will treat you regardless. The Triage system doesn't cover whether you are entitled, it solely covers priority.
I would make sure you are well insured to avoid any potential fall out, but the administration side of things is pretty slow in all honesty. The IT is also very dire (my field) so you would not face what you would expect in a US hospital.
They won't confirm citizenship or draw up your NHS number before treatment, although don't expect much help from a GP surgery. I would suggest obtaining a list of Walk In centres in the area you expect to visit for general illness but for hospitals they will treat you regardless. The Triage system doesn't cover whether you are entitled, it solely covers priority.
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I don't think people understand the difficulty in what A&E workers face and I wish they did more to educate the general public.
Until laws change to filter out the garbage visits, it will never change. The amount wasted on drunk women who claim to have had their drinks spiked, other drunk nonsense, people with colds who think they are dying, stubbed toes and other nonsense... they are bound to struggle.
Seeing drunk people taken to hospital in ambulances sickens me, it angers me. They should be made to pay if only to make them think about their last few rounds of shots next time.
Just not enough consequence or accountability. The people who suffer are those with genuine concerns.
If people keep this up we won't have socialized medicine soon. You can enjoy healthcare that prioritizes profit over successful treatment.
Just because someone is breathing doesn't mean it's reasonable to see them after a few hours. I know all about the shortages of staff etc. Still doesn't make it right. People go to a&e deserve to be seen much faster.
I'm starting to think that my perception of what A&E should be is very different to other people's, in which case arguing about it won't lead anywhere.
Only that it doesn't in the timescales you need it. Going in A&E with a special situation that requires a specialist and being told by the generic A&E dr that you should go to your GP and get a referral is useless. They may provide enough care on the spot to keep you alive but without specialist care (on the spot) you can deteriorate and suffer tremendous loss of quality of life in the meantime. Again, as above, I have a different view on what A&E should be about - and it seems reality is something very different than what I have in mind.
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I do completely understand where you're coming from, though I worry about the pensioner who has to count every penny not calling when she has chest pain because she's worried she might be charged if it's a false alarm and she can't afford it.
I work in prehospital care and I completely agree that we need to be so much better about educating people about what we're there for, what alternative sources of help are available and teaching basic first aid to give people some basic skills in terms of management of minor cuts, scalds, and D/V etc.
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I think we should just start with the abuse of ambulances. That alone will free up resources and save a fortune.
I don't think we can go beyond that, but the Trusts need cohesion. Someone coming into an A&E with one issue might actually need a Mental Health trust for example.
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Since it's an ambulance service I work for my experience is in that area, and that's what I mean. The person who has rendered themselves unconscious on a Friday night does possibly need hospitalisation, the 90 year old granny with chest pain, might after investigations, be declared fit as a fiddle.
My concern is that the fine doesn't stop the intoxicated person from having that last pint but it does stop the granny from calling because she's misunderstood the message. We can't know granny is fine until we do the investigations and I would hate the thought that she's delaying accessing the help she might need because she's worried someone will fine her if the results come up negative.
Similarly I hate the thought of a 20 year old person dying because they've choked on their own vomit while incapacitated by drink because their friends didn't want to run the risk of the fine. We should be educating those we see as abusing the service, not penalising them.
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A charge should be implemented say ~£1000 for initial consultation for everyone.
That'll get rid of the drunks, old people that go to A&E because they're lonely & Asians with minor ailments that are uneducated & come from backwards countries without healthcare.
That'll get rid of the drunks, old people that go to A&E because they're lonely & Asians with minor ailments that are uneducated & come from backwards countries without healthcare.
That would get rid of 75% of the UK population.
its 200Kr (~£20) to visit a doctor at point of contact in Sweden. That is for removing a splinter or open heart surgery after a moose attack.
I spent a week last year in hospital here and it was by all accounts as good as Hospitals i've visited in the UK.
I've been to A&E twice in ten years and we got seen within 4 hours, which i think is really quite impressive. Most of the waiting was for Xrays to be done. (non life threatening triage just stuck us on the queue)
I think the real BS in the NHS is the out patients system having gone through that with my mum after she was recovering from cancer. Appointments given for 9am and basically turning up and waiting till 4pm hoping to get to visit the specialist who would literally say " you ok? good! ok cya next month" sign a bit of paper and walk out of the door.... Happened on a few occasions
I've never gone private.
I do get your point about drunks though. They should deffo be billed after for the service at least £100. Im sure that would carry a minefield of potential other problems too as the first drunks choke on death on their own vomit, rather than pay etc etc....
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A most people who will not be able to afford it. Its a stupid idea, it will mean emergency treatment for the wealthy and no one else.
Yes, in an ideal world people would be seen quicker. However, you would be unaware of the actual workload the staff were facing at the times you mention. The targets are for people to be seen within a certain timeframe. The resource level in environment/staff/equipment versus the actual workload makes that impossible in many cases - there is not a nice even spread of patients 24/7. Therefore, they will see people on order of priority.
Now you know the actual priority maybe you can appreciate why that is the case.
I don't think it is I think it was your perception of what actually construes an emergency was wrong and now you've actually had it explained to you why what you thought were emergencies actually were not then you've gone back to wanting the same thing but are looking for another reason to justify your stance.
What you want is a quicker and more efficient service. Well that requires a wholescale rethink with requisite policy, proper funding and then a large number of years to actually use those circumstances to slowly crawl back quality if that would happen if we did so - that is debatable whether it would occur even given the ideal environment.
If you need to be referred you will. Now it may not be as timely as you would like but that is another issue as per my point above. The practitioners you see are more than qualified to give you care 'on the spot' to prevent deterioration.
What you are expecting is the immediate implementation of what we could call 'definitive care' ie the most ideal treatment possible for you at that time.
Now this is not quite as easy as you think. If we had a load of medical staff (of varying specialities) awaiting your arrival then that would be prohibitive from a cost point of view. Moreover, if we had such a surplus of staff how would they get the requisite skillset and then maintain it without the repetition of practice and the benefit of constant learning from experience.
There are two issues you have raised in this thread:
1) A poorly performing NHS - statistics back this assertion up the NHS has drifted down quality wise since the recession.
2) An unresponsive A+E system for emergencies - on this you were wrong because what your understanding of what an emergency is or rather was did not match the actual definition and target demographic and that actually it appears from what you described the people were seen in accordance with guidance for their actual need on the information you have given us.
