NHS=Negligent Health Service

[Minstadave]

So basically to reiterate what I said then, complaints are primarily not resource issues, all the things I mentioned result in poor care.

Complaints are predominantly resource related, no time to assess properly because understaffed, no time to communicate because too busy or we've bought in staff with language issues because we don't value training adequately in this country, not treated in a timely fashion as services overstretched, training time cut to next to nothing because we don't value training adequately and service provision dominates clinical time.

 

[Minstadave]

all the things I mentioned result in poor care.

No, the suggestion that protocols and guidelines result in poor care is not an easy one to sell from my experience.

Certainly in my work all the majority of significant events come from failure to provide the standard of care laid out in the appropriate policies/guidelines.

 

[shorttricky]

the NHS needs to focused 100% on healthcare for the sick and ill (physically/mentally) and nothing else i.e. no "cosmetic" stuff unless it's part of recovering from an injury or illness (for example burns, reconstructions etc) so it'd be no boob jobs to just make someone feel happy but it'd OK for breast cancer victims etc

This may be tough to hear, but despite what rags like the Mail and Express like to scream about all the time, cosmetic surgery isn't that common on the NHS. Examples include women with uneven or no breasts, who are having long term mental health issues because of it - or women whose breasts are large enough to cause actual physical ailments. Amazingly it's pretty simple to work out that a £3k cosmetic surgery might save tens of thousands of future treatment in counselling/prescriptions/physios/etc.

There's even some interesting anecdotal evidence that breast implants may be an appropriate treatment for certain cases of anorexia, a disease where treatment can easily run into the hundreds of thousands over a lifetime.

I realise none of that is as compelling as a headline like DISGRACE OF FREE BOOB JOBS ON NHS, but maybe you could have done the barest amount of reading up before you decided that physical/mental health isn't a good reason to do cosmetic surgeries, despite saying that the NHS should treat physical/mental health

 

[Minstadave]

This may be tough to hear, but despite what rags like the Mail and Express like to scream about all the time, cosmetic surgery isn't that common on the NHS. Examples include women with uneven or no breasts, who are having long term mental health issues because of it - or women whose breasts are large enough to cause actual physical ailments. Amazingly it's pretty simple to work out that a £3k cosmetic surgery might save tens of thousands of future treatment in counselling/prescriptions/physios/etc.

There's even some interesting anecdotal evidence that breast implants may be an appropriate treatment for certain cases of anorexia, a disease where treatment can easily run into the hundreds of thousands over a lifetime.

I realise none of that is as compelling as a headline like DISGRACE OF FREE BOOB JOBS ON NHS, but maybe you could have done the barest amount of reading up before you decided that physical/mental health isn't a good reason to do cosmetic surgeries, despite saying that the NHS should treat physical/mental health

Completely agree. The NHS is not overburned by masses of cosmetic procedures, that is just make believe.

 

[Energize]

Complaints are predominantly resource related, no time to assess properly because understaffed, no time to communicate because too busy or we've bought in staff with language issues because we don't value training adequately in this country, not treated in a timely fashion as services overstretched, training time cut to next to nothing because we don't value training adequately and service provision dominates clinical time.

I think it's a bit of a reach to attribute all communication complaints on being too busy, it's a convenient scapegoat for medical staff though.

No, the suggestiion that protocols and guidelines result in poor care is not an easy one to sell from my experience.

In general, obviously guidelines are a good thing, but when they are followed as dogma that's when they can cause poor care, like following the stepwise pain ladder and giving paracetamol and naproxen when someone has been in a vehicle collision.

 

[Minstadave]

I think it's a bit of a reach to attribute all communication complaints on being too busy, it's an easy scapegoat for medical staff though.

You reach this conclusion from your deep experience of dealing with complaints I take it? There's a multitude of other reasons but if you look how tight the time pressures are on patient contacts you'll soon see why complaints happen. I can't sit down for 20 minutes with the family of a sick child to explain what's going on because there is often 40+ other kids waiting to be seen in our ED. GPs have sub 10 minute appointments, including getting the patient in and out of the room, taking a history, examining them if needed, making a plan, giving any info needed and documenting everything at great length because of ridiculous lawsuits like this:

https://www.pulsetoday.co.uk/news/c...st-gp-for-not-advising-folic-acid-supplement/

You can't win.

Maybe ask @SexyGreyFox for his input, he works in NHS complaints.

In general, obviously guidelines are a good thing, but when they are followed as dogma that's when they can cause poor care, like following the stepwise pain ladder and giving paracetamol and naproxen when someone has been in a vehicle collision.

Sounds entirely reasonable to be honest. You'd be equally upset when your Dad is given an excess of Oramorph by some cowboy doctor and leaves them vomiting, drowsy and can't take a dump for 2 weeks because someone didn't treat him with NSAIDS first off.

 

[SexyGreyFox]

Maybe ask @SexyGreyFox for his input, he works in NHS complaints.

I work very closely with Complaints, I'm the next level up.

 

[dlockers]

I work very closely with Complaints, I'm the next level up.

Full blown mega-Karen handler?

 

[Minstadave]

I work very closely with Complaints, I'm the next level up.

I'm a grubby clinician, I don't understand all this admin/management stuff.

 

[Energize]

You reach this conclusion from your deep experience of dealing with complaints I take it?

So we're comparing who has more anecdotes now? And you are only talking about official complaints here or the general forum moanings?

From what I've experienced and my friends and family, the assessments are fine with enough time given and the correct diagnosis is reached but it falls short at the treatment stage and the clinical outcome from NHS care ends up being the same as no care. And things like a lack of automated letters to communicate aren't a resource issue.

But if you want to argue that the NHS is terrible at assessments from your experience I won't argue with it!

Sounds entirely reasonable to be honest. You'd be equally upset when your Dad is given an excess of Oramorph by some cowboy doctor and leaves them vomiting, drowsy and can't take a dump for 2 weeks because someone didn't treat him with NSAIDS first off.

This is a false dichotomy isn't it, extreme dogma or extreme recklessness as opposed to reasonable clinical judgement.

Not like, "take naproxen and paracetamol, 5-10mg morphine if required".

 

[Minstadave]

So we're comparing who has more anecdotes now?

I'm not sure you can compare anecdotes from your pals to over a decade of working in the NHS.

This is a false dichotomy isn't it, extreme dogma or extreme recklessness as opposed to reasonable clinical judgement.

Not like, "take naproxen and paracetamol, 5-10mg morphine if required".

Reasonable clinical judgement is to treat and advise on reassessment if not effective, not to give out Opiates "just in case". Nobody sensible does that for obvious reasons.

 

[Energize]

I'm not sure you can compare anecdotes from your pals to over a decade of working in the NHS.

I think that's the problem though, you can become blinded to the real world experiences of patients out in the community because of an insulated environment and dealing with primarily official complaints.

Reasonable clinical judgement is to treat and advise on reassessment if not effective, not to give out Opiates just in case.

Had already been assessed and prescribed at A&E and was unable to walk at the time of seeing the GP, stock answer of "we don't have anything stronger". And you wonder why the darknet drug markets are doing so well...

Patients then overdose on NSAID's or paracetamol and end up at A&E.

 

[Haggisman]

Seems that for every good experience there are 100 bad ones with the NHS.

That's more down to the fact that people are more like to scream and shout when they have a bad experience than when everything goes well. "Five year old girl dies due to NHS negligence" is going to sell far more papers than "Patients receive perfectly adequate care and recover as expected"

Of the 11 people my son and I shared various wards with over the past few weeks, none had a problem - the only complaint I heard was some stuck up teenager accusing the ward staff of being "****ing racists" because she "needed" a kebab and "I can't eat white food, I need Arab food"

 

[dlockers]

That's more down to the fact that people are more like to scream and shout when they have a bad experience than when everything goes well. "Five year old girl dies due to NHS negligence" is going to sell far more papers than "Patients receive perfectly adequate care and recover as expected"

Of the 11 people my son and I shared various wards with over the past few weeks, none had a problem - the only complaint I heard was some stuck up teenager accusing the ward staff of being "****ing racists" because she "needed" a kebab and "I can't eat white food, I need Arab food"

I'm with this chick. Especially when a donnar and chips is probably less £/cal than the stuff they serve you.

 

[Minstadave]

I think that's the problem though, you can become blinded to the real world experiences of patients out in the community because of an insulated environment and dealing with primarily official complaints.

This is a poor argument. Even though I'm an NHS drone I still have personal and family experience of the NHS on top of my dogmatic view on its awesomeness.

He has already been assessed and prescribed at A&E and was unable to walk at the time of seeing the GP, stock answer of "we don't have anything stronger". And you wonder why the darknet drug markets are doing so well...

Patients then overdose on NSAID's or paracetamol and end up at A&E.

This story evolves everytime, I'm not sure it's a useful exercise for us to to and fro on your father's car without the full picture. You can buy codeine over the counter these days no need to rush to the darknet.

 

[do_ron_ron]

I'm with this chick. Especially when a donnar and chips is probably less £/cal than the stuff they serve you.

The time I was in recently, food was the only poor thing. It seemed to be outsourced and the result was watery tasteless fare. Given that patients require food which will aid their recovery it is a false economy. The care was excellent. One patient was moaning about it and other patients rounded on him asking him what was wrong. After a load of moans it turns out his problem was nothing to do with the NHS but welfare services when he came out of hospital.

 

[ianh]

I realise none of that is as compelling as a headline like DISGRACE OF FREE BOOB JOBS ON NHS, but maybe you could have done the barest amount of reading up before you decided that physical/mental health isn't a good reason to do cosmetic surgeries, despite saying that the NHS should treat
physical/mental health

Maybe you should have done the barest amount of reading of my post as what you said "I have said" is not even close to what I actually said.

Instead what I actually said is absolutely 100% in agreement with what you also agree with - if it is a physical or mental health reason then cosmetic surgery is ok by me - I've never ever said anything different so I'm a little confused as to why several posters have claimed I'm saying something I'm not.

Maybe, based on your response of "mail and express screaming" etc it's your own bias at play, deciding that I might read those because you've misread my comment as one that a frothing gammon might write and so triggered your disingenuous auto-reply, I don't know but hopefully you do.

 

[Energize]

This is a poor argument. Even though I'm an NHS drone I still have personal and family experience of the NHS on top of my dogmatic view on its awesomeness.

The point is a clinicians experience isn't representative, when I've seen polls taken in the past of patents the picture is different to the one you are painting.

This story evolves everytime, I'm not sure it's a useful exercise for us to to and fro on your father's car without the full picture.

He was a pedestrian hit by a lorry, it's probably not useful to go over individual examples as I'd have to elaborate on them too much, but I think to suggest that in the general case clinicians have no sort of reasonable judgement of what analgesics are going to be effective in a given clinical scenario is a little ridiculous.

It also doesn't match up with my experience of being prescribed morphine in hospital straight away, as opposed to giving naproxen and leaving me in severe pain for an hour to see if it works following a stepwise approach. I get the impression that if I had been under your care I would have had a torturous experience!

The US has too liberal an approach to prescribing opioids but the UK one is far too conservative.

 

[Haggisman]

I'm with this chick. Especially when a donnar and chips is probably less £/cal than the stuff they serve you.

Given the amount the NHS spends on treating obesity, that's probably not necessarily a bad thing!

The time I was in recently, food was the only poor thing. It seemed to be outsourced and the result was watery tasteless fare. Given that patients require food which will aid their recovery it is a false economy.

I wonder if this varies by trust (e.g. who they outsource it to). While the food certainly wasn't gourmet quality, and I couldn't wait to get back to a proper home cooked meal, it wasn't particularly bad.

 

[Werewolf]

There is also an army of civil servants and NHS staff behind them who should be advising them.

That's assuming the average politician (especially current generation) will actually listen to anyone.