NHS - how long until my appointment at a back clinic at my local hospital?

[Ethan]

Population increases drive demand, but that isn't one of the most important reasons for the current problems.

The reasons are, and they vary in their relative importance from area to area, but all apply everywhere:

Massive increase in paperwork. My wife used to spend approximately 1 hour doing paperwork/form filling per hour of seeing patients. Now she does 3 hours per. That robs massive amounts of patient time, obviously, so her waiting times lengthen and pressure in the system increases. Urgent cases need to be squeezed in but that can only happen by displacing someone else.

The number of hospital beds has dropped massively in recent years.

http://www.nuffieldtrust.org.uk/data-and-charts/overnight-hospital-beds-england

That means people pitching up at A&E have less chance of being admitted, so can't be cleared, and the system grinds to a halt.

Patient expectations have risen, mostly driven by politicians. One of the reasons is they want to reduce the power of the medical profession to make it easier to enforce changes in pensions and pay which in turn makes it easier to hand the whole thing over to US private healthcare companies. Alan Milburn started this and is still involved in the background. The new head of NHS England is from exactly such a private HCO.

The NHS now operates under many more protocol and policies. In the past doctors were allowed to use their clinical judgement. Not now. Clinical judgement often means they offer expensive treatments, but the NHS doesn't want that any more.

The 8-8/7 thing is a distraction, and a mixture of undeliverable promise and political power play. Cameron neglected to mention that time created at the weekend means time lost during the week, and he also forgot to mention that there are no plans to bring in all the other people needed to run a true 7 day service, because that would mean a massive increase in staff and costs. So it is all empty rhetoric.

The NHS is spending a massive amount of money on vanity PFI projects. These cost a huge amount, for example £30bn for £7 or 8bn worth of facilities, and stories of £200 light bulbs abound. Many of these contracts were so profitable that they were sold on at huge profit right after being signed. PFI doesn't count as public borrowing, so it is really all about the smoke and mirrors.

Unfortunately none of the major parties can be trusted on the NHS because they all see it as a way of exercising ideological policies and getting easy political points.

 

[chrisd]

I recently golfed away for a few days with two dentists, one who's wife is a GP and a leading consultant at a hospital in Kent and they said that the mountain of paperwork is the biggest burden to them all. It is pretty much the same in schools too, so much paperwork and too much testing of primary kids

 

[SocketRocket]

Had a bet with myself that it wouldnt be long until the population increase was blamed

Anyway - along with Rooter and Fishi can only say good things about the hospital near us

4 years ago my wife had issues - had a scan in 2 weeks , results within a week and an Op booked for 1 week after that - all done within a month.

I had asthma issues last year - xray and tests within 2 weeks also and results within the week and book for a speclist a week after.

Couple of guys i play golf with have had their hip replacements with the same hospital and all done within 6 months.

Glad you won your bet but population being a major factor you were on to a winner. Do you not think the large increases in population affect hospital loading. Also Schools, Housing and Doctors Surgeries?

My wife was scheduled for an operation in January which was cancelled on the day due to bed shortages, a mate of mine had his knee replacement op cancelled twice on the day of the ops. The situation is far from ideal!

 

[SocketRocket]

Population increases drive demand, but that isn't one of the most important reasons for the current problems.

The reasons are, and they vary in their relative importance from area to area, but all apply everywhere:

Massive increase in paperwork. My wife used to spend approximately 1 hour doing paperwork/form filling per hour of seeing patients. Now she does 3 hours per. That robs massive amounts of patient time, obviously, so her waiting times lengthen and pressure in the system increases. Urgent cases need to be squeezed in but that can only happen by displacing someone else.

The number of hospital beds has dropped massively in recent years.

http://www.nuffieldtrust.org.uk/data-and-charts/overnight-hospital-beds-england

That means people pitching up at A&E have less chance of being admitted, so can't be cleared, and the system grinds to a halt.

Patient expectations have risen, mostly driven by politicians. One of the reasons is they want to reduce the power of the medical profession to make it easier to enforce changes in pensions and pay which in turn makes it easier to hand the whole thing over to US private healthcare companies. Alan Milburn started this and is still involved in the background. The new head of NHS England is from exactly such a private HCO.

The NHS now operates under many more protocol and policies. In the past doctors were allowed to use their clinical judgement. Not now. Clinical judgement often means they offer expensive treatments, but the NHS doesn't want that any more.

The 8-8/7 thing is a distraction, and a mixture of undeliverable promise and political power play. Cameron neglected to mention that time created at the weekend means time lost during the week, and he also forgot to mention that there are no plans to bring in all the other people needed to run a true 7 day service, because that would mean a massive increase in staff and costs. So it is all empty rhetoric.

The NHS is spending a massive amount of money on vanity PFI projects. These cost a huge amount, for example £30bn for £7 or 8bn worth of facilities, and stories of £200 light bulbs abound. Many of these contracts were so profitable that they were sold on at huge profit right after being signed. PFI doesn't count as public borrowing, so it is really all about the smoke and mirrors.

Unfortunately none of the major parties can be trusted on the NHS because they all see it as a way of exercising ideological policies and getting easy political points.

And which political party went bon a PFI spree?

 

[Snelly]

Am waiting to hear if GP can accelerate the appointment with a second letter.

It would be £150 for a chat with a consultant, £600 for an MRI scan and then if I need back surgery (e.g. partial laminectomy), for an anaesthetic, hospital stay and surgery then the cost is another £8K. With this kind of bill being a possibility and given that I have had this pain since last September, I think I can wait another week to see if my GP can improve the waiting time.

Plan B is see the consultant privately and see what the diagnosis is and then go from there.

Thanks for all the responses though!


Interesting reading Ethan's posts too. Frustrating and illuminating in equal measure.

 

[Fish]

I tell a lie, the only negative I had when I came out of Warwick Hospital was the car park bill, £9.40

 

[Rooter]

I tell a lie, the only negative I had when I came out of Warwick Hospital was the car park bill, £9.40

If you had asked the ward matron they would have sorted it, most recently my eldest had her tonsils out, over 2 days I parked up in the busiest car park in the world and didn't pay a penny as she was on the ward.

 

[Fish]

If you had asked the ward matron they would have sorted it, most recently my eldest had her tonsils out, over 2 days I parked up in the busiest car park in the world and didn't pay a penny as she was on the ward.

I asked if there were tokens or free passes for emergencies like mine which meant I had to stay and be operated on, they said no, because its nothing to do with them and they have no control at all. Obviously they tender it out but then these private companies win the bid and put the prices up, I reckon I was around 5hrs in total so almost £2 p/hr.

 

[Ethan]

I asked if there were tokens or free passes for emergencies like mine which meant I had to stay and be operated on, they said no, because its nothing to do with them and they have no control at all. Obviously they tender it out but then these private companies win the bid and put the prices up, I reckon I was around 5hrs in total so almost £2 p/hr.

They normally provide concessionary passes when kids are in hospital. Not so much for adults. Remember also that staff have to pay for parking, which I think is an outrage.

 

[Ethan]

And which political party went bon a PFI spree?

Note I didn't blame one party over another. Both are culpable. Thatcher brought in the purchaser-provider split and started the thing going, but Labour pushed it forward with gusto to show they were not afraid of business/privatization. Then the Tories picked up the mantle again and they are responsible for the latest re-organisation, which is basically intended to prepare for franchising bits off to private companies.

 

[Jimaroid]

The SNP have abolished NHS car parking charges in Scotland, with some exceptions due to poorly negotiated contracts. I don't want to turn this political but it's one of the moral victories I think they can rightfully be proud of.

 

[HomerJSimpson]

To balance this up a little, the trust I work at faces a budget shortfall and currently all the admin staff in the hospital are subject to an admin review to try and down grade jobs (with minimal pay protection) or lose as many as feasible. It's hardly conducive to a happy working environment and yet the ones I deal with are working on with a resigned stoicism and doing their best to maintain as good a service as possible for the patient. We are certainly not guilty of some of the accusations on here of maliciously wanting to cancel appointments, and most are too hard pressed already to have time to gossip.

As always care will vary from NHS and while my own trust has its faults and the admin staff at all levels are not beyond making mistakes, I do feel strongly they are trying their best despite numerous hurdles in their path. Of course there will be bad ones too and hopefully this admin review will sort that out. What it means for the equally pressed doctors and nursing staff and their already increased admin responsibilites remains to be seen (this review seems to be heavily looking at medical secretaries as one area in particular) but I fear this won't pan out well for them either. In a few months my own area is coming under the same scrutiny so I'm not immune.

I hope the OP can find a way to get fast tracked as it seems a nasty problem and causing great discomfort and pain. Sadly these days it is sometimes the case of having to create a nuisance and fuss to get anything done, something that I've been brought up not to do and which goes against my personal grain but I guess if needs must!

 

[Tashyboy]

Missis Tash was finished as a bank nurse coordinator at the local hospital. She was involved in training, hiring and firing. She loved her job. They covered jobs through the bank for any nurses and care assistants etc that were off through holidays or sicknes, long and short term. They covered over 95% of available shifts every week.
her job was made redundant to save £35-40K.
(as it happened it was the best thing that happened to her) However that's not the point. The local newspaper is reporting that the same hospital is having a recruitment drive looking for 140 nurses (locally) because it cannot afford to keep paying £400K per month to agency's supplying Nurses, care assistants etc etc.
Stinks to high heaven is an understatement. The same middle management clowns that disposed of Missis Tashyboys job promise to support the new highly skilled nurses that will start. Flippin Hypocrits.
Off to work now ranting.

 

[Ethan]

To balance this up a little, the trust I work at faces a budget shortfall and currently all the admin staff in the hospital are subject to an admin review to try and down grade jobs (with minimal pay protection) or lose as many as feasible. It's hardly conducive to a happy working environment and yet the ones I deal with are working on with a resigned stoicism and doing their best to maintain as good a service as possible for the patient. We are certainly not guilty of some of the accusations on here of maliciously wanting to cancel appointments, and most are too hard pressed already to have time to gossip.

As always care will vary from NHS and while my own trust has its faults and the admin staff at all levels are not beyond making mistakes, I do feel strongly they are trying their best despite numerous hurdles in their path. Of course there will be bad ones too and hopefully this admin review will sort that out. What it means for the equally pressed doctors and nursing staff and their already increased admin responsibilites remains to be seen (this review seems to be heavily looking at medical secretaries as one area in particular) but I fear this won't pan out well for them either. In a few months my own area is coming under the same scrutiny so I'm not immune.

I hope the OP can find a way to get fast tracked as it seems a nasty problem and causing great discomfort and pain. Sadly these days it is sometimes the case of having to create a nuisance and fuss to get anything done, something that I've been brought up not to do and which goes against my personal grain but I guess if needs must!

Homer

One of the problems is that the apparatus of Trust structures has caused a proliferation of people in non-clinical jobs. Some of these are more useful than others. The medical secretaries are amomngst the most useful, and if they are cut, it will add to the grossly excessive amount of paperwork done by doctors and nurses, delay letters getting out to GPs and cause chaos.

In the old days, hospitals had a Unit Administrator and a small number of support staff. Now they have large executive committees, a highly paid so-called CEO (although it is not a proper CEO position as understood in private industry), marketing people, press officer and a bunch of others who contribute little of any use.

The practice of appointment spoiling is endemic in the NHS due to the pressures placed on budgets and clinical departments, not as a result of mean-spiritedness or malevolence. It may or may not happen at the RBH, or you may or may not be aware of it.

 

[DCB]

And which political party went on a PFI spree?

PFI did drag us out of the dark ages as far as hospital buildings were concerned up here.

Having experienced serious surgery and a lengthy stay in hospital this time last year, I've no complaints about the NHS service at the sharp end of the stick. I wouldn't be here now if they hadn't done things the way they did. I've seen enough as an outpatient over the past six months to know all is not rosy in the garden, but, it's a heck of a lot better than it used to be. I had to go in to get a minor procedure done last Nov, day patient stuff. Date given was a Saturday so that they could keep up with their target dates etc. Worked for me.

I do sometimes wonder if patient expectation is realistic though.

 

[Foxholer]

...
PFI doesn't count as public borrowing, so it is really all about the smoke and mirrors....

There's the problem!

Had it been 'on balance sheet', as has now been recommended by Treasury Select Committee, I believe there would have been far more investigation into 'value for money' and the actual projects themselves!

To me, this was a loophole used by both Labour and Tories far exceeding any of the ones any government has tried to close with their crackdowns on 'aggressive tax avoidance'!

 

[SocketRocket]

Homer

One of the problems is that the apparatus of Trust structures has caused a proliferation of people in non-clinical jobs. Some of these are more useful than others. The medical secretaries are amomngst the most useful, and if they are cut, it will add to the grossly excessive amount of paperwork done by doctors and nurses, delay letters getting out to GPs and cause chaos.

In the old days, hospitals had a Unit Administrator and a small number of support staff. Now they have large executive committees, a highly paid so-called CEO (although it is not a proper CEO position as understood in private industry), marketing people, press officer and a bunch of others who contribute little of any use.

The practice of appointment spoiling is endemic in the NHS due to the pressures placed on budgets and clinical departments, not as a result of mean-spiritedness or malevolence. It may or may not happen at the RBH, or you may or may not be aware of it.

The problem with organisations being over administrated and abundant with 'red tape' is the norm for nationalised industries and services. Some do work hard and do their best but ultimately the system will drag them down.

In private organisations the cost of administration is an overhead that will be kept to a minimum such that it is just adequate to allow for efficient services, production and customer satisfaction. The well branded outcry of 'Privatisation' and protectionism by the Unions and senior administrators IMO restricts the opportunity to get the best value for money. There is an abundance of expert people that understand how businesses should be operated and administered and it's not beyond the wit of man to apply best practice principles to the NHS.

 

[Foxholer]

The problem with organisations being over administrated and abundant with 'red tape' is the norm for nationalised industries and services. Some do work hard and do their best but ultimately the system will drag them down.

In private organisations the cost of administration is an overhead that will be kept to a minimum such that it is just adequate to allow for efficient services, production and customer satisfaction. The well branded outcry of 'Privatisation' and protectionism by the Unions and senior administrators IMO restricts the opportunity to get the best value for money. There is an abundance of expert people that understand how businesses should be operated and administered and it's not beyond the wit of man to apply best practice principles to the NHS.

I'd totally agree with this if the organisation was a PLC etc. However, the NHS is not one of those, nor is it ever likely to be one (or many) - even under Conservative administration. The simple fact is that the NHS is a black hole that will gobble up as much money as can be thrown at it - and then some! The hypocrisy of waiting lists that can be jumped where the same facility and staff are used is obscene! The supposed excellent managers/directors of Trusts are simply not capable of balancing books and providing an ever more demanding and expensive service - and some of them are vastly overpaid for their ability in the first place! The only good thing that has come out of the move to Trusts is that real medical experts have been allowed to get on with their are of expertise - practicing medicine! But that hasn't prevented significant amounts of wastage and several scandalous disasters and subterfuge!

It's the relative lack of responsibility - a major difference between PLCs and NHS Trusts - that allows the above to occur. My personal experience of my local Trust is actually great, though that's mainly through A&E, which is a bit higher profile - and there was still some issues there with folk using it instead of their GP. I have also had the misfortune to know someone whose life (and certainly quality of life) was severely curtailed by some abysmal treatment, for which a settlement was reached shortly before he died. My late FiL was also treated extremely badly (imo) during his last weeks.

 

[Snelly]

So I went private.

Paid a consultant to see me three weeks ago, paid for an immediate MRI scan, consultant diagnosed the problem and referred me to a specialist physio. Just finished my fifth session with him and I am fixed. Completely fixed.

Total cost of £1,055.00.

A bargain when you consider that I would have another 19 weeks to wait before seeing the same consultant for an initial chat under the NHS.

The stupid thing is I had already spent over £400 on chiropractors, physiotherapists, sports massage, osteopaths and acupuncture therapy. None of this helped and I have been in varying degrees of pain for almost 9 months.

Lesson learned for next time is if I have a problem with my back again, go and see the top man in the area as soon as possible and get it sorted. The cost is irrelevant.

 

[Baldy Bouncer]

Welcome to the Tories version/vision of/for the NHS.:sbox: