Saturday 6 July 2013

John’s Blog No. 134 – NHS


Two weeks ago, for only the second time in my life I was treated to the delights of an overnight stay in hospital. It was not by choice obviously but by illness, which overtook me at the convenient time of midnight on a Sunday

I woke with breathing difficulties, which got steadily worse until my wife and I decided to call the out of hours service, found the booklet, the number and no longer available reply, tried 111 and received another number to dial, then was connected.

Of course in a normal emergency one would expect to be asked symptoms and questions to decide urgency, but not at that stage personal details from someone having difficulty talking. On hold while a nurse was contacted and then in good call centre practise, started from scratch again.

It was decided on an ambulance, which arrived fairly quickly and then the medical excellence started; efficiently working through their check list of tests, they then decided on hospital and took me out to the ambulance made me comfortable and carried out more tests, ECG etc before deciding to drive off.

One of their concerns, during the 30 mile journey, was of another emergency as they were the only crew on duty, but luckily this did not occur. At emergency a rapid transfer occurred, with no sitting about in the Ambulance as widely reported, again a wide range of thorough tests and then a wait for a doctor to become available.

In a cubicle with curtains open and passing staff checking you were alright, then an emergency next door and the curtains were drawn and isolation began, this is my only crtiticism, the lack of contact and communication and having to call out several times as someone passed, when I needed attention.

Things had improved since my previous visit many years ago, but I was stuck by the complete contrast between medical staff and management. The staff were helpful, cheerful, efficient and overworked, patients were difficult, with the usually lack of communication skills of doctors and consultants, but one had the overall impression of things being haphazard and disorganised.

There was a routine but it clashed at times with doctors rounds, cleaners and maintenance staff came and went at their convenience with the usual long mop pushing the dirt from the doorway round the ward and out again, although there was a full clean the next day.

After a fitful sleep, had just dropped off when the 6.30am medical check started plus a cup of tea, water jugs were collected , taken away and not returned until half an hour later, there was a lot of hassle, breakfast, cleaners orderlies etc., which disturbed the peace.

Visiting hours were restricted, but there was not a lot of activity in the afternoon, so it could have been continuous from lunchtime. There were no night rounds with a complete dependence on the panic button.

One couldn’t help thinking of the good old matron days, experienced when visiting parents and everything seemed quiet and efficient, with little escaping her eagle eye. The care problems now arising result from this lack of this overview and the patient considerate manner exercised on the spot by the matron.

There is no-hands on management occurring, with time taken in balancing budgets, meeting targets, planning and trying to fit two pints into a pint pot, whilst dictating what happens in daily routine, staff levels etc. This is a formula for chaos which is appearing steadily in our NHS.

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