Sunday, 13 March 2011

The NHS dilemma

For the past few years the previous government and the new coalition have talked about the patient being at the centre of the their current NHS ethos and 'choice' being pivotal in moving the service forward. I have three separate first hand experiences with Vicki that illustrate the great challenges that remain ahead.

Story one involves Vicki having some vaccinations. Regular readers of my blog will recall that whilst Vicki is still under the overarching care of her consultant at Leicester Royal, her actual care is taking place at Northampton. The consultant at Leicester wrote to the Northampton consultant asking him to arrange a series of vaccinations for Vicki as her immune system starts to return to normal. The Northampton consultant then writes to our GP to ask them to arrange this. This should be straightforward except that we had changed GPs earlier, so our old GP had written to us in this matter. No problem I thought, I'll simply give a copy of the original letter to our new GP and they would make the necessary arrangements. The nurse at our local surgery asked us for clarification, but I could only say that I had the same information that she had! She said that she needed to know exactly what was needed and that letter from the Leicester consultant wasn't explicit enough. OK, fair enough, but I'm not a medical person so the only course of action that I could see was for the nurse to contact Leicester (the author of the original letter) and seek clarification there. This she did, and here's the first shock; she was told that Vicki was no longer their patient, so they couldn't help. Whilst this is only partially true, isn't it irrelevant as the letter originated from Leicester in the first place? Not to be foxed by this, the nurse then contacted the Northampton consultant who sent her a copy of the same letter that she already had. Now this is where it gets bizarre. Armed with no more information that I'd already presented the nurse with originally, she was now happy to proceed. What a waste of everybody's time that was. Can anyone else see how ridiculous this was?

Story two leads on from this incident. While we we eventually getting Vicki's first batch of vaccinations, I enquired about the HPV vaccination. Vicki had been due to receive this in Year 11, but had been in hospital at the time so missed out. We were advised that we'd need to contact the Young People's Nursing Service to arrange this and they gave me the number to arrange this. So I called them, explained the scenario, and they confirmed that Vicki was eligible and that we should come to their drop in service which is exactly for this kind of thing. I arranged a date for this and was told that the service would be alerted to our visit. When we arrived, some two weeks later, we discovered that they weren't expecting us. No matter, we'd just need to fill some forms in. Then a nurse came down to talk to us, she started telling us that Vicki WASN'T eligible. She asked me who I'd spoken to, which of course I couldn't remember at this point. I asked the nurse how was Vicki supposed to get the HPV and receive the protection that it offered if she wasn't eligible. She just shrugged her shoulders. Very helpful. I pointed out to the nurse that she'd missed the school run of this vaccination due to serious illness and that if she wasn't eligible now and couldn't get the HPV elsewhere, who should I sue should Vicki contract cervical cancer in later life because she'd missed the vaccination. The nurse disappeared for a few minutes muttering to herself and then called Vicki in to receive the vaccination. Whilst I was happy that she was now receiving the vaccine, why the hell did they make a fuss and tell us that she wasn't eligible? Again, am I the only one that thinks that this is mad?

The third and final story is from the local hospital. They left a message on my answerphone the day before Vicki had an appointment and asked me to contact them, By the time I got in from work it was nearly 8 in the evening, so I rang the hospital straight away. They explained that they were very busy and could they postpone Vicki's appointment. To say that I wasn't happy with this was a bit of an understatement; I'd already booked the time off work and had no more leave to take, so I explained this, but they still wanted to cancel the appointment. I said that it wasn't practical to cancel the appointment at this short notice so reluctantly they agreed that Vicki could still come in for her appointment as scheduled, but warned me that we may have to wait a long time due to their workload. I was fine with this. I've spend what feels like half my life waiting around various NHS establishments for numerous reasons so a little extra time wasn't going to make much difference! Now here's the thing. We arrived on time, and were seen and out of the hospital in 2 hours, which is less than normal! So why did they make all this fuss? Damned if I know. For the third time of asking, anyone else think this is mad?

All this happened to one patient in the span of about a month. Either Vicki is very unlucky or there are patient-centric issues that the NHS still needs to address. I'll let you make up your own minds, but none of this made me feel that the patient comes first!

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