Jeremy Hunt NHS Goalposts

[the_bloke]

Last time I went to A&E, I went to Northern General after twisting my ankle so badly I thought it was broken. The initial diagnosis was that I had broken it, and the Dr was surprised it wasn't when he looked at the X-Ray. That was a Saturday.

 

Anyway, in the bay next to me was a man who had come to A&E, seen the receptionist, been triaged and had made it to a consultant because he had missed his routine GP appointment the day before. All he wanted was a repeat prescription, and he wasn't even low on medication. He'd been there for 5 hours. I overheard this because the consultant was rather irate and vocal about him wasting everyone's time.

 

Yet the stupid system still processed him instead of sending him away.

[Jpeters]

I find it very hard to believe such a filter algorithm is not already in usage. Does anyone know?

 

I don't find it that hard to believe. I would imagine that the receptionist has low levels (if any) of medical training. What if they made a mistake and sent someone away who had say a headache, but that person later died. The NHS would be sued.

[Supertramp]

The French or Germans wouldn't stand for this, but we the British will.

 

Stand for what exactly?

 

---------- Post added 10-01-2017 at 08:54 ----------

 

The latest study (March 2014) into the 'appropriateness' of self referrals to A&E said that 85% were appropriate.

 

http://www.bbc.co.uk/news/health-27512613

 

To be honest, I expected that figure to be higher. But it does beg the question what is & what isn't appropriate, not everyone has a medical qualification, and if you're genuinely poorly logic is the first thing to go out the window.

 

The 85% sounds very high to me based on my experiences but I only have anecdotal evidence, also the sample size looks very small.

 

A&E is for Major or Life Threatening Illness or Injury only.

There is a minor injuries unit for sprains, or small broken bone injuries. A GP for bugs and for those who are saying they can't get a GP appointment there is a walk in service.

[Robin-H]

Stand for what exactly?

 

---------- Post added 10-01-2017 at 08:54 ----------

 

 

The 85% sounds very high to me based on my experiences but I only have anecdotal evidence, also the sample size looks very small.

 

A&E is for Major or Life Threatening Illness or Injury only.

There is a minor injuries unit for sprains, or small broken bone injuries. A GP for bugs and for those who are saying they can't get a GP appointment there is a walk in service.

 

The NHS England's own figure is that 30% of people going to A&E do not need to, which I imagine would be based on a much larger sample size, as presumably they have access to the records of why people have turned up and so could give an actual figure, not an estimate (although I'm not sure if that is what they have done).

[sgtkate]

Like others on here I cannot stand Jeremy Hunt, but I think he is right with this one. The problem comes with classifying patients and how hospital management might try to play the figures to ensure they hit the targets. Unless there are EXTREMELY tight and totally objective measures on who is and who isn't a priority case then it's fairly easy to turn a broken ankle into a non-priority case simply so targets are met. If he can find a way to sort that then I'd be in support, but I think it's an impossible task.

 

The biggest problem is a lack of community care and GP availability. That's why so many people end up needlessly in hospital because they are unwell or in pain and have nowhere else to go. My own anecdotal one:

 

I have been abroad over Christmas and new year. My baby was taken ill with a chest infection while abroad and was seen in hospital and sent home with a nebuliser. We were given very clear instructions that her condition needed close monitoring and to see a GP within a few days when back in UK to ensure there was no further issue that needed hospital attention. So I rang my doctors from Poland to try to arrange an appointment for when we got back. I was told the first appointment was this Friday. I rang last Thurs. So what do I do now? I have v specific instructions from another doctor that she needs a follow up appointment but I can't get one in a sensible timeframe. GP said take her to the walk-in-centre or A&E, yes that's right they suggested A&E for what is almost certainly a routine check up. Absolutely stupid situation. I'm not going to take my daughter to a walk-in-centre and wait for potentially hours for this nor would I even vaguely entertain the idea of A&E, but I can absolutely see why others would.

 

This is just 1 single example of how things end up in hospital when they shouldn't and there are similar stories from all over the place, so rather than focus on A&E which is a symptom we need to focus on the cause which is a lack of local health care available with a day or 2 notice.

[unbeliever]

Like others on here I cannot stand Jeremy Hunt, but I think he is right with this one. The problem comes with classifying patients and how hospital management might try to play the figures to ensure they hit the targets. Unless there are EXTREMELY tight and totally objective measures on who is and who isn't a priority case then it's fairly easy to turn a broken ankle into a non-priority case simply so targets are met. If he can find a way to sort that then I'd be in support, but I think it's an impossible task.

 

The biggest problem is a lack of community care and GP availability. That's why so many people end up needlessly in hospital because they are unwell or in pain and have nowhere else to go. My own anecdotal one:

 

I have been abroad over Christmas and new year. My baby was taken ill with a chest infection while abroad and was seen in hospital and sent home with a nebuliser. We were given very clear instructions that her condition needed close monitoring and to see a GP within a few days when back in UK to ensure there was no further issue that needed hospital attention. So I rang my doctors from Poland to try to arrange an appointment for when we got back. I was told the first appointment was this Friday. I rang last Thurs. So what do I do now? I have v specific instructions from another doctor that she needs a follow up appointment but I can't get one in a sensible timeframe. GP said take her to the walk-in-centre or A&E, yes that's right they suggested A&E for what is almost certainly a routine check up. Absolutely stupid situation. I'm not going to take my daughter to a walk-in-centre and wait for potentially hours for this nor would I even vaguely entertain the idea of A&E, but I can absolutely see why others would.

 

This is just 1 single example of how things end up in hospital when they shouldn't and there are similar stories from all over the place, so rather than focus on A&E which is a symptom we need to focus on the cause which is a lack of local health care available with a day or 2 notice.

 

Does your GP surgery understand that this is for a baby and that medical professionals have told you not to wait that long? My local GP takes account of such things and does prioritise.

[sgtkate]

Does your GP surgery understand that this is for a baby and that medical professionals have told you not to wait that long? My local GP takes account of such things and does prioritise.

 

Yup. I know, I was pretty surprised too. In the past they've shifted hell and high water to find us an appointment when she's been sick. It's not a whinge at my local surgery really, they've been great in the past, just showing a reason why people can end up in A&E when their symptoms mean they shouldn't be.

 

If she still had bad symptoms I'd be ranting at the receptionist or in the walk-in-centre, but luckily it seems to have cleared up a great deal so I'm far less concerned. This post wasn't about my babies health per se, just an example.

[Supertramp]

Does your GP surgery understand that this is for a baby and that medical professionals have told you not to wait that long? My local GP takes account of such things and does prioritise.

But there are walk in centres if your GP cannot accomodate you.

[tinfoilhat]

But there are walk in centres if your GP cannot accomodate you.

 

They aren't everywhere though - nearest one to Chesterfield is Sheffield or Mansfield.

[Afilsdesigne]

I watched Jeremy Hunt deliver his statement live yesterday and, after some reflection, decided he has not got much of a clue how to make things better in the NHS. He might be right that 33% of all cases should be dealt with elsewhere, but in order for that to happen, other services must be available and must work all the time. They don't. He laid much of the blame on an ageing population (didn't see that one coming eh Jeremy), ducked both questions about alcohol related admissions (basically said people should be better behaved) and, amazing neither said anything, nor was asked anything, about the Elephant in the room that is the impact of immigration / health tourism. In short, things will remain the same or get worse.

 

Our NHS needs some massive reforms starting with a basic statement of what it is supposed to be doing (providing emergency care for all and basic healthcare for all UK residents), who for and to what extent. We need strong border controls to log people in and out of the country and only allow in those that have proper health insurance. Then we need to tackle care for the elderly and maybe detach this from the local councils remit and add it to the NHS so it can be properly managed and staffed with at least some trained nurses. After that, we need to tackle GP services such that people can contact the surgery easily and get appointments rather than having to go to A&E or ring 999 for attention. Self inflicted injuries caused by drinks or drugs might need a harsh payment penalty system? The 111 'service' is in my experience, totally pathetic and is worse than useless. It needs scrapping. Quite a list and yet that only scratches the surface of what needs to be done and quickly unless our NHS is going to implode.

Edited January 10, 2017 by Afilsdesigne