Tag Archives: general practitioner

People Power Works!

A landline telephone

A landline telephone (Photo credit: Wikipedia)

0844    0844   O844    0844    0844    0844    0844    0844 

Company to stop marketing 0844 numbers to GPs

The latest issue of PULSE MAGAZINE, the Doctor’s in-house journal, has a very interesting story proving that ‘people power’ still has clout. It says “A major supplier has promised to cease marketing 0844 numbers to NHS organisations, due to public opinion over the use of premium numbers by GP practices.”

Now The Daisy Group, which owns the Daisy Line Surgery telephone service,
installed in more than GP 2,000 practices, has said it will stop marketing 0844
numbers to NHS-related organisations due to public pressure. Mr Andrew Goldwater, commercial director of system services for the Daisy Group said that they will bow to public opinon and stop proactive marketing 0844 numbers to practices. So in future, once there is no incentive to keep patients hanging on, you might even find you get through quicker. However, be warned!  The Daisy Group has announced they will “continue to work with our GP customers to develop
alternative solutions, supporting them by providing them with the products of their choice.
Mr David Hickson of campaign group Fair Telecoms said the Daisy Group should go
further and assist all practices currently using 0844 numbers to switch to the
equivalent 0344 number.
In which case, those of you who have BT Option 3, or similar packages, will get
these calls for free.
verite@greenbee.net

NHS shoots itself in foot – again

English: NHS logo

 

Death

 

League

 

Tables

 

My Heart Surgeon leant over the desk: ”now I have to tell you the risks”.   (Having just been told I needed a 7-hour heart operation, surely I was savvy enough to realise that carried a huge risk?)

“If anything happens, will I know anything about it?”

“No – you will be under anaesthetic” he told me.

“Right – then it’s your problem”, was my reply, and we went on to more sensible questions.

What Doctors are For

Drugs had produced my heart problems, and I relied on my doctor to choose the best person to operate and repair the damage.  I SO did not need ‘Choose and Book’;  faced with a list of possible surgeons, I wouldn’t have had a clue whom to choose;  but a sensible doctor would know which surgeons had a good record for survival, because they had accepted ‘last hope’ cases whom no-one else would help.

NHS Interferes

 LaLaLite (the new Health Minister, Jeremy Hunt) is showing  just as much grasp of essentials as his predecessor,   LaLa Lansley.  Latest dictat info from Richmond Towers says “surgeons will be ranked by how many people die in their operating theatres”. 

This means a junior doctor, newly qualified and only trusted with the most basic procedures, will be top of the tables;  an experienced surgeon with patients queueing up from around the world, who will operate on many ‘no hopers’, will probably be way down the bottom of these silly, time and money-wasting statistical tables.

Can we please get back to sensible health care, where one’s GP is trusted to do their best for their patients, not waste valuable time and money having to compare paper statistics?

 Does anyone listen?

After shooting itself in the foot, today’s dictat is called

 Everyone Counts.

Well, if the bean counters in Richmond Towers haven’t noticed, is there any hospital really operating ’7  DAYS A WEEK’?

LaLaLite obviously inhabits the same Alice in Wonderland country as his predecessor.

Wonder how much this latest exercise cost us? 

Has anyone thought if they got down to actual work, instead of writing Fairy Stories (even though it is Christmas) they could go a long way to saving the money the NHS needs.

But I suppose this will mean a lot of ‘Consultants’ will be out of work.  Well, if this is the standard of their work, a good thing too.

Enhanced by Zemanta

Warning on taking medicines

Dr. Grumpy’s latest warning

Grumpy Bear in the Nelvana episode "Home ...

 

 

 

Dr. Grumpy is an American GP (or MD as they are known in the States).

He records the weird observations made by his patients – latest is one about which he says “I have a bad feeling about this

Dr. Grumpy: “What medications are you on?”

Mr. Scattered: “I don’t know. Whatever my girlfriend puts in my pill cup.”

Dr. Grumpy (to girlfriend): “What pills does he get?”

Ms. Girlfriend: “I don’t know the names. Whatever his mother tells me to give him.”

Dr. Grumpy: “Where can I reach your mom?”

Mr. Scattered: “She’s in jail.”

Enhanced by Zemanta

How we ran an event – and almost had to close the doors to newcomers

WELLBEING DAY – WHY HOLD THIS?

Kensington and Chelsea LINk ran a fun event designed for cancer patients and by cancer patients.

This was probably the first time such a large event had been organised.  But why did they do this?

Several reasons:

  • Cancer Patients often complain of feeling neglected and abandoned
  • When their ‘treatment assembly line’ finishes, they can find it difficult to tie up all the loose ends, deal with side effects, find where to ask advice about benefits, etc.
  •  Often it can be difficult to difficult to  find information, especially on dealing with side effects, as these may not follow a ‘normal’ pattern
  • There are many services available, but patients don’t know how to get information about them
  • They are told to “ask your GP”, but doctors may not be able to keep up with all the latest information

So Kensington and Chelsea LINk cancer group had the idea of bringing helpful services and products together under one roof, as a Wellbeing Day.  Organised by Ijeoma Igwume, and assisted by  Simmone Hall who MCed the event, it turned out to be so popular that at one time organisers wondered if  ‘Elf ‘n Safety” would make them close the doors because so many were queuing to get in!

This is my unofficial account of how we planned the day, and what happened.  I work on the cancer group, and was delighted to see how an idea mentioned in a committee meeting became a wonderful reality.  This is my slant on the day – NOT an official account.

With many thanks for photos by Barrie Leyshon of Cancer Voices, and others.

End Result

The Event was an incredible success;  many of the visitors asked and emailed to say ‘run it again’.  People were going round with big smiles on their faces.

Speakers such as Mark Davies (who wrote ‘ Saving My A*’) had standing room only for their talks;  the companies who generously provided goodies and took stands were asking “when is the next event?”, and two of them, Urban Retreat at Harrods and The Organic Pharmacy, have already said they are going to carry on offering more services for cancer patients.

Stop PressPaul’s Cancer Support Centre in Battersea has just announced they are planning on running not one but two similar events, copying the format.

So K & C LINk’s trail blazer proved that there is a need to have information available for cancer patients, of the kind that medical staff are often too busy to provide.

The Event must have been interesting.  Having come to open it, the Mayor, Councillor Julie Mills, enjoyed herself so much she came back again in the evening!  This is her on the stage; also in the photo is Paula Murphy (left), in charge of the hard-working LINk team.

Conclusions

Anecdotal evidence showed that about 50% of the visitors were from the BME community – which LINk are keen to contact.

168 visitors filled out a questionnaire  – a very high proportion of those attending

4 major events are planned for cancer patients as a result of being shown what could be achieved

And as an added bonus LINk said that they picked up new members.

So if you want to run your own event go for it – and here’s some background information to help you run a Wellbeing Day

SERVICES

This web page leads you to articles about all the different companies who contributed;  who won top prizes; and background information about the companies that participated:

http://after-cancer.com/category/a-wellbeing-day/

Please feel free to copy and write to those contributing.  Many of them are only too pleased to help.  They make products that will help cancer survivors, but often the NHS doesn’t have time to try them out, evaluate them and promote.

WHO WAS INVITED?

Patients, members of support groups, nurses, therapists, physios, members of cancer charities, GP surgery staff and doctors

SPONSORS

We worked with Macmillan to target the BME community, and in return they gave us generous sponsorship.

STANDS

www.after-cancer.com/category/a-wellbeing-day/

Gives a summary of articles about the various companies that generously gave us fantastic amounts of goodies to pop into bags.

Vikki Ullah invited me to lunch afterwards and I had great fun trying on their wigs (cost £100 upwards and they accept NHS vouchers).  During lunch there was  very positive outcome in a long discussion about various initiatives that they already offer, or are hoping to offer to cancer survivors.

A really positive result!

 

COSTS

All these were generously covered by a Macmillan grant, which also provided enough funds to enable us to offer refreshments too – most welcome and lots of people commented on this.

If you can’t get sponsorship to pay for food and drink – think local supermarkets.  Firms such as Waitrose and Tesco often have a policy of helping local charities and will donate tea bags, coffee, milk and often eats as well.  Approach the local Store Manager (not the Head Office).

Just don’t forget you will need volunteers to serve, clear up and wash up!

VENUE

Aim high.  If a venue, hotel or sports centre is opening, ask if you can ‘use’ their space in return for publicity for the new venue.

Football clubs, racecourses, swimming and health centres etc. often have suitable space.

It helps if you are going to invite a personality that will give the venue  media coverage

In the States many cancer hospitals will ‘lend’ their reception space for the day.  Try your local NHS hospital. However, asking for another event, I sent long detailed emails when hospitals asked for them – only to find I didn’t even receive the courtesy of a ‘thanks but no thanks’  reply.

SPONSORSHIP

We found that Macmillan had funds to sponsor events particularly targeted at the BME community;  this was a natural for any major city such as London – so thanks to a generous grant we were able to provide door prizes, refreshments etc. for free, and didn’t have to charge stand holders.

STANDS

Since Macmillan had provided sponsorship, we didn’t have to charge companies to take part.  So instead firms such as Flexitol and Synergy were incredibly generous, and provided boxes of samples for our Goody Bags instead.  We also had representatives from Age UK, Citizens Advice Bureau and local Advice charity Nucleus, Royal Marsden Hospital, Paul’s Cancer Support Centre, Cancer Charities, Krish Shastri whose stand provided information about travel insurance (another very popular stand), Macmillan, Europa Donna, Organic Pharmacy,  etc.

Particular care was given to providing information to help the BME community;  this is a major concern in this part of London.  Talking to a BME leader, she said that although the Macmillan questionnaire said that 12% were from this sector,  anecdotal evidence suggested we got nearer 50% attendance, but many might not have had time to fill in forms.

COMMITTEES, VOLUNTEERS, WORKERS etc.

I used to run events for the Lifeboats with John Sainsbury (now Lord).  One could see he was going to go far because he got on with the work.  Two of his favourite maxims were

“the best committee is a committee of two – with one person ill”. 

And “if you have a committee, get them decide on the important issues, like the colour of the tickets;   leaving your committee of two to work out the rest of the details without discussion“.

But, we were agreed that you need a committee – a big one – if you have to sell tickets.  Luckily for us, Macmillan gave a grant which enabled us to run the event and not charge visitors.

So Ijeoma Igwana and myself communicating by email, was incredibly effective.   Aided by some special help from Gaenor Holland-Williams, who was brilliant at getting the very popular stands offering benefits advice, such as Age UK, Nucleus, etc.

HELP FROM OFFICIALDOM

This can vary: your local cancer centre might be very supportive but not have anyone to spare to help you;  another group will go out of its way to be supportive.  So, realising that these Centres were over-stretched, we asked them to distribute invitation flyers, and had one centre present which has several BME groups in its membership.

SPEAKERS

We had a separate room with a platform, ideal for various speakers.  We asked representatives of cancer charities and the Prostate Cancer session was full.  Mark Davies spoke, and promoted his book.  Local hospital provided a dietician/nutritionist whose talk was tremendously popular.  Another speaker talked about how to handle the new benefits claims, etc.  Organic Pharmacy had a very popular session;  you will probably find major pharmacy chains such as Boots or Lloyds would be happy to provide speakers.

And the session with a local dance group entertaining was tremendously popular;  just make sure the singing and dancing are contained, as otherwise those in main hall trying to talk to stall holders can’t hear themselves think!

Only time there were spare seats was in-between speakers

THERAPIES

This corner was very popular.  Local Spas will often provide mini-massages, make-overs, manicures etc. in return for the publicity they gain.  Make sure it is as quiet as possible, and away from main crowd.

CATERING

It is vitally important that guests get something, even if just a cup of tea.  You may be obliged to make use of the Venue’s catering company, in which case see if you can get a supplier to sponsor refreshments.

If you are allowed to supply catering, don’t forget you will need people to do serving, washing-up, clearing etc. People will volunteer, but you need plenty!

If you want supplies, local branches of Supermarkets such as Tescos and Waitrose have a policy of helping local charities.

If you need to contact a company, go on the Internet, find out who is their PR company – and approach them. The PR company has to provide exposure, so will love the chance of saying XXX number of people will be present and persuading the company on your behalf that it would be a good idea to donate what you need.  This can often get a better result than you approaching the company direct, unless you are friendly with one of their major executives – or you happen to work for them.

If providing food, remember some will be vegetarians, or have had cancer;  we were offered curries, but had to turn these down as patients often can’t take highly spiced food.  Bland is best!  And ensure food and contents are labelled clearly.

GOODY BAGS

Difficult to get the actual bags;  I had been promised these by a PR company, but they lost their Over-the-counter medicines account just before the event, so didn’t have any to give us.  So it was a mad scramble at the end.

But – filling these was no problem.  Companies were incredibly generous.  See

www.after-cancer.com/category/a-wellbeing-day/  for ideas.

Often it is better to approach the PR agency handling a company’s press, rather than approaching the company direct.  You find out who they are by looking on their website under Press or Media mention.

If you offer any products make sure they aren’t likely to cause controversy.  We handed out cans of a new beverage,  but I made sure this didn’t contain ‘E’ numbers and was ‘pure’.  Same thing with over-the-counter remedies;  Rohto provided samples of eye drops that help with ‘dry eye’, but I checked with an Opthalmogist who often recommends this product.

PROBLEMS?

One set back was caused by Trend-Micro, a company that had been employed by the NHS to filter out Internet spam.  They blocked every single email coming from a major ISP provider – and one happened to be my supplier!  So emails due to be sent out reminding people about the event disappeared into the ether.  However, if we had had more the doors might have had to be closed!We had an unexpected set-back:

The North West London Cancer Initiative group is the overall cancer body for our area of London.  Two weeks before our event, we get to hear they had called a massive conference for the same day, so theoretically all their 400 members would be going to this conference, instead of coming to us.  Several of this group said they were horrified, and were coming to or event as they wanted to know what patients wanted, and what was provided for them.

So much for ‘Patients are at the centre’, etc!

TIME

Don’t underestimate the time it will take to organise and confirm arrangements.

But at the end it will be incredibly worth-while.  I couldn’t believe how many lovely congratulations came our way, and at the end I was presented with a plant that is still sitting across the room.

So if you want to organise a similar event, Go For It!  Best of luck!

Enhanced by Zemantas

Understanding NHS jargon

Keeping up-to-date

Peter Carter, British nurse and General Secret...

Peter Carter, General Secretary of the Royal College of Nursing: Wikipedia

 

You are going to hear a lot about CCGs

(Clinical Commissioning Group)

This is one of the new terms in LaLa’s weird vocabulary.

 

This week LaLa himself came out of his Whitehall bunker to appear at the RCNurses’ conference;  bet he wishes he had stayed put.

One delegate reported on a comment to the Minister from the general secretary of the RCN, Peter Carter. As LaLa had used his jargon-filled speech to deny there was anything wrong with the NHS, a friend reports  Carter rounded on him and told him:

“Because conference has been polite to you, do not leave here thinking we are happy, satisfied or relaxed about the future. We are not.  We are very upset.” As one, the Congress rose; a standing ovation for their leader.

Other members of the audience used less elegant language;  one nurse calling him “barmy”.  Non-PC in today’s NHS jargon, but very apt.

 

LaLa and his minions seem to speak a different language to the English I learnt growing up.  Understanding what is being said needs an interpreter to translate the jargon.

To find out more I go on the Dept. Health website for clarification.  And had to give up before they carried me off screaming.  The front page tells me about a raft of pages that will tell me everything from how they get their authorisation papers (don’t ask) through to the adult social care engagement exercise.

In other words, they daren’t explain why LaLa got rid of three tiers of admin to create five.  Nor what the dictats mean.  No wonder the NHS is a massive employer;  they need the minions to think up these jargon-filled slogans.

Interpreting the jargon

So I turn to the invaluable  Roy Lilley of nhsManagers.net, who tells me CCGs “are the new celebrities in the NHS.  I’ve listened to a good few CCG chairs in the last few weeks and I think I’m beginning to get the hang of it”.

Emotions range from schoolboy enthusiasm to downright cussedness. The GP’s who want to commission care so that they can tidy-up some irritations and anomalies in local care pathways and others who seem to have old scores to settle with the local hospital.  (Wish my doctor would copy them).

But your CCG may take some time to get going.  Lilley says, “One CCG chair proudly announced they were having a ‘time-out’ to ‘develop their constitution’. When Lilley asked him why they were not adopting the DH model constitution, there was a pause and he replied; ‘What model constitution? No one’s told us about that”.

iPads

However, most CCGs have got their priorities in order. They have bought iPads.  The funny thing is on recent visits to superb Consultants, I notice every one of them using an old-fashioned fountain pen to write up their notes;  not a keyboard in sight.  You could buy a pretty snazzy Mont Blanc for the cost of an iPad.

“We all know these are risky reforms, even in the hands of the experienced they would be a danger. In the hands of the well-intended part-timer they are a menace with the potential to be a hazard to health and a peril to the public purse. LaLa can’t say; ‘No one told me that.”  But as patients we might cast a beady eye over the expensive gizmos that are going to be carried around by all the members of these CCGs, and question who authorised them.  Then ask “what about data protection?”  if CCG members go on about sharing info.

But to ensure that our local CCG gets off to a flying start, ‘my’ GP has been unavailable for three days a week for the past year,  whilst she works at setting up the local group.  I have done my bit to help;  three times I have turned up for appointments, only to be told “Dr. X has cancelled your appointment – didn’t she tell you?”  Instead, I have ended up with the newest drafted-in Locum;  nice chap.  I just need to train him to send off referral letters promptly.

Latest Jargon dictionary

Cancer Pathways  The National Cancer Action Team is supporting a number of initiatives to help develop stronger commissioning of cancer services. Part of this process is to ensure there are clinically effective pathways, accessible through the Map of Medicine, against which cancer services can be commissioned.

Clusters – No, it’s not the nutty ones, although I am beginning to feel like one.  It refers to what happens when lots of quangos join up together to make sure they can have even more meetings together.  Very sociable over the tea and biscuits they are.

Development opportunity  – what’s given to the new Outpatient receptionist who manages to lose all your notes

Mission statement – telling them to devise a mission statement has got to be the best way of giving someone employment to produce a fatuous statement highlighting the blindingly obvious.

moving forward – opposite of what happens after the hospital committee has put in ‘improvements’

NHS Choices – the appointments office whose job it is to confuse you so you are unable to make an appointment that suits you,  With any luck the appointment is so much in the future you go privately, taking you off the list and saving the NHS money.

QA – quality assessment   These are the reports hospitals now have to produce for their local LINks.  Theory is they identify quality of hospital’s service.  Actually, a test in how those who compile QAs manage to ‘overlook’ items of important to patients, such as MRSA, Mixed Wards, etc.

Stakeholder engagement – NHS website explains this is all about “building relationships with people who (sic) you affect through your work, or who could make an impact on your success.  It is the foundation of effective organisational responsibility, and refers to the formal management of the human dimensions of change”.

Er – don’t they mean ‘getting on with people’?

World class -  NHS services on a par with Third world services

LaLa and his minions need to go back to school and learn to speak modern English. Not expect us to swallow the  clap-trap the hierachy spouted to serfs behind the old Iron Curtain.

Enhanced by Zemanta

Health Bill cut backs can be challenged

PCT decisions are NOT final

 

 

 

 

 

 

The Royal Marsden Hospital Pain Clinic was quite definite:  I needed a course of 22 Manual Lymphatic Drainage treatments for my swollen limbs.

They had tried the ‘usual’ bandaging, raising limbs (who can do that today?), cut out all salt etc., etc. and nothing worked.  At times I just wanted to get a Stanley knife and plunge it into my swollen skin.

So I went to see my GP to ask them to get authorisation for this exceptional spending, by applying to my local PCT (Primary Care Trust).   They were reluctant to do this, trying every means of sending me backwards and forwards to the Marsden’s Lymphoedema nurses. Eventually, they very nicely said they had told me and told me they couldn’t do anything;  probably because I had other problems that might have been caused by the fact I had had polio, and side effects from cancer drugs had given me such dry skin that wearing tight support hose was painful.

After having kept on and on all last Autumn, asking when I might receive an answer, I received a copy of their reply to my GP at the beginning of April.  My heart sank.

The panel made a unanimous decision to decline funding on the grounds of existing commissioning services available.  

In reaching its decision, the panel followed its ethical decision making framework as well as the evidence you provided in support of the patient’s exceptional circumstances.

No mention of where and how I could obtain these ‘existing commissioning services’.  I knew these did not exist, so someone was prepared to write about a non-existent service to get out of funding treatment.  This needed a lot of thought, as I plotted what to do next.

In London we are finding we are becoming victims of the ‘post-code’ lottery, particularly when it comes to Lymphoedema services.  So I decided that first thing to do was find out what are existing commissioning services available. 

Then things started to get interesting.

Reply

For the next week the PCT and I played a game.  I would phone to ask what services were available.  Was told that the ‘ethical’ panel had said that these services were available in my part of London.  I knew that there was one service sometimes available to patients, in a far area of North London, which was vastly over-subscribed. But nothing else.

Several phone calls later, I discovered that this panel had been listening to rumours, and without any justification, had taken these as fact.  I kept on phoning to ask where was the service? whom did I contact?  How did I join it?

The PCT kept on saying “we’ll call you back”.

But never did.

When I would call back to speak to the original person – who hadn’t bothered to call back – I was constantly told “they are in meetings”.

Gradually I teased out the ‘facts’ on which the ‘ethical’ members of the panel had based their judgement.  The service had been talked about, according to nurses at the hospital.  Someone was going to start this, but had left again.  There were rumours that the hospital were about to interview a therapist.

I went to see nurses, receptionists and admin. at the hospital.  Was either met with a blank face, or a nurse telling me they had thought about it ..but …..

All these rumours had formed the basis for the ethical panel members unanimous decision to turn down my application. !!!!!

Blowing my top

Eventually, being sure in my own mind that this service definitely didn’t exist, I started to phone the PCT to speak to the person who had signed the letter.  Surprise, surprise.  Again, she was constantly ‘in a meeting’, but would phone me back.

So I would wait – and then phone back.  She was still in meetings;  this must have been the longest in history.

After a week I blew my top.  And started to mention that I was going to contact my MEP in Brussels.

I knew it was no good approaching any Conservative or Lib Dem MP (even though ours is a very good one) because they have to toe the party line when it comes to Health.

But MEPs – that was a different kettle of fish.  But I didn’t have time to Google ‘Your MEP’ before I was phoned by the official who had been in meetings all week, and told that my application had been approved.

And I am off this week for my first treatment.

Who else can help?

The MedLaw website  is a self help tool for patients to make applications and appeals for NHS funding for treatment. Information and guidance is provided on the processes to follow, the forms to complete, the evidence required and on the law.  It is written clearly, easy to understand, with a lot of sensible advice.

As they say, “many treatments are not routinely funded by the NHS and these include newer treatments for rare cancers, rare disease, and surgery. Consultants and GP on behalf of patients now have to make applications and appeals for funding under what is known as the Individual Funding Request (“IFR”) process.

For cancer patients, the Interim Cancer Drugs Fund acts as a “back stop” so you can apply to them for further funding for cancer drugs only once you have exhausted the application and appeal process”.

www.medlaw.eu

Enhanced by ZemantaMoral of the story. 
  • Be sure of your facts
  • Then challenge the PCT.
But suppose I had been an OAP who wouldn’t know how to challenge the PCT?
And why was it that my GP had allowed the PCT to write this letter, and not challenged it?                                                             They should know what cancerservices are available locally – but don’t

GPs make too many mistakes when prescribing

GMC say one in six prescriptions 

 

could have errors

Medicine drugs

 

Shocking statistics have recently been released, saying that errors happen in far too many prescriptions.

I didn’t believe this, so took my bag of pills into my local Boots, and asked the Pharmacist to review them.  I came out a very much wiser person.

If I could find errors in prescribing, considering myself fairly savvy – no wonder the elderly can be particularly at risk.

The magazine Pharmacy Voice has responded to the findings of a study into GP prescribing, which found that around 1 in 20 prescriptions written by family doctors contained an error.

The research, commissioned by the GMC (General Medical Council) looked at a sample of GP practices in England and found that the most common errors were

  • missing information on dosage
  • prescribing an incorrect dosage
  • failing to ensure that patients got necessary monitoring through blood tests
  • not saying if pills should be taken before, during or after meals (this was what happened to me)

Ian Facer, Chairman of Pharmacy Voice said:

“With millions of prescription items issued by GPs each day, some errors are perhaps inevitable – so it is important to have a safeguard against patient harm; that safeguard is provided by local pharmacies.

Headlines echo concerns

The GMC reports GPs are making too many mistakes when prescribing drugs to patients.  They are calling for longer consultations, to give doctors time to evaluate other drugs taken by patients, and monitoring the effects.

Its study – based on 1,200 patients – found the elderly and the young were the worst affected.

But the report said although many mistakes were only minor, and some would have been corrected by the pharmacist before the patients were actually given the drugs, nonetheless, it was clear there was room for improvement.  They are calling for better training for GPs and more checks on their prescribing practices.

They also suggested the length of the GP consultation should be increased from 10 minutes to 15 to ease the time pressure on doctors.

Lead researcher Professor Tony Avery added: “It’s important we do everything we can to avoid all errors.”
The most common type of error identified was incomplete information on the prescription, followed by problems with dose and timing of doses.

In total, 18% of patients experienced a mistake with at least one prescription over the course of the year.

But for the over-75s the figure increased to 38%, reflecting the fact they were often on a number of different medications at the same time.

Children under the age of 14 were also more likely to experience an error – something that was put down to the difficulty of getting doses right.

But the overwhelming majority of cases were not classed as serious, with only 4% of errors judged as severe.!!!!  In other words, one in 25 of us will have a serious incident.  Thanks a bunch!

These serious cases included incidents where patients were given drugs which they were allergic to, and a lack of monitoring of potentially risky drugs such as warfarin, which thins the blood.

Reassuring?

Why aren’t I reassured?  LaLa Lansley says the government is working with GPs to improve practices.  Considering he and the GMC are at loggerheads, I don’t see how this is to happen.  But fear not, he said patients should be reassured that even when GPs made mistakes, there were systems in place to make sure patients were not affected.

“The vast majority of prescriptions are checked by community pharmacists, who spot and put right any errors when they are dispensed.”      Well, thank heavens for that.

So take  advantage of free check services

The National Pharmacy Association survey for Ask Your Pharmacist Week (7-13 November) found :

  •  Only 8% of people know that the vast majority of pharmacies have consultation rooms from which numerous NHS health and wellbeing services are delivered.  (Almost 9 in 10 pharmacies have NHS-accredited consultation areas)
  • There is no waiting time (you often don’t have to make an appointment), and the pharmacist will be with you for as long as it takes to help you.
  • New Medicine Service is an NHS service,  aimed at helping people who have been newly prescribed a medicine. People often find they have problems when they start a new medicine, but NMS helps to sort these out.  Now you can visit your local pharmacy to get expert help and advice.

 

Pharmacies such as Lloydspharmacy offering Medicines Use Reviews are available free on the NHS in pharmacies.

Anyone taking two or more prescribed medicines for a long term condition can benefit from this, and, as I found out when I tried out the service, even if you have been on medicines for some time, my pharmacist was able to suggest simple steps that helped with side effects, and reduced nausea effects.  I had a private, very informatived and helpful interview which wasn’t rushed, and I was able to discuss all my worries for free.

 

Enhanced by Zemanta

Look your doctor in the eye!

NO STARING AT THE SCREEN

 

 

 

I had an appointment with someone who treats the Royal family;  it was a delightful experience.

Treated with the utmost courtesy;   the Consultant got up when I came into the room, and during the whole consultation I was looking at them full-face – not a computer screen in the way.

What a difference from the computer whizz kids constantly tapping their keyboards.   A recent survey in Pulse (the doctors’ magazine) complained that consultations had become more complicated and intense over the last five years.

  • only 55 per cent of any consultation was spent “speaking to patients” and “addressing their concerns”
  • one third was spent on paperwork and data input.
  • 38 per cent felt they could not give patients enough eye-contact because they had to spend so much time entering information on to computers to meet Government targets. Much of the information that doctors must input relates to bonus payments for the performance-based aspect of their contract i.e. the dreaded QOFs.

So instead of making life easier for doctors and giving us more ‘quality time’ during appointments, the NHS wastes time by changing the rules.

GPs are now compensated for the different conditions they treat, rather than giving every practice an overall payment according to how many patients are on the books.  Hence the amount of time GPs  spend in-putting data onto screens, so they can claim the maximum fees from the PCT, rather than observing us and answering our needs.

Vanessa Bourne, Head of Special Projects at the Patients Association says,  “GPs are the gatekeepers to all other healthcare. Patients must be able to trust that an accurate diagnosis is being made. At the very least that means having a proper look at the patient”.

So what actually happens?

Worryingl

  •  half of GPs said that their Primary Care Trust (who pay for GP care) did not support them in “offering high-quality patient care”
  • 27 per cent said PCTs were “actively obstructive”.

One wonders if they worry more that forms are filled in, rather than patients are getting proper care.

Average consultation lasts 11 minutes – although GPs say they need around 14 minutes to give us adequate time.  However, under a new payment contract introduced in 2003 (when QOFs reared their ugly head), doctors are working seven hours less per week. The harshest critics have said that if doctors worked longer, they could spend more time giving personal care.

“If PCTs are to blame for the wrong priorities in a consultation, then patients risk being shortchanged twice over – once by their GP and again by the PCT. For over a quarter of GPs to feel that their PCT is being “actively obstructive” tells patients that urgent action is needed,” according to the Patients’ Association.

Demand to see a Consultant

The Clinic system as offered by the NHS would only be tolerated by us.  I can’t see other nationalities meekly waiting to see a Consultant, then allowing the staff to shuffle them off to see another doctor

  • whom they have never met
  • who only has ten minutes in which to get a grip on their case
  • who in that ten minutes won’t have time to read their notes and familiarise themselves with your case
  • is expected to give a balanced judgement about your treatment for the next few months, when they may never have seen you before

What can you do?

Needless to say I don’t get marks for popularity;  when called through during a Clinic to see an unknown doctor, I politely tell the Receptionist “I am here to see Mr. XXX” .  She usually tries to push me through anyway, but I say sweetly that I will wait.  And sit back.  They will try and pay me out by making me wait at least an hour, but I reckon if I am going to see a Consultant and have the appointment paid for by my NHS contribution, I have to put myself out to a reasonable amount.  But to see a stranger, who has no idea of my medical history, is not fair on me as a patient.

Best of luck.  Doctors are supposed to be asking for more time with patients – so supposedly they will support your action.  And even if they don’t, you are seeing someone who knows some of your medical history – is not coming to it cold.

To see the original Pulse Magazine article and download the full survey results, please visit:
http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4124116&c=2

To see more about the Patients’ Association, or to sign up for their excellent newsletter, http://www.patients-association.org.uk/Join-Us.

 

 

Enhanced by Zemanta

Who gives NHS staff permission to call us by our first names?

Cameron highlights

 

bad treatment for elderly

 

 

But it’s not only the elderly who are subjected to rudeness and bad treatment by some NHS staff.  The NHS needs to put itself into a patient’s shoes, and work out what is best for THEM – NOT the hospital.

And remember that the NHS is funded by the patient – NOT out of a bottomless purse.  So make sure the patient gets value for money.

Somehow, treating patients with dignity and courtesy seems to have two meanings:

1.  Staff meaning might be :  “you are ONLY a patient”, and may give no thought to what patients are actually feeling.

2.  Official attitude might be:  we say we care for out patients (to stop them complaining).

This was amply demonstrated in the TV Junior Doctors programme, when ‘caring’ doctor Lucy was shown spending a great deal of time looking after one elderly patient, and even asking about her arrangements for when she got home.  Those who care for elderly relatives who were in the same ward know full well that the reality can be very different – when cameras aren’t around to record what actually can happen.

The same hospital has a £600 banner waving above its Atrium, proclaiming that it won a PEAT Award for ‘Dignity’  i.e. treating patients with courtesy.

What’s a PEAT Award?  Er – something awarded by the hospital to itself.

So you guess that dignity and courtesy can be lacking.

Name calling

I went to see Mrs. M in hospital – a very old friend and employee.  Asking a nurse where I could find her, and was there anything I could do to help, the nurse said it would be helpful if I could remember to shout.  Shout?  Her hearing was razor-sharp.

Talking to her (in a normal voice) she said that she didn’t answer if they called her Joan.  Only if they addressed her as Mrs. M.

One feisty old lady’s solution to bad manners;  a pity nurses don’t ask patients how they want to be called as a courtesy.

Good things

Having a Colonoscopy probably isn’t high on most patients wish list, but this hospital has a department run by Sue, where the staff are unfailingly polite.  They work in a cramped corridor (called a ‘ward’), yet Sue’s staff are the type of nurses you just have to hug – they are so helpful and courteous.  So if Sue can give dignity, kindness and courtesy to patients on her ward – why not others?

DOB

The Receptionists who snarl “what’s your date of birth?”  (what’s dignified about that?) try to tell you that this is the way their IT system works.  Obviously this has been set up by someone with not an ounce of courtesy in their veins.

So what happens in the private sector?  They know that to ask this question in front of a packed waiting room is a security risk;  in fact Scotland Yard frowns on the practice, and says no-one should give out personal information in front of strangers.  So in the private sector, if a Receptionist has to ask for a DOB, they push paper and pen across the desk and politely ask if you will write this down.

I now ask for pen and paper every time an NHS receptionist asks for this – and surprise, surprise – they are perfectly happy to comply, making me think that they must have been warned to do it this way, but have ‘forgotten’ until a patient reminds them.

Receptionists

Watching patients arrive at A & E, it is obvious that some are in pain.  They may not be very polite;  understandable when every step is painful, yet one frequently hears receptionists snap “I don’t have to listen to your rudeness”.

It’s NOT being rude, and they should realise that the person shouting at them would probably be horrified if they knew how they were behaving.  But when you can’t think for pain, your manners go out the window. The receptionist is NOT in pain and they should be trained that part of their job is to make allowances.

Being drunk is NOT an excuse for bad manners, and if a receptionist snaps at an abusive drunk they should be applauded.  But training should tell them the difference.

Another local hospital has some horrors as Outpatient Receptionists.  Check in, and although they know the Consultant hasn’t even come down from the operating threatre, they say nuffin.  After an hour or so, you meekly ask if someone has forgotten you exist?  Visible sneers, and you are told Consultant is still upstairs/is running an hour late, etc.

Another hospital has installed an expensive LED screen to alert patients.  Only problem is, Receptionists can’t be bothered to up-date it.

Perhaps best system would be for Patients to ask when checking in, “how late is so-and-so running?”  Last time I did this Receptionist was very happy to tell me “he’s running an hour late”.  So I told her I would be back in one hour, and went off to see a friend.

Lost notes

For patients to be told that a Clinic has lost their notes can be devastating.  You have been waiting for months to see the Consultant, and then realise you are expected to make another appointment weeks down the line.

Last time this happened to Bettina, she said “I smiled sweetly and said I quite understood this must be a problem for them, but I would wait whilst they looked for the notes.  My appointment had been for 3 pm – the notes were ‘found’ at 4.55.  But at least I got information I needed on that day and didn’t have to wait weeks for another appointment”.

Another friend had the same thing happen to her.  Her consultant said she would see her, they talked, and consultant said she would email the test results when they turned up.  Results turned up in her inbox two days later;  on the same day that a letter arrived from the hospital saying ‘as you didn’t turn up for your appointment you are off the list.  If you wish to re-book you will have to get a referral from your GP’.  That is really polite!

Appointments

Figures get bandied about regarding the cost of the NHS computer system (did I hear £60 billion?).  What seems extraordinary is that in a system where various hospitals can belong to the same trust, they can’t work out a way of checking if a patient has already got an appointment booked when they confirm a date.

Imperial NHS Trust ‘owns’ several hospitals.  Patients can be booked into one for an appointment, but need to have another appointment – so you can guess what happens.  The two appointments can invariably be scheduled for same day with not enough time for a patient to travel between hospitals – especially if their first appointment is running late.

It would be courteous and helpful if

  • Every appointment letter gave out a dedicated number so a patient could phone straight through to change times/dates, rather than the general number which can see patients waiting up to 30 minutes to be answered.
  • If an appointment is running late, Receptionists did everything possible either to ‘insert’ a patient in next, or to help the patient by phoning through to the next clinic, explain what is happening, and work out with that receptionist if the doctor can see them later.

 What to do

LISTEN to patients.  The NHS is a National Health SERVICE, and as such is there to serve contributors i.e. the general public.

And imagine every patient is a friend of your mother/father.  Treat them the same.

Enhanced by Zemanta

Is Lansley deaf?

SAVE THE NHS

 

The National Health Service Norfolk and Norwic...

Image via Wikipedia

 

We have all tried to tell Lansley he is going about NHS reforms using a sledge hammer that is out of control – but he doesn’t  seem to be listening.

LaLa wanders around with a smug smile on his face, but when brave campaigners have tried to put their point across, he just pushes past without paying any attention.

Two years ago, I was one who said that the NHS needed to save money, and welcomed the idea of reform.  One only had to step over the doorstep of almost any NHS centre to realise that joined-up thinking was often lacking, and stupid rules and regulations were costing money.

BUT – living in London, I began to realise that the Post Code Lottery is rife;  ‘new’ ways of saving money are designed to save money for a NHS centre, but not for the service overall, GPs are sitting on referral letters – I went to mine for a referral in August;  in October I asked what was happening and was asked, “do you still want it?”.  The referral was finally sent off on January 25th.

So there is ONE FINAL petition that you might like to sign.  It doesn’t cost anything – and might be the proverbial straw – miracles sometimes happen!

http://secure.38degrees.org.uk/NHS-petition