Another post not about wood. NHS this time

[AJB Temple]

NHS can do a fantastic job at times.
Doc (friend) investigating an issue with my bod. Need to see various specialists. One of which is a very entertaining Haematology consultant at Tunbridge Wells hospital. Saw her on Monday and she said I had to have various scans inc MRI plus bloods etc. On Tuesday at 7.30pm they rang me to fix the MRI appointment. Fixed it for Thursday pm at Maidstone hospital (same NHS trust). Turn up early and told it was for the previous day. Clearly a mix up. Emailing occurs. They ring me up next day and offer me various slots for this weekend, so I am going in tomorrow. I think that is pretty brilliant service.

Interesting though that the dots are not fully joined up. The booking service is outsourced to a private company, which is where the slip up occurred. The NHS send text confirmations for absolutely everything, plus a means of cancelling / re-arranging but the private outfit doesn't.

 

[Lurker]

I think if every part of the NHS was required to use best available practices they wouldn’t need more money.
Why isn’t there an auditor saying to the private outfit “ you are in breach of your contract so we are not paying your fees”. And then making other parts of the nhs aware.
40 years ago I worked for a medical equipment manufacturer and nhs national procurement made us jump through the hoops at all stages.

 

[RogerS]

Fingers crossed for you, Adrian, and you get sorted. I'm thinking we need to relocate to Kent !

 

[AJB Temple]

Thanks. It was just a shout out for outstandingly quick NHS action really. Had the comms worked (not NHS fault) I could have been in the specialist scanner (2 hours) within 40 hours of seeing the specialist. Our part of Kent seems to be really good. We have two very big hospitals within a radius of 9 miles, plus various specialist facilities on different nearby sites. The consultants seem to be very well connected to each other and very friendly. The MSM is always going on about waiting lists etc, but that has not hampered me so far.

 

[Lons]

There is a definite issue with communication between departments though and little consistency. I've had excellent service right through my shoulder issues but my wife who has Parkinsons saw her consultant at the end of May, I was with her and he said to make an appointment at the desk for another check in 4 months. Receptionist says no problem we'll send out an appointment, it's now past the date she should have seen hin and during several 'phone calls has been informed "yes you're on the list for us to make an appointment".
My wife isn't bothered but it's irritating.

 

[Artiglio]

My personal opinion is that there’s a very carefully concocted system to make the seem to work better than it does.
I had an urgent referral, get a message from nhs saying its been received and eventually reading through the message getting to a bit that says if i’ve not heard from them by “x” to contact them on number “y” and use reference “z”.
So x passes and i call y, get an almost endless message that says any referral will be dealt with in order its received , if i need to change things call “a”, any problems go my gp , but at the very end ( many would have followed one of the earlier instructions) it says , follow the instructions on the message that said they received the referral, so go on hold.
Eventually get through to a call handler, try to give reference z , that isn’t in the handlers system and so we start with DOB and name, eventually my referral is found and lo and behold i get an appointment that just falls into the referral target time.
Lots of times in that process where someone could think they’ve done the right thing and end up getting an appointment well outside the target time , but if you complained you’d be seen as having not followed instructions, but those that are more likely to complain and follow all the instructions read/listen to all of every interaction do get appointments within timescales. A very cynical system.

I’m also in kent but fall under the East kent Hospital Trust, which is is seemingly intent on stumbling from failure to failure. On another occasion I needed and MRI,my local hospital could’nt do it, unless i paid to have it done under their private provision ( apparently they didn’t have the funding to run that scanner) so eventually i get an appointment at the next nearest scanner 4 weeks later ( same trust so you assume same funding) , again on the last day of the target period, no nhs transport available, so either have to get someone to waste half a day taking me or use the train ( injury meant driving myself was impossible).

I have a number of nhs workers in my social circle , the waste, spanish practices, averted eyes and backscratching that goes on is surprising and means it’s no wonder all the extra money doesn’t achieve what it should.

 

[AJB Temple]

Bizarre isn't it? Experience totally different and we are not that far apart as the crow flies.

 

[Artiglio]

Yep, you wouldn’t believe it, the failures at Margate maternity department traumatise those going there. I’ve a friend in hospital there that has to use different phrases for various to find what some nurses understand, things as simple as asking for the curtains to be drawn whilst using the commode, nurse did’nt understand “shut” but did “ close”. Has a note in their records saying they have refused medication, but that’s because the medication is no longer required following a steroid injection, but the other medication has’nt been removed from their prescription.

Service at GP services is variable from appalling to excellent, largely depending on the level of deprivation in the area the surgery serves. Recruitment is an issue, the best potential nhs staff just don’t want to work in east kent apparently, the maternity dept struggles especially as thanet has the highest number of obese mothers in the country, the extra problems this entails means midwives etc would rather work elsewhere. I once had a surgery where the best time to get an appointment was on a sunny afternoon, you could walk in and be seen immediately as all the junkies, alcoholics and professionally unwell would rather be doing other things than tirning up for their appointments. Any other time the same ne’er do wells basically ran the surgery, knowing that just by creating enough of a ruckus they’d get seen nigh on immediately. I moved to another area of town.

My view is that the effects of deprivation are far more reaching than many realise.

 

[wallace]

I got sent for a simple spirometry over two years ago. after a while I got a letter asking if I still wanted an appointment, then a few months later I got a call from an actual GP asking if I still wanted to be seen for said test, then I get an appointment which is changed a while later. So 18months after the referral I get test. Tester wanted a ct so we start again.

 

[Lons]

It's been said many times that the NHS is brilliant for emergency situations but for general day to day issues can be pretty dire. We have a number of such examples both very good and very bad but I won't knock the NHS too much as several of my immediate and extended family are employed by them.
Staffing on the front line is the main problem and has been for a very long time with money grossly wasted at higher levels. Good, caring staff either burn out or leave, my daughter in law is in such a predicament at the minute and my niece, a GP had a breakdown last year, though she's back with much reduced hours now after coming seriously close to quitting.

It seems to vary greatly between regions and communications are dire which is inexcusable given that almost everything is electronic and can be sent at the push of a button but it doesn't happen. Anyone who's recently sat in a hospital waiting room will have seen people in scrubs wandering back and forwards with one piece of paper and sometimes peering around as if lost. A bit irritating when you've been there in plenty of time but it's over run by an hour or two. Unfortunately the words NHS and efficiency can't often be said in the same sentence.

 

[RogerS]

While getting my RSV jab the other day, I asked J (the nurse) why there were so few online GP appointments compared with a year or so ago. We get on very well and so I knew I would hear it straight. One of the major factors (at least at this surgery) is that they are still playing catch-up after Covid. This Summer they were starting to get on top of things but it's starting to pick up again.

They still have the same number of GPs, the weekly hours are the same as was, just that demand is so high. There are daily appointments but you need to get on the phone to the receptionist asap at 8am...which is pretty much par for most surgeries, I guess. They do keep a few appointments in reserve each day for an emergency but even if they are all gone and it really is an emergency then they will make sure the patient is seen. I have no reason to doubt that.

Like many other places, it is the poor receptionists who get all the abuse which is totally wrong and unfair.

 

[AJB Temple]

Well, I turned up for my 11.20am MRI appointment at 10.45. Took under 5 minutes to do the forms and they took me straight in. Extremely friendly and efficient. Apart from reception ALL of the staff in the scanner facilities (I think they have 3 new MRI scanner pods) were Asian - just making the point that NHS depends on a lot of Asian staff and they seem to have a great work ethic.

I fully get why it is hard to get good GP services in unpopular areas. My GP is a friend and I think where she works is typical: it's a partnership that they collectively own. She wants to live in a nice area, close to good schools for her children, and within an area where she knows the consultants and specialists. Doctors are in demand, and it's not surprising that they are less than keen to work in an areas with a bad reputation.

Therefore, I've often wondered why the NHS doesn't have a fully staffed GP practice annexed to every hospital, along with a pharmacy and vaccine facility. The hospitals near us all have little satellite facilities for physio, scans etc very close to the hospital, so why not a GP facility as well? I am not suggesting replacement of village / town GP surgeries, but just something that is much more joined up than we have now. Frankly dentistry requires a major sort out as well.

 

[Lurker]

Regarding GP practices.
An unfortunate knock on from COVID
People have quickly forgotten how brave our medics were in the early days.
No one knew the outcome was going to be quickly brought under control.
I know a GP who had two colleagues die and another three are still suffering from long covid. So just in the south of Nottingham city that’s essentially five GPs less.
At the end of the first year, medics were getting the very first dose of vaccine but no one actually knew if it was going to work.
Then they spent months jabbing thousands of us , and every jabbee with the potential to infect them with a fatal disease.

 

[Artiglio]

The main problem with dentistry is lack of education about oral/ dental health in schools and similar lack of interest of many parents and kids. A friend is a primary school “behaviour mentor” nasically does all sorts with any kid that has issues/misbehaves, has to assess every kid that arrives at the school , raise concern sheets etc, one of the questions “ do you have your own toothbrush?” The number of families that don’t give them to the kids or they share one is horrendous, it would surely cost next to nothing to hand out brushes and paste on request , the saving s in dental care would surely outweigh the cost.
Contents of kids lunchboxes also a sight to behold it seems. Again the things that happen in “deprived” areas ( though the amount some families receive in benefits is not insubstantial in many cases) has to be seen to be believed. Some ver warped priorites and attitudes. Same school has family liasion officers that go and knock on doors if a kid doesn’t turn up, not unusual for noone to be out of bed and parents blame the kid for not getting themselves to school. I also know a speech therapist, during lockdown all the sessions were on line, parents would blame the social worker for not having reminded them of an appointment ( ie online session).

There’s a whole different world out there.

 

[Lons]

Doctors are in demand, and it's not surprising that they are less than keen to work in an areas with a bad reputation.

Adian
I thought I read somewhere that there was a surplus of doctors but practices can't afford to employ them. Maybe that's not the case?
Practices have certainly changed, ours is nowhere near as good as it was although I have no complaints with the staff, many of whom we know personally, some being ex colleagues of my wife's when she was an NHS nurse. What they have all done is take most of the mundane tasks away from GPs who rarely now take blood, check BP etc. and also employ nurse practitioners as an in between but of course cheaper than a GP. BTW many of those GPs although working the same hours do much of it from home via the 'phone although I'm all in favour of an initial telephone conversation with a follow up appointment if deemed necessary.
My daughter in law is a practice nurse/manager so we see it from her side as well and it's not a good picture.

 

[Artiglio]

In wales they have a different problem, the requirement for many posts for being able to speak welsh hinders recruitment, the authorities argument that no problem exists as employers can seek an exemption is little more than hot air as a professional in healthcare is often going to have an equally professional partner and finding two posts where there’s an exemption is nigh on impossible. It’s affecting many employers not just the welsh nhs. The health service there is fine if you can actually get into it, the game playing to pretend targets have been met is absurd. An elderly relative waiting years for a hip replacement routinely had appointments cancelled because someone in greater need had presented and on one memorable occasion the operation was cancelled the day before, because the operating theatre was being refurbished, not something you’d think is arranged at the last minute.

 

[Lurker]

I was reading the other day that actual Welsh speakers were a tiny proportion of the population in Wales.

 

[AJB Temple]

Statistics for 2023 say that 29.2% of people in Wales over age three or over speak Welsh to some extent. It is declining by 0.6% each year. I imagine age profile and mortality is a factor.

 

[Lurker]

not so tiny then.

 

[Artiglio]

It very much depends where in wales you are, some areas mid and north wales its very much the first language of the middle aged and above. The 29.2% figure will be very skewed given that it is COMPULSORY that welsh is taught to 5-16 year olds in school. A not uncommon complaint from parents is that they’d be better off learning more academic subjects in that time and that their kids are always on the web via their phones and very little content is in welsh. So yes lots may speak it to a degree but how many actually use it regularly is another thing. I’d guess that if you took welsh out of the public sector in wales it’d be a tiny percentage of the welsh population that actually use it.
I’d almost guarantee that if the costs were were met as a specific charge on council tax and people could choose not to pay that fraction, very few would choose to.

 

[RogerS]

Been a few letters in the press about some Welsh speakers in England making rude comments to each other about another person's dress/looks/whatever and not realising that they too could speak Welsh.

 

[Chris152]

In wales they have a different problem, the requirement for many posts for being able to speak welsh hinders recruitment, the authorities argument that no problem exists as employers can seek an exemption is little more than hot air as a professional in healthcare is often going to have an equally professional partner and finding two posts where there’s an exemption is nigh on impossible. It’s affecting many employers not just the welsh nhs.

I've not read that - apparently all public bodies have to have a Welsh language policy, and Welsh is often described as desirable, and clearly in some posts it'll be necessary, but I've not heard of it being a recruitment problem.

More generally, 'Latest Census data showed a decline in the percentage of Welsh speakers to 17.8% of the population.
But a government survey, external said the figure was 29.5% - or 900,600 Welsh speakers.'
The latter is probably wrong.

Welsh language data deemed misleading by statistician

Welsh government survey suggests its close to its one million target but census data says otherwise.

www.bbc.co.uk

 

[AndyP]

Of course anything can be proved with statistic.
I always draw a line between speaking a language and understanding what is spoken.

 

[Artiglio]

Chris152, my parents moved there in ‘87, currently in process of selling the place and mum moving back closer, she’s in coastal mid wales just inside the snowdonia national park. The whole feel of the place has changed in the last 15 years, lots discontent amongst the farming community that they’re ignored and having their lives made hard by the welsh government more interested in keeping the more densely populated areas happy. As a whole wales is rapidly running out of money and ways to get it, ( they’ve bought the holiday home industry to its knees with the increased council taxes on places not let for enough days in the government’s opinion, but the season is relatively short and new standard nigh on impossible for many to attain. Few people argue that some measures are needed for regular houses taken out of the local market, but no differentiation for the places created as part of homes or purpose built for holiday use over the years ( the modern version of the farmer getting extra income for what was bed and breakfast in days gone by) ,unlikely that hotels will fill the gap due to the short season, all a bit of a mess) .
Farmers being forced to give over a %age of their land to tree planting if they want to access grants, not a problem for the big farmers/ landowners but a real headache for the small hill farms.

As for the language debate, some feel that the rules are there to try to ensure decent jobs would be avaialble for youngsters in wales if they choose to do the appropriate training and so try to encourage the bright young born and bred welsh to stay in wales rather than move elsewhere. One of the biggest boons to rural wales has been the surge in working from home post covid, people returning to wales to live working from home and accepting the long journey times for the occasions they do have to go to the office. So the changes are still happening.

 

[AJB Temple]

^^ Very interesting. In our brief sojourn to Wales recently, we saw a great many posters in windows saying "No Farmers No Food No Future". In the National Trust properties in some places, we found a markedly antagonistic attitude from staff towards English tourists, which we witnessed several times. (We were all actually speaking German, so I only experienced this personally once). It seemed odd given that these venues depend on tourism. But what also struck me, spoking out to various places from Aberystwyth, was that although the countryside was spectacular, it was extremely hilly and rocky, and not much of it was suitable for arable or anything other than sheep.

Throughout much of Wales that we travelled, it was very quiet, with very few cafe's or restaurants and there didn't seem to be a great deal for young people to do. Bright young welsh people will not be kept there by rules forcing welsh language employment I suspect. If that really is the aim, then the welsh politicians don't understand what motivates young men and women.

 

[RogerS]

..... although the countryside was spectacular, it was extremely hilly and rocky, and not much of it was suitable for arable or anything other than sheep.

.....

Sounds like Northumberland. Only replace the interesting rocky bits with scrub.

 

[RogerS]

I browse various GP websites and it doesn't soud like good news when you read something like this....

One in 10 GPs expected their practice to close or hand back its contract within a year and 42% expected to leave the profession within five years, according to RCGP polling carried out in the run-up to the general election.

 

[Lurker]

I browse various GP websites and it doesn't soud like good news when you read something like this....

One in 10 GPs expected their practice to close or hand back its contract within a year and 42% expected to leave the profession within five years, according to RCGP polling carried out in the run-up to the general election.

Only one in ten?
That’s a surprise, hearing what my DiL (GP partner) says, I’d have estimated nearer 25%
The 42% will be mostly retirees

 

[Artiglio]

^^ Very interesting. In our brief sojourn to Wales recently, we saw a great many posters in windows saying "No Farmers No Food No Future". In the National Trust properties in some places, we found a markedly antagonistic attitude from staff towards English tourists, which we witnessed several times. (We were all actually speaking German, so I only experienced this personally once). It seemed odd given that these venues depend on tourism. But what also struck me, spoking out to various places from Aberystwyth, was that although the countryside was spectacular, it was extremely hilly and rocky, and not much of it was suitable for arable or anything other than sheep.

Throughout much of Wales that we travelled, it was very quiet, with very few cafe's or restaurants and there didn't seem to be a great deal for young people to do. Bright young welsh people will not be kept there by rules forcing welsh language employment I suspect. If that really is the aim, then the welsh politicians don't understand what motivates young men and women.

Yep, your observations sum things up nicely, there are some spectacular private houses/estates dotted about built on fortunes made from slate and the industrial tycoons from the midlands of days gone by. Their survival depends solely on wealthy outsiders with the money to maintain them , they bring with them a surprising number of jobs and spending to the local community, ( one family friend is employed 1 day a week to visit one such place to do the checks required by the insurers for what is basically a family holiday home , it’s huge, they also meet and liase with trades, supply flowers when guests are due, meet the delivery drivers and stock the freezers etc, cost is to a degree no issue) but the owners are considering selling because of all the negative publicity associated with them owning such a home but not living in it full time. It has no real use for anything else it’s pretty much a monument to a bygone era.
The small hill farmers are slowly giving up and selling to the large landowners who can play the subsidy game to the extent the farming becomes a side gig.
Then in the coastal areas there is talk of abandoning the sea defences and allowing areas to flood again when they finally collapse, blighting whole areas as no one is going to invest when such notions are circulating. Though when many discover how poor the welsh nhs can be , they often think retirement elsewhere may be a better idea.

Took my parents 10 years to be accepted as “locals” away from the “antis” the local community is fantastic, no one seems to forget a good deed and just bides their time until they can do something in return when needed. Dealing with the local council / county council is best avoided on a face to face basis as it’ll usually start with condescending contempt from the officer you’re dealing with as they correct your pronounciation of the house’s welsh name that they’ve asked you to repeat 3 times.
But local politicians are either utterly inept or looking to climb the greasy pole, throw in wales being a devolved nation and sorting somethings out is nigh on pointless, especially when the tories were in power and the welsh authorities would be oppositional to any tory point of view purely on principle. So if you had an issue that was covered by both the Senedd and Westminster you have no chance of getting any sort of sensible answer. ( in our case council tax is a devolved power , but the Valuation Office Agency is still under westminster, so you’re trying to deal with 2 mps ( our welsh mp wouldn’t even reply to queries) and authorities who won’t talk to each other, leaving you for the most part in no mans land).

They’ll no doubt be ok under the current westminster gov. but longterm its hard to see how wales can become self sufficient.

 

[Phil Pascoe]

Took my parents 10 years to be accepted as “locals”

Cornwall. My grandmother was always called Mrs. S........ rather than by her forename by her neighbour, as she was a blow in. Even after sixty eight years.

 

[RogerS]

....
The small hill farmers are slowly giving up and selling to the large landowners who can play the subsidy game to the extent the farming becomes a side gig.
....

Are they still offering subsidies in Wales. I got the impression in the UK that that was pretty much over or at least minimal.

 

[Artiglio]

Maybe subsidies is the wrong word, but there are payments made to farmers of some sorts, the last conversation i had with one small hill farmer was about a requirement to turn a certain percentage of his land for tree planting, but to do so meant he’d have to use what little flat low lying land he had, which in turn meant he’d have less winter grazing or land on which to grow his sileage. If he didn’t do it je would be placed at considerable financial disadvantage.
However that was over a year ago, so maybe things have changed since then.