NHS - Time to privatise?

[paulfoel]

After this weekend I'd say its time to scrap it and start again. Seems to be populated with too many people who dont give a monkeys and there is zero accountability.

 

Dad had cateract operation last week. Hes got sight in just one eye. They operated on the other. 10am on Friday they sent him home.

 

Blind. Hes 81 and lives alone. He lives in a flat up stairs. Hes got more stairs to go the toilet. He can't see to cook food/make a cup of tea. He can't see the numbers to call someone on the phone. He can't read to take his medication. He certainly can't see the eyedrops hes supposed to take.

 

I saw him on saturday and have spent the whole weekend trying to get some help for him. I must have argued with/threatend 10 people. Standard response is "he should have stayed in hospital, its not out responsibility" (but the ward in question is closed at the weekend). Some of these people I wouldnt let look after my hamster.

 

Finally got something sorted Sunday evening. At last. What a fight to get that.

 

Today I have spoken to the ward manager of the ward he was on and asked why he was discharged in a state like this. Her answer "not our fault we close the weekend". And worse still "well he didnt say anything". Hes 81 years of age.

 

I'm definitely going to complain about this. Its just appalling that this is the state of the NHS in a civilised country.

[unclebulgaria67]

They close the ward at the weekend and don't provide other options, because they don't have the budget. The hospital staff should have a duty of care though to contact family or social services.

 

With a private service there would be a profit motive, with board of directors thinking about shareholders etc.

 

You need to complain to the hospital, with a copy to your MP.

 

At one time you had a network of local cottage hospitals, which acted as a safe place in the community, when people could not return home after hospital treatments. These started to be closed down during the 1980's from what i can remember. Also since May 2010 the government have cut back on social care.

[think about it]

This is difficult and I'm sorry that you've had such a trying weekend.

 

However from reading your post; its seems your father isn't acutely unwell. What he needs/needed was assistance in living, not medical care. Social care and the difficulties around it, ie the availability of a safe place to discharge patients to is one of the biggest issues we face in the NHS. Your father needs to recover, the best place for that is at home. Not in a hospital bed around acutely unwell patients and the infection risks that this poses.

 

People, until recently it seems, have struggled to see the link between the cuts in Social Care and the impact on the NHS to provide quality care. The line between where medical care stops and social care starts is difficult to clearly define but going to the bathroom, making food etc isn't 'medical care'.

 

Nevertheless, there's a reasonable expectation that the hospital will have checked this and I fully accept that there ought to have been more careful planning in discharging your father but, I assume, he has capacity to make his own decisions. And, when asked 'are you ok to go home?' he responds positively then what should the nursing team do other than accept what he's saying? I'd be utterly incensed if my GP rang my family and said 'well, he says he's okay but what do you reckon?' despite being in full control of my faculties regardless of my age. If this were the other way around and someone had called a family member to second guess a decision I'd made then I'd be posting here too, equally disgusted.

 

I agree, you ought to complain, if only to fully understand what's happened and the processes involved. But, please, don't confuse being tied up in process with not caring.

 

As UncleB says if you privatise all you get is the same service with a hefty bill at the end of it and a shareholder rubbing his dirty little hands together.

 

I hope your father has a speedy recovery and good luck in getting the answers you need.

[paulfoel]

This is difficult and I'm sorry that you've had such a trying weekend.

 

However from reading your post; its seems your father isn't acutely unwell. What he needs/needed was assistance in living, not medical care. Social care and the difficulties around it, ie the availability of a safe place to discharge patients to is one of the biggest issues we face in the NHS. Your father needs to recover, the best place for that is at home. Not in a hospital bed around acutely unwell patients and the infection risks that this poses.

 

People, until recently it seems, have struggled to see the link between the cuts in Social Care and the impact on the NHS to provide quality care. The line between where medical care stops and social care starts is difficult to clearly define but going to the bathroom, making food etc isn't 'medical care'.

 

Nevertheless, there's a reasonable expectation that the hospital will have checked this and I fully accept that there ought to have been more careful planning in discharging your father but, I assume, he has capacity to make his own decisions. And, when asked 'are you ok to go home?' he responds positively then what should the nursing team do other than accept what he's saying? I'd be utterly incensed if my GP rang my family and said 'well, he says he's okay but what do you reckon?' despite being in full control of my faculties regardless of my age. If this were the other way around and someone had called a family member to second guess a decision I'd made then I'd be posting here too, equally disgusted.

 

I agree, you ought to complain, if only to fully understand what's happened and the processes involved. But, please, don't confuse being tied up in process with not caring.

 

As UncleB says if you privatise all you get is the same service with a hefty bill at the end of it and a shareholder rubbing his dirty little hands together.

 

I hope your father has a speedy recovery and good luck in getting the answers you need.

 

Well the thing is normally hes fine. He doesnt need care.

 

I know in the past hes been in hospital and they've actually said no you can't go home yet until you're ok on your own even when hes wanted to go home. This time they just got rid of him as soon as they could (and no they didnt ask him).

 

I appreciate the lines are blurred but a nurse has a duty of care to ensure hes in a safe environment. The NMC would agree on this - its standard.

 

But I do disagree. The people I spoke to do not care. I asked for help and all I got was excuses, not my problem etc. One district nurse even told me sorry I'm a qualified nurse I've got other things to do. Is the sign of caring?

 

I appreciate there are responsibilities but not one of these doctors or nurses said look its not really me but I'll take ownership and get something sorted. Thats caring. Saying not my problem is not caring at all.

 

I'm sorry my wifes a nurse and I have got many friends who are. My wife works in the community. Many times shes done things that are not her job because the patient needs it or shes got on the phone and sorted things out.

 

Its sad that I only managed to get anything sorted when I actually started threatening people. Sad state of affairs.

[citizenB]

Does the hospital he was in have a PALS office ? (Patient Liaison). Speak to them if they do.

[paulfoel]

Does the hospital he was in have a PALS office ? (Patient Liaison). Speak to them if they do.

 

Its in Wales and if I remember the system is different here.

 

I know there is someone but all they do is tell you how to fill out the complaint forms....

[think about it]

It's sad, it's sad that the duty social worker (I trust you called social work at the local council) didn't pick this up from the outset. The cuts in social care are such that now it seems to take forever to get someone in to help.

 

Purely as devil's advocate here I'm certain if it was a dressing that needed changing, or assistance with a syringe driver for a terminally ill patient that the District Nurse would have been right there but it's not her role to prepare a meal or assist with finding the toilet, and again, the cuts in funding mean that she's so fully utilised that she doesn't have the ability to get there especially if it means not going to someone who needs a syringe driver putting up. But, is it for the on-call opthalmologist or medical Dr to arrange someone to come in and prepare a meal, perhaps not. But I accept that someone should have at least signposted you to the most appropriate place (duty social work at the council).

 

Likewise with other Doctors and Nurses, they're right - it's not their role, it's their role to care for the acutely unwell patients in the hospital - it is however for social work/care to pick up where there's a need for assistance in the community, they should have done this and quickly. Likewise, the discharge team should have asked, I can't imagine he went without so much as a word - was he put in a taxi home? Did someone accompany him to his door? How did he get in to his house? Did one of you go and collect him? I can't help but hope that they didn't shuffle a blind man out of the front door and expect him to fend for himself with no opportunity for him to say 'wait, I can't manage'.

 

I'm also saddened that you felt the need to threaten. You should never have to 'threaten' anyone and in some respects dependant upon the 'threat' many NHS workers, me included would have just hung up. I'm not here for that I'm afraid and neither are my colleagues.

 

Like I say, please don't think that I'm not disgusted and if it were my father I'd be just as incensed but I am trying to provide an objective look at this for you.

[paulfoel]

It's sad, it's sad that the duty social worker (I trust you called social work at the local council) didn't pick this up from the outset. The cuts in social care are such that now it seems to take forever to get someone in to help.

 

Purely as devil's advocate here I'm certain if it was a dressing that needed changing, or assistance with a syringe driver for a terminally ill patient that the District Nurse would have been right there but it's not her role to prepare a meal or assist with finding the toilet, and again, the cuts in funding mean that she's so fully utilised that she doesn't have the ability to get there especially if it means not going to someone who needs a syringe driver putting up. But, is it for the on-call opthalmologist or medical Dr to arrange someone to come in and prepare a meal, perhaps not. But I accept that someone should have at least signposted you to the most appropriate place (duty social work at the council).

 

Likewise with other Doctors and Nurses, they're right - it's not their role, it's their role to care for the acutely unwell patients in the hospital - it is however for social work/care to pick up where there's a need for assistance in the community, they should have done this and quickly. Likewise, the discharge team should have asked, I can't imagine he went without so much as a word - was he put in a taxi home? Did someone accompany him to his door? How did he get in to his house? Did one of you go and collect him? I can't help but hope that they didn't shuffle a blind man out of the front door and expect him to fend for himself with no opportunity for him to say 'wait, I can't manage'.

 

I'm also saddened that you felt the need to threaten. You should never have to 'threaten' anyone and in some respects dependant upon the 'threat' many NHS workers, me included would have just hung up. I'm not here for that I'm afraid and neither are my colleagues.

 

Like I say, please don't think that I'm not disgusted and if it were my father I'd be just as incensed but I am trying to provide an objective look at this for you.

 

No I didnt phone the council. To be honest - I dont know how it works. Why would I? Dad had a list of numbers to call so I tried that. Then I spoke to the senior nurse at the hospital who told me to ring GP out of hours and they would arrange it.

 

I understand what you mean about responsibilities but the hospital caused this problem. It needed someone to take ownership, and even if its not them, to help sort the problem out.

 

His neighbour picked him up. And yes they saw him being helped towards the exit by his neighbour. They KNEW he lived alone and they KNEW his circumstances. Yes he should have spoken up but hes 81 years of age and hes of the generation where you just go with what people tell you. They told him you're going home so as far as hes concerned.

 

The nurse discharging him should have said, no wait a minute this is no good. Then phoned the council for him. Bear in mind this was 10am friday morning - the ward was open until 730pm. He could have stayed until something could be sorted maybe. They didnt even call me as they promised they would before he got sent home.

 

When I say threat I dont mean physical or anything silly. However, I did point out to a few of them that, know they were involved in this and I had just told them of the situation, they would become involved if my Dad had an accident. I dont think this was unfair. I dont expect ANY healthcare professional to simply say not my problem, I dont care. At the very least they should be ensuring you are connected to the right person.

 

Like I said, the sister of the ward says it was done correctly. As I pointed out, I will be speaking to the NMC. If the nurse in question has done it correctly, then he/she has nothing to worry about.

 

Sounds like you are a healthcare professional (like I said my wife is). For people who care (like it sounds you do), I think it should be encouraged to ensure standards are kept. One less nurse is better than one who does not care.

[think about it]

Sounds like you are a healthcare professional (like I said my wife is). For people who care (like it sounds you do), I think it should be encouraged to ensure standards are kept. One less nurse is better than one who does not care.

 

I am, although I'm not a clinician. I completely agree that we ought to maintain standards at the highest level, hence my encouragement to complain. It's only though patient feedback that we can learn from situations where things go wrong. It's the reason we also have our own internal reporting systems to seek out opportunities to learn and improve. I see you're in Wales, if you'd like to rattle their cage a little more, ask for the DATIX number and a copy of the report. Datix is the tool we use to notify and investigate such issues internally.

 

Good luck with the complaint and to your dad in his recovery.

[paulfoel]

UPDATE

 

As I said, ward not interested this am. Not their fault, wait and see. So I've kicked off again and they agreed to see him today.

 

Turns out the op went wrong and they left a bit behind. So hes on list for today and staying over night. Which is good because I'll be making sure this time hes not sent home without proper consideration.

 

So good news is its getting sorted.

 

Its so sad that I've got to kick off not only to get care, but kick off to get them take thing seriously. It hardly inspires confidence that they can do anything properly.