benaj
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Post by benaj on Jan 31, 2024 20:57:46 GMT
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Post by bracknellboy on Jan 31, 2024 21:05:01 GMT
Another example of the type of thing that infuriates me. A friend of mine is a surgeon. Earlier this week she was called to operate on an old man who had dementia. He lived in a care home. He was delivered to the hospital with no medical records. She knew what procedure she was expected to carry out, but had no information on any other conditions he might be suffering from, or anything on the medication he was on. So obviously this took time and effort to resolve. Apparently it's standard. Nobody ever arrives from a care home accompanied by their medical record. This boggles my mind. And the inefficiency must cost an absolute fortune. EDIT: And it's not rocket science. This sort of thing should be trivial to mandate across the UK. He didn't just rock up from the care home, though, did he? Surely he'd been seen by a GP and referred, then seen by a consultant or one of the team before it'd got to the surgery stage? So isn't this an internal-to-the-hospital issue, even an internal-to-surgery-team one? I mean, nobody comes from their own home bearing their medical records... the major point here surely is that: with an efficient NATIONAL health service, given basic identity information it SHOULD be possible to pull up your records at the drop of a hat. Not just within hospital records, not just GP to hospital and vice versa, but anywhere in the NHS. And actually, it also ought to be doable from private medical institutes as well. We all know that is not how the NHS works even though it could and should. Other countries do. Oh, and a national identity card scheme could help as well.
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michaelc
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Post by michaelc on Jan 31, 2024 21:16:07 GMT
He didn't just rock up from the care home, though, did he? Surely he'd been seen by a GP and referred, then seen by a consultant or one of the team before it'd got to the surgery stage? So isn't this an internal-to-the-hospital issue, even an internal-to-surgery-team one? I mean, nobody comes from their own home bearing their medical records... the major point here surely is that: with an efficient NATIONAL health service, given basic identity information it SHOULD be possible to pull up your records at the drop of a hat. Not just within hospital records, not just GP to hospital and vice versa, but anywhere in the NHS. And actually, it also ought to be doable from private medical institutes as well. We all know that is not how the NHS works even though it could and should. Other countries do. Oh, and a national identity card scheme could help as well. Yeah but that would cost billions and billions paid out to private contractors who still won't do the job properly.
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registerme
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Post by registerme on Jan 31, 2024 21:22:28 GMT
Data is one area where I actually have some sympathy for the NHS. You can imagine the different legacy systems, different data formats, different media, different retention policies, different security implementations etc etc etc that have built up over the decades across different institutions and authorities, under different governments, different structures, and with different funding and resourcing.
Cleaning that up is a Herculean task. In fact Augean might be a better term.
It would be expensive, it would be challenging, it would be risky, and it would take time. But it is possible.
Can you imagine the benefits that would accrue from doing this successfully?
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Post by bracknellboy on Jan 31, 2024 21:27:22 GMT
Medical Records accessible online :Need DOB &Name (plus patients agreement to access). They are rarely up to date and can be useless. Up till last week I felt that the NHS was shite . HOWEVER 1/2 collapsed with Heart Attack . 999 produced an ambulance within 3/4 of an hour . (We are 30 miles across some of the worst rural roads in England). Blue lighted to a hospital 60 miles away as neither Shropshire or Hereford do angioplasty . Straight out of wagon into surgery at Worcester Royal and then home again 3 days later. (he's a very fit 72 yearold,but comes from a family of hearts) However the Heart Dept is chocker full of whales ,both in bed or visitng. I have never seen such overweight monsters. The reason why NHS is not fit for purpose is because Brits are not fit for ..... Confession time. Snap, near as damn it, except mine was end of week before last. And I'm a fit late fifties. No significant prior indications, except in hindsight I allowed myself to mistake symptoms as being Covid recovery issues. I didn't collapse thankfully. I was fully aware. Once I finally made the decision that it was ambo time, the ambulance was with me in 4 minutes from the time they pressed the button on it. That shocked but also pleased me. The staff in cardiac care were great: extremely caring. The ward I was in had a good level of staffing - unlike times when I was with my elderly father and I had to do stuff for him that I shouldn't have had. Different hospital. Unfortunately I went in on a Friday, so no chance of getting into theatre until Monday, and then bumped and bumped. The final bump was actually when outside the theatre door. Got done on Tuesday. No complaints with that: I was stable and less of a priority. I was in total of 5 days. The follow-up from the hospital has also been A1: I already have follow-up scan, rehab session, and cardiologist review in the diary. Back to efficiencies though. Before I finally went in, I was chatting to the theatre administrator nurse (not sure of title). We got talking about that very subject 'cos she was complaining that it was bottlenecks in the system that constantly held things up, and reduced theatre utilisation. In my case, a small one, but the original consent form I had been given to sign was the wrong one (was only for angiogram). But they didn't have any of the paper versions of the correct form to hand 'cos they were phasing out for electronic (good). But off ward, they didn't have any access to the tablets to do it on. So another delay. Brits not fit for purpose: a lot of truth in that, but not always the case obviously. My contrast: on one side I had a lovely block, a bit overweight but not massively. But his fundamental problem like me was his heritage. He was on a wait to get transferred to London hospital for a triple bypass. He was there when I came in, and only left to go on the morning of day I came out. So minimum of 5 days. On the other hand, there was a complete **** on the other side (we all agreed on that). Not overweight, but heavy smoker. And insisted on having 5 sugars in this tea. And entitled. And utterly rude and a complete b*****d to one of the nurses. He had multiple health issues. I digress. Hope your other 1/2 does well in his recovery.
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Post by bracknellboy on Jan 31, 2024 21:28:57 GMT
the major point here surely is that: with an efficient NATIONAL health service, given basic identity information it SHOULD be possible to pull up your records at the drop of a hat. Not just within hospital records, not just GP to hospital and vice versa, but anywhere in the NHS. And actually, it also ought to be doable from private medical institutes as well. We all know that is not how the NHS works even though it could and should. Other countries do. Oh, and a national identity card scheme could help as well. Yeah but that would cost billions and billions paid out to private contractors who still won't do the job properly. But they manage it in other countries. Probably partly because the system itself is primarily private care providers. But yes, in this country we have a torrid track record of public sector IT procurement.
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benaj
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Post by benaj on Jan 31, 2024 21:29:20 GMT
What about the NhS app? does it show all the medicines, consultations and other record? Is it missing record?
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Post by bracknellboy on Feb 5, 2024 7:57:44 GMT
Pertinent to this discussion: Public back ‘patient passports’ to share medical records with any doctorNo Sh*t Sherlock. Certainly this member of the public does. Other countries manage it. The inability of a hospital to get the prescription record for my father, and therefore give him his standard daily meds was nothing short of shocking. On the second major occasion this happened - on the occasion of his final hospitalisation - the awful impact it had on him was nothing short of disgusting. That shouldn't be happening to anyone in this day and age. Especially when compounded by the fact that on the second occasion we had ensured that his prescription list had actually travelled with the paramedics for that very reason.
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benaj
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Post by benaj on Feb 5, 2024 9:27:36 GMT
Well, I admit some professionals working for the NHS don’t care “too much” about the patients. One of those who was also a family member told me there’s nothing to do about my cough unless blood appears or lasting 4 weeks or longer.
If I chose a health service not provided by NHS, they would at least give me same or next day face to face appointments even without getting any data from NHS, and give me something to relieve my symptoms. The medication only cost £10.
The truth is, it should be that hard to obtain prescriptions, but it’s very hard to get the “right” medication without authorisation of a doctor.
If our “doctors” can only diagnose accurately based on “data” stored in the cloud, but not paying attention actually to the patient, are they really that good?
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Post by bracknellboy on Feb 5, 2024 10:25:16 GMT
Well, I admit some professionals working for the NHS don’t care “too much” about the patients. One of those who was also a family member told me there’s nothing to do about my cough unless blood appears or lasting 4 weeks or longer. If I chose a health service not provided by NHS, they would at least give me same or next day face to face appointments even without getting any data from NHS, and give me something to relieve my symptoms. The medication only cost £10. The truth is, it should be that hard to obtain prescriptions, but it’s very hard to get the “right” medication without authorisation of a doctor. If our “doctors” can only diagnose accurately based on “data” stored in the cloud, but not paying attention actually to the patient, are they really that good? @banaj I'm assuming this is comment about my immediately prior post. This wasn't about whether professionals "care" per se, its about stuff that stops them from doing their job properly. Admittedly, the fact that no staff member asked me about his baseline drugs - and I assumed for 48+ hours that they knew because we had passed it on - does beg questions to some degree about care, but more about process. The likeliehood of a 91 year old being admitted to a ward and not being on some variety of daily meds is I suspect quite low. This also has nothing to do with whether they can diagnose the currently presented acute condition or not. And regardless, that can be a more complicated business if pre-existing conditions are not known. In this case, the diagnosis of the acute condition though was clear. The fact that what he was experiencing was massively compounded by withdrawal symptoms from a number of fairly powerful drugs was inexcusable. To his credit, when I raised it with the SAS doctor - after I twigged and asked the nursing staff what he was being given - he agreed and acted promptly. When I offered to go my father's surgery and get a stamped repeat prescription list for them, he told me not to worry as they 'have ways round it'. Which simply compounds the issue: on a prior admission they had told me they couldn't access records because of GDP/privacy reasons, but now apparently they could get the information. Why on earth is it not part of standard admission procedure to get the patients current prescription regime ?
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registerme
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Post by registerme on Feb 5, 2024 10:48:30 GMT
bracknellboy this is precisely the problem my friend faced when a patient arrived, from a care home, for surgery, with no patient records and no record of what meds they were on.
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keitha
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Post by keitha on Feb 5, 2024 11:31:33 GMT
Last week I finally got to talk to GP about the issues my grandson has which are genetic, and the conditions have come from his mother, to be honest its caused, and still causes me sleepless nights as obviously it's 50-50 it came from my side, and have siblings and lots of cousins etc all of whom could potentially be impacted if it's me that carries it.
Doctor had a very blasé attitude, "you probably won't have any more children why worry" no thought that I have other children and therefor potentially more grandchildren in the future.
she even had to google one of the syndromes, and was dismissive when I asked could it be related to the numbness in my hands that is nearly 6 months now ( numbness and pins and needles is a symptom of one of the conditions ) but the answer was "you should have noticed this earlier in your life if it was the case "
instead of offering a genetic test, I've been offered a lifetime supply of sleeping tablets "so it doesn't cause sleepless nights"
Along with a couple of other issues I have it seems the NHS would rather address the symptoms than the root cause.
I suppose it goes with the other concerns on the NHS:- in Blaenau Gwent 80% of the population is overweight or obese 28% of the adult population smoke we have a life expectancy of 76 for men 80 for women
Both smoking and obesity will contribute to the lower than average life expectancy, they also tend to cause more health issues during a lifetime
the average person has 3.3 GP consultation per year, however the "frequent flyers" account for 40% of all consultations, Consultations with GPs increased from a median of 13 in 2000 to 21 in 2019 and consultations with all staff members of GP clinics increased from 27 to 60. Think about it 60 consultations a year 5 a month ! frequent flyers are also becoming more demanding ie they have doubled their usage of the system over the last 20 years.
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adrianc
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Post by adrianc on Feb 5, 2024 11:41:29 GMT
Last week I finally got to talk to GP about the issues my grandson has which are genetic, and the conditions have come from his mother, to be honest its caused, and still causes me sleepless nights as obviously it's 50-50 it came from my side, and have siblings and lots of cousins etc all of whom could potentially be impacted if it's me that carries it. Doctor had a very blasé attitude, "you probably won't have any more children why worry" no thought that I have other children and therefor potentially more grandchildren in the future. she even had to google one of the syndromes, and was dismissive when I asked could it be related to the numbness in my hands that is nearly 6 months now ( numbness and pins and needles is a symptom of one of the conditions ) but the answer was "you should have noticed this earlier in your life if it was the case " instead of offering a genetic test, I've been offered a lifetime supply of sleeping tablets "so it doesn't cause sleepless nights" Along with a couple of other issues I have it seems the NHS would rather address the symptoms than the root cause. From the PoV of your GP treating you, though - it isn't directly relevant. If you had the genetic condition, then it's massively unlikely the symptoms would start now. If you are a carrier for the condition, then you aren't going to be passing it on any more. If your relatives of child-bearing age are worried if THEY are carriers, then THEY need to see THEIR GPs. You're one of four grandparents for this kid. If the condition is solely matrilineal, then - you're right - that rules the father's two grandparents out... but it also rules the maternal grandfather out, doesn't it? SWMBO used to work for a charity that supported families with kids with genetic conditions. There are a myriad of conditions, many of which affect one or two kids only, many of which are simply medically unidentified. (Also - remember, your GP is almost certainly employed by a privately-owned business contracted to the NHS, not by the NHS directly.) I think I'm on about 0.1-0.2 at most.
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keitha
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Post by keitha on Feb 5, 2024 12:01:41 GMT
I'm on about 3 at the moment, 2 of which are monitoring one condition.
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Post by bracknellboy on Feb 5, 2024 12:05:12 GMT
bracknellboy this is precisely the problem my friend faced when a patient arrived, from a care home, for surgery, with no patient records and no record of what meds they were on. the care home of course should know better and at least provide the meds record as they know how the system works. Having been bitten once, we did do that for my father: only for it to be either ignored or lost in the system: either the paramedics didn't hand it over or they did and it never got entered into the system. For separate reasons this was the one time I've been (very) nonplussed by the attending paramedics. It was the carer that called them on her morning visit: she suspected a second stroke. The paramedics eventually called me to discuss. They were pushing back on taking him to hospital. They asked me in a loaded way whether I wanted him to go. I checked with them what the carer had stated: that he couldn't see further than immediately in front of him. I also confirmed that this was definitely new symptom. I also pointed out that on his earlier stroke he had also passed the FAST check so relying on that was not necessarily an accurate indicator. After we came off the phone, they had another go at the carer, told her they didn't think it was necessary and it wasn't a taxi service [my father was 91, had major mobility issues, and had just had what we suspected was another stroke: not appropriate for the stick thin carer to try and get him to hospital]. He never left hospital and passed away about 2 and 1/2 weeks later. The stroke had left him totally blind, but his brain didn't know that (Charles Bonnet syndrome: I wasn't aware of it until then). I should add that on all my other touchpoints with ambo crew, I've been nothing but impressed and grateful.
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