Waste in the NHS

I have a bad knee.
From experience and 4 previous operations, I have a tear to my meniscus - a torn cartilage.
I went to my GP, who promptly identified it and diagnosed it as I did.
MRI scan needed.

Now the waste.

My referral has to be triaged, firstly by an unqualified clerk for routing. When routed into the correct channel, a nurse clinician - less qualified than the GP, will assess the GP's notes and recommend what is needed.

The triage unit are an overloaded, bloated unit that actually serve little or no useful purpose.
They expect to let me know within 4 weeks of my referral as to what I need - which my GP has already told them.

Why not get shot of the whole triage service and spend the money on more useful frontline staff?

And whilst they are reviewing services, let Pharmacists prescribe some basic medicines such as insulin and associated paraphernalia, painkillers and antibiotics, to customers KNOWN to the pharmacist and on their system.

Andy wrote:I have a bad knee.
From experience and 4 previous operations, I have a tear to my meniscus - a torn cartilage.
I went to my GP, who promptly identified it and diagnosed it as I did.
MRI scan needed.

Now the waste.

My referral has to be triaged, firstly by an unqualified clerk for routing. When routed into the correct channel, a nurse clinician - less qualified than the GP,  will assess the GP's notes and recommend what is needed.

The triage unit are an overloaded, bloated unit that actually serve little or no useful purpose.
They expect to let me know within 4 weeks of my referral as to what I need - which my GP has already told them.

Why not get shot of the whole triage service and spend the money on more useful frontline staff?

And whilst they are reviewing services, let Pharmacists prescribe some basic medicines such as insulin and associated paraphernalia, painkillers and antibiotics, to customers KNOWN to the pharmacist and on their system.

I had this exact same thing about 7 years ago, in both knees. The first consultant I saw poked my knee and told me I had arthritis. I knew I didn't so I demanded a second opinion. I got a better consultant, got an MRI and got diagnosed with torn meniscus. Eight month waiting list for the op. I decided not to have the op and opted for holistic healing. I've never had a problem since. My knees are obviously not fantastic, in that I have to be careful with them, but I'm pain free and they click a bit, but on the whole they are fine.

My knee is a mess, HT, I could live with it EXCEPT I have just started a little garden clearance enterprise. £10/ hour, cash in hand, word of mouth on reccomendations. So far, so good,, lots of stuff in the pipeline. Beats sitting at home watching Jeremy fucking Kyle and reading dross from Didge

Andy wrote:Why not get shot of the whole triage service and spend the money on more useful frontline staff?

Sounds an excellent solution. Why not send your complaints, along with remedial suggestions, to the organizers, using your situation as a case-in-point.

Or, you might suggest by-passing the triage unit when the referral is by a physician.

Pointless exercise, Quill , as the current Health Secretary, Matt Hancock has fingers in private Healthcare pies and wants to fully privatize the NHS and have compulsory insurance.

Tory Health Secretary backs think tank who want NHS replaced by insurance

https://www.mirror.co.uk/news/politics/tory-matt-hancock-teams-up-14481100#ICID=Android_TMNewsApp_AppShare

Corrupt bastard.

https://www.independent.co.uk/news/health/nhs-privatisation-donations-matt-hancock-health-secretary-institute-economic-affairs-a8442001.html

And this:
https://www.mirror.co.uk/news/politics/tory-matt-hancock-teams-up-14481100

Andy wrote:Pointless exercise, Quill , as the current Health Secretary, Matt Hancock has fingers in private Healthcare pies and wants to fully privatize the NHS and have compulsory insurance.

Tory Health Secretary backs think tank who want NHS replaced by insurance

https://www.mirror.co.uk/news/politics/tory-matt-hancock-teams-up-14481100#ICID=Android_TMNewsApp_AppShare

Corrupt bastard.

https://www.independent.co.uk/news/health/nhs-privatisation-donations-matt-hancock-health-secretary-institute-economic-affairs-a8442001.html

And this:
https://www.mirror.co.uk/news/politics/tory-matt-hancock-teams-up-14481100

Ahhhh...so make the NHS as undesirable as possible. Sounds like you need a new administration in Parliament.

The conservative party are a failed empire.
Most Tories think the party has imploded.
We go into the next GE with the most wide open choice in decades.
Conservative.
Labour
Lib Dems
UKIP
Brexit Party
Change
Greens.

UKIP and the Brexit party will split the Conservative vote, whilst Change, the Greens and Lib Debs will split Labour votes.
Wide open.

Good luck.

The best part is the myriad of staunch Conservative party posters used to talk about their party being the best thing since sliced bread. Now most shun discussion about them.
Oh how they have changed their tune.
Labour are far from perfect, Corbyn is marmite, but the signs are that they are the strong party for climate change, law and order, schools, welfare and the NHS, which are the everyday things that affect 95% of the population.
The Conservatives still bang on with their mantra of austerity, tax cuts for the rich, privatization of the NHS, welfare cuts and demonizing Corbyn.
Little wonder so many respected former members are leaving for altenative parties.

Tories are finished, all PM's May's fault. Corbyn wants to spend other people money, [same as all Labour PM's ] personally, don't care now, as it wont affect me whoever wins !

Andy wrote:I have a bad knee.
From experience and 4 previous operations, I have a tear to my meniscus - a torn cartilage.
I went to my GP, who promptly identified it and diagnosed it as I did.
MRI scan needed.

Now the waste.

My referral has to be triaged, firstly by an unqualified clerk for routing. When routed into the correct channel, a nurse clinician - less qualified than the GP,  will assess the GP's notes and recommend what is needed.

The triage unit are an overloaded, bloated unit that actually serve little or no useful purpose.
They expect to let me know within 4 weeks of my referral as to what I need - which my GP has already told them.

Why not get shot of the whole triage service and spend the money on more useful frontline staff?

And whilst they are reviewing services, let Pharmacists prescribe some basic medicines such as insulin and associated paraphernalia, painkillers and antibiotics, to customers KNOWN to the pharmacist and on their system.

Pharmacists are not qualified to prescribe medicine. For a start, the level of medication could change, so if they prescribe the same thing all the time, they might be prescribing too much or too little. I take medication, the levels of which do need to change, but I had to get the prescription changed by a consultant.

You can't have a pharmacist prescribing antiobiotics - what if an infection is a virus? Overprescribing of antibiotics is already a problem.

I don't really understand the triage thing tbh.

Looks like Britain could be in for another coalition guvm'nt next time round --  no matter which side wins..

At the moment it doesn't look like either Labour or Tories will have a majority  ?

******************************

As for the O/P :

18 months ago,  I stumbled and fell onto my knees --  cracked kneecap (yep, I "broke" my kneecap !   ) strained ligaments and tendons, dislocated finger (which I 'reset' myself..), half-crippled for several weeks..

Compared with what looks like taking Andy some months,  in less than a fortnight I went :

GP -->> local hospital for x-ray, plus saw their orthopedic resident and a physio -->> GP  -->> referral to MRI (mostly covered by Medicaire, some may have to pay a portion depending on income level) --> back to GP..

And I had to pay $30 for a knee brace while at the hospital (that's a bit less than 'retail', thanks to hospitals buying in bulk..); didn't need to buy a walking stick, as I had one that belonged to my father..

Britain's NHS definitely needs a "fresh broom" through it..

God help the British public if the Tories ever do succeed in privatising it  !!!

Too many people in the country could have something to do with it !

WhoseYourWolfie wrote:

Looks like Britain could be in for another coalition guvm'nt next time round --  no matter which side wins..

At the moment it doesn't look like either Labour or Tories will have a majority  ?

******************************

As for the O/P :

18 months ago,  I stumbled and fell onto my knees --  cracked kneecap (yep, I "broke" my kneecap !   ) strained ligaments and tendons, dislocated finger (which I 'reset' myself..), half-crippled for several weeks..

Compared with what looks like taking Andy some months,  in less than a fortnight I went :

GP -->> local hospital for x-ray, plus saw their orthopedic resident and a physio -->> GP  -->> referral to MRI (mostly covered by Medicaire, some may have to pay a portion depending on income level) --> back to GP..

And I had to pay $30 for a knee brace while at the hospital (that's a bit less than 'retail', thanks to hospitals buying in bulk..); didn't need to buy a walking stick, as I had one that belonged to my father..

Britain's NHS definitely needs a "fresh broom" through it..

God help the British public if the Tories ever do succeed in privatising it  !!!

There is an arguable case for the privatisation of some of the ancilliary services such as cleaning, catering, transport, maintenance and procurement so long as there is also robust and enforceable budgetary control to prevent profiteering and the sort of individual get-rich-at-taxpayers'-expense results that we saw from the privatisation of utilities such as water, energy, telecommunications and rail transport.

Those of us old enough to remember the post war era when such essential services were state controlled and effectively run by regional "boards" comprising mainly local councillors and political party nominees with little or no business acumen and even less common sense all have bitter memories of the sheer frustration caused by bureaucracy and a painful slowness to act on anything from the running of a railway to the purchase of paperclips.

But privatisation of actual medical care? Never.

And, since you mention it Wolfie, the last Labour administration arranged more privatisation than the succeeding Tory government, and were responsible for much of the private finance initiative arrangements that they had attacked so violently when it was first introduced by the Conservatives under John Major.

The NHS is simple not workable anymore.

Its why not a single country has ever adopted our NHS system

Its time we converted our system, to one that works and is affordable.

As for waiting times. Well that is the reality people will now face, with an aging population, high birth rates. The two groups most susceptible to illness. Hence the bigger the population grows. Then it stands to reason more pressure will apply to hospitals and waiting times. That is a no brainer and throwing money continually into the system. Will only ever be a short term fix. Its never going to solve the many problems of the NHS longt term. Its time we scraped this unworkable system. For one that does work and is free on the point of entry.

Fred M. wrote:But privatisation of actual medical care? Never.

I'm glad to hear you say that, Fred. Medical care, like defense of the nation, police and fire protection, is a fundamental right or guarantee, not to be made subject to market delivery.

The market--be it an insurance market, or a direct market-- is dominated by profit first. WTF? We are concerned with saving lives and curing illness, and there is someone waiting just outside the door with a bill?? Fook that.

I agree with you that matters like house cleaning and repairing might be left to private providers, but that's a matter of internal accounting. There should be nothing in the guarantee of medical care, that comes back to haunt the individual as a hidden profit mechanism.

In the US, when you reach 65-years, Medicare kicks in. But it only pays 80% if the cost. The remaining 20% of the cost is known as the "gap". You can get "gap" insurance coverage, but it turns into another profit center. Insurance companies simply hike up the cost of "gap" insurance to be, what is for the young, the cost of general insurance.

The incentive for profit is what the market will bear, not what it actually costs. That’s how twisted profit is.

Just out of interest, it seems that several people on this forum have a problem with their knees or joints.

Has anyone tried steroid injections? I've been offered a systemic one, but I'm a bit wary because of side effects, and also I'm not sure it would work because steroid tablets don't work for me.

I once had a steroid injection for a stiff back.
It had the side effect of giving me a stiff front!

Raggamuffin wrote:Just out of interest, it seems that several people on this forum have a problem with their knees or joints.

Has anyone tried steroid injections? I've been offered a systemic one, but I'm a bit wary because of side effects, and also I'm not sure it would work because steroid tablets don't work for me.

Knees are pounded constantly throughout life by walking, so suffer wear and tear. Also being overweight puts enormous pressure on knee joints.

I guess it depends on the source of the problem. Steroids wouldn't work on wear and tear issues, only on inflammatory joint problems.

Raggamuffin wrote:Just out of interest, it seems that several people on this forum have a problem with their knees or joints.

Has anyone tried steroid injections? I've been offered a systemic one, but I'm a bit wary because of side effects, and also I'm not sure it would work because steroid tablets don't work for me.

The medical community around here is dead set against steroid, or cortisone injections. Particularly in seniors, it is associated with inflammation, osteoporosis or osteonecrosis, nerve damage, and increased sweating, as well as other complications.

https://healthprep.com/conditions/8-horrific-side-effects-of-getting-cortisone-injections/13/?utm_source=bing&utm_campaign=267614450&utm_medium=search&utm_term=injections&utm_content=1264438652169220

Original Quill wrote:

Raggamuffin wrote:Just out of interest, it seems that several people on this forum have a problem with their knees or joints.

Has anyone tried steroid injections? I've been offered a systemic one, but I'm a bit wary because of side effects, and also I'm not sure it would work because steroid tablets don't work for me.

The medical community around here is dead set against steroid, or cortisone injections.  Particularly in seniors, it is associated with inflammation, osteoporosis or osteonecrosis, nerve damage, and increased sweating, as well as other complications.  

https://healthprep.com/conditions/8-horrific-side-effects-of-getting-cortisone-injections/13/?utm_source=bing&utm_campaign=267614450&utm_medium=search&utm_term=injections&utm_content=1264438652169220

I can't see much from that link, but thank you anyway.

Cortisone injections are supposed to treat inflammation, not cause it.

The trouble is that once you have the injection it lasts for about two months, so presumably you can't get it out of your system if it does cause side effects.

Andy wrote:My knee is a mess, HT, I could live with it EXCEPT I have just started a little garden clearance enterprise. £10/ hour, cash in hand, word of mouth on reccomendations. So far, so good,, lots of stuff in the pipeline. Beats sitting at home watching Jeremy fucking Kyle and reading dross from Didge

Keep your weight healthy, and try not to eat foods that cause inflammation. The meniscus can't heal as quickly as other body parts because the blood supply is less. So it takes more time. They can, and do heal. Listen to your body.

Raggamuffin wrote:

Andy wrote:I have a bad knee.
From experience and 4 previous operations, I have a tear to my meniscus - a torn cartilage.
I went to my GP, who promptly identified it and diagnosed it as I did.
MRI scan needed.

Now the waste.

My referral has to be triaged, firstly by an unqualified clerk for routing. When routed into the correct channel, a nurse clinician - less qualified than the GP,  will assess the GP's notes and recommend what is needed.

The triage unit are an overloaded, bloated unit that actually serve little or no useful purpose.
They expect to let me know within 4 weeks of my referral as to what I need - which my GP has already told them.

Why not get shot of the whole triage service and spend the money on more useful frontline staff?

And whilst they are reviewing services, let Pharmacists prescribe some basic medicines such as insulin and associated paraphernalia, painkillers and antibiotics, to customers KNOWN to the pharmacist and on their system.

Pharmacists are not qualified to prescribe medicine. For a start, the level of medication could change, so if they prescribe the same thing all the time, they might be prescribing too much or too little. I take medication, the levels of which do need to change, but I had to get the prescription changed by a consultant.

You can't have a pharmacist prescribing antiobiotics - what if an infection is a virus? Overprescribing of antibiotics is already a problem.

I don't really understand the triage thing tbh.

They do abroad. You can buy antibiotics over the counter. When I was in Greece, I had a water infection. Went to the chemist, and the pharmacist prescribed what I get in this country without the week long wait. Cost me Five Euros.

Raggamuffin wrote:I guess it depends on the source of the problem. Steroids wouldn't work on wear and tear issues, only on inflammatory joint problems.

Wear and tear often goes hand in hand with inflammation though.

eddie wrote:

Raggamuffin wrote:Just out of interest, it seems that several people on this forum have a problem with their knees or joints.

Has anyone tried steroid injections? I've been offered a systemic one, but I'm a bit wary because of side effects, and also I'm not sure it would work because steroid tablets don't work for me.

Knees are pounded constantly throughout life by walking, so suffer wear and tear. Also being overweight puts enormous pressure on knee joints.  

I wore my knees out dancing. Nearly two decades of pounding them. I put the weight on after the injury, rather than before it, because I couldn't exercise. Never had hip problems though. That must be awful.

HoratioTarr wrote:

Raggamuffin wrote:I guess it depends on the source of the problem. Steroids wouldn't work on wear and tear issues, only on inflammatory joint problems.

Wear and tear often goes hand in hand with inflammation though.

It can do. In rheumatoid arthritis, for example, the inflammation leads to damage. However, that doesn't happen with me, although I have autoimmune problems.  Osteoarthritis doesn't usually involve much inflammation though.

HoratioTarr wrote:

Raggamuffin wrote:I guess it depends on the source of the problem. Steroids wouldn't work on wear and tear issues, only on inflammatory joint problems.

Wear and tear often goes hand in hand with inflammation though.

These terms are used loosely in everyday speech  but in the strict medical sense there are two distinct types of arthritis. 
1. Osteoarthritis  OA  - which is simply wear & tear from daily use and it affects everyone to a greater or lesser extent as we all age. Blood tests are  perfectly normal. 

2. Rheumatoid Arthritis RA which is inflammatory arthritis and is auto immune induced and  is the commonest in that group,  it can attack at any age, even in childhood. Blood tests show various markers.

Actually i'm not 100% sure now, if RA is indeed the commonest. As Ragga suffers from it, I guess she'd know the answer.

It's a forum, it's good to talk. 

HoratioTarr wrote:

Raggamuffin wrote:I guess it depends on the source of the problem. Steroids wouldn't work on wear and tear issues, only on inflammatory joint problems.

Wear and tear often goes hand in hand with inflammation though.

I tried physio and was prescribed 3 injections to help my painful knee 5 years ago. Nothing worked, and the hospital consultant was gobsmacked when he saw Xrays of my knee because I still had full movement of it.
He booked me in for a full knee replacement, done on the NHS which has been a brilliant.
Unfortunately the other knee is going now.
I am not overweight and pretty healthy.
I think being very active and sporty for decades has played a part in wearing the knee joints out.

Mine is due to 45  years of heavy lifting at work, combined with playing 500+ games of cricket over 40 years, Many as a wicket keeper, which means you squat 6 around 250 times per match. Real toll on the knees. Already had 4 knee ops. This time I pinged it playing golf.

Jules wrote:

HoratioTarr wrote:

Wear and tear often goes hand in hand with inflammation though.

These terms are used loosely in everyday speech  but in the strict medical sense there are two distinct types of arthritis. 
1. Osteoarthritis  OA  - which is simply wear & tear from daily use and it affects everyone to a greater or lesser extent as we all age. Blood tests are  perfectly normal. 

2. Rheumatoid Arthritis RA which is inflammatory arthritis and is auto immune induced and  is the commonest in that group,  it can attack at any age, even in childhood. Blood tests show various markers.

Excellent post Jules, although I'm not sure which is the most common.

There is almost universal confusion about these two types of arthritis, but they are very different, and they are caused by different things. RA is not age related, and it's not really anything to do with the weather either. People say they have "arthritis" but they never say which type.

I have a bizarre and rare type of inflammatory arthritis. Some doctors say it's not actually RA, and some say it's a form of it. The treatment is the same though.

There are other types of arthritis like gout, which is caused by uric acid crystals in the joints.

Syl wrote:

HoratioTarr wrote:

Wear and tear often goes hand in hand with inflammation though.

I tried physio and was prescribed 3 injections to help my painful knee 5 years ago. Nothing worked, and the hospital consultant was gobsmacked when he saw Xrays of my knee because I still had full movement of it.
He booked me in for a full knee replacement, done on the NHS which has been a brilliant.
Unfortunately the other knee is going now.
I am not overweight and pretty healthy.
I think being very active and sporty for decades has played a part in wearing the knee joints out.

Ironic, isn't it? You try to be fit and sporty and bugger up your knees.

HoratioTarr wrote:

Syl wrote:
I tried physio and was prescribed 3 injections to help my painful knee 5 years ago. Nothing worked, and the hospital consultant was gobsmacked when he saw Xrays of my knee because I still had full movement of it.
He booked me in for a full knee replacement, done on the NHS which has been a brilliant.
Unfortunately the other knee is going now.
I am not overweight and pretty healthy.
I think being very active and sporty for decades has played a part in wearing the knee joints out.

Ironic, isn't it?  You try to be fit and sporty and bugger up your knees.

Yep, life can be a bitch.

Raggamuffin wrote:

Jules wrote:

These terms are used loosely in everyday speech  but in the strict medical sense there are two distinct types of arthritis. 
1. Osteoarthritis  OA  - which is simply wear & tear from daily use and it affects everyone to a greater or lesser extent as we all age. Blood tests are  perfectly normal. 

2. Rheumatoid Arthritis RA which is inflammatory arthritis and is auto immune induced and  is the commonest in that group,  it can attack at any age, even in childhood. Blood tests show various markers.

Excellent post Jules, although I'm not sure which is the most common.

There is almost universal confusion about these two types of arthritis, but they are very different, and they are caused by different things. RA is not age related, and it's not really anything to do with the weather either. People say they have "arthritis" but they never say which type.

I have a bizarre and rare type of inflammatory arthritis. Some doctors say it's not actually RA, and some say it's a form of it. The treatment is the same though.

There are other types of arthritis like gout, which is caused by uric acid crystals in the joints.

Awesome that so many different diseases can cause arthritis - or be strongly associated with it, as part of a syndrome.

In the AI category alone there are so many ailments associated with 'hurty joints' …  eg sjogrens and  psoriasis iirc. 

Sickle cell can cause it too - making the suffers scream in agony for hours/days.

Really 'arthritis' is just a vague umbrella term that covers a multitude of joint diseases,  with many subgroups …... which are further divided into smaller subgroups. Aaargh confusing minefield.

this is why the NHS needs to be disbanded and privatised

Andy wrote:I have a bad knee.
From experience and 4 previous operations, I have a tear to my meniscus - a torn cartilage.
I went to my GP, who promptly identified it and diagnosed it as I did.
MRI scan needed.

Now the waste.

My referral has to be triaged, firstly by an unqualified clerk for routing. When routed into the correct channel, a nurse clinician - less qualified than the GP,  will assess the GP's notes and recommend what is needed.

The triage unit are an overloaded, bloated unit that actually serve little or no useful purpose.
They expect to let me know within 4 weeks of my referral as to what I need - which my GP has already told them.

Why not get shot of the whole triage service and spend the money on more useful frontline staff?

And whilst they are reviewing services, let Pharmacists prescribe some basic medicines such as insulin and associated paraphernalia, painkillers and antibiotics, to customers KNOWN to the pharmacist and on their system.

oh no

i hope youre not in awful pain

No pain. It must be far worse having a cancer growing inside your brain, Skunky, a cancer of hate, bigotry and homophobia.
It will kill you eventually.