NHS Treatment Experience.

kingrollo

Is it just me or my GP practice ? or is it the NHS as a whole.?

I have had hell of battle getting my back complaint taken seriously by the NHS - which I half expected due to cut backs and rationing of resources.

But then bumped into a old work colleague, the conversation cropped up about he had a hip replacement. I asked him about his experience "Fine he said - Went to GP told him about pain, Sent for an X-RAY - confirmed hip needed replacing - start to finish under 3 months"

I had involve the local MP - as the GP surgery were adamant the injections were no longer funded - and were to risky. With help from the MP I got referred to an Orthopaedic consultant - who said due to time between injection (on average 5 years) and the low dose , and the fact that they had helped in the past - they would be appropriate - and will do such injections shortly.

Against all logic it would my particular GP surgery were blocking the treatment. Pretty sure I got hip pain - my GP wouldn't have me booked for a replacement within 3 months.

I am seriously considering changing my GP practice - hence the question are they all the same ?

Ben6899

I think your old colleague answered your question. A couple of things are not always that well joined up between the hospital and the GP, in my experience, but on the whole... no complaints.

Matthewfalle

didn't you post about this a while ago or was it a different bloke?

Matthewfalle

ah - yes you did.

viewtopic.php?f=40011&p=20455285#p20455285

tangled_metal

Change gp if you can but pot luck on what you'll get.

Our practice is good but they cater for oap patients or anyone not working only. Then if you want a late booking (anything after 4:30) then you have to go to the next town main practise. The GPs are great, only they don't want to work the hours must surgeries offer in the area.

The only other alternative practices include a larger training one down the road with late appointments. Great! What's isn't great is the turnover on GPs, foreign GPs with poor English or certainly I can't understand plus even the English GPS you might get to see eventually aren't great. Mostly you'll see a nurse practitioner who if you're lucky will tell you he has managed to grab a gp to see you straight away because it's beyond his training. If unlucky you have to re-book to see a gp.

Then sitting in the waiting room you hear the receptionist repeating the reasons patients give to her question about why they want to see a doctor. So basically everyone calling in gets screened by the receptionist who decides whether a gp or a nurse or a nurse practitioner is needed. OK I understand that, but why does she repeat it back to you over the phone so patients in the waiting room can hear? Plus she's shirty with you if you say it's confidential between yourself and the gp.

My only experience is because our son is with them because it's easier to get to see someone last minute. My partner usually takes him because I can't guarantee the gp will be understandable by me. She's good with languages and aspects of linguistics.

Basically a gp is the gatekeeper to the test 3 if the nhs services. Their role is to filter out as much as is safe to do so. Within that function there is a small window of movement to give good it bad service. Good luck finding a good one.

Having said that I've gone to the gp at 3:30pm Friday, been booked in for an xray at the hospital 35 minutes drive away and got to the xray suite just before it's closed. First time I read in and out in 5 minutes without even sitting down in the reception. Second time it beat that record and I was in and out in 2 minutes. Took me longer to walk down the corridor to get there once I was in the relevant hospital building! Won't happen again. Because they've stopped Friday afternoon appointments after 3pm and the ones before them now take at least 3 weeks wait.

Sorry for being negative. There's good and bad in the nhs but it's pot luck what you get when you get it. It's not just postcode lottery IMHO it's also about what you need the nhs for.

jgsi

My experience has been very positive and quick.
I've been given an all clear but the GP is keen to refer me onto a specialist for what I suspect are possible clinical trials to offset what she says are potential issues when I hit my 80s. She foresees a long life due to cycling.

(Back issues are notorious for very difficult diagnoses are they not?)

tangled_metal

Everything running in our family have age restrictions on testing. Basically I need to wait until 50 to start getting tested for a type of cancer that's strongly in one side of the family. Nice says 50 before testing but I've heard of quite a few people dying before reaching 50. A mix of "famous" and just people my friends and family know.

Pross

I'm not a fan of GPs, in fairness to them they have to cover such a range of conditions and their knowledge of many will be very limited. They're mainly a referral or dispensing agent.

My opinion is clouded by the amount of time it took our then GP to refer our daughter to a paediatric specialist - we took her countless times over the course of a couple of months when she was 4 as she was being sick every day, he put it down to reflux at first and then when it continued it was probably stress due to starting school. When she finally got to see a specialist about 3 months later he knew what it was likely to be before she even sat down and sent her off for an immediate CT scan that confirmed a brain tumour. That was on a Friday lunchtime and on the Monday morning she was undergoing a 10 hour operation to have it removed. I'm just glad we kept going back when we felt we were being fobbed off as over-protective parents.

tangled_metal

I think you have put the truth of the situation right there in that post.

The GP is a filter on the nhs system. It limits the numbers going to the secondary care by filtering out as much as they are happy to do. By this I mean they use guidelines rigidly because they bag hide behind them if things go wrong.

For example bowel cancer has Nice guidelines about the access to internal investigation which is basically the only way to be sure issues down there isn't cancer. If they follow them there can be no blame or fault on their part. The guidelines are 50 or above age related access to these investigations irrespective of risk due to familial cases of the condition.

So when someone gets bowel cancer younger than 50 it's considered an outlier and the guidelines protect their filtering action.

To get referrals to secondary or tertiary care you need to be persistent if you believe some condition is serious to you. It's a fight to beat the filter.

It's really not them but the system though so please always bear that in mind and treat them fairly too.

kingrollo

Pretty much as I see it - its a sad indication that I was absolutely staggered my mate got his hip seen to pretty quickly !

I have had these injections in the past with 100% success rate - but this time the first Doctor said "it wasn't clinically appropriate" - When I pushed him he said the injections "were too much of a risk" - He then booked a session with a senior GP ?? at the practice - who predictably backed his decision, but also told me the CCG would block any funding for any such injections - Eventually she agreed to refer for an orthopaedic assessment - but was still 100% that I wouldn't get the injection.
Once I got there and told them my history - all of the CCG guidelines suddenly became a non issue - and the consultation and treatment were booked in.

Ironically had my GP initially said - "We are very sorry but that treatment isn't available on the NHS" - I would have probably paid and had it done privately - But I knew "not clinically appropriate" was bollocks - and made me very determined to get it done.

tangled_metal

A good few years ago I got a really nasty cold type bug (I don't know what flu is I call it a cold if I can still stand up but flu if I can't get up even to pick up a £50 note - once told me as a test for flu). I was passing out for several days and ear infection that led to burst eardrum. Being on holiday in Wales I got an emergency gp appointment and then antibiotics with a free prescription!

A few months later I got similarly bad ear infection and a cold bug (although I didn't pass out as often with it. I know antibiotics aren't given for bugs like cold / flu because they're viruses in most cases and they don't work on viruses. The symptoms of the second bug was very similar to the first which two days of antibiotics stopped all symptoms. The gp gave me the strict guidelines which he had printed out on his noticeboard in front of him. Showed me a load of percentages and timescales showing that statistically antibiotics would reduce your symptoms by 18 hours. Having had over a week of steadily increasing ear pain I said I'll take it by he said no.

What I find surprising is one gp who doesn't know me or have access to my medical history gives me antibiotics the normal doctor with access to n records doesn't. I'm not a regular gp visitor and I'm fact hate going so it can't be them thinking hypochondriac thing going on.

It's down to your gp and how they enact the various guidance on treatment they get. Some consider the patient first, others consider the guidelines first and patient later.

kingrollo

Tangled Metal wrote:

A good few years ago I got a really nasty cold type bug (I don't know what flu is I call it a cold if I can still stand up but flu if I can't get up even to pick up a £50 note - once told me as a test for flu). I was passing out for several days and ear infection that led to burst eardrum. Being on holiday in Wales I got an emergency gp appointment and then antibiotics with a free prescription!

A few months later I got similarly bad ear infection and a cold bug (although I didn't pass out as often with it. I know antibiotics aren't given for bugs like cold / flu because they're viruses in most cases and they don't work on viruses. The symptoms of the second bug was very similar to the first which two days of antibiotics stopped all symptoms. The gp gave me the strict guidelines which he had printed out on his noticeboard in front of him. Showed me a load of percentages and timescales showing that statistically antibiotics would reduce your symptoms by 18 hours. Having had over a week of steadily increasing ear pain I said I'll take it by he said no.

What I find surprising is one gp who doesn't know me or have access to my medical history gives me antibiotics the normal doctor with access to n records doesn't. I'm not a regular gp visitor and I'm fact hate going so it can't be them thinking hypochondriac thing going on.

It's down to your gp and how they enact the various guidance on treatment they get. Some consider the patient first, others consider the guidelines first and patient later.

Keyword - Guidelines - not rules - thats gives everyone wriggle room.....

Did you get your ear sorted ?

tangled_metal

First time it was showing signs of healing after a couple of weeks. It's OK now. The second bug fortunately didn't get quite a bad so no perforated ear drum. Let me tell you an ear drum perforation was big relief. It was excruciating pain then a pop and my ear leaked but no pain. It felt soooooo good. No lasting issues but I think I might be getting more ear infections than I used to get before the first bug.

Yes, guidelines only. In my case the welsh gp ignored them my local gp doesn't, ever. Reason? They say most bugs causing ear infections are viruses that don't get affected by antibiotics. The only way they work is by tackling the secondary bugs which may be bacteria which antibiotics can treat. That leaves your system to battle the virus. Truth with my ear infection was the antibiotics worked almost within hours of taking my first dose. By day 2 no pain in the ear that didn't perforate. 3rd day I did a 50 mile challenge walk in 16 hours. If really a virus out shouldn't have worked that quick.

Of course I support the refusal of antibiotics because one day they'll stop working at all but that's going to speed up if we use it for minor reasons like colds, ear infections, etc.

DeVlaeminck

It makes you sound like an entitled **** but if you have concerns you do have to keep pushing the NHS. An old training partner of mine was getting stomach cramps in the bike, then symptoms progressed, he kept getting fibbed off, eventually when he'd list 3 stone (off race weight) he got referred by which time his bowel cancer had spread and he lived about a year. Similar with my youngest brother, kept being told it was a skin condition brought in by stress, when he finally got referred the consultant knew it was cancer at first sight - he lived about 2 years more. I realise they are underfunded but you don't want to be one of the ones that dies as a result.

FatTed

These are the guidelines
https://www.nice.org.uk/guidance/ng59/e ... 2726157998

bonk_king

Personally I haven't had any problems with the NHS and i've had a few procedures over the years. My wife on the other hand was awarded just shy of £500'000 after a very long drawn out court case regarding gross clinical neglect. That is probably as broad a spectrum of experience you're going to get on this thread regarding the NHS.