No room at the inn

I am not always mad keen on the general practitioners that I come across on the telephone discussing admissions as you may recall but the ones I have dealt with recently as a patient and a parent are marvellous. First of all I had neglected to arrange a repeat prescription of contraception and appeared in my practice on a Friday afternoon to ask if they could help, I was deliberately a bit vague and stupid as I was after anything helpful; the pills themselves, a prescription or even a promise that I could collect a prescription tomorrow. The receptionist took about 5 minutes to hand me a signed repeat prescription for 6 months of pills. Next up, first born child was mildly unwell requiring non urgent attention, an appointment the same day at a convenient time was given.

It was all marvellously satisfying. It didn’t take much to make me very happy with my GP and I only saw one for 2 minutes whilst she advised on which ear drops to try. The infrastructure that allowed a same day appointment and the helpful receptionist were just as important as any medical care.

Some of my patients are irritated this week with the care they are getting in the Big Hospital. I have spent time every day apologising for delays in scans being done, scans being reported and scans being cancelled due to more important ones being needed. Also, due to patients waiting endlessly for rehabilitation beds two of my elective operations didn’t get beds on the main ward and were boarded out. This is totally appalling and something us doctors are not allowed to publicly complain about. I have four elderly but well patients who need rehabilitated prior to getting home. I have patients coming in for elective surgery but my ward is full. So the crazy situation occurs that the new operative patients are sent to the far corners of the hospital and are cared for by non specialist nurses (though still good nurses) and by any old ward junior doctor. Up on my ward with the highly skilled and experienced nurses and my team of juniors who I know and trust and crucially know and understand this sort of operation and the post operative course, lie four well and lovely old people who need help getting dressed and washed and are a bit wobbly but ARE NOT ILL. I am not saying that the elderly should be moved and boarded, of course not. Should we cancel elective operations on the grounds that the right bed isn’t available? Maybe, it would certainly make management listen and take action. It’s like going to an Italian restaurant and on arrival being told you are going to be sitting next door in the Indian restaurant and someone will bring your dinner through to you. Wards are wards and restaurants are restaurants management must think and although you’ll get a knife and fork in every restaurant, you’ll be offered mango chutney and a poppadom instead of Parmesan if you’re having linguine in the wrong place. I know my patients that have been boarded will get on ok and be looked after just fine on a different ward but it is far from optimal.

So, General Practice: score 1 for a satisfied mother and another 1 for a satisfied patient. Big Hospital: score -2 for boarded electives and -3 for scans delayed, cancelled and not reported.
Number of times I apologised for our rubbish service: too many to count.



2 thoughts on “No room at the inn

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