What would you change?

In the news at the moment there is a lot of talk about how GP's have to change the way they deal with their patients and how they provide their services.

If you had the chance to change something in the way your GP. local hospital, specialist services dealt with what would it be?

I would like to see one person who could coordinate with all the people I need to see so at least one person gets the whole picture.

nutty

18 Replies

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  • I would like to see g.p's provide better care and actually listen to and try to help people who live with chronic pain.I find that since I've had fibromyalgia there is a lack of understanding of this condition by g.p's and some don't even think it's a real condition,so frustrating!

  • Morning Nutty

    BOB here

    In our area they were testing a new computer program that the Hospital and GP had instant viewing of how treatments were going and the results of tests and X Rays. Now I am up country I do not know if the system has been extended as yet. So I have a meeting next Wednesday I will bend a few ears and see what the situation is in Berwick. As the system was working well.

    All the best

    BOB

  • @ haribo

    being listened to and not having to repeat the same things every time you see a different gp. It is so demoralising to keep going over old ground again and again and yet get no further forward with treatments.

    nutty

  • Hey Bob

    We had a similar system in Wales that really worked and meant information was never lost and always at the doctors finger tips. Here it is all sent by post from one dept to another and no xrays taken at one hospital are available at another. They are just asking our permission to share our medication on a national database small beginnings I hope may grow.

    Hope your meeting next week goes well and you get much needed continuity of care.

    nutty

  • One thing - a bit more creative or intuitive thinking from doctors that gets symptoms and signs and history and family history linked up, rather than the very black and white "test says no so you can't have it" thinking. It really means moving away from the cost based treatment protocols the NHS seems to have taken on that deal with maybe 80% of folk well (eg the low back pain protocol that tells GPs that it isn't worth doing xrays), but the remainder just totally slip through the net.

    I'm going to go for another thing too - that every region and every speciality clinic gives a full hour with doctors for the first consultation, and includes having tests, xrays, physios etc all available in the clinic at the same time. I know a few areas are doing this kind of multipurpose visit where you get to see several different people in the one clinic time and get everything done at once so you don't have to go back later for imaging or blood tests or physio, etc, but it would be great if everywhere did that.

  • My GP is good,he will admit when he is wrong or doesn't know the answers to questions. BUT the main hospital is awful,like a cattle market. The staff are so overloaded that they have become inhuman. We have a more local hospital ,a minor injuries unit which runs clinics. The atmosphere is so much better. The small hospital is so under used and the large one over busy. Why can't we go back to "the old days" and have what were called cottage hospitals,a much more humane place.

  • I agree with much already posted. My change would be small but massive in outcome - that the doctor looks at me and listens to me when we are having our consultation. Also that he/she examines me, actually getting up off that chair! Medicine isn't an exact science, even the "scientific" tests aren't always conclusive, so let's have a return to hands on diagnosis, listening, touching, looking.

  • Agree! I can't believe the number of times decisions have been made about my treatment after a doctor has had a quick look at my file, or a five minute chat with another doctor - and on rather too many occasions without me even being seen in person by them. Or they have made up their mind what they are going to do before I walk into the consultation room and nothing I say or do will change that. And as for examinations, what are they????? So different from another country I lived in where on the whole GPs and specialists were far more engaged with patients - but then that country did have a very effective complaints system (that treated complaints as an indication that something was wrong with the system, and needed to be investigated and dealt with, rather than assuming that it was just a nuisance patient who had misunderstood the doctor or didnt understand).

  • Yes to looking at me. One GP even queried why and who was my husband recently. "who's he". Also to not have to phone at 9 that day and have to keep dialling. Only to find some moments later all appointments full. Telephone appointments are brilliant provided you can describe the details. I would like the GP to deal with more than one thing wrong at one consultation. Some say only one thing each time and you have to book another appointment. Dad???? for arthritis of any sort affects different parts and they are related.

  • I think the most obvious thing that everyone agrees on is that we want to be treated as a whole person, by people who have all our information at their finger tips. I agree with the comment about cottage hospitals we have a lovely one near us that I can see my specialist at every 3 months. It is an all together much better experience with xray and blood tests all done at same time.

    I hope the future brings us back to the values we have lost and by returning to them that we all get better more consistent care.

    nutty

  • Is it the Gp or us who need to change. There is an expectation that the NHS can provide all the answers it cannot. We need to examine ourselves and see for ourselves what does work or what does not.

    There is recognition among University researchers that a faulty tissue may look the same in several different people, but on the internal level in the tissue everything may be different in all the people concerned and require different treatments.

    There is a recognition that drug trials show people who have been helped and show people who have been damaged by the drug.

    Yet the GP issues drugs as if it will work the same in everyone according to the synopsis of the drug trial which fails to mention the failures that occurred in the Trial.

    The regime needs to change so that treatment consists of developing management and observation skills, and the NHS educates people to be able to do this. In handling long term disibilities time management skills become a necessity. Yet everyone is expected to learn all the necessary skills to handle their long term disibility by themselves. This needs to change. Much distress can be avoided if the necessarily management skills are acquired quite early on instead of in my case at least six years after the intial injury that created the long term health disibility.

  • I think another worrying thing I'd like to change is the way that specialist care is gradually being replaced by lower trained staff "with a special interest". For example, in our area, you don't get to see a consultant orthopaedic surgeon any more for the 6 week joint replacement follow up - you get to see a physio. Also, a lot of our "specialist" clinics are being operated by "GPs with special interest". That may work fine for 60-80% of cases where its fairly straight forward, but the whole point of having "specialists" is that they have the in-depth knowledge and understanding to be able to pick up the things that aren't straight forward. I'm also a little wary of telemedicine and clinic by videoconference. If you live in a very remote area, it can be a good way to "see" a specialist more often, but it can never be a substitute for the specialist actually having you in the room, and able to examine you properly, or pick up on the subtle signs that you aren't going to see on a TV screen.

    Don't get me wrong, I'm all for "nurse specialists" and "physio specialists" working alongside consultants, but to my mind they are taking over far too many of the clinical decisions, and doing far too much of the gatekeeping and preliminary diagnosis, and thats where folk can really miss out if they aren't a classic and obvious case.

  • Some doctors just want patients to be in/out, why can't we not have longer sessions with doc? Is 10mins enough, to get your point over?????

    Even some surgeries, you can get 20mins...is this still enough time?????

    I feel with my experiences, that chronic pain just gets pushed to the side....either that or we just get pushed from one specialist to another....

    Joe

  • This question prompted me to think about the GP's point of view.

    The powers that be are always tinkering with institutions, and in the spirit of get an expert to do the fixing, if my car needs tinkering with I want a mechanic to be in charge of the spanner thank you very much.

    I came up with this blog. Given the conundrum of the issue tis a bit long. But her points at the end are worth reading.

    patient.co.uk/blogs/sarah-s...

    Yes I have come back from appointments and howled in frustration. Felt let down, not listened to and demoralised. But in my family when the s' hit the fan they have always been there, even when they could do no more than put a hand out to steady the ship so to speak.

    So in answer to the question, I want the Powers that hold the purse strings to take the first step, stop talking, and listen to the people who know more than they do.

  • The problem is that every political party thinks it can "fix" the NHS (or says it's going to fix it during an election campaign but then does everything possible to grind it down). This means that nothing ever gets sorted out properly because the goal posts keep changing.

    I think if you're usually fit and well there should be clinics where you can go for routine check ups which are open before and after normal work hours and you shouldn't need to have to bother your GP for those, you could go anywhere to suit you. But if you're properly poorly or got a long-term health need such as chronic pain you need a GP appointment that's easy for your to get to.

    There are community matrons attached to GPs who can oversee patients with multiple health problems -though in some areas you have meet certain criteria to get a matron.

    I am all for multidisciplinary clinics in the community and in hospitals where you get to see all of the professionals involved at the same appointment - different people have different ways of looking at your problem and where one clinician might dismiss you another might have a solution.

    Also a big believer in being treated with some basic respect. I am a health worker and a patient and it's not until you've been the patient do you really see what it's like (even if you try your absolute best at work you can always learn more). I would make it compulsory for all health staff (even those who don't see patients) to spend a day in a wheelchair, blindfolded, and possibly gagged, forced to drink lots of water but made to wait for the toilet. And with cramp.... The health minister would be first on my list!

    There also needs to be more invested in setting up services for patients to get support. If we felt more able to cope we might not need to spend so much time at the GPs.

  • Here here to the last paragraph. I have searched long and hard in my area for some kind of support group. I was desperate for the Pain Management course to offer a 6 monthly meet up for people who had been though their books.

    Understandably perhaps it was beyond their Ken. I is still lookin.

  • Thank you all for responding to this it has made very interesting reading and shows many common complaints.

    nutty

  • Getting an appt. in a few days would help. A GP that does not pre judge you if you have anxiety and says that every ache and pain is anxiety related. Not taking too many patients on there book so that they are unable to offer quick appt.

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