This isn't the first time, nor the second time that this situation has come to our attention.
GPs in Southampton received this e-mail:-
“Dear Colleagues,
I have been asked to inform you urgently that Southampton University Hospital Trust is currently on ‘Black Alert’ with Ambulances queuing outside A/E and the Ambulance Service [SCAST] indicating that there is a 1.5 hour wait for even urgent requests for ambulances to be dealt with.
Clearly in this difficult situation we would request wherever possible that if measures can be taken by you to avoid hospital admission or A/E attendance for patients we would be most grateful.
I am conscious that communications of this nature are often deemed unhelpful, but I hope that you will take this circumstance into consideration, in consultation with patients and carers, in informing your clinical decisions this afternoon.”
Now, firstly you need to know that the only type of alert over and above a “black” one is a full-scale Major Incident: the sort of thing that happens when there is a plane crash or a pile up on the motorway, or indeed, a railway accident- all of which could so easily happen near to Southampton.
So, the discerning reader might ask him or herself what disaster happened on this day? Did we miss something in the papers? Was there an earthquake? Was it mid-winter? No dear reader, this is mid- May. You are not hallucinating. There is NO flu epidemic, no SARS and no accidents over and above normal.
This is what happens when you leave the control of a public service to the ignorant pool of dripping cunt-slime that consists of politicians (of both parties). All these vermin can think of is closing beds. Even the noble Lord Darzi seems to be intent on the same. One is also left pondering what exactly GPs are supposed to do when confronted with messages like this.
Do people think we drive around the streets looking for old people whose shoe laces are undone so we can send them into hospital between our endless rounds of golf? No, our patients are so shit-scared of going into these mediaeval cesspools of MRSA and C Diff, that they have to be knocking on death’s fucking door before they will let us send them there. Of course, in sensible Western Countries like France and Germany, they know that an efficient hospital functions best at about 90% capacity so that there is time to sterilize the mattress between one admission and the next.
In the UK, which, under El Gordo, now spends as much on health as some of these countries, the hospitals are usually running at over 100%, with the beds still warm from the previous corpse when the next lucky “customer” gets to lie in it. “How can this be?” you no unreasonably ask yourself. Maybe it has something to do with the gargantuan monetary waste spent on the bloated corpse of paper- shufflers and meeting-attenders, who, like an obscene inverted pyramid, sit on top of the doctors and nurses who try to run the service? Some of these, in the form of the local PCT, were the same fucktards who decided not to pay GPs for doing minor injuries: their strategy of using their walk-in-centres and A&E seems to have backfired on them fairly spectacularly. Only a Nu-Labour organisation like the NHS could spend more money on management consultants than clinical consultants.
Pandemic Flu, anyone?










12 comments:
Amen to that. When playing musical beds with the acutely ill, I often think of Dr Gill Morgan's (ex chief exec. NHS Confederation) little gem:
"Every time a hospital cuts beds, it is seen as a terrible thing and attracts bad headlines, but often the trusts have redesigned the services to give patients faster, and actually better, care...There are a lot of beds that could still go...But we won't be able to make these changes and invest in the community unless people start to abandon the idea that beds are sacred. They are just a piece of furniture, that's all."
The Observer, May, 2006.
You are, as usual absolutely right (and I'm not sure that even "no-one" could really disagree, though he will doubtless try).
The real tragedy is that a form of this letter has been received so many times by GPs that it can be difficult to get worked up. It's the ultimate in crying wolf - it has no impact on the clinical decisions we take except that it is becoming a kind of self-fulfilling prophecy, in that patients are prepared to stay at home when they are more unwell than they used to be to be begging for admission.
No doubt some wank-pot management consultant will see this as evidence that the admission was unnecessary and they were right to close the beds, but we've long since crossed over the line between legitimate efficiency-drives and inadequate provision.
Beds may just be furniture but you still need to have enough of them, and we don't, simple as that.
I disagree
Dr. R,
Does this mean you are coming round to DK's, and by extension, the LPUK's ideas for private healthcare?
i agree with this post from the good drs rant
my solution would be along the lines of printing the patients a cheque to take to any clean hospital that will take them, and let the patients choose where to take the cheque
let the dirty hospitals close from lack of people taking cheques to them
take the deicisons away from politicians and give them to the customers the patients
the real no one
What you describe no one can already happened in theory. The govt introduced free choice at the start of April. If the patient is informed of the choice by their GP they can go to any hospital on the list including private ones.
yea but give them a real cheque where they can choose to take it to a belgian hospital if they want
and real money to change their mind after their 30 milliseconds with the GP
so they can change their mind when walking into a hospital which is obviously rude and dirty
GPs from the patients point of view again:
Friend just moved address
One GP practise very close but only opens 9 to 5 Mon to Fri and locals all think its a rubbish surgery.
Other 6 closest surgeries, which according to the PCT should be able to register with
"Hi can you tell us if you are accepting new patients"
"Yes, depends where you live"
"Oh where's your limit then?
"Oh you have to come in and fill in the forms and then the doctor will deicide"
So any pretence that the patients have any buying power in this transaction is fantasy
Come back New Zealand where you can live the other side of Auckland and the docs are quite happy to take your money
The UK really is fucked isn't it?
So the chickens are coming home to roost (again) in Southampton ?
I can understand why Rahere can barely stifle a yawn - why should GPs have to endure a tedious, and entirely predictable missive from the PCT ?
I suggest the GPs respond en masse with Morgans priceless "piece of furniture" nonsense.
But what I find particularly irritating is when a manager end up in A&E (often for fairly trivial reasons) - how long before a coterie of hospital suits gather outside the cubicle, eyes darting in search of the key players on the shop floor ?
I mentally start the count down until an underling shuffles over and murmers are you aware his royal nibs is in cubicle 8 - of course, I respond, I'm just trying to sort a piece of furniture, sorry, bed for him right now............ I know I should be strong and treat managers just like any other punter but the A&E C/N has become weak in his dotage and the the thought of being pulverised by a swarm of clip boards is simply one battle too many.
"I'm just trying to sort a piece of furniture..."
I've decided I'm going to take Morgan at her word, and henceforth will be re-directing ambulances to Ikea. Self-assembly might be a touch challenging for those with a low GCS, but I'm sure we can re-brand the experience as patient empowerment of some kind.
(BTW - and possibly by virtue of some creative accounting - SUHT have announced that they are sitting on a surplus of £18m. Doesn't quite square with the desperate shortage of beds and staff that I encountered at SGH as a student nurse. Or does it?)
I was lucky enough to stay at a Luxury (and I do mean LUXURY) Hotel in the Far-East. For some reason they had been extra busy. The place was crawling with staff complaining about over 80% occupancy. Sister would regard that as a rest cure on her ward. Remember a hotel only does beds rooms and meals. No faffing around with sick peopl;e or medicines for them. M.R.S.A.and the rest are asll because of hot-bedding. Empty beds are good and needed!
ICU Nurse with four funded beds, five patients and four staff (inc me) and two on route.....not an unusual situation. My trust recently carried out an audit on critical care bed useage and availability. Its surprising result was that critical care was at 50% occupancy and therefore over staffed. The end results was thirty (yes thirty) skilled ICU Nurses given the old heave ho....wow i hear you say..a critical care department with over forty beds at 50% occupancy..how can this be...well, the audit was carried out in two days over a two week period, the same period when the general surgeons, the plastics, ENT, Maxfax and cardio thoracic surgeoans where on holiday (as well as most of Scotland). As a result Management decided that we had more than enough staff and promptly removed them. Two hours after the last nurses left we had no beds, two in resus, one in MHDU, two in theatre and one being nursed in the treatement room with NO staff.
We now run with a 100 - 150% occupany rate...bunk beds are sounding great, but can you stack ventilators one on top of each other, or shall we just have patients share ventilators
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