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Hormone treatment lack of support from NHS.

User
Posted 09 May 2019 at 10:36

Since being diagnosed with intermediate prostate cancer in March and because of previous surgery not related to the cancer the consultant advised that hormone treatment followed later by radiotherapy would be the best course of action.

After an initial busy period of hospital visits I received a course of drugs followed by my first injection of prostap which lasted a month. At no time was I contacted to monitor how the treatment was progressing or if I was suffering side effects.

The month soon passed and I was ready for my second injection of prostap which had been arranged for Easter Sunday at my local district nurse clinic.

I arrived with my wife at the clinic and was asked by the nurse did I have the prostap which I didn't. It appears that because three different medical agencies were involved in my case there had been in breakdown in communication.

My wife and I then spent the next three hours trying to first get a prescription off the emergency doctor then finding a pharmacy open on Easter Sunday to dispense the prostap.

We eventually did and arranged for the district nurse to call at my home address to administer the injection. She called later that afternoon and gave me the prostap into my stomach.

Within a very short time the area became red and sore and this lasted for a few days with a 50p sized hard lump appearing, it did eventually disappear but at no time since have I been contacted to assess my health and if the treatment is working.

It seems, especially in my case that follow up appointments during the treatment are not an option and it is up to the patient to monitor there own condition and deal with the side effects alone.

I do feel abandoned by the NHS and when I have contacted them, I seem to have been passed from pillar to post with the local cancer hospital saying my case is now the responsibility of my local health trust and they in turn refer me to my GP surgery which uses a lottery system for appointments regardless of your condition.

 

Edited by member 10 May 2019 at 09:47  | Reason: Misspellings

User
Posted 10 May 2019 at 09:42

Originally Posted by: Online Community Member
Par for the course in our "wonderful" NHS

The NHS IS wonderful, and without it, most of us would be dead - or dead broke. Or both.

Sure, it isn't perfect, but whingeing about minor cock-ups - when all the NHS staff are under terrible pressure, with loads of unfilled vacancies, not to mention most haven't had a decent pay rise in 15 years.

We are all perfectly capable of booking follow-up appointments with the specialist nurses if we feel we need them; or popping in to see our GP at any time.

Personally, I'd rather free the NHS staff up to deal with bigger problems than mine, for as long as I can.

I don't defend poor communication in the NHS, but in most cases, a bit of initiative, self help and common sense are all you need.

Cancer is a horrible thing to have. It's easy to feel angry about it, and the injustice of it. But looking around for someone to blame is not the answer; because it ain't their fault. It's no-one's fault.

.

-- Andrew --

"I intend to live forever, or die trying" - Groucho Marx

User
Posted 10 May 2019 at 23:23

The simple answer to this is that the NHS is understaffed and underfunded and in places poorly organized. It does pretty well with what it has and the pressure it is under. It does not compare well with healthcare of some other leading European Countries where they have a far better doctor to patient ratio and provide a better service, consequently, you don't have such long waits for appointments/treatments/results and often better/newer equipment overall. I can confirm this from my treatment and follow ups in Germany and good reports have also come from France and Italy among others, The fact of the matter is that for too long we have not incentivized, sufficient numbers to join the medical profession and provided reasonable working conditions and pay to retain them. In order to get by we have relied too much on employing staff that have already been trained by other countries. We are now at crisis point and indeed more places are being made available in the UK to train would be doctors. The problem is particularly acute at GP level where many are overworked and are retiring early or moving elsewhere. My previous GP was a case in point. He left a very busy practice in Devon to serve in a less pressurized environment serving a very small community in Scotland. It will be a slow process to raise the level of service provided throughout  the NHS where the service can fluctuate considerably but with a growing and ageing population this has assumed even greater importance. Meanwhile, it is incumbent on us to be proactive about our health concerns and monitoring.

Edited by member 11 May 2019 at 02:29  | Reason: Not specified

Barry
User
Posted 11 May 2019 at 01:59

Well, I've been impressed with the NHS so far. When I asked for an extra consultant appointment because I had more questions, they fitted it in that week. Macmillan nurses have seen me a couple of times walking in with no appointment.

Various of the diagnostic tests took a while (8 weeks for template biopsy, nearly 3 months for a PET scan which didn't happen and became a full body MRI instead), and then the 3 week wait for results each time. I was seen and initially diagnosed very quickly though - that's a target they do meet.

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User
Posted 09 May 2019 at 10:57
Par for the course in our "wonderful" NHS
User
Posted 09 May 2019 at 11:45

I don't think it has anything to do the NHS. I've had all my cancer treatment (HT+RT) privately and nobody has checked up on me to see how I'm doing with my HT. I think it's normal to assume that if the patient has concerns they'll visit their GP (which seems entirely reasonable to me). Your GP is your primary care provider.

Cheers,

Chris

Edited by member 09 May 2019 at 11:47  | Reason: Not specified

User
Posted 09 May 2019 at 12:47

All the literature regarding the hormone therapy states that the patient should be monitored regularly to check for serious side effects and the efficiency of the treatment.

Unfortunately I do not have private health care so unable to choose my own pathway to successful treatment so rely on the NHS and on my numerous visits to my GP surgery I have not seen the same doctor twice and in some cases I know more about my condition than they do.

Continuity of care and confidence in the health professionals is paramount in a stress free journey to beating the cancer.

User
Posted 09 May 2019 at 13:39

There is no monitoring for the HT side effects - this surprised me a bit. I had seen some mention of monitoring on US forums.

It really is up to you to make yourself familiar with them, and avoid those side effects which you don't want and can be avoided, and ask for appropriate meds where necessary. This is important because some of the symptoms can be reduced or avoided, but become permanent if you don't. That's where this forum comes in really handy.

Do you have an assigned urology or Macmillan nurse? They can be a good first contact point. They may have given you a booklet on handling side effects of HT - I got a load of leaflets/books on diagnosis, and it's worth reading them twice with perhaps a month between, as you won't take it all in first time.

At each consultation, I take a list of things I want to ask, and I also include a list of side effects in case it comes up. In one consultation, there was also a guest GP present who was spending a couple of days shadowing the urology consultant to get more urology experience. The consultant did ask me to go through the list or HT symptoms for the guest GP's sake, and that sparked a few discussions. The consultant was unaware of some of the side effects.

Here's a quick list of side effects (and I'll probably miss some). No one gets them all, and the order you get them may be completely different to anyone else. Some research has shown the medical profession think people don't want to know in advance, but when researchers questioned patients, that is not borne out, and most do want to know what to look out for. In the case of HT, many can be avoided if you know what to do at the time.

Loss of nocturnal erections and "morning wood".
This is more important than you might think - see Reduction in erection size below.

Loss of libido.
This can have a major impact on relationships, and it's important you both communicate and understand this, and find ways to keep your relationship working. Counseling may be available.

Loss of semen (dry orgasms).
This doesn't stop you having orgasms, but they may feel different (for some people, better).

Improvement in urinary flow, if it was slow.
This is because it shrinks prostate, and so it may press less on urethra.

Reduction in erection size.
This is also tied in with Loss of nocturnal erections, and loss of libido.
Loss due to HT is avoidable, see https://community.prostatecanceruk.org/posts/t21301-Penis-size#post216227
(However, loss due to other treatments is unavoidable.)

Shrinkage of testicles.
Unavoidable (although I don't know if everyone gets it or notices it). May be some reversal after HT ceases.

Nipple pain and breast growth (gynecomsatia).
Most people can avoid or reduce this by taking tamoxifen (70% success rate, but contra-indicated in case of other medical conditions such as DVT) or a one-shot RT blast to breast tissue (50% success rate, but 1-2% chance of minor damage to heart muscle, although this is not normally even noticed). There is some disagreement about whether these have to be started or done before gynecomsatia starts, but certainly you don't want to leave it for any length of time after it starts if you plan on using either of these. Some people who get gynecomsatia report a little breast shrinkage when they come off HT, but not a return to no breasts. Breast reduction surgery afterwards may be available in some cases too.

Thinning and loss of body hair acquired at puberty.
This mainly impacts chest, back, arms, legs, armpits. Beard and pubes tend to grow slower, but for most people are not lost. (Maybe they are for people on lifelong HT - I don't know.)

Hair on head - may get some reversal of balding, or a pause in balding getting worse whilst on HT.

Hot flushes.
This is often identified as a particularly annoying side effect. It can start soon after starting HT, or after as much as a couple of years, but not everyone gets it at all. If it's bad, there are drugs which might help, but they are also backstop drugs if your PC later becomes uncureable, and use at this early stage may reduce your options later. Also things like acupuncture help some people, and identifying and avoiding particular triggers.

Change in body composition.
There's a tendency to put on fat on waist and thighs (a more female form). Watching what you eat and doing exercise can reduce this, but it's difficult to completely avoid. People report some reversal after HT finishes.

Loss of calcium from bones.
Bones need testosterone, calcium, and vitamin D to remain strong and healthy. You will be missing testosterone, and the alternative which works for some people is exercise which involves stress/shocking bones (together with the calcium, and vitamin D). Jogging is the most effective, and weights, and you might want to discuss taking calcium and vitamin D supplements with your GP. If you can't exercise and you are suffering from loss of bone calcium, there are other drugs that may be used.

Loss of body odor.
Deodorant no longer required, although perspiration is as before. Very useful for summer exercising.

Fragile fingernails.
A hand and nail moisturiser may work.

Fuzzy memory.

Difficulty in gaining and retaining muscle.
Testosterone is an important factor in muscle gain in men, which makes it much harder to gain muscle, or even retain muscle. Exercise may be key here, providing you are eating enough protein.

Blood pressure.
Can cause an increase or decrease in blood pressure.

Blood Glucose.
Can raise blood glucose levels, resulting in Type 2 Diabetes

Edited by member 18 Jun 2019 at 21:36  | Reason: Added more possible side effects.

User
Posted 09 May 2019 at 13:56

Originally Posted by: Online Community Member

I don't think it has anything to do the NHS. I've had all my cancer treatment (HT+RT) privately and nobody has checked up on me to see how I'm doing with my HT. I think it's normal to assume that if the patient has concerns they'll visit their GP (which seems entirely reasonable to me). Your GP is your primary care provider.

Cheers,

Chris

Re private in the UK this is fundamentally delivered by the same consultants working with the same ethos ie you are just another appointment.

There is no concept of care for the whole person anymore the NHS and private has been reduced to a "transactional" system.

This is certainly manifest at my GP practice where every contact goes via the "triage" regardless of previous treatment or actual needs.

User
Posted 09 May 2019 at 18:31

Andy62 - an excellent summary of the side effects of hormone therapy. 

Ulsterman

User
Posted 10 May 2019 at 09:39

Looks like every possible side effect is in your list but if they are unlikely to happen except in the most exceptional cases then it would be sensible to concentrate on the most common that effects the majority of patients.

I am almost 64 years old in a physically demanding job and finding it harder and harder to carry out my duties without constant rest periods.

I am experiencing the most common side effects such as fatigue, nausea and hot sweats, other than that I am fine.

Does anyone in my age group or younger actually experience any of the other more serious side effects in you list, I haven't seen any evidence.

One side effect that I would welcome would be the regrowing of hair on my bald head, I haven't had a full head of hair for forty years.

 

User
Posted 10 May 2019 at 09:42

Originally Posted by: Online Community Member
Par for the course in our "wonderful" NHS

The NHS IS wonderful, and without it, most of us would be dead - or dead broke. Or both.

Sure, it isn't perfect, but whingeing about minor cock-ups - when all the NHS staff are under terrible pressure, with loads of unfilled vacancies, not to mention most haven't had a decent pay rise in 15 years.

We are all perfectly capable of booking follow-up appointments with the specialist nurses if we feel we need them; or popping in to see our GP at any time.

Personally, I'd rather free the NHS staff up to deal with bigger problems than mine, for as long as I can.

I don't defend poor communication in the NHS, but in most cases, a bit of initiative, self help and common sense are all you need.

Cancer is a horrible thing to have. It's easy to feel angry about it, and the injustice of it. But looking around for someone to blame is not the answer; because it ain't their fault. It's no-one's fault.

.

-- Andrew --

"I intend to live forever, or die trying" - Groucho Marx

User
Posted 10 May 2019 at 10:11

Originally Posted by: Online Community Member

I am experiencing the most common side effects such as fatigue, nausea and hot sweats, other than that I am fine.

Does anyone in my age group or younger actually experience any of the other more serious side effects in you list, I haven't seen any evidence.

I've experienced the side-effects of breast growth (sorted out by taking Tamoxifen) and weight gain since being on HT. I've also completely lost my body odour - I can sweat like a pig and it's completely odourless😀.

Cheers,

Chris

 

User
Posted 10 May 2019 at 10:20

I don't know which part of the country you live in but popping in to see your GP in my area is a non starter.

The system of appointments is based on a first come first serve basis via an early morning call which if you manage to get through you are then placed in a queue and even this does not guarantee an appointment.

The practice will not arrange a pre-booked appointment with a doctor of your choice regardless of your situation and refer you to A & E if you think your condition requires immediate attention.

The NHS is struggling but this is down to poor management and a lowering of the skill/qualification bar which means some staff are not up to the job.

A few years ago I was offered minor knee surgery in a local private hospital through the NHS and although I only spent a day there I was impressed by the suberb facilities and the professionalism and politeness of all the staff.

Most had come from the NHS reluctantly but could not see a future in an antiquated and chaotic organisation.

 

User
Posted 10 May 2019 at 11:04

Originally Posted by: Online Community Member

Looks like every possible side effect is in your list but if they are unlikely to happen except in the most exceptional cases then it would be sensible to concentrate on the most common that effects the majority of patients.

I'm 57, and doing loads of exercise.

I took the list from my diary, and added other things I'm aware of from this and other forums, and the research I did around HT when I first started it. (I just edited that post and added a couple more possible side effects.) I have specifically checked for the possible side effects. Many (possibly most) people may not do this and may be unaware of some of them (in which case, they clearly aren't any concern).

In the order they hit me:
Loss of nocturnal erections and "morning wood". (probably from day 2).
Blood pressure increase (2 weeks).
Loss of libido (3 weeks).
Loss of semen (gradual, gone at 8 weeks).
Testicle size reduced (noticed at 9 weeks and still continuing).
Nipple pain (11 weeks), and breast bud growth (12 weeks) - both completely reversed by tamoxifen (at 25 weeks - could have been much faster if I'd understood tamoxifen dosing better at the time).
Body odor gone (noticed at 13 weeks but could have happened earlier - it wasn't a side effect I knew about beforehand).
Thinning of body hair (13 weeks, and continuing).
Fragile fingernails (30 weeks, fixed by hand and nail moisturiser).

Things that haven't hit me (yet):
No Hot flushes.
No Weight gain (although I might be starting to see it, but too early to be sure).
No erection problems or loss of size (I took the "use it or lose it" advice very much to heart from the start, although it's surprisingly difficult with no libido).
No fatigue (beyond what I'd expect from increasing my exercise level substantially).
No memory problems (at least, not that I can remember).

No idea about loss of calcium. My exercise is cycling, which is not the best choice for bone strength, but miles better than nothing. I bought a pull-up bar which I used for a couple of months, and then pulled a tendon, which is still painful some months later, so that's on hold. I self-medicate with one AdCal-D3 tablet per day, which is half the RDA for calcium and vitamin D3, this taken before exercise.

Muscle - I managed to put some on during first 6 months, but struggling to maintain that recently and might be going in the opposite direction now, but too soon to know yet.

Edited by member 03 Jun 2019 at 13:02  | Reason: Add another side effect

User
Posted 10 May 2019 at 13:34

Originally Posted by: Online Community Member

Originally Posted by: Online Community Member
Par for the course in our "wonderful" NHS

The NHS IS wonderful, and without it, most of us would be dead - or dead broke. Or both.

Sure, it isn't perfect, but whingeing about minor cock-ups - when all the NHS staff are under terrible pressure, with loads of unfilled vacancies, not to mention most haven't had a decent pay rise in 15 years.

We are all perfectly capable of booking follow-up appointments with the specialist nurses if we feel we need them; or popping in to see our GP at any time.

Personally, I'd rather free the NHS staff up to deal with bigger problems than mine, for as long as I can.

I don't defend poor communication in the NHS, but in most cases, a bit of initiative, self help and common sense are all you need.

Cancer is a horrible thing to have. It's easy to feel angry about it, and the injustice of it. But looking around for someone to blame is not the answer; because it ain't their fault. It's no-one's fault.

Sorry but it IS the NHS that is at fault, this doesn't mean it should be replaced, but it does mean it needs fixing.

You are wrong about pay too, in the old days there was one scale for each profession and everyone knew what it was and how much people got paid. Now you have locums earning a small fortune (nurses too, a quote from a locum nurse I overheard while he was chatting on a night shift was 1200 quid for 1 weekend!). GpS who are incentivised to retire early and no longer have patients - just appointments. Well assuming you can get past the "highly trained receptionist" and the triage nurse, oh and of course you have to ring dead on 8am or all the spots are gone, oh and you can't book anything but on the day!!

 

User
Posted 10 May 2019 at 23:23

The simple answer to this is that the NHS is understaffed and underfunded and in places poorly organized. It does pretty well with what it has and the pressure it is under. It does not compare well with healthcare of some other leading European Countries where they have a far better doctor to patient ratio and provide a better service, consequently, you don't have such long waits for appointments/treatments/results and often better/newer equipment overall. I can confirm this from my treatment and follow ups in Germany and good reports have also come from France and Italy among others, The fact of the matter is that for too long we have not incentivized, sufficient numbers to join the medical profession and provided reasonable working conditions and pay to retain them. In order to get by we have relied too much on employing staff that have already been trained by other countries. We are now at crisis point and indeed more places are being made available in the UK to train would be doctors. The problem is particularly acute at GP level where many are overworked and are retiring early or moving elsewhere. My previous GP was a case in point. He left a very busy practice in Devon to serve in a less pressurized environment serving a very small community in Scotland. It will be a slow process to raise the level of service provided throughout  the NHS where the service can fluctuate considerably but with a growing and ageing population this has assumed even greater importance. Meanwhile, it is incumbent on us to be proactive about our health concerns and monitoring.

Edited by member 11 May 2019 at 02:29  | Reason: Not specified

Barry
User
Posted 10 May 2019 at 23:27

Think it’s the nhs in general my husband had prostate removed March 20th catheter out 27 March no one has been in contact and he’s in agony wen weeing he’s  seen his own doctor 4 times in last 2 weeks with problems he’s having he should of gone back to see consultant on 6 week for biopsie results I eventually got hold of specialist nurse today she said appointment is in the pipeline I think once they get you on the books for treatment they get paid for it and after that they don’t really give a s*** your just a number 

User
Posted 11 May 2019 at 01:59

Well, I've been impressed with the NHS so far. When I asked for an extra consultant appointment because I had more questions, they fitted it in that week. Macmillan nurses have seen me a couple of times walking in with no appointment.

Various of the diagnostic tests took a while (8 weeks for template biopsy, nearly 3 months for a PET scan which didn't happen and became a full body MRI instead), and then the 3 week wait for results each time. I was seen and initially diagnosed very quickly though - that's a target they do meet.

User
Posted 11 May 2019 at 09:56

Looking back at Andy62’s list of side effects, I have to say that as a man in his late 40’s on HT, I think it’s a very accurate list.  I had a RP, so my erection and ejaculation issues were already present when I started HT.  I experience nearly all of the other side effects.  There may be some men who don’t experience the side effects, but, in my experience, they are not to be underestimated.  To me, HT is a necessary but very unpleasant treatment and I can’t wait to come off it in August.

Ulsterman

User
Posted 11 May 2019 at 10:55

I don't think the NHS is underfunded and anyway its a bottomless pit and no amount of money can fix the inefficiency and chaotic way it is being run at the moment..

I do believe it's time that FREE treatment for all should end and to introduce gradually a more efficient and professional service that can't easily be used and abused like it is at the moment.

How many people are prescribed drugs they don't want or won't use I know of dozens of people who end up taking bags full of unused drugs back to the pharmacy.

I also have a gastro health condition which was recently diagnosed and needed to arrange an appointment after several phone calls and  4 separate letters sent by the NHS I was given the appointment I had discussed in my first call.

On a more serious side my 53 year old sister was told she had cervical cancer back in January and had to undergo major surgery and deal psychologically with the news of her cancer.

Astonishingly a couple of months later at a follow up consultation she was given the shocking news that she didn't actually have cancer and she was signed off with no explantation to how this was possible.

Mistakes due to inefficiency and slap dash procedures are what's killing the NHS.

 

 

 

 

User
Posted 12 May 2019 at 05:43
Alan,

Of course the NHS is understaffed and underfunded!! There are many examples one could give of this and indeed you gave one in your post of 10th May at 10:20. You complained about the difficulty of getting an appointment with your GP. The appointment system you referred to (which is very similar to my present surgery), has been adopted because the GP's are struggling to cope with the work load, so much so that they are even resorting in many cases to using reception staff at triage medics to help determine priorities and where appropriate to decide whether a telephone appointment would suffice rather than an a surgery one. And when you can't get through to reception there is a recorded message saying that if you believe your problem could be urgent you should call 111 or go to A&E immediately, where you will doubtless be triaged and experience a wait because the doctors there are so permanently overloaded. Then if you are in a pretty bad way you might might have to be held temporarily on a trolley or unsuitable area until a bed becomes available because unlike some countries where they have beds waiting for patients, in the UK there are often patients waiting for beds. This means somebody has to regularly check with other hospitals on whether a bed has become available. Despite the Government endeavoring to eliminate mixed sex wards they still exist due to pressure of numbers requiring admission and for other reasons. Then it's come to the stage where notices have to be put up in surgeries and hospitals because staff are being subjected to abuse from people who are intoxicated or affected by drugs or disgruntled. Police had to be called twice to my ward during a 9 day stay I had in hospital. Not surprising in the circumstances that moral is low also not helped by pay restraint,

As in any major organization there are going to be mistakes and sometimes things that could be better organized, although thankfully much greater effort is made presently to ensure patients are getting the right treatment and operations. I disagree with you about a lowering of standards and qualification of nurses. In fact they are more highly trained and skilled nowadays and have taken on more responsibilities and some that were previously undertaken by doctors. More training places, better pay and conditions would assuredly lead to higher standards but these are not presently low. I am not surprised that you experienced a more congenial and polite experience in a private hospital where they are undoubtedly better resourced numerically and enjoyed a less pressurized environment. Of course staff are going to be attracted away to private hospitals where they have better pay and conditions or as many do become agency staff serving the NHS where they are better paid for doing the same job. Provide better pay and conditions and not only could more existing staff within the NHS be retained but others be attracted into the profession if given the opportunity. As the saying goes, 'You get what you pay for', or are prepared to pay for be it private or state run.

I don't profess to have an intimate knowledge of the NHS but my wife's sister was a nurse and we have a GP in the family and also a nurse in my discussion group who has enlightened us on the current situation. I have also had a lot of medical problems for which I have been treated within the NHS and privately, so I know something of it and can make comparisons with treatment I have had in several countries abroad, both civilian and military. I reiterate, the NHS is too understaffed and underfunded to do deal well with it's ever increasing work load.

Barry
User
Posted 12 May 2019 at 08:03

Sorry but disagree, go to any NHS establishment and you are overwhelmed by the numbers of staff members and not all of them being utilised to their full potential.

We have so called qualified nurses who can't give injections properly or fit a cannula with confidence my own experiences.

If you are lucky enough to be offered an appointment at the GP surgery you can't help but notice that there seems to be very few patients in comparison to the doctor's available and most attending with minor ailments.

In a nutshell the NHS is a victim of its own success and nothing can be solved by throwing more money into the bottomless pit or employing more underutilized staff.

Stop prescribing drugs in the huge amounts currently being prescribed. Use staff more efficiently and ensure that they are up to the job and update current dated systems and procedures.

I also have friends and family working in the NHS and don't see them struggling financially in fact just the opposite with top of the range cars and large detached houses being purchased.

Finally there is a politically motivated group in the NHS who have strong union and left wing connections and influence the way some decisions are made and they are stopping the necessary modernisation of our NHS by being too PC or terrified of changing the current status quo which suits there political needs.

 

 

Edited by member 12 May 2019 at 08:15  | Reason: Not specified

User
Posted 12 May 2019 at 22:55

Alan, you say ".. go to any NHS establishment and you are overwhelmed by the numbers of staff members and not all of them being used to their full potential." Demonstrably untrue because you haven't been to every establishment and I could take you to many where this is not the case. So don't try to justify your assertions by uninformed assumptions. I suggest you learn some of the facts as for example we have almost the worst Doctor to Patient ratio in Europe. Suggest you read this and other reports on the NHS to educate yourself on the subject - http://www.pulsetoday.co.uk/news/gp-topics/employment/uk-has-fewest-doctors-per-1000-patients-in-eu-finds-think-tank/20036765.article

In my area, as in many others, the GP numbers have not kept pace with the growing population and when on occasion my GP has phoned me he has apologized for the lateness due to the considerable number of calls he has had to make (and he is working beyond his normal hours.) But even the non medical staff are struggling to keep up.  Last week I received the written report from UCLH about a procedure I had in December last.

Some of the nurses struggle as coming from abroad they are not familiar with the ways of the NHS and English is not their first language. There was one such young Italian nurse on my ward who was rather at a loss but this makes my point that they are here because we are desperately short of nurses and some of them were working well after their shifts without overtime pay, as I learned first hand. We have a growing and ageing population who are expected to be cared for and the medical profession are using more advanced equipment and systems and sometimes experiencing serious abuse. Some consultants and senior administrators may not be severely affected but most of of the staff are and pay increases have been restricted so that many are worse off than they were several years ago. In these circumstances it's not surprising that they wish to address this through unions as well as the fact that they want to avoid a worsening situation for patients.  And overstretched staff being expected to keep tabs on patients not needing monitoring between appointments would add further to the work load and cost.

I am not going to comment further on this because it would clearly take too long to convince you how wrong you are other than in regard to the over issue of drugs, something that is being addressed in the NHS and elsewhere.

Edited by member 13 May 2019 at 09:50  | Reason: Not specified

Barry
User
Posted 13 May 2019 at 08:12
It seems Alan’s biggest problem is that his GP refuses to arrange prior appointments, even with the nurse and even if that is to administer a time-critical injection. Since GP practices are private companies and most GPs are self employed, it seems pointless arguing about or blaming the NHS.

If the private company cannot deliver what your prescription specifies, complain to the practice manager and then to CQC, in writing.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 May 2019 at 10:24

No your right I haven't been to every medical establishment in the country that would not be possible so I base my assumptions on what I have personally experienced.

There are extremes in the system from a rural practice with few patients to city based practices who are dealing with high populations and localised social problems.

Why do we have so many more foreign workers now in the NHS it's because the people born and trained in the UK are disillusioned and fed up with the poor management and obvious wastage in the NHS and moved on most reluctantly to bigger and better things.

With some current NHS staff unable to understand or speak English as you stated the situation can only get worse with more mistakes and an increase in medical claims against the NHS which are at a all time high.

The NHS as we know it needs major surgery immediately or it will implode on its self with disastrous consequences for the country.

User
Posted 13 May 2019 at 10:48

Well that's news to me that my GP practice could a private company and if that's the case why don't I know, I have never been informed or seen anything to suggest the are not NHS run.

The communication issues between the medical agencies certainly include the NHS who constantly make mistakes when contacting the practice such as addressing letters to a non existent Doctor who left the practice several years ago despite me supplying up to date information twice.

The injection situation was extremely frustrating but my wife and I sorted it out but I have lost confidence in the NHS and dread what I may experience in the coming months.

The cancer I have I can deal with it but it's the system that is really the problem and I have considered coming off the treatment and let nature take its course.

 

User
Posted 13 May 2019 at 10:54
GPs are not employed by the NHS - they are either self-employed or are partners in the private company that is known as your GP practice. Some GP practices also put together tenders to provide some NHS services but at a profit - e.g. physiotherapy, holiday jabs, urology services (in the South West, anyway).

I thought everyone knew that. You can probably find your GP’s financial accounts on their website or at Companies House.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 May 2019 at 12:03

I think you will find that most people  don't know that GP practices are run privately but understand them to be under the NHS.

I not having a go at the NHS per se but more the various trust's management teams who wouldn't last two minutes if they had to run a profitable business in the real world.

I understand people defending the NHS especially if they are part of it or politically motivated and still think it's possible to offer FREE care from birth to the grave for everyone in a ever changing country like the UK.

Edited by member 13 May 2019 at 12:07  | Reason: Not specified

 
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