So – last Tuesday my wife had a recurrence of sinusitis meaning very painful (ie hardly able to move her head) sinuses, eyes and head in general and she was going to leave it till today to see her GP but I insisted she went to the emergency GP at the hospital on Saturday morning as it had become even more painful.

She explained what was wrong and explained that the last time this happened she was prescribed anti-biotics.

The doctor took a quick look and said she was fine and her tonsils weren’t inflamed. My wife had her tonsils removed as a child. Eventually the doctor asked for a second opinion and eventually they told my wife to take an over-the-counter inhaler. They also suggested she drink more fluids as ‘the fluid will make the mucus more runny’. Now that sounds like a HUGE crock to me and anyway my wife is a serial water drinker, getting through pints a day as it is.

What they DID do, though, was write a prescription for the over-the-counter medicine in case she couldn’t buy it (I assume because if they had run out on the shelves, they could then give her the ‘prescribed’ identical version). Only the doctor couldn’t work out how to write a prescription using the computer (how is this if he is the duty GP in a hospital)? Eventually he had to get help to show him how to do it.

SO this morning, with no improvement at all, she went to her own GP and he immediately prescribed a double-length course of anti-biotics as the condition had come back with a vengeance. He also said if this prescription didn’t cure the problem, my wife would need to go on a permanent inhaler.

Useless – what IS the point of having a service when the doctors manning it don’t know either their job or the procedures they need to employ?

Did you notice whether the nurses were fat ?

Am currently in hospital waiting for some stuff for my ears. I have seen two consultants, several nurses and had a number of hearing tests. I may have to have grommets installed in 9 months time.

Stirling service for me; goodness knows what’s going to happen once we turn into the US style of healthcare that the government is currently proposing.

I didn’t because I wasn’t there.

I’ll ask…

how is this if he is the duty GP in a hospital

Probably a locum and never been to that hospital before.

Don’t get me wrong – I know the service can be amazing (seen it with my mum’s recent operation and subsequent care and with my children in special care).

But to have people who simply cannot do their job (and can’t even identify whether or not a patient has tonsils) is rantworthy.

I didnt know that you got GPs in a hospital.

Whenever I’ve needed the nhs for serious, life threatening stuff they have been outstanding.

So, your rant is about a hospital (singular) rather than your general experience of hospitals (plural)?

While slow, I’ve never had issue with the level of care I’ve had at a number of hospitals around Edinburgh.

Oh, and maybe you had one of these guys:
http://www.bbc.co.uk/iplayer/episode/b00zh82t/Junior_Doctors_Your_Life_in_Their_Hands_Episode_4/

goodness knows what’s going to happen once we turn into the US style of healthcare that the government is currently proposing.

Ummm… It will get better?

And people want to protect the NHS budget so this kind of ineptitude can continue?!

And before I get flamed I’m a big fan of the NHS, just not the levels of waste and non accountability we see across large parts of public service.

And people want to protect the NHS budget so this kind of ineptitude can continue?!

Not sure how you think a change of how the NHS is budgeted will get rid of those that make mistakes.

So, your rant is about a hospital (singular) rather than your general experience of hospitals (plural)?

It is, that is correct.

Well actually it isn’t, there was the time before Christmas when one of our daughters had a bacterial infection that developed into pneumonia and spent two nights in hospital but the emergency out-of-hours GP wouldn’t prescribe anti-biotics for her twin even though she subsequently displayed identical symptoms. On that occasion we insisted on a second opinion in order to get the anti-biotics and our insistence was applauded by our GP at a subsequent follow-up appointment.

Ummm… It will get better?

Your proof for that being? Certainly not if we turn into a mini US. Rich get all the benefits, the poor get asked for their credit cards or don’t get treated. Or don’t go to their GPs because it would cost too much.

Sounds like a locum to me. While I think it’s a great idea that some A&Es have introduced GPs as gatekeepers so that services don’t clog up, there is no point in doing it if they can’t diagnose. The arrangements differ from trust to trust though, so as ever it’s dangerous to make sweeping generalisations. Unfortunately it is often very difficult to persuade experienced GPs in local practice to cover services like this.

bol – I am entirely sure that is the case and it has left me very angry as my wife could be on the road to recovery yet she has only just got the diagnosis confirmed that she tried to tell the GP about on Saturday.

Part of me wonders whether they have targets for spend on prescriptions too.

And – is there any sense in the suggestion she drinks more fluids to ‘dilute’ the mucus which may be causing some of the pain?

@adamw

Real competition coupled with complete information leads to better, more efficent, more customer centred services.

If you want ‘society’ to pay for it, fine, have the government finance insurance coverage.

Prescribing antibiotics is not always the answer. Some doctors do it just because they have patients demanding them and it makes their life easy.

Having said that in your case sounds like the first GP was incompetent no noticing that the tonsils weren’t even there.

jonb – I do agree but, given the history of the complaint, we knew anti-biotics got rid of it last time and reasonable assumption would be that they would do so again. On both occasions she left it for a few days (just taking Sudafed and painkillers) in the hope it would get better and on each occasion it didn’t work.

I didnt know that you got GPs in a hospital.

In Harrogate it is done as a central service for all out-of-hours cases – you ring your GP and tell the operator your problem, they decide whether a GP should call you back or you should MTFU. If the GP rings you back you are either told to MTFU or asked to go in to the hospital to see them.

Ohh, and the GP on the phone said he’d write a prescription for anti-biotics if my wife was happy for that, but said he was suitable concerned that he felt she should actually go down to the hospital to have it checked out! Then she got that service! Mad.

My GP mentioned my sinusitis, could be down to fungi!

All I could think of for the next week was, Ive got fungus growing in my head!

😯

He did say, if it was fungal, anti-biotics were no good for treating it & warned against the nasial sprays as they could make it worse in the long run too!

Mine cleared up after using the old fashioned bowl of steaming water three times a day for two weeks!

How do you know that it was the ABx that improved her condition? And not the natural course of the disease which resulted in her getting better?

Mastiles – You titled the thread incorrectly its actually Out of hours GP Service. The fact that it is in the hospital is just coincidental.

Does sound like your wife saw a locum, but if your questioning his clinical ability then maybe you should take it up as a complaint, not just a moan on an internet forum?

Also if your wife has a recurring problem, has she spoken to her GP about getting an ENT referral?

No idea whether water makes any difference – I’m a faceless NHS beurocrat, not a clinician. I doubt they’ve got targets re prescriptions – other than to try and keep as much of a lid on them as possible.

@theyeye: good luck with that. Personally I think it could be a disaster. The easily defined, stand-alone procedures will get cherry-picked and there will be little or no competition for the more complex stuff – just less resource. Even the GPs can see that all they’ll end up doing it rationing services. You’ll notice that no-one in government refers to postcode lottery any more…

Mastiles – You titled the thread incorrectly its actually Out of hours GP Service. The fact that it is in the hospital is just coincidental.

Does sound like your wife saw a locum, but if your questioning his clinical ability then maybe you should take it up as a complaint, not just a moan on an internet forum?

Also if your wife has a recurring problem, has she spoken to her GP about getting an ENT referral?
1 – fair enough

2 – I suggested this and she can’t face doing it although I feel it is worth telling them about

3 – Her normal GP is nor monitoring it (after she saw him this morning) and recognises it may be part of an ongoing developing problem

How do you know that it was the ABx that improved her condition? And not the natural course of the disease which resulted in her getting better

We don’t, but they helped last time and this time (after a full seven days with a progressively worsening condition) she has realised that what she is taking isn’t having an effect yet.

And she is doing the bowls of steaming water daily too (with Albas Oil).

@adamw
Real competition coupled with complete information leads to better, more efficent, more customer centred services.
If you want ‘society’ to pay for it, fine, have the government finance insurance coverage.

Utter rubbish. Competition causes the easiest cases to be cherry picked, allowing remaining hard stuff to dropped back into then-underfunded NHS, including where the private gods of medicine screw up. Result: everyone ends up having to take insurance or not get treated. The US is a perfect example of how awful it can be.

Last time I took my wife to hospital was for an appointment at the GP Assessment Unit… arrived, confirmed we were expected (i.e. had an actual appointment)… and finally got home a brief 5 hours later… if that’s how long they take when they’re expecting you heaven only knows what happens if you pay a surprise visit… saw 3 different nurses/doctors who each asked exactly the same questions & wrote down our exactly-the-same answers each time – what value does that add to anything? – I suppose at least they’ve got the paperwork in triplicate… maybe in a weird and twisted way I’m supposed to be grateful for being able to use what my tax/NI has been pumped into all these years for 5 whole hours, rather than the meagre 20 minutes it could have taken…

And then it dawned on me.

Problems experienced with the Health ‘Service’ in the UK make perfect sense once you learn to understand it’s not really a service & patients are just a pain-in-the-butt inconvenience.

Set your expectations low enough & the NHS is just an extenstion of whatever it was that injured you or made you sick in the first place.

she has realised that what she is taking isn’t having an effect yet.

Is that the ones she started today?

Problems experienced with the Health ‘Service’ in the UK make perfect sense once you learn to understand it’s not really a service & patients are just a pain-in-the-butt inconvenience

Really? I guess I shouldn’t be in the NHS then.

she has realised that what she is taking isn’t having an effect yet.
Is that the ones she started today?

Sorry I made a mess of explaining that – what I meant that the combination of things she has been taking since last Tuesday (steam baths, painkillers, decongestants, inhalers etc) haven’t helped and she is in more pain today than she was 7 days ago. Obviously she isn’t expecting the anti-biotics she got this morning to be working yet.

Have had similarly ropey service from out-of-hours GP service on a couple of occasions. I suspect their reliance on locum GPs to staff it do have some impact on the quality of service (which is not to say all locum GPs are rubbish).

joao3v16 – that was a rather poor attempt at a troll, right?

Or are you really that much of a tosser?

I think I know Woody.

5 hours, that’s good going must be a quiet hospital it was taking a over 40 mins for us to hand over an emergency case on Friday. Partly because of the people wasting hospital’s time with things that could have waited or arranged Out of hours visit for. But no they can’t wait at home for up to 4 hours for visit but they’ll happily sit in a waiting room for 5 hours or more.

Problems experienced with the Health ‘Service’ in the UK make perfect sense once you learn to understand it’s not really a service & patients are just a pain-in-the-butt inconvenience.

Set your expectations low enough & the NHS is just an extenstion of whatever it was that injured you or made you sick in the first place.

OK, I’ll bite. I’ve read some crap on STW over the years, but this is currently winning the “so depressingly ill-informed it hurts award for ignorance”. Sure, there may be places where patients aren’t given the respect, choice or quality of care that they ought, but I don’t think I have met many people in the NHS – even the not particularly effective ones – who aren’t motivated by wanting to make people’s lives better.

Drac – does your PCT do home visits?

Pfff, 5 hours is nothing. I went into the acute admissions and receiving unit at my local hospital on Monday at 2:30pm, and was finally discharged on Friday at 1:00pm. And they’re none-the-wiser as to what’s wrong with me.

Drac – does your PCT do home visits?

Well they’re supposed to but they usually just ring 999.

Drac – they don’t in Harrogate – that is long-since gone unless you have special circumstances such as my mum when she was recovering from her cancer operation when they came out to do some monitoring.

To be honest I didn’t think anyone did home visits at all any more and was surprised when my mum told me they had with her.

Not sure how you think a change of how the NHS is budgeted will get rid of those that make mistakes.

If budgets are better managed then there’d be more accountability, if somebody wasn’t doing their job properly they’d be let go. If you employed somebody that couldn’t do the job, what would you do with them? Keep paying them a wage out of your own pocket while your business lost money/customers or find someone that could do the job?

We pay for this service so I think we’re entitled to expect a good service. The not knowing how to fill a prescription part of the above you can understand if it’s a locum, but if a doctor can’t even see that your tonsils aren’t there what the hell else are they missing?

If you employed somebody that couldn’t do the job, what would you do with them?

I know what I did/do and I work in the NHS, so would you like to try again?

if a doctor can’t even see that your tonsils aren’t there what the hell else are they missing?

Agree but if it’s not reported then their employer won’t know about it.

Yeah MF it varies area to area not all NHS areas have Out of Hours visits.

but if a doctor can’t even see that your tonsils aren’t there what the hell else are they missing

Is a very good point.

He didn’t even feel around her sinuses – just took her temperature, listened to her chest and looked in her throat. Which all seemed odd when she was complaining of sinus problems around her eyes.

And still – can anyone shed any light on this ‘water will make mucus runny’ suggestion by the GP?