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Something that we can all do to help reduce pressure on the system is to make sure that we have enough training to self fix ourselves, our buddies and any incidental problems that we encounter. Knowing that the injured may be waiting some time for help means that carrying some simple environmentals should be a no-brainer; a spare layer, a sit mat and at least two foil blankets should be in your pack at all times. It might be you sat on the ground for hours with a collar bone fracture; you might be first on scene when a pensioner falls in the street.
We can mitigate some of the impact we have in engaging in our (slightly) risky activities through first aid training and self treating where suitable. Our lifestyle choices can make an impact on the actual day when we get hurt but overall, these same choices lead to us having healthier lives with much less need for medical support over a lifetime.
An extension of that same mitigation- For a lot of years, this has been one of our key objectives in setting up and providing medical cover at Scottish ultra marathons. Building up the event structure and resourcing in such a way as to minimise potential impact on the health service, treating the vast majority of our casualties and illnesses at the event instead of having to ship them out. Normally, we'll be able to for example clean and suture wounds there and then, so that's one less person waiting for hours in a Q at A&E on a Saturday night. On scene blood analysis allows for differential diagnosis, exclusion of serious illness and recovery in our remote care setting. Still learning though..
a sit mat and at least two foil blankets should be in your pack at all times. It might be you sat on the ground for hours with a collar bone fracture;
With a collar bone fracture you walk out not wait for assistance FFS
Foil blankets are pretty useless
TJ, you know me; I've walked folk out in that (and worse) situations on several occasions. But many people will not cope with that pain level and will sit down. Foil blankets are far from useless; a bothy shelter, lots of clothes, a heat blanket and a rescue team are all better but we're trying to educate here, not criticise.
Fair enough.
Nonsense shows how ;little you know about the health service. Most staff work well above and beyond the call and their job description
Many do I agree
The conversation I had with the nurse when I asked him the umpteenth time when am I am going as I was bed blocking is that it made no difference to him as someone else would then be in it.....
My experience of maternity services doesn't make me surprised at the scandals emerging
The treatment of ambulance staff managing a late night transfer akin to entering an American prison
If we continue to pedal the myth of a NHS full of saints we will never fix the organisational culture issues
The NHS can be great, world leading, but it also has problems, some are funding, some are organisational culture
And again - you show your ignorance and lack of understanding of how things work.
He has a point tbh, some of the practices and cultures my mrs tells me about really gets your goat, not everyone is trying their best, right through the pay grades.
of course not. But to say its organisational culture them blame the shop floor staff is wrong and blaming individuals for burnout that leads them to be cynical is also wrong - as is as B&D did continually asking the same questions for something that is not in the nurses power to do anything about but to continue to waste their time then is surprised when he gets a snippy answer
With a collar bone fracture you walk out not wait for assistance FFS
Foil blankets are pretty useless
I've told this story before, but I was up on a Peak ridge when a rider coming the other way went OTB quite fast. She'd clearly knackered her shoulder and was bashed about and in no mood for walking off a hill with a painful dislocated shoulder. What was a lovely breezy sunny day (we were only wearing T-shirt and shorts) quickly became quite cold after we stopped riding. I guess we waited for about an hour, she was cold shivery and blue after about 10 minutes. Fortunately, some passing walkers had some sleeping bags and a bothy bag to keep her warm.
Nowadays, a foil blanket is the only concession to first aid that I carry (Because race bike).
Superficial
Free Member
With a collar bone fracture you walk out not wait for assistance FFSFoil blankets are pretty useless
I’ve told this story before, but I was up on a Peak ridge when a rider coming the other way went OTB quite fast. She’d clearly knackered her shoulder and was bashed about and in no mood for walking off a hill with a painful dislocated shoulder. What was a lovely breezy sunny day (we were only wearing T-shirt and shorts) quickly became quite cold after we stopped riding. I guess we waited for about an hour, she was cold shivery and blue after about 10 minutes. Fortunately, some passing walkers had some sleeping bags and a bothy bag to keep her warm.
Nowadays, a foil blanket is the only concession to first aid that I carry (Because race bike).
As stated earlier, if practical, get them down the hill, depending on how many are there it's a simple case of immobilising the shoulder, getting others to carry the kit and slowly descending, or getting to a pick up point where someone can then drive too.
Staying static isn't helping anyone with this type of injury, just letting them get cold, possibly going into shock and so on.
https://www.nuffieldtrust.org.uk/news-item/70-years-of-nhs-spending#then-and-now
Nuffield Trust clearly shows that:
97 - 2010 investment in the NHS increasing
2010 onwards investment in the NHS decreasing
I wonder what happened
B&D did continually asking the same questions for something that is not in the nurses power to do anything about but to continue to waste their time then is surprised when he gets a snippy answer
Except there was, they checked why I was still there, turns out a new junior Dr had failed to finish issuing the prescription, hence no drugs to go home with. He sorted this eventually, then sent trainee nurse to get them as it was that late.
Why the ward manager wasn't more interested in why I was still there than the nursing staff socks is the issue. I could have been kept in for an additional night for absolutely no reason if I hadn't been a pain.
Organisational culture is about every level, not just the nurse at the coal face.
Organisational culture is about every level, not just the nurse at the coal face.
Absolutely this 👆
BUT organisational culture doesn't just appear, it's a product of training and leadership which both rely on appropriate levels of investment.
Organisational culture is about every level, not just the nurse at the coal face.
yes - and who has set it up to fail deliberately - the tories
You are confusing cause and effect here just as the tories want you to do so
the cause is lack of investment, training and bad reoganisations - plus burnt out over worked staff
You are being taken in by the tories
Nuffield Trust clearly shows that:
97 – 2010 investment in the NHS increasing
2010 onwards investment in the NHS decreasing
I wonder what happened
BUT organisational culture doesn’t just appear, it’s a product of training and leadership which both rely on appropriate levels of investment.
Nope, organisational culture isn't just determined by money
It's not even the training, it's the "way we do things around here" that's why every institution and the separate departments will have distinct cultures
Leadership can change it but it takes a lot of effort
If it was just investment the scandals that happened during the peak of cash wouldn't have happened. But they did. Not everywhere and some parts are world class. Blaming the change in investment is ignoring the reality that many were baked in before when cash wasn't an issue.
I’ve told this story before, but I was up on a Peak ridge when a rider coming the other way went OTB quite fast. She’d clearly knackered her shoulder and was bashed about and in no mood for walking off a hill with a painful dislocated shoulder. What was a lovely breezy sunny day (we were only wearing T-shirt and shorts) quickly became quite cold after we stopped riding. I guess we waited for about an hour, she was cold shivery and blue after about 10 minutes. Fortunately, some passing walkers had some sleeping bags and a bothy bag to keep her warm.
Nowadays, a foil blanket is the only concession to first aid that I carry (Because race bike).
There's an argument that neither she, nor you, were particularly prepared for a foreseeable circumstance. Unless you are racing at the time (when there are marshalls to help in a crash) is it actually reasonable to go in the hills with just a foil blanket for protection? possibly not even if the ambulance service wasn't stretched - you'd still have a long wait for a MR team to assemble or an ambulance crew to get to you. Look at what MTB trail leaders get forced to lug around with them and then ask yourself why? I don't go as far as that - but proper mountain biking I carry a bothy bag (better than foil), and have enough skills and simple kit to improvise a sling etc.
I noted that this weekend the MR team had three different shouts at Glentress on one day all of which resulted in an ambulance as well as the team being mobilised. Perhaps that is just the nature of randomness, but if MTB is putting those sort of demands on services its probably time to think about how we minimise our impact - perhaps that will mean some sort of charges and rangers who can assist like ski patrols for those who aren't brave/equipped enough to go off piste?
Blaming the change in investment is ignoring the reality that many were baked in before when cash wasn’t an issue.
Posted 39 minutes ago
pre 1974 then? thats the last time the NHS had enough money to do what it was supposed to do. so this culture you are complaining about ( that is a figment of your imagination) has lasted thru how many tory reoganisations and massive cuts in activity.
“way we do things around here"
total figment of your imagination. Never seen that in 40 years of working in healthcare.
If it was just investment the scandals that happened during the peak of cash
Again a total lack of understanding - the boost under Blair repaired some of the damage done and increased the sciope of activity but never brought funding up to where it is needed. thousands of pounds less that most of europe per head of population, less than half of the US
There’s an argument that neither she, nor you, were particularly prepared for a foreseeable circumstance. Unless you are racing at the time (when there are marshalls to help in a crash) is it actually reasonable to go in the hills with just a foil blanket for protection? possibly not even if the ambulance service wasn’t stretched – you’d still have a long wait for a MR team to assemble or an ambulance crew to get to you.
Worth posting this again?
http://testedtodestruction.blogspot.com/2020/02/go-outside-sit-down-wait.html
total figment of your imagination. Never seen that in 40 years of working in healthcare.
TJ - are you really saying that in 40 years in the NHS you never once came across a department or an individual who did something in a really inefficient way just because that's the process that's always been in place? Because I find that truly remarkable. I've never once gone to an organisation and found everything they did was logical or optimal. Clearly there are stories of the complete opposite - people or departments who go out of their way to do things better/smarter and I don't think anyone with the "that's the way it works" mantra is doing it vindictively, a few might be doing it to protect their own job but most probably just have no practical mechanism to introduce change, or as I said much earlier the change requires cooperation outside their own department which then means there's budgets and empires and politics involved. B_n_D's point is initiating change from the front line is very difficult, but with the right leadership at the top is possible. How you could do that with the recent series of Health Secretaries at the very top is problematic... The same challenges face education, policing etc - how can a leader at the top foster change if they aren't trusted by the boots on the ground?
No - what I am saying is that what B&D claimed is not true.
Of course there are occasional instances but his idea of a unchangable culture of " thats the way we do things here" is nonsense
In my time in the NHS I have seen massive changes in practice always evidence based. You used to see more of the " thats the way we do things here" decades ago than you do now - simply because its all about "evidence based practice" now. Most of the innefficiences I have seen are direct results of tory dogma.
I cannot think of a single example of innefficiences because of " thats the way we do things here" for decades apart from when these inneficiences are imposed top down
Its been really difficult to make improvements because tory dogma hamstrings too many folk
B&D is just parroting tory anti NHS propaganda
There’s an argument that neither she, nor you, were particularly prepared for a foreseeable circumstance. Unless you are racing at the time (when there are marshalls to help in a crash) is it actually reasonable to go in the hills with just a foil blanket for protection? possibly not even if the ambulance service wasn’t stretched – you’d still have a long wait for a MR team to assemble or an ambulance crew to get to you. Look at what MTB trail leaders get forced to lug around with them and then ask yourself why? I don’t go as far as that – but proper mountain biking I carry a bothy bag (better than foil), and have enough skills and simple kit to improvise a sling etc.
Yeah, that's probably fair. I guess in the Peak I never feel that remote. Nowhere is that far from civilisation so I felt safe. Whereas that experience highlighted that somewhere that's not particularly remote can be hazardous to an immovable person in less-than-perfect weather. FWIW the crashee was doing some orienteering event so didn't know the Peak at all, and there was not a marshall in sight. I don't know if she had anything useful with her - she was dazed and too distressed to think straight.
If I go for a big ride I'll take a bag with extra layers. I'm not a trail leader though - I'm not responsible for anyone else. I often ride with a friend who is in the local MRT and he doesn't seem to take any more than me 🤷♂️
Nope, organisational culture isn’t just determined by money
It’s not even the training, it’s the “way we do things around here” that’s why every institution and the separate departments will have distinct cultures
Leadership can change it but it takes a lot of effort
If it was just investment the scandals that happened during the peak of cash wouldn’t have happened. But they did. Not everywhere and some parts are world class. Blaming the change in investment is ignoring the reality that many were baked in before when cash wasn’t an issue.
You've got this half right, but the bit you are failing to acknowledge is that without spending appropriate levels of money (investment), you can't deliver the training and attract the leaders necessary to make the cultural changes needed.
Its not labour to blame – the NHS improved hugely under the last labourr government even tho money was wasted on PFI.
TJ it is totally disingenuous to blame everything on the Tories and absolve all other political parties of any responsibility, even though it is clearly the fashionable thing to do on stw these days.
You can't be so dismissive of Labour's role. They didn't simply waste money on PFI, they left a lasting legacy. Today the NHS has to spend billions paying off debts to profit hungry investors, instead of patient care, because of the decisions made by a Labour government. This contributes significantly to the current NHS funding crises.
2010 onwards investment in the NHS decreasing
I wonder what happened
Among the many things that happened austerity champions, Vince Cable and Danny Alexander, took centre stage. Unable to resist the temptation to score cheap political points and blame the previous Labour government for the international credit crisis, and the inevitable deficit the worse global financial crises since the 1930s caused, they enthusiastically embarked on an austerity programme.
Not only was the NHS directly affected in 2010-15 but it was also massively affected indirectly due to cuts in welfare and local government spending. The collateral damage left in the wake of the coalition government's austerity drive was huge, invariably the NHS was required to pick up the causalities.
As it said previously, the we have only had 4 years of Tory majority government in the last 24 years, it is frankly ridiculous to blame the Tories for everything, especially when the differences between the three main political parties are so minimal. And doing so suggests that you are not really interested in finding solutions.
Labour share some of the blame for PFI but they did increase funding significantly as well but PFI was invented by tories and remains tory dogma even if done by labour. Its all about reducing government borrowing - a tory target. Blair is a tory after all 🙂
From my experience on the shop floor - under labour services improve and extend. Under tories its cut cut cut
Limp Dems are just beneath contempt for their part and you are right to highlight it
the other point of course is for labour its not deliberate policy to run down the NHS whereas it is for the tories
Much of the PFI was done under the tories as well and of course the provider / purchaser split that cost 10% of the NHS budget for no gain was a tory idea
Well, on the back of some of the discussion above about taking personal responsilbility, I just bought me a new Lifesystems 1st Aid kit to go in the bottom of me CamelBak in case of mishaps. Upgrading from what I have been carrying.....
As it said previously, the we have only had 4 years of Tory majority government in the last 24 years, it is frankly ridiculous to blame the Tories for everything, especially when the differences between the three main political parties are so minimal. And doing so suggests that you are not really interested in finding solutions.
You sound like a tory apologist? I think we can blame the Tories. The clear rapid decline in funding in the NHS post 2010 was a Tory plan. 2010 - That's 11 years of Tory govt.
The fact that they are now using Covid to gut the NHS is clear intent to privatise, and they (and the charlatans in the IEA/TPA/55 Tufton Street) are really not trying to hide it anymore.
You sound like a tory apologist?
For pointing out that for the last 25 years we have only had 5 years of Tory majority rule?
Okay fair enough, I've been called a lot of things in the past but never a Tory apologist, if you think that it's a fair label go for.
Although since what I pointed out is a historical fact it's a strange conclusion to come to.
Would you call someone who pointed out what happened in England in 1066 a Norman apologist?
Edit : I know that I didn't mention it but you do realise that Vince Cable and Danny Alexander were Liberal Democrat politicians, when you talk of a 'Tory plan', don't you?
Do you think they were hypnotised by David Cameron?
Are you an apologist for the LibDems?
You sound like a tory apologist? I think we can blame the Tories
+1. One of the best tricks the Tories have managed is to get people claiming "they're all at it" or "they're as bad as each other". They aren't. They all have faults and issues but Tories are worse by a margin
disingenuous tho Ernie - 11 years of hardline tory governments and 9 years of right of centre governments
Deleted because it really is pointless
I get your point Ernie that others share some of the blame but during my career in healthcare I have worked 3 times as long under tory governments than labour ones and the difference is really obvuious that under labour NHS funding improves and under tories it does not
so yes - others share some of the blame but the tories carry most of it - because apart from anything else its deliberate policy to damage the NHS and the damage they have done is so much more severe
the difference is really obvuious that under labour NHS funding improves and under tories it does not
Well I'm not claiming the NHS is better off under the Tories ffs am I?
Thread resurrection time.
Just out on the York to Selby path and came across a bloke on the floor spouting claret from his temple after an unplanned dismount. It was twenty minutes since he had called 999 for an ambulance and they had told him it would be at least a couple of hours before they could get to him. This was for a solo rider on the floor, broken helmet, moderate bleeding from a deep split on his temple and no recollection of the fall.
But arguably he's conscious, breathing and was presumably able to converse with ambulance control in a fairly lucid and coherent manner therefore it's highly likely there will be significant numbers of people who are in a worse situation than he is who require more immediate medical attention and are rightly given a higher priority. This is always going to happen in a system with a finite resource and won't change unless you have a system with massive amounts of redundancy.
Everyone believes their emergency is the most important but unfortunately to the people who deal with this stuff all the time it's probably not.
Everyone believes their emergency is the most important but unfortunately to the people who deal with this stuff all the time it’s probably not.
Harsh but true.
Absolutely no context to what else is going on in that area, it’s a single story with only there version of events. It’s very rare for the call handler to give a time frame for a response.
I’m sat looking at ongoing and waiting jobs currently. I’d say there’s at least a dozen that would get a higher response than that example.
We've just had first hand experience of the ambulance service and they were amazing. Our two week old was vomiting, went white, dodgy breathing and after a call to 111 first they put us through to the SW service and were here in 15 mins. We are very rural too.
The paramedics said they had a choice between a drug addict in Exmouth or us..they opted for us luckily. They said they are trying to cover more calls with less resources. Their area is Sidmouth to Honiton but some nights end up as far as Cornwall, two hours from their base.
Austerity is to blame. For many of the social issues that have grown out of it to then the lack of services that support said issues. People cannot vote Tory then moan about lack of services to support communities.
People cannot vote Tory then moan about lack of services to support communities.
You've not met my mother, have you?
Haha, I haven't MCTD.
I think many just don't like to admit their actions have impacted people negatively or admit mistakes. It's all a culture of blame, no one takes responsibility for their actions.
I think many just don’t like to admit their actions have impacted people negatively or admit mistakes. It’s all a culture of blame, no one takes responsibility for their actions.
Apparently it's still all down to Blair and Brown, leaving that note saying there was no money left. Though to be fair, I know a lot of Labour voters who still blame Fatcher.
Follow up - maybe I should have said earlier but I was in the cafe still on my ride. The guy was speaking ok, but clearly very shaken up, not walking steadily. He agreed that if we could organise some way to get him to A&E without the ambulance we should. We identified nearest access points we could get a car to and I was in the process of ringing a mate in York to bring his car down. At that point another cyclist stopped to lend a hand too, on a nice red Harry Hall tourer. She was exactly the person for the job, her brother was the farmer half a mile away and had access keys to the field gates on the trail. She got him on the batphone and ten minutes later he arrived on the trail in his van, scooped up the casualty and headed for York A&E, he'd brought his son along to ride the blokes bike back to the farm for safe keeping. Ambulance cancelled.
Great work from the farmer 👍
Sounds like it worked well in the end.
its what we've voted for and its what we pay for.