NHS and summary care records – whats the point!

Home Forum Chat Forum NHS and summary care records – whats the point!

Viewing 40 posts - 1 through 40 (of 73 total)
  • NHS and summary care records – whats the point!
  • Premier Icon dirkpitt74
    Subscriber

    So we moved house last year and registered with the new doctors surgery.
    When we filled all the forms in there was a section about creating and sharing the summary care records which seemed like a good idea as it means that when you go to A&E or where ever they have all the up to date info…..

    From the NHS website it says this record contains the following info:

    At a minimum, the SCR holds important information about;

    • current medication
    • allergies and details of any previous bad reactions to medicines
    • the name, address, date of birth and NHS number of the patient

    So, a couple of weekends back I had to take the Wife to local A&E as she was having really bad kidney pain (we go to A&E as she only has 1 kidney and they can usually use stronger IV drugs to treat infection quicker). So we rock up and give name and DOB – only to find that the wonderful NHS system still has our old address, old GP’s details and no mention of the 2 antibiotics that she’s allergic to….

    Oh and the records were still in her Maiden name – we’ve only been married 6 years…. surely the computer system isn’t that slow….

    And Friday I had a letter from the Hospital about booking my 12 month appointment with the shoulder consultant – guess which address that went too……… good job we still have our mail redirected.

    What’s the point of a summary care record when it’s fairly obvious that the NHS’s computer system doesn’t work.

    tjagain
    Member

    Summary care records are all about monetary value for selling your data not about improving care

    Premier Icon GrahamS
    Subscriber

    A new income stream for the NHS then. Surely very welcome in these difficult times?

    Premier Icon martinhutch
    Subscriber

    I don’t know, the insurers and Boots aren’t going to be happy if we’re selling them dodgy data with incorrect addresses and names. What if they ask for their money back?

    stevextc
    Member

    I was in my local A&E yesterday …

    Triage ask about allergies … to which I never know what they want.

    Do they mean IgE only or are they including other immunoglobulin responses?

    The triage nurse doesn’t seem to understand what immunoglobulin is… but surely they should start off with my medical records instead of asking me.  I have a bad IgE reaction to an anti-biotic .. which should be in my notes given the GP had to switch anti-biotics only a couple of years ago after a (very) bad reaction.  I can’t remember what the antibiotic was .. I was hallucinating at the time… surely they can get this from my medical records?…

    “Have you broken a bone before?” ??? seriously FFS  how can they not know this stuff? (Its only a year since I fractured the other arm) .. how can it not be in my records?

    Anyway, they decided not to X-Ray as “it would hurt more than that if it was broken” … so another 3-4 hours of my life wasted.

    Premier Icon stevie750
    Subscriber

    <div class=”bbp-reply-author”>tjagain
    <div class=”bbp-author-role”>
    <div class=””>Member</div>
    </div>
    </div>
    <div class=”bbp-reply-content”>

    Summary care records are all about monetary value for selling your data not about improving care

    </div>

    Got any actual evidence for this?

    And Friday I had a letter from the Hospital about booking my 12 month appointment with the shoulder consultant – guess which address that went too……… good job we still have our mail redirected.

    they still use post as the primary form of communication? especially for communication after several years break. The mind boggles.

    poly
    Member

    Stevextc – is it really that difficult to work out what information they want when the ask you if you have any allergies?  Or are you just being awkward for the sake of it?  If you have a drug to which you have a significant adverse reaction do you think it best to rely on the outdated medical records system or for you to find out (you can request your notes at any time).  Why would you assume that the notes available in that hospital are up to date, accurate and properly categorised so that allergies are highlighted rather than buried on line 23 of page 48 – when there is seemingly well informed individual sitting in front of you who can tell you not only about the treatment in those records but potentially treatment too new or too historic to be there or which was performed out of the country or perhaps where the patient took a medication at home and never reported the ADR to their doctor (obv only minor reactions, but sometimes they get worse, and even minor reactions are best avoided if possible!).

    OP – the system is terrible, poorly joined up and you’ve assumed a level of communication that doesn’t exist.  You need to tell each specialist you have moved.

    FunkyDunc
    Member

    but surely they should start off with my medical records instead of asking me

    No because your medical records will not be up to date, you my not have been to that hospital before, your medical history can change over night.

    Its standard practice to always take medical history in any setting, especially A&E.

    Premier Icon Drac
    Subscriber

    Triage ask about allergies … to which I never know what they want.

    They want to know if you’re allergic to anything. People develop allergies over time, they also can stop being as sensitive to an allergy. It’s best to confirm there’s no changes. If you have an allergy may I suggest you find out what it rather expect the healthcare attending you to just know.

    cheers_drive
    Member

    I fractured a finger last year and it was more convenient to use the hospital near my parents than our local one. They had my address down as my parents home which I had left 23 years ago and 6 moves around the country ago!

    Premier Icon v8ninety
    Subscriber

    but surely they should start off with my medical records instead of asking me.

    But but but… Haven’t you just highlighted how untrustworthy and potentially incorrect the notes could be? And you’re then suggesting that a clinician uses the notes rather than just asking you?!? Can you see why his might happen? If you’ve noticed how unreliable medical notes are, do you really think clinicians have not noticed? Best practice is to take your own history. It’s a simple primary vs secondary source thing, really.

    DrP
    Member

    Anyway, they decided not to X-Ray as “it would hurt more than that if it was broken” … so another 3-4 hours of my life wasted.

    WHy was that 3 hours of your life wasted?? What did you want to happen? The doctor to stamp on your wrist so that you DID actually have a break?!
    You went to A+E and waited for an assessment. Not necessarily a specific treatment or outcome; but an assessment.,

    You got the assessment. Yes, you waited 3-4 hours, but you got the assessment.
    Job done surely?

    DrP

    Premier Icon nickc
    Subscriber

    If nothing else, threads like this reveal what a lot of people think the NHS can do, vs what it can actually do.

    Premier Icon xora
    Subscriber

    Being in hospital right now.

    yes is can be annoying being re-asked the same info a few times. But its infinitely better than dieing of penicillin allergy, because someone forgot to tick it along the way.

    docrobster
    Member

    To answer the OP. When used properly, the scr is very useful when I’m doing out of hours gp sessions. When I ring the nursing home or wherever about the delirious 90 year old it means I at least have access to an up to date medication record.

    Hospital IT systems seem to not work well with the national spine- they need to be updated manually when people uses services rather than primary care which updates pretty much in real time as everyone uses or at least is registered with a gp. For hospitals  this doesn’t happen because I suppose there is no registered list so no guarantee that any particular patient will ever use their services again.

    Progress is being made but it is very slow.

    Premier Icon v8ninety
    Subscriber

    Just to add; doesn’t matter how good the IT gets, we’ll still ask you if you have any allergies. Along with a whole host of other questions you’ve been asked ten times before. Even if we have no intention of giving you any drugs. They are fairly important questions, and a hard habit to break…

    May as well just get used to it.

    Premier Icon dirkpitt74
    Subscriber

    @docrobster – thanks for the post, very informative. I wrongly assumed that the SCR was held centrally by the NHS and could be accessed by GP’s and Hospitals.

    Premier Icon Drac
    Subscriber

    It’s a habit that does not need breaking.

    docrobster
    Member

    Sorry dirk if I mislead you. Your assumption is correct. It (the scr) is held centrally. GPs and (some bits of) hospitals can look at it. Not everyone does though.

    The difference is perhaps the way the centrally held data is used to update the locally held clinical systems. If I see a patient and there is a mismatch between what is on our system and the national spine I see a little red box which I click on to tell me what the mismatch is- different phone number, address etc. I then have to pick one which overwrites the system either changing our local record or the national one. Some things like eps prescriptions can’t be processed until these mismatches are resolved. This is completely separate from scr which I can view when working out of hours but can’t edit.

    stevextc
    Member

    Stevextc – is it really that difficult to work out what information they want when the ask you if you have any allergies?  Or are you just being awkward for the sake of it?

    Yep, I asked a simple question as to if they meant IgE mediated or any immunoglobulin … it’s a simple question to a medical professional.???..

    (Using this bit twice)

    If you have a drug to which you have a significant adverse reaction

    I have adverse reactions to many of the coatings and packing/bulk on drugs as opposed to the active ingredients.  (So it’s important to me but at this point I don’t want to have to reel off a list of over 100 brand specific formulations… nor indeed can I)

    If you have a drug to which you have a significant adverse reaction do you think it best to rely on the outdated medical records system or for you to find out (you can request your notes at any time).  Why would you assume that the notes available in that hospital are up to date, accurate and properly categorised so that allergies are highlighted rather than buried on line 23 of page 48 –

    How many billion did they spend?  Largest IT project in the world… you’d think the allergic reactions should pop up pretty automatically right along side my GP’s surgery etc. that they do have.

    when there is seemingly well informed individual sitting in front of you who can tell you not only about the treatment in those records but potentially treatment too new or too historic to be there or

    OK, fair point on pre-existing records, I’m reasonably well informed on auto immune disorders… but frankly strains of anti-biotic I have no clue outside the major ones… I was feeling pretty unwell at the time.. I’d at least expect this gets flagged in my local NHS… rather than rely on my memory of some rather exotic anti-biotic?  (Though at this point to get back after DrP’s comment see **)

    which was performed out of the country

    Which is most of my medical history from 18-35 … only since other countries have different diagnostic criteria they prefer to ignore it.

    or perhaps where the patient took a medication at home and never reported the ADR to their doctor (obv only minor reactions, but sometimes they get worse, and even minor reactions are best avoided if possible!).

    Again, there seems to be a great reluctance to accept patients word over clinical trails.  Not to mention surely no-one has a good reaction to some drugs… (even if the outcome is good surely everyone has a crap reaction to prendisone)

    You went to A+E and waited for an assessment. Not necessarily a specific treatment or outcome; but an assessment.,

    You got the assessment. Yes, you waited 3-4 hours, but you got the assessment.
    Job done surely?

    Well, I went in with a few things … last time when I fractured my ulna on the other arm they ended up treating me for a whole load of things I wouldn’t have bothered with… (or basically would just get in the shower and scrub the dirt out with a brush then pour over some antiseptic (depending which body part as KI is nice unless you need the skin exposed – then its obviously better to use something that stings more but doesn’t dye your skin or hair)

    This time it seems I went in with concussion, a sore wrist and a sore trachea…. as I can’t remember the actual landing I’ve no idea how the trachea is so sore but then this morning I have a big bruise… I also lost a lot of skin but only mostly shallow…

    I’m just a dumb MTBer but surely “I can’t actually remember hitting the floor” is a clue I may have blacked out and have some short term memory loss???  I’ll admit at my age my memory isn’t what it once was… BUT I’d remember hitting the floor hard.

    Despite this I kept pointing out it was my RIGHT hand despite the left hand having a lot of missing skin.. but they kept trying to X-Ray the wrong hand and say are you sure its the left hand as the right hand is missing most of the skin…

    At this point I’d rather just get major stuff done, sure its more pleasant getting a professional to clean out the dirt but using an old toothbrush to remove any scabbing then pouring over some KI or electrical grade isopropyl works as well.

    Anyway… as I say back to the basics… you’d think that if you decide not to believe a patient has a pacemaker for example (to they are having problems communicating) the scar would give it away… and you wouldn’t try and stick them in a MRI .. whereas for my father I had to call the ex-head of imaging then retired (who was a personal friend of my father) to get him to explain he has a pacemaker and an MRI is not an optimum imaging technique.

    However many billion and they can’t even get this right?

    Not to mention it was a Friday night he was rushed in from the nursing home.

    The nursing home sent over all his medication all prepared and blister packed but the hospital can’t use it as it must come from THEIR pharmacy which is now closed until Monday.

    Back to the largest and most expensive IT project in the world…

    If you have a drug to which you have a significant adverse reaction do you think it best to rely on the outdated medical records system or for you to find out (you can request your notes at any time).  Why would you assume that the notes available in that hospital are up to date, accurate and properly categorised so that allergies are highlighted rather than buried on line 23 of page 48 –

    How many billion did they spend?  Largest IT project in the world… you’d think the allergic reactions should pop up pretty automatically right along side my GP’s surgery etc. that they do have.

    when there is seemingly well informed individual sitting in front of you who can tell you not only about the treatment in those records but potentially treatment too new or too historic to be there or

    OK, fair point on pre-existing records, I’m reasonably well informed on auto immune disorders… but frankly strains of anti-biotic I have no clue outside the major ones… I was feeling pretty unwell at the time.. I’d at least expect this gets flagged in my local NHS… rather than rely on my memory of some rather exotic anti-biotic?  (Though at this point to get back after DrP’s comment see **)

    which was performed out of the country

    Which is most of my medical history from 18-35 … only since other countries have different diagnostic criteria they prefer to ignore it.

    or perhaps where the patient took a medication at home and never reported the ADR to their doctor (obv only minor reactions, but sometimes they get worse, and even minor reactions are best avoided if possible!).

    Again, there seems to be a great reluctance to accept patients word over clinical trails.  Not to mention surely no-one has a good reaction to some drugs… (even if the outcome is good surely everyone has a crap reaction to prendisone)

    You went to A+E and waited for an assessment. Not necessarily a specific treatment or outcome; but an assessment.,

    You got the assessment. Yes, you waited 3-4 hours, but you got the assessment.
    Job done surely?

    Well, I went in with a few things … last time when I fractured my ulna on the other arm they ended up treating me for a whole load of things I wouldn’t have bothered with… (or basically would just get in the shower and scrub the dirt out with a brush then pour over some antiseptic (depending which body part as KI is nice unless you need the skin exposed – then its obviously better to use something that stings more but doesn’t dye your skin or hair)

    This time it seems I went in with concussion, a sore wrist and a sore trachea…. as I can’t remember the actual landing I’ve no idea how the trachea is so sore but then this morning I have a big bruise… I also lost a lot of skin but only mostly shallow…

    I’m just a dumb MTBer but surely “I can’t actually remember hitting the floor” is a clue I may have blacked out and have some short term memory loss???  I’ll admit at my age my memory isn’t what it once was… BUT I’d remember hitting the floor hard.

    Despite this I kept pointing out it was my RIGHT hand despite the left hand having a lot of missing skin.. but they kept trying to X-Ray the wrong hand and say are you sure its the left hand as the right hand is missing most of the skin…

    At this point I’d rather just get major stuff done, sure its more pleasant getting a professional to clean out the dirt but using an old toothbrush to remove any scabbing then pouring over some KI or electrical grade isopropyl works as well.

    Anyway… as I say back to the basics… you’d think that if you decide not to believe a patient has a pacemaker for example (to they are having problems communicating) the scar would give it away… and you wouldn’t try and stick them in a MRI .. whereas for my father I had to call the ex-head of imaging then retired (who was a personal friend of my father) to get him to explain he has a pacemaker and an MRI is not an optimum imaging technique.

    However many billion and they can’t even get this right?

    Not to mention it was a Friday night he was rushed in from the nursing home.

    The nursing home sent over all his medication all prepared and blister packed but the hospital can’t use it as it must come from THEIR pharmacy which is now closed until Monday.

    Back to the worlds most expensive IT project… and they can’t get basic stuff like having a pacemaker or get his prescription ???

    stevextc
    Member

    It’s a habit that does not need breaking.

    There is a difference between asking to confirm and asking because the last 10 times you asked you didn’t enter it into the system.

    You can ask an unconscious patient but their response is not going to be very informative.

    You can ask a patient with concussion and perhaps their response is diagnostic… perhaps their inability to remember the exact spelling of some drug indicates confusion???

    It (the scr) is held centrally. GPs and (some bits of) hospitals can look at it. Not everyone does though.

    The difference is perhaps the way the centrally held data is used to update the locally held clinical systems. If I see a patient and there is a mismatch between what is on our system and the national spine I see a little red box which I click on to tell me what the mismatch is- different phone number, address etc. I then have to pick one which overwrites the system either changing our local record or the national one. Some things like eps prescriptions can’t be processed until these mismatches are resolved. This is completely separate from scr which I can view when working out of hours but can’t edit.

    But isn’t that the least important medical information?

    Unless there is a geographic outbreak of something how does getting the address correct help with anything but billing?

    Premier Icon Drac
    Subscriber

    There is a difference between asking to confirm and asking because the last 10 times you asked you didn’t enter it into the system.

    Yes the difference being that they may have since developed an allergy but not informed anyone.

    You can ask an unconscious patient but their response is not going to be very informative.

    **** me it’s Dr Kildare.

    Premier Icon allthegear
    Subscriber

    The NHS still use three different NHS Numbers in correspondence to me. Contacted them multiple times pointing this out, still continues…

    rachel

    Premier Icon bails
    Subscriber

    Unless there is a geographic outbreak of something how does getting the address correct help with anything but billing?

    It’s literally in the OP of this thread:

    only to find that the wonderful NHS system still has our old address, old GP’s details….

    Oh and the records were still in her Maiden name – we’ve only been married 6 years….

    And Friday I had a letter from the Hospital about booking my 12 month appointment with the shoulder consultant – guess which address that went too……

    stevextc
    Member

    Yes the difference being that they may have since developed an allergy but not informed anyone.

    Other than having this diagnosed abroad though how do they actually know they developed an allergy and to what?

    The point I’m making is …

    It’s literally in the OP of this thread

    only to find that the wonderful NHS system still has our old address, old GP’s details….

    I’m less concerned about my geographic location than the “system” actually having my up to date medical information.

    I’m not against supplementing it … it’s more about the fact it’s start from scratch each time.

    You can ask an unconscious patient but their response is not going to be very informative.

    <span style=”font-size: 0.8rem;”>**** me it’s Dr Kildare.</span>

    So if it is necessary to reconfirm allergy information every time what the **** are you going to do if the patient is unconscious or otherwise unable to communicate.

    Taking my father’s example… you’d think multiple bypass operations, pacemaker, Parkinsons, Alzheimers and cancer might be RELEVANT medical information….  but even if he wasn’t having a crisis how do you get reliable information out of a patient with advanced Alzheimers…

    He could tell you pretty much anything from up to the present century… he could probably still build a MRI but he couldn’t tell you what happened last week or last year.

    In the same way if I’m hit on the head trying to remember a very specific and somewhat exotic anti-biotic is not very likely…

    The whole process seems to rely on the memory of people who by definition are not at their best..

    I’ve never seen my medical records… and up until recently I was charged to even request a copy..(and to be blunt the whole focus of the medical community has for decades been to prevent people seeing their own medical records). so the way this works in other countries where you can carry them around just doesn’t work.

    Since I know bugger all about medicine I need a professional to tell me what is relevant and what I need to be able to tell them.  I don’t have access to my information… I had a prescription… it got handed over .. none advised me to make a note in case I had an adverse reaction.

    When I saw my GP with the adverse reaction she took away the antibiotics … and I would hope made a note that pops up in flashing red every time anyone accesses my records… if this isn’t the case surely she should have written it down for me and advised me to take a copy next time I am in need of medical attention…

    In terms of priority for a £11,000,000,000,000 Project actually making relevant patient information that is required to treat them seems to me to be higher than checking my phone number didn’t change.

    I’m not saying keeping up to date contact information isn’t needed … I’m saying it’s surely of less medical priority than relevant medical history.

    Premier Icon v8ninety
    Subscriber

    You can ask an unconscious patient but their response is not going to be very informative.

    This is true. But do you think that when presented with an unconscious patient, a clinicians first thought is ‘let me just check the pooter to see what allergies they’ve got’? The A in ABC is Airway, not allergy, lol.

    What you are experiencing is the fact that clinicians know that the IT system is untrustworthy.

    Premier Icon Drac
    Subscriber

    Other than having this diagnosed abroad though how do they actually know they developed an allergy and to what?

    Errrr! You ask. I developed an allergy to micropore after years of using it at work, I didn’t know until I had some applied to me. I make sure they know when asked if I have allergies. Rather unsurprisingly they didn’t know I had an allergy to it until I told them.

    So if it is necessary to reconfirm allergy information every time what the **** are you going to do if the patient is unconscious or otherwise unable to communicate.

    Use the drugs and equipment with very low allergy risk. It’s almost like it’s been thought of.

    Premier Icon v8ninety
    Subscriber

    I developed an allergy to micropore

    ZOMG! How on Earth are you going to fix the ambulances now, when the satnav/mirror/cupboard door etc drops off?!? 😉

    Premier Icon Drac
    Subscriber

    ZOMG! How on Earth are you going to fix the ambulances now, when the satnav/mirror/cupboard door etc drops off?!?

    It’s the greatest Multitool in the world. We no longer stock it thankfully.

    stevextc
    Member

    This is true. But do you think that when presented with an unconscious patient, a clinicians first thought is ‘let me just check the pooter to see what allergies they’ve got’? The A in ABC is Airway, not allergy, lol.

    Airway and Allergy are not mutually exclusive though..

    What you are experiencing is the fact that clinicians know that the IT system is untrustworthy.

    Yep and I’m not criticising them for checking (when possible) .. I’m saying that updating the relevant medical information should be a HUGE priority above billing information.

    The other alternative is not really worse but I don’t see the NHS chucking away £11Bn… and just give patients a portable medical record they can carry with them…

    It might just be text on a phone or it might be in a RFID chip you can have on a bracelet etc.

    Moreover I don’t disagree with the claim earlier that this is about selling on your data… (as well as billing the correct part of the NHS) … Ive seen some great stuff… transmission of my X-ray to another hospital before I arrive.. which is all cool but I could have carried it with me (or attached to me)

    New hospital though and non of the medical history (or allergies) just gets lost.

    6 years ago my son spent 10 days in St. Thomas’s P-ICU and had to be resussed several times…

    Our then local hospital had the tests they had made before he was stuck in an ambulance from St Thomas’s in the opinion of the attending doctor from St Thomas’s about to die unless he intubated him right there and then.

    The ambulance journey took 17 mins bed to bed… (including the intubation)

    His tests and medical records had still not arrived 10 days later!  When they did arrive after he’d been put on the normal ward they were “doctored” (pun intended) … to remove the mistakes and missed SLA’s the Paediatric unit had made in Kingston.  Some of this was documented…. they claimed he was seen and treated in 4 hours and this is what the records said… I had a parking ticket for 9 hours… what do they think we were doing for the other 5 hours?  Others were missing tests that had been run and the fact the nurses had moved him to a room at the far end of the corridor because his attempts at breathing was disturbing them after the Paediatric consultant had left early!   His O2 stats were not even recorded … my partner did query at the time but the nurse said the machine must not be working properly…

    So I’m fully supportive of the medical records being unreliable … which is why they should be updated live.

    Screw the KPI’s… in the case of the 8 hour wait and then not seeing the consultant there was actually a good reason and possibly there was a reason for the 2nd visit to A&E taking 6 hours before we saw a Jnr Doctor. (our reason for being there was because his GP had phoned for a consult and been instructed to send us to A&E) .. but really the point is that records need to be filled in and made live or at least given to a patient (or carer).

    I might be cynical but it seems to me the current focus of correcting information seems to be more about accounting than medicine.

    Premier Icon Drac
    Subscriber

    Airway and Allergy are not mutually exclusive though..

    Correct but what difference will spending time accessing their notes give over starting immediate care?

    regenesis
    Member

    The system is an utter shambles.

    I’m having yet more treatment at the moment.

    One hospital STILL has not uploaded 3wks of MRI’s CAT scans, blood work, lumbar punctures, bone marrow collections and more to the system.

    THREE YEARS after being there.

    They STILL have not sent this info to the previous GP, let alone the new one. (Well if you call 18mths new…)

    They still despite 11 requests by the consultant have not forwarded it to him to cross reference degeneration with the current position.

    Theres loads more too.

    This ain’t about a central record – this is DIRECT requests to them for specific information.

    so I now have certain tests that can’t be run until they know the level of damage they dealing with as they do not have a definitive timescale for how long/fast it’s taken for the current level of damage to have produced the symptoms I now have due to many being sudden onset caused by other underlying degeneration.

    Right now the US/Spanish/etc system of being able to literally walk in carrying your medical files would be ******* useful!

    tjagain
    Member

    Jeepers I thought the Lothian / Scotland computer system was poor!  We have TRAK.   All your records are on it.  All scans, tests etc are on it and there are no paper records.   Of course it’s far from perfect.   Gps don’t have access to it.  They have their own system that does not communicate with TRAK and have to rely on letters to tell them what happened in hospital or KIS (key information summary)  but all hospitals have access to your full record at all times and this automatically produces alerts for such things as allergies and anyone with access can see everything on the record

    Go for a scan it’s automatically put on TRAK for all to see

    Premier Icon Drac
    Subscriber

    Blimey your GPs can’t accesss your Scan? How prehistoric I had an MRI last year, my GP could access it the same day. They still confirm allergies though.

    stevextc
    Member

    Assuming they are stable then I’d expect you’d probably not want to start administering steroids they are known to have adverse reactions to… ??

    But I’m not really following you …

    What I don’t understand is whether a patients medical history is potentially relevant or not and if it affects the treatment.  Do you just shove the bloke with the pacemaker in the full body MRI regardless or do you assess if this is perhaps a non-optimal imaging technique?

    Is it more important to know which part of the NHS gets billed or is it more important to know the medical history?

    My experiences are more like those of regenisis….

    I go to one specialist… they do some tests.

    I wait weeks/months for those test results… none knows where they are.

    I don’t really understand but when the GP scheduled the urgent removal of the mole she seemed to think it was pretty urgent… 2 years later the results have still not arrived… so with my limited medical knowledge I guess that means it’s no longer urgent as I’d already be dead.

    But don’t worry… because the hospital have my GP’s details and know who gets billed for the test even though they never actually delivered any results!

    Right now the US/Spanish/etc system of being able to literally walk in carrying your medical files would be ******* useful!

    Yep, I know exactly what you mean…. except our system is set up to prevent us ever getting the medical files.

    Last X-Rays I had in France, Spain and Italy (geez I’m accident prone) I was given a copy of the x-rays

    I lived in France for years and every test you get the results.. pretty much any test that can be done the same day you get the results the same day on copy with the GP.  (Obviously some tests simply take longer)

    About 7yrs ago I had to have a series of tests and after each I had to see the cardiologist.

    My Dr scheduled the tests 6 weeks apart to give time for the results (90% of which were same day serology)

    I turned up to the second appointment and specialist told me there is no point as the results didn’t arrive yet!

    Rescheduled then had more tests … and these didn’t turn up either….  meanwhile I’m not all that good and keep having tachycardia and passing out… but essentially what was a series of 4 appointments with the specialist and tests in France would have taken a week, (perhaps 2)… too the best part of a year.

    poly
    Member

    So if it is necessary to reconfirm allergy information every time what the **** are you going to do if the patient is unconscious or otherwise unable to communicate.

    Well some people with known life-threatening allergies wear a medicalert style bracelet/necklace for that situation, but otherwise exactly the same as if the patient has never been treated with that med before.

    The other alternative is not really worse but I don’t see the NHS chucking away £11Bn… and just give patients a portable medical record they can carry with them…

    I don’t think anyone is suggesting the system is efficient, a sensible use of money or as good as it could/should be in 2018.  A portable record is great for those who plan to use hospital facilities especially if they are the right demographic to have the necessary tech – but may be less useful for unexpected use and/or those who live chaotic lifestyles or with dementia etc. (big users of the NHS).  Patient carried notes are used in some cases for patients moving between hospitals – but its not ideal either – it means the docs spend the first 10 minutes skimming through your notes, looking at scans etc.  With electronic transfer they can already have a treatment plan in place.

    Yep, I asked a simple question as to if they meant IgE mediated or any immunoglobulin … it’s a simple question to a medical professional.???..

    Since I know bugger all about medicine I need a professional to tell me what is relevant and what I need to be able to tell them.

    Are you sure – it sounds more like you are trying to score points.  They have no idea you have some sort of immunology knowledge so just answer the question in lay terms.  Here’s how the conversation normally goes:

    Medic: Are you allergic to anything?
    Patient: Yes, amoxicillin.
    Medic: And what happens if you take amoxicillin.
    Patient: I get a red rash over my whole body.
    <span style=”font-size: 0.8rem;”>Medic: Has it ever caused you breathing problems?
    Patient: No.</span>
    Medic: When did you last take it?
    <span style=”font-size: 0.8rem;”>Patient: about 10 yrs ago.
    </span>

    Other than having this diagnosed abroad though how do they actually know they developed an allergy and to what?

    People who have think a drug has made them ill usually know.  If you aren’t sure the “allergy” probably isn’t serious enough to worry about.

    I have adverse reactions to many of the coatings and packing/bulk on drugs as opposed to the active ingredients.  (So it’s important to me but at this point I don’t want to have to reel off a list of over 100 brand specific formulations… nor indeed can I)

    Probably easier to tell them the actual ingredient(s) you are allergic to.  If thats really not possible and you have a list of 100 formulations you might want to bring it on a piece of paper.

    But isn’t that the least important medical information?

    Its used for a lot of rather important things, nothing to do with billing.  e.g. making sure they are actually talking about the right patient not a different “Steve Jones”, sending you follow up appointments/advice, making sure the GP has the right patient when they tell them whats wrong with you, contacting you after you leave the hospital if a problem emerges (e.g. an unusual blood result, or a consultant radiographer spots something after a junior doc sends you home), or contacting family if you things go bad.  Its probably also a useful hint about: social support on discharge, head injuries, dementia etc.

    tjagain
    Member

    Aye Drac it’s bonkers

    Hospital records fully computerised and accessible to all hospital staff anywhere but not to gps.  TRAK stops much of the nonsense talked about on this thread but it not being available to gps is utterly stupid

    Premier Icon Drac
    Subscriber

    Assuming they are stable then I’d expect you’d probably not want to start administering steroids they are known to have adverse reactions to… ??

    And if they’re not stable, as in the airway needing secured or just maybe treating the reason they’re unconscious. You brought up the unconscious patient theory into this so I was hoping you knew why.

    Whole thing is rather crazy TJ it should have been sorted years ago.

    milky1980
    Member

    I’m the same as allthegear, as in I have 3 different NHS patient numbers.  All at different addresses and they still send out post to each one!   Tried getting them amalgamated into one as I needed to have access to full records when applying for my C1 license and I ended up getting a copy of each, fetching each one from where it was sent then going down to the DVLA to explain that each one was in fact me.  They refused to believe me for ages.

    Apart from that inconvenience it’s a bit worrying that my lists of concussions (a few..) are split over 2 sets of records, the record of when I collapsed and stopped breathing from choking is on the one with only 1 concussion on and the details of my asthma and allergies are on the third!   I think there must be a 4th record somewhere as 2 hospital visits are missing, one for CO poisoning (working on an old car) and another from when I broke my ribs.

    The NHS is a great institution but the reality of dealing with it on certain things is an unmitigated nightmare.  The delay in getting my C1 license meant I very nearly lost my job!

Viewing 40 posts - 1 through 40 (of 73 total)

You must be logged in to reply to this topic.