NHS’s Tech ‘Efficiency’ Adds Layers of Inefficiency and Pain
In an age where technology promises efficiency and streamlined processes, my recent encounter with the NHS’s approach to handling medical cases paints a different picture — one of inefficiency and frustration that is symptomatic of deeper systemic issues.
On December 9th I went to the gym and had a routine session, and nothing seemed untoward at the time, but the next day, I found myself in excruciating pain. My arm was immobile, my neck stiff and I experienced shooting pains and tingling sensations.
The next day, I went to my (private) osteopath, and after manipulating my neck, he mentioned he’d seen these symptoms many times before and that it was a typical slipped disc. He then strongly recommended that I get an MRI scan.
Knowing the challenges of securing a GP appointment by telephone, I physically visited the surgery on December 12th and was pleasantly surprised to schedule an appointment for December 14th.
Understanding the severity, my GP booked an MRI scan, assuring me of a text within two weeks for confirmation.
However, instead of an appointment by text, on December 26th (a full two weeks after visiting my GP), I received a perplexing message about a “physiotherapy referral” and a link to complete a digital assessment via Phio, an NHS automated chatbot.
This process took an agonising 40 minutes with a myriad of questions and instructional videos of how to move my arm to test symptoms and seemed utterly pointless since an MRI was already deemed necessary by my GP. The questions seemed to go on forever, and eventually (40 minutes in) I started putting quick answers just to get it done. I suspect many other people will do the same thing, having lost the will to live halfway through the process.
The next day, I received a call from “NHS Physiotherapy” to book a telephone appointment — not for the MRI, but to speak to a physiotherapist first. When I asked why I needed to talk to a physiotherapist, stating I thought the whole process was about scheduling an MRI, I was told I had to speak to a Physiotherapist first.
It then booked this appointment for January 9th 2024, adding another pointless layer to an already convoluted process. It’s a baffling cycle: a phone call to expect another phone call, where I will probably have to go through a complete repetition of my symptoms, which I’ve already communicated to my GP and through the digital assessment.
In my view, this experience highlights a glaring irony. The NHS, in an attempt to integrate technology for efficiency, has created a labyrinthine process that delays treatment and adds unnecessary steps. The question arises: why involve a physiotherapist when my GP has already prescribed an MRI? Why are multiple calls and assessments needed when the path should be straightforward?
Someone calling me to tell me to expect another phone call seemed incredibly wasteful and counterproductive. It makes no sense.
This is about more than just a failed attempt at using technology efficiently. It reflects a systemic issue within the NHS — where attempts to save costs lead to more wastage, both in terms of resources and patient time. The NHS’s investment in this software, presumably running into millions, seems to have backfired, adding layers of bureaucracy instead of cutting through it.
My story is one of many where patients are caught in the crosshairs of inefficient systems masquerading as technological advancements. It’s high time the NHS re-evaluates its approach, focusing on actual efficiency and patient care rather than on overcomplicated processes that serve no one.
Shane McEvoy runs Flycast Media, a specialist digital marketing agency in London.
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Shane. I feel for you and have sympathy for your plight and pain.
I do hope NHS’s senior managers can be made available to media to explain all this. Don’t rely on MP’s, and don’t let MP’s inject themselves. The people running/changing/ruining the “system” need to be held both responsible and accountable for spending “other people’s money” to provide health services.
As an arthritis sufferer (diagnosed 20 years ago, but still required to see a physio for ‘assessment’ before getting any meaningful treatment), I understand perfectly. IMHO, we have it all the wrong way round. If I have a problem with my car, I take it to the Master Mechanic. He diagnoses the problem, then gives it to the normal mechanic, or to the apprentice to carry out the fix. I don’t take it to the apprentice who asks me ten questions, tops up the oil, and then tells me to come back in two weeks if it doesn’t fix it. A process that eventually has the Master Mechanic deal with it after much delay and fannying about. So with the NHS. I have a concept for ‘Diagnosis Centres’ attached to hospitals. You might see a GP, (not a practice nurse) who can then send you down a corridor for whatever tests and checks you need, right there. Hospitals have MRI’s. If you need an MRI, it should be in 15 minutes from now, and the results in front of a consultant 15 minutes after that. The way to speed up treatment is to stop your case going through dozens of… Read more »
The difference from the garage is that your GP is trained as a master-mechanic (if not a specialist) and is the gatekeeper and referrer, but all the subsequent assessment is done by junior mechanics second guessing the referrer.
A very interesting point. I work in IT and we (not unusually) try to “protect” our generalist gurus by having service desk staff do triage – staff who know little about the subject matter or the inner workings of our products. Quite a lot of the issues eventually end up with the generalists anyway, by which time the client is probably getting frustrated and layers of obfuscation have been added to the ticket. I often think we’d be much better off having a guru at the front of the process who can route issues to the correct expert with a high level of accuracy. I don’t really understand the purpose of service desks for complex systems like human health or a specialist software product, other than to provide some noise that makes the client think something is happening, as someone else pointed out. Incidentally this post is an example of why I post anonymously – so that I can discuss matters connected to my friends, family and work without worrying about causing offence- I think it would be bad form to wash dirty linen in public without a layer of obfuscation. That and the fear of getting sacked for being… Read more »
Sadly in my experience the purpose of all too many service desks is fobbing customers off! If only you can get past the desk to the resident automotive engineer who can put into context the expensive failure of your car heater matrix just after the car warranty has expired…
Possibly. We certainly don’t want to fob customers off, though it might seem that like to them. I would be interested to try and largely ditch the service desk model, but my boss doesn’t seem as keen as I am, despite him having a very genuine desire to resolve customer issues (he regularly raids the ticket list and resolves dozens of them).
Making people redundant is painful for all involved, made more difficult by employment law.
Apologies, just to be clear I wasn’t getting at your company’s service desk, which for all I know could be exemplary.
Thanks for the apologies but no need – offence is taken, not given. I think they try reasonably hard and we mean well but the results are not as good as we would like. It’s a tricky job and there are trade offs.
‘Nice’ (actually not nice at all) story which warrants being told here: My original ISP in the UK was Virgin. I’m usually running my own caching (DNS) resolver on my PC, mainly because I don’t want to send a web browsing trail in form of DNS requests to my internet service provider for privacy reasons. One day, this ceased working. As I was able to confirm by experiment (traffic inspection on some other computer on the internet), this was because Virgin had chosen to block access to the DNS port (53), ie, one of their intermediate network demolition devices was dropping my query messages. I then called customer support despite I didn’t expect much from that. I ended in a forwarding loop where I would explain the technical problem to some person (who doubtlessly didn’t understand any of that) who would then declare itself not competent to deal with it and forward my call to someone else. Goto 1. Ultimately, I ended up with a guy who assured me he could certainly help me, but wanted to explain to me how to configure DNS servers on Windows in exchange for a charge. I politely declined and got forwarded on. And… Read more »
The reason why service desks exist is that – unfortunately – the overwhelming majority of people who call customer services number are just pissed off for some reason, likely as not entirely unrelated to any product, and want to complain to someone about something.
That may be true in some cases. I don’t think it’s true for our customers, but we have a small number of long term clients and a few thousand users, not millions.
For me, calling customer support is usually a good way to get even more pissed off than I already am.
“ I often think we’d be much better off having a guru at the front of the process who can route issues to the correct expert with a high level of accuracy.”
Gurus of any sort, Medical, Health 🙂 , IT, or Cooking, are few and far between.
That’s the problem, and there’s no encouragement for the mere ordinary to aspire to be gurus, apart from ‘greed’, and that it thrown at you at the slightest opportunity.
Well anything other than a very small firm ought to have a few “gurus” capable of performing the triage role. I don’t see anything wrong with “greed” as an incentive. Our brightest staff get given the most opportunities but we back that up with money. We also try to treat all our staff decently, and accord them what flexibility we can within the constraints of our business. All of this is of course much easier in an SME where the senior management are fairly hands-on and know what is going on everyhere.
Sorry but most GPs are clueless. I’m not a fan of the British non-specialist gatekeeper system.
That is a really excellent point.
It is a system that would very well with no need for a stalinist bureaucracy behind it.
Which is why it cannot happen anytime soon at least.
Policy is made by civil servants and the blob, not ministers and their loyalty is to their comrades. Not the public. I generalise the the tendency is clear.
In so, so many cases of this sort, the cure is simple, get government out. Education is another good example.
Our problem is the general public still mostly believe the government myth, that they are capable of running anything efficiently.
Sorry to go on a bit!!
But it’s true!
Whether it’s Health, Manufacturing, Oil / Gas, Water, or Rail, there’s always a cry to nationalise it.
Government need to remember to allow the public to give unto Caesar that which is Caesar’s, and let the professionals take responsibility in a sensible manner, and empower the individual.
The same thing happens when you call for an ambulance. I had to explain why one was needed to 5 different NHS people on the phone before it came and then the crew went through it all again which took a good 30mins before attempting to move the patient. I appreciate they need to screen whether an ambulance is really necessary but it is such an inefficient system.
This issue is not just one of the NHS.
The public is supposed to do all the leg work and comes up against systems that are rigid and can’t deal with nuance. The added layer of chatbots makes it worse as I have not yet found a chatbot that can answer any of my questions.
In your case the NHS has added the physiotherapist as the expert who can decide on an MRI rather than trusting a GP to make that judgement. If I were a GP I would be fuming.
My view when I worked in the NHS was that with a scan waiting list of several months, getting various triages, assessments, phone calls and letters enabled the illusion that something was happening, whilst also raising the possibility that some people might throw in the towel, thus reducing the growth of the waiting list for the actual target.
What they never seemed to think of was spending all the money on an extra scanner and operator instead.
One of my GP colleagues, noting how clinical tasks were being delegated to nurses without the necessary depth of experience, spoke about “getting a nurse out of the drawer.” Now, of course, the same tasks are likely to be delegated to non-nurse practitioners, who don’t even come out of a drawer, but the back of a cupboard.
Time can be a great healer – see my bit above, which also gives an example of the art of GP delegation. In my case it wasn’t even the GP who did the delegation, but the receptionist when I said what the problem was! She refused to give me a GP appointment.
I was surprised at how quickly my scan appointment came through. I was told 6 weeks but in less than 2 weeks I was phoned and told my appointment was 8.30 the next morning having missed a call the day before. Perhaps it being a scan for a brain tumour speeded it up.
You can get a private MRI scan and then visit the GP with the result but you will still have to wait to see the consultant but at least with a scan you could go private again.
I had a problem with a knee. After suffering intermittently with what I thought was arthritis I got a sudden pain when turning to enter a room. I was unable to walk and was in extreme discomfort. A trip to A&E ensued and after spending the whole night waiting for an investigation I was eventually rewarded with an X-ray which told them there was no arthritis in my knee and they diagnosed a torn meniscus. Time, I was told, would heal it. After 6 months of varying levels of discomfort I approached my GP. He would not see me but insisted I go to the practice physiotherapist who treated me for a torn meniscus and assured me that the X-ray showed no bone deterioration. Afyer another 6 months of zero improvement I went first to a private physio who diagnosed a torn ligament (!) and gave me a program of exercises. More months passed with no improvement and I went to see a private GP. He sent me for an MRI scan and then referred me to a knee specialist because he couldn’t interpret the MRI. Incidentally, I found out that anyine can walk into a private facility and have… Read more »
Hope the improvement continues, recommend continuing with the exercises as part of a balanced regimen of strength and endurance training, with joint mobility built in.
Thanks TOF. The private physio recommended a static exercise bike as the best means of doing exactly what you recommend, and I think both that and the loss of 2 stones (courtesy of a two month course of Mounjaro) have helped a lot.
Good stuff! Exercise bike doesn’t do much for upper body though. I’m no expert but my go-to all round exercise is the rowing erg, or swimming. Swimming is good for joint mobility and much more interesting and pleasant than using machines, IMO. Ski erg and cross trainer also potentially good.
I don’t know if these will be of interest but this bloke usually talks a lot of common sense:
https://www.youtube.com/watch?v=2jhuVDCC_Tg
https://www.youtube.com/watch?v=dD-r_EYOw1w
https://www.youtube.com/watch?v=yNUUGXuQgiU
I have mixed feelings about these drugs but open to the idea that used appropriately they are a positive.
Row ergonomic is excellent.
Some weightlifting will also help with strength and mobility.
Strength training is a must IMO for oldies like me
I have endless knee problems and I sympathise totally.
Private providers manage to deliver good care in useful periods of time.
Amounts spent on Private health care should be tax deductible.
The NHS is all about our NHS not about making life better for patients.
And they Don’t bother even trying to hide it any longer.
For a long time, the purpose of the NHS has not been to help people stay fit and well. It has transformed into a vehicle for grifters of all kinds.
“Tech” grifters, IT firms “at the top of their game”.
“Vaccine” grifters keeping us all “safe”.
“Consultant physicians” who “studied hard”.
And the rest.
There are some fantastic, stand out individuals who hold it together and do great work, but they manage it by going far above and beyond, then get peed off and leave.
The technocratic era began for me in 1984 (thank you Uncle George!), returning to Heathrow airport after a cycling holiday in France.
Two of our party’s bikes had been damaged in transit and we needed to initiate a compensation claim for the cost of repairs. On the flight home, we’d seen a headline telling of a rail strike next day. We needed to catch the last train from Euston that evening to avoid being stuck in London for the following day and thereby going AWOL from paid employment.
A hiatus ensued at the Heathrow baggage desk. An embryonic computer was down. Time passed and the train connection got tighter by the minute.
A Basil Fawlty moment somehow got a result, with incident report initiated using pen and paper. That was just the beginning. Technocracy has been taking us up hill and down dale ever since.
I could write a book about my own experiences with the NHS. I guess most could.
I could also write three books about my mother’s experience with the NHS.
Lord knows, I’m tired of it all.
Beautiful weather outside.
I have had similar experiences. For me, from recent experiences, the NHS system appears to be a flow chart exercise, of yes no actions that would hopefully achieve an outcome. The NHS system does not allow for a short circuit as in any other entry apart from the one designated by the flow chart concerned. Me, having come to an impasse within the flow chart of my allotted treatment, have to start all over again with the hope that when I get to a relevant yes/ no junction the opportune treatment path will occur.
In speaking to the surgeon on my last visit it was indicted that the doctors within the system are tied to the system and cannot deviate from the (suspected) flow charted process. The fellow concerned was not a happy person, and apologized which I think was wrong. But an attempt to cover up his embarrassment for not being able to offer a treatment they were clearly qualified to undertake.
They killed my mum, but that was during covid, during their finest hour, their battle Britain moment… pass the sick bag Alice.
Other side of the coin: I wrote a book (“Mad Medicine” – see above). It probably won’t make you feel any better but you will see that frustration with the NHS is not confined to patients. In the end I got peed off and took early retirement.
I could write a book about the collapse of our useless NHS. Ooops, wait a minute. I did write a book. I co-wrote a book “WHO CARES?” with Midlands housewife, Amanda Steane, how her husband was mistreated and then driven to suicide by a frightening series of NHS failures and cover-ups.
Shane, you misunderstand the purpose of the system. It’s not to cure, it’s to delay. Many problems resolve themselves if left long enough. Some people just get fed up & live with it.
I think the main purpose of the NHS is to function for its own benefit and not patients.
Or die.
A visitor suffered excruciating pain so we drove him to a local hospital: it was midnight on a Saturday. Within 15 minutes they had taken a blood and urine sample, after another 10 minutes he had an ECG. Then he had to wait another 10 minutes for the lab results to come back. It was a kidney stone so he was put on a drip for an hour or so for the pain.
The doctors said he was welcome to stay over the weekend (the hospital’s urologist would not be in until Monday) but our visitor felt much better so they just gave him some pain killers and a medication to dissolve the stone. They told him to come back any time and recommended he should have another check-up on Monday at a local urological clinic.
He was charged 100 euros (£84).
That is the German health system for you. We were lucky there was nothing going on that night but otherwise if you ever want to see a doctor, you see one; if you want an MRI scan, you get one.
The NHS should be dissolved and the UK health system privatized – it is that simple.
If all you have in Germany is the general, public health insurance (AOK etc), your chances are very good that some doctor will just fob you off. The classic would be to go the doctor because of acute lumbago (as excruciatingly painful as simple to cure — benzodiazepines will resolve that almost instantly but they’re close to being the most strictly verboten drugs of all drugs, presumably, because they actually help people) and then, meet a woman pissed of with her period who tells you that you should consider yourself lucky that men don’t get children and apart from that, get lost speedily. Guten Tag.
Then you go to another doctor, which the AOK will happily allow you to do.
Yep. Or to a dozen other doctors which will all be equally unhelpful. My brother once went through this and had (totally useless) painkillers thrown at him until these caused bleeding in his intestine before he finally found someone willing to prescribe something which actually worked. Because he had still some of the pills left, he then gave them to me after I had the experience described above (I was also offered a Novalgin injection despite I had told the non-lady that I wasn’t in pain ATM, just that I would be at the end of my next workday). I’m German and I’ve been living in Germany for long enough to know how the German health system works. The great plus is that you can actually go to a doctor, even a dentist, mind you, without a prior appointment. OTOH, this absolutely doesn’t mean the doctor (or any of a number doctors) will be willing to treat lowly Kassenpatienten (AOK patients). The general public health insurances have a fixed and not exactly large budget for treating patients per doctor per month and once this has been used up, they won’t pay for further treatments until next month. Even assuming that’s… Read more »
So you prefer the NHS or what are you suggesting?
I’m not “suggesting” anything, just telling you (and anybody else who might see it) that the German health system by far not so great as you’ve described it because I have +30 years of experience with it. You can count on speedy treatment if you belong to the classes of the population with so-called “private health insurance”, although this is somewhat counterbalanced by the fact that you can equally count of getting a lot of medically dubious if not outright useless “health procedures” performed on you because the private health insurance will pay for that.
If you don’t, it’s – at best – hit and miss. Dozens of doctors all telling you that they basically refuse to treat you are of little help and some people have other things to do with their time than doctor cruising.
A relative had a heart attack. Within 10 minutes the emergency doctor (‘Notarzt’) was with her, a few minutes later the ambulance. She was taken to hospital, had an immediate operation, got two stents and is now holidaying in the south of Spain. She has the AOK insurance. She has a good GP and I have never heard her complain of poor service.
Sure, Germany will have its share of bad or poor doctors, but the system allows you to go to whomever you wish. Maybe there are better health systems in the world but the German system is certainly a lot better than the NHS.
Judging from personal experience with both systems, I think they’re about equal for hoi polloi for general medical issues. The main advantage of the German system is that dentistry is considered medicine and not better plastic surgery rich people may have to kill the time (while poor people will simply lose teeth).
Is it really called ‘AOK’ – what a great name, in English at least…. ‘You’ll be AOK’
It is ironic that the Remoaners will never allow us to have one of the good parts of the EU, their health services.
As a bright young student (!) I always thought the simplest thing for a politician to do is to travel around the world and see which other countries do things better than we, and just copy whatever it is! I still think the same.
Trying to improve the NHS is just like flogging a dead horse.
Yes. Streeting did the travelling around in Opposition but it seems to have borne little fruit. Is he being sat on by Starmer? Or does he fear radical surgery might dent his popularity in a leadership election which may happen sooner rather than later?
I had exactly the same thing – went to the GP with an exquisitely painful and very swollen knee but was told I had to see a physio before I had an x ray. The wait for the physio was around 9 weeks. I couldn’t walk properly or drive. I said, what’s the point, because a physio won’t touch it without it being x-rayed? I just got a shrug, and was told it was up to the physio to order x-rays. I therefore paid for a private x-ray and consultation and the problem was diagnosed and treated within a week. The whole system is designed to delay you seeing who you need to see, and to manipulate the figures downwards to make waiting times look better.
Advice for the future: ask to see a rheumatologist. If a joint is suddenly swollen and painful it might be a mechanical problem but might equally be gout or another crystal arthropathy, or, rarely, an infection. it may also represent a flare of an underlying arthritis. A swollen joint may be painful because the capsule is being stretched, or the joint contents are provoking an inflammatory reaction, or both. Removal of the fluid produces almost instant relief and the fluid can be tested for crystals and infection, informing further treatment. Joint injections are rheumatological bread and butter.
Debbie Evans is the one to watch at UK Column on anything NHS related. Her slogan ‘Scrap the App’ is noteworthy.
NB. “Tech”, and machines only automate an existing manual process, usually doing it more quickly and requiring less labour. However if the manual process is not efficient, “tech” cannot introduce something that is not already there, it will just repeat the inefficiency more quickly. France… me. Shoulder problem, GP writes prescription for X-ray/ultrasound – done same day as GP appointment at nearby radiology clinic. Return to GP same week with pictures and report – inconclusive. GP refers me to rheumatologist (appointment following week) for further evaluation to see whether MRI would be helpful. He decides not as he diagnoses trapped ligament and writes prescription for physiotherapy – 30 sessions. Start sessions a few days later, twice a week. Treatment successful. These providers were private operating within the national insurance convention (l’Assurance Maladie) paid per patient and/or per treatment. No patients, no money. L’Assurance Maladie reimburses only 70% of treatment cost – paid direct to providers by me – reimbursement a few days later into my bank. Most people (me too) have “top-up” private insurance to cover fees not covered by l’Assurance Maladie. The system operates well, is usually quick and effective. Similar systems operate throughout Europe – except the UK… Read more »
These providers were private operating within the national insurance convention (l’Assurance Maladie) paid per patient and/or per treatment. No patients, no money.
This is key. The NHS needs an Elon Musk to get to this.
One of the first rules of trying to improve or automate any process – make sure you understand it fully before lifting a finger. Automating a crap process means it’s still a crap process
But it has the advantage of being an automated crap process.
Think of how much faster you will be able to get the same crap results but in volume on an industrial scale.
And it will not cost as much.
Obviously fixing everything after each crap outcome will cost much more as there will be so much more to fix.
This is called scientific and technological progress, like Starmer’s new great idea of AI with chips.
Sadly no one has told him the sad reality that AI is in fact AS.
Artificial Stupidity. But we get the stupid delivered much faster.
I have a similar problem, I requested a reissue of long-term medication but was told I needed a medication review before they would do that, so I asked for the review and the medication to avoid running out. I then collected blood forms to get a necessary blood test, but after booking this (I have to wait a month for the first available appointment) I now find that even after I have the blood test I cannot book a diabetic clinic appointment because there are none available in the month-long timescale offered.
This is all done via several separate systems which I have to log into at different web sites. It all feels disjointed and disconnected.
Now I will need to bother the GP surgery again because the link to book the unavailable clinic appointment is only valid for a week, and the blood test isn’t for another 3 weeks after that.
It feels disjointed and disconnected because it is – they are trying to apply a ‘standard’ generic process to suit all situations, and as we all know, that isn’t possible
Most discussions of efficiency are very superficial. Anyone can look at a complex system and alter it in such a way that a particular part of it will work better at the cost of all the other parts, or will at least appear to be that way for the sake of performance metrics. They are so blinkered in their thinking. Real efficiency means the best of all possible worlds and they are so far away from that but they can’t see that their narrowness of their consciousness is so destructive.
Exactly – a likely very real efficiency gain in many of the NHS processes could be ‘have a human look at it and decide’, however I’d posit that is very low down their list, preferring AI or similar
I have experienced exactly the same thing but for a different but serious injury. When I checked the NICE Guidelines they were very clear and I should have been referred as a matter of urgency to the first available musculoskeletal clinic. That was not done. One reason for the problem is because it seems NHS medics have been told to stop referring patients for MRIs. In my area MRIs have been outsourced to a private company so are even more expensive than ever. The reality is that when I attended urgent care the doctor who triaged me did not do the referral when it really was his responsiblity. I could have been referred immediately as urgent care is adjacent to A&E and I could have had an MRI the same day as an urgent case. The urgent care doctor instead told me to get my GP to refer me for an MRI – that way the cost falls on the GP service I presume and does not come out of the hospital’s budget. This was of course compounded by the urgent care doctor failing to record in the urgent care notes that he advised an MRI was necessary because with… Read more »
Just one of several experiences include a GP trying to force me to have surgery involving drilling into my skull for a condition which I did not have diagnosed by a sociapathic or psychopathic consultant. Consultants who cut [surgeons] get paid more than the ones who don’t and if your surgeon wants to keep getting well paid then he needs to ensure he has a full list for surgery. After massive effort to force a second opinion I was eventually seen at a specialist tertiary care London teaching hospital. The one abiding memory of this is being repeatedly asked at numerous appointments ‘Were you really diagnosed with X’ because they could not believe it – but they had to because it was all over my medical notes. I was not diagnosed once with a condition I did not have and referred for surgery. I was diagnosed several times. Totally barking mad. A medical friend of mine says I should write about all my bizarre NHS experiences and publish all the accounts in a book. It is quite incredible but documented in the medical records. I now advise family members that if they want to live longer then to avoid visiting… Read more »
CORRECTION TO MY FIRST POST HERE:
“However, this was only confirmed at an ultrasound appointment which occurred over
fivefour months after the original injury.And the upshot was I was referred urgently to a specialist sports injury private hospital where I got an MRI but
fourfive months after the original injury.”Oh and don’t expect the GMC to do anything about protecting patients. My experience of them is they do everything they can to put obstacles in your way as a patient. They are IMHO as bent as a nine pound note. They maintain a fraud that there is an independent Medical Practitioners’ Tribunal. There isn’t. It is called the Medical Practitioners’ Tribunal but in fact it is the GMC. They have not actually separated the functions of investigation, prosecution and deciding cases. It is a total fraud on the public and on the medical professions IMHO. They have shown themselves to be more interested in pursuing caring doctors who warn patients about dangerous stuff like vaccines – and there have been enough of them during the scamdemic – or who offer very safe effective treatments which don’t involve their mates in the drug industry getting loads-a-munnay for dangerous drugs which cause more harm than anything else. PS. The number needed to treat for statins is 1 in 40 so this means 39 people have to suffer serious side-effects which include stuff like memory loss and cognitive deterioration, irreversible muscle-wasting disease for every one patient who also suffers these dangerous side-effects… Read more »
I should point out that blood cholesterol is made in the liver from carbohydrates and a low cholesterol diet is thus a waste of time; that statins work (weakly) because they are anti inflammatory and the cholesterol lowering effect is an epiphenomenon. The research that led to the lipid obsession decades ago was flawed. You can lower cholesterol much more effectively with PCSK inhibitors than with statins but they are no better, and probably worse at lowering cardiac risk.
No one should think that these systems are designed by experts with the enthusiastic cooperation of clinicians. Over a decade ago the notorious “Choose and Book” computerised hospital outpatient appointment system was introduced without consulting the hospital consultants, who found themselves unable to prioritise referrals, spent hours trying to work the system and if they were like me gave up. I detailed all this in my book “Mad Medicine”. It would appear nothing has changed.
As someone who has gone through the process of having knee arthritis and lumbar spinal stenosis diagnosed in the last two years. I totally “get” your experience. GP’s don’t really do muscular-skeletal and refer you straight to the local NHS Physio service. Then the fun starts. They have a limited budget to see you and decide on a diagnosis/treatment pathway. The amount of pain and immobility you are in (and describe) will determine the speed and efficiency of treatment.
I truely feel sorry for those unable to afford to push this process forward using the private physio route as the whole NHS process seems deliberately designed to delay and triage you out. In then end you need to follow both routes simultaneously and provide each side with the evidence obtained to make progress.
It is a confusing process with many dead ends that takes months to figure out. Duplication and waste inevitably occurs. The NHS should really accept private diagnostic evidence and be able to include it in their pathways.
It is decision by flowchart and you have to be determined, time rich and frankly pretty clued up to force your way through.
I was seen by the physio at my GP practice who expertly diagnosed a tear of the medial collateral ligament of my knee following a fall. Because I was unable to strengthen my knee despite his initial NHS treatment he considered an MRI necessary in case the ligament was blocking the knee extension and needed surgical treatment. Both he and my GP assured me that an MRI was essential but that an NHS referral would involve considerable delay and despite their recommendations the MRI could well be refused. Fortunately I was able to afford an MRI scan privately which showed that the tendon was torn and thickened with scar tissue which did not require surgery but much more intensive physio – also only available quickly if I paid for the necessary sessions. Had I not been able to afford to pay my knee would likely have become even more fixed and limited in movement leading to further disability and probably a knee replacement! The lunatics really do appear to be in charge of the NHS asylum and it’s costing us all a fortune to fund an inefficient NHS or to bypass it in the private sector. The cost implications of… Read more »
This is, sadly, a common tactic of the NHS. When I first started in general practice specialists would understand that the person actually with the patient, who had taken a history and performed an examination, was in the best position to decide what should happen next. Referrals were not rejected or argued about.
over recent years things have changed, and a process inserted where nurses or physios take the GP referral and then triage it using a protocol. So a physio who has not actually seen a patient can arrange an MRI but a GP can’t.
Before I retired I had a lady “triaged out” of one of my colleagues’ urgent referral for suspected bowel cancer. Using a protocol, so that was fine-except that the GP was correct and the protocol wrong. Sadly for the patient…
Spot on. If a referring doctor wants an opinion they should get one. I never rejected a referral. A few were “bad” but there was no difference in these between the poor and the brilliant GPs…
This is nothing to do with technology. It’s the NHS rationing procedures without any regard for the wellbeing of the patients who pay for it (albeit indirectly). The NHS is unreformable. Treatment must be provided by private entities paid per treatment. The money must follow the patient.
This is the NHS trying to avoid using their expensive machinery 24/7/365. I know they may be short of radiographers, but not using it continuously is a ridiculous waste of resources. A person to just operate the machine might take a week to train sufficiently, so there is zero excuse for lack of staff. It may be that there is a lack of Radiologists (there is) who are the full diagnosis function, but spotting a slipped disk is hardly difficult. I am sure that jabby could spot one from the MRI pictures in a couple of minutes!
The fact NHS assets are not used routinely 24/7 is a travesty – let alone outsourcing scans like MRI’s, I assume to avoid having capital investment on the books? Given the NHS is vast enough to have amazing purchasing power, this situation is totally crazy
Shane, I think you will enjoy my book in which the NHS gets several mentions for dysfunctionality. The book is philosophical, but, I am told, also entertaining: https://www.hughwillbourn.com/book