 Poster: A snowHead
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[quote="pam w"]
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NHS resources are finite, and demand almost infinite. We can't always be first in the queue. |
Well said, there is a big difference between wanting to see a doctor quickly and needing to see a doctor quickly and the NHS is pretty good at deciding if it is a case of want or need and acting accordingly.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| pam w wrote: |
| Did the piste patrol keep your skis till their bill was paid? Happens sometimes and easy to lose track if you don't have someone with you to help. |
No, they were rental and I returned them yesterday.
The insurance want me to get a Fit to fly certificate from a doctor, so they can book a whole row for me, so doing that today.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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First line of my travel insurance winter sports section states that they will cover the cost / refund / reimbursement of ski equipment hire / ski lessons and ski pass in the event that I am unable to use them due to an injury or illness max claim £250 per claimant per week, seems pretty clear for that bit.
Jeez...reading it my insurance will even pay out if I lose my ski pass and have to go buy another or if my personal kit gets stolen and I have to hire while they sort the claim to replace my own skis.
Further reading shows that mine will only pay for physio once I return home and then only up to a limit of £350
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Rest, ice, compression, elevation, as recommended by doctor in France seek advice on return home for a definitive diagnosis and ultimately physio is likely to be necesssary or at least advised but for now rest is more important. Delay in full diagnosis while counterintuitive is not fatal to an ultimately good outcome. So sorry this has happened, dont angst about the lift ticket or the bindings you are pretty much on a hiding to nothing, certainly on the bindings count although the local lift operator may give you a refund, what you need to do is take a bit of time out to "feel sorry for yourself", you are entitled to this and then work at getting fixed and fully fit again.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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My wife injured her knee at four weeks ago in Italy. When we got home we phoned NHS Direct exactly to enquire about the A&E/GP route and she was advised to go straight to A&E.
Our local hospital has an Urgent Treatment Centre and she was sent straight there - you can only access with an A&E referral. Saw a physio and was x-rayed that day, CT and MRI scans within ten days along with accompanying consultant appointments and has now started ongoing physio.
So if the NHS advises you to go to A&E I'd go.
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You'll need to Register first of course.
You'll need to Register first of course.
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Urgent Treatment Centre and she was sent straight there - you can only access with an A&E referral
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This is very unusual. If you read the NHS advice that I linked above you will see that Urgent treatment centres are GP-led and you can be referred by NHS111 or you can just walk-in. They are a facility designed to take non life-threatening cases, like week old injuries, away from the emergency centres, A&E.
I suspect that you were triaged away from the A&E to the treatment centre specifically to avoid over-loading the emergency services.
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I was not going to respond further on this thread, but feel that I must, as your NHS web link does seem to be a little, well, out of touch and meaninglesd as far as the realities on the ground always work.
For instance, our urgent care centre is usually only nurse led and could not, I believe, deal with a traumatic knee injury, which they could only refer back to a major hospital. They are shut more than they are open - and it has long been wanted to close it completely and centralise all services in 1 big hospital, presumably via A&E. Where I used to live we did not have UCC at all, only part time MIUs (with or without x ray, and mostly with no ability to deal with fractures, major soft tissue injuries etc) or full A&E in major cities or towns. Most residents did not know that the MIUs existed... Where I live now we have only a small basic part time MIU and this quasi UCC, plus an after hours urgent (medical consult only) centre, no walk ins, 2 A&E units at the 2 not nearby major cities' large hospitals. If you phone 111, the usual answer is either see the GP if you can wait, go to A&E if you can't (or are in pain, injured, have certain clinical signs, etc etc); if they actually ever answer the phone, of course: which mostly they do not.
My old GPs allowed you to self refer to physio, my current one demands a wait first for a GP consult, then a wait for physio. And I thought that GP time was valuable, too..?
I can and could in either location join only 1 GP practice as there was only one: so changing, as you suggested, upon poor service and knowledge, is simply not possible.
I think the picture coming out here is that a standardised, seamless and functioning triage-based nationwide system, with appropriate known and separate acute, emergency and urgent assessment, treatment and ongoing care pathways (in primary or secondary care settings), plus a national phone advice line and GP feed-ins, is anything but. It is the old postcode lottery (or PCT and CCG lottery), and service, and services available, varies widely across the country. In my experience, there are nurse practitioner facilities quite widely for minor ailments, minor medical issues, infections, minor injuries etc - but for people such as those coming back to the UK with ligament or bone injuries (who would have gone to A&E doubtless if the injury/incident had occurred in the UK), the referral pathways often seem to be lacking. Fact.
Are you really surprised that the only thing which many people might think - nay, are advised (and not just by amateurs) - to do is to go to A&E, and hope that they will then get sent to the right place? If the system works properly, once arriving at an instinctive point of help (and I say instinctive because A&E is ingrained in the national lexicon, and all these UCCs, MIUs and all the rest of it are not, by a long way), then they should not waste valuable true A and E time and expertise, but are quickly assessed as to need and signposted elsewhere (or booked in to other clinics) accordingly. In general, from my experience and reading of others', this works reasonably well, if not 100% efficient or speedy for those in considerable pain or inability to self ambulate and self drive.
Ideally, the whole A&E signposting step should be able to be done over the phone by 111 or your GP, but this does not in practice always work. Not news, I'm afraid.
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@Grizzler, well said. I have absolutely no idea what a UCC or MIU is. What I do know is that if I go to my GP for an injury they have no idea how to get you into the system. I returned with a serious leg fracture. All I needed was a referral to the fracture clinic...it was like I was asking for unicorns breath. I had to tell the doctor what to do and chase chase chase ...I got what I needed (not what I THOUGHT I needed) but it would not have happened without being proactive...the potential delays would have kept me on crutches and off work for weeks longer than was necessary.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| Rareperk wrote: |
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Urgent Treatment Centre and she was sent straight there - you can only access with an A&E referral
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This is very unusual. If you read the NHS advice that I linked above you will see that Urgent treatment centres are GP-led and you can be referred by NHS111 or you can just walk-in. They are a facility designed to take non life-threatening cases, like week old injuries, away from the emergency centres, A&E.
I suspect that you were triaged away from the A&E to the treatment centre specifically to avoid over-loading the emergency services. |
Sorry, yes, you're right, the centre can be accessed with an appointment from NHS111 or even as a walk-in. To be fair to the NHS Direct operator, the initial diagnosis from the trauma centre in Italy was a potential broken knee, so that could be why we were directed to A&E.
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I guess every NHS Trust has slightly different rules.
Around here we have a MIU (Minor Injury Unit) + Fracture clinic - there are not always doctors in the MIU, so unless its a minor injury you can get sent to one of 2 A&E (both about 15 miles away).
Ive gone to MIU with a week old foot injury that didn't go away & was told that I should have gone via my GP for a referral (i explained I thought as it was an injury, I had to go via MIU).
GPs can refer for xrays & other scans, blood tests, & other outpatient diagnosis, etc. This is usually done there & then by the GP.
Physio is a walk-in clinic & from there they may refer you the physio department. Same for Podiatry.
This information is not really clearly given. So GPs/A&E, etc. feel obliged to help & waste time sending people to the right services.
GPs are now referring people to visit their Pharmacy first for what seems minor ailments for over the counter remedies.
My GP do an over the phone triage service where the GP will call you back for a quick over the phone consultation. They give an appointment, or advice or send you to the correct services.
While the NHS is free, it would help itself if it explained where people should go at first instance, rather than rocking up at A&E because of a runny nose.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| Grizzler wrote: |
... My old GPs allowed you to self refer to physio, my current one demands a wait first for a GP consult, then a wait for physio. And I thought that GP time was valuable, too..?
... Are you really surprised that the only thing which many people might think - nay, are advised (and not just by amateurs) - to do is to go to A&E, and hope that they will then get sent to the right place? .. |
The GP's paid around £137 a year for you, plus other profits from incentive schemes and other stuff like renting their buildings back to the NHS. Their contracts means that many of them don't need to work until normal retirement age - their time certainly is expensive (or "valued" if you like). A business-savvy GP could refer pretty much everything to someone else, thereby maximising their pay whilst burning a lot of CCG (taxpayer) money. Some CCGs have incentive schemes to reduce that problem, and it sounds like yours has one of those. They're probably incentivizing your GP to triage people. The idea is to make Primary Care do the work, thereby increasing overall system capacity.
People obviously will "do a home run" on Primary Care by going straight to A&E. In some countries they put Primary Care at the front of the hospital for that reason.
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FAQ
