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NHS - very impressed

NHS - very impressed

Old May 7th 2018, 11:18 pm
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Default NHS - very impressed

My 89 year old mum has enjoyed pretty good health up until recently. She's recently been suffering from COPD, heart failure, water retention, and so on. I happen to be visiting her and have experienced first had just how well she is being looked after by the local NHS in Lancashire.

On Friday, I went along with her to meet her GP, a lovely Asian lady. Despite signs up on the wall saying appointments are only 10 minutes, she spent a good 45 minutes with us and apparently did the same last week. The doctor has arranged for a 24-hour ECG test, an echo-test, various blood tests, a cardio specialist visit, and more. My mum was prescribed a blood thinner, a beta-blocker, and a diuretic. On Saturday, on our way back from a great Indian meal out, she banged her (water-retention-swollen) leg against the wheelchair and had a very large 'blood blister' form - about 4" by 1", very scary looking. Since she just started taking blood thinners, we worried that if it burst, she may bleed badly so we called a 'district nurse' number, and in a few hours a couple of lovely nurses showed up at her home and did a great job of bandaging the entire area. Today (Monday) there was a lot of pain in the area, so I called the district nurses again at 4pm, and they came out again around 8pm, and noticed a lot of redness /etc and they decided to call a doctor, so then an on-call doctor visited within an hour and gave her penicillin to prevent infection. Tomorrow she goes in to be fitted for her 24 hour ECG, and Thursday she has another appointment (I can't keep track of what that one is for), and on Friday the nurses are coming back to change the bandage on her leg.

All this for an 89 year old. And not even a mention of payment. I'm pretty impressed.
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Old May 8th 2018, 5:12 am
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Default Re: NHS - very impressed

My mother, who passed away last year at the age of 96, also received excellent care from the NHS right up to the end.
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Old May 8th 2018, 2:10 pm
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Default Re: NHS - very impressed

I think my Dad's NHS care in Bolton was pretty good. OTOH my cousin in WA lost her mother who lived on the Isle of Wight recently and she is furious with the poor care she feels her mother got from the NHS there.
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Old May 8th 2018, 2:41 pm
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Default Re: NHS - very impressed

My sister has been undergoing chemo since last November. After her final session next week, she will undergo a scan -- and then have to wait a month for the results. Apparently the NHS outsources reading the scans overseas and thus it takes such a long time. That sounds insane to me. When she was first diagnosed in September, they said she was stage one; by the time they had finished messing around taking forever to schedule tests and obtain results, she was stage four. I can't imagine waiting a month for test results in the US.
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Old May 8th 2018, 5:48 pm
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Default Re: NHS - very impressed

Scans here the result is emailed to you next day. I had a biopsy last month and the doctor phoned with the result 2 days later. The care you get from NHS staff is usually very good. But where the NHS falls down compared to the US is in getting appointments and scheduling tests.
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Old May 8th 2018, 6:08 pm
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Default Re: NHS - very impressed

Originally Posted by lansbury View Post
Scans here the result is emailed to you next day. I had a biopsy last month and the doctor phoned with the result 2 days later. The care you get from NHS staff is usually very good. But where the NHS falls down compared to the US is in getting appointments and scheduling tests.
Yes, my sister has been well cared for once they got started, but I found the time that elapsed between each test and its result excruciating—and it will be the same again with the next round of tests.
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Old May 8th 2018, 8:54 pm
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Default Re: NHS - very impressed

I hope your mother gets well soon.
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Old May 9th 2018, 12:48 am
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Default Re: NHS - very impressed

Originally Posted by lansbury View Post
Scans here the result is emailed to you next day. I had a biopsy last month and the doctor phoned with the result 2 days later. The care you get from NHS staff is usually very good. But where the NHS falls down compared to the US is in getting appointments and scheduling tests.
Can't comment on the NHS, but some in the US struggle to get appointments/tests in a timely manner, for example some Medicaid patients, especially those in rural areas. And the uninsured may be truly out of luck. But I certainly agree that those with good insurance who live in areas with a good supply of doctors, your treatment - at a cost - will be pretty good. Mine has been.
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Old May 9th 2018, 12:57 am
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Default Re: NHS - very impressed

Originally Posted by Nutmegger View Post
My sister has been undergoing chemo since last November. After her final session next week, she will undergo a scan -- and then have to wait a month for the results. Apparently the NHS outsources reading the scans overseas and thus it takes such a long time. That sounds insane to me. When she was first diagnosed in September, they said she was stage one; by the time they had finished messing around taking forever to schedule tests and obtain results, she was stage four. I can't imagine waiting a month for test results in the US.

I'm sorry to hear this and hope she's doing better now.

This all screams for proper funding of our health service. It is shameful what has been done to it. I hold no brief for Tony Blair but if I remember correctly he did invest in it and wating times went down.
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Old May 9th 2018, 4:46 pm
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Default Re: NHS - very impressed

Happens here in the US too. Depending on the doctor I might get an email telling me my results are online within minutes of the lab finishing them. Other times I've had to wait a month because the doctor won't release results in any form except face to face, and doesn't have appointments for a month.

Then you get a mystery bill from the lab nine months later for $32 which the insurance didn't cover. Not much but it was so long ago I now I have to check that that bill is genuine - I've had so many fake bills it's not funny anymore.

Good and not so good in the NHS, both for patients and for staff. I don't recall any particularly bad experiences for any of my family - usually quite the opposite.
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Old May 10th 2018, 3:36 pm
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Default Re: NHS - very impressed

The NHS is truly wonderful and I will have a tear in my eye when they celebrate its 70th birthday in July - I was born in the hospital that launched the NHS on 5th July 1948 and have passed the plaque proclaiming this proud fact every visit - from childhood illnesses and broken bones, volunteering as a teenager and as an adult visiting ill relatives.

Having said that, there is a degree of lottery with how good your local services are, which is down to two factors - the policies of your local Health Authority on the structure of their care facilities (hospitals, clinics etc) and what treatments they will fund, and how well your local GP surgery is managed. My parents are fortunate to live in an area that has both excellent services for geriatric patients, and a great GP surgery. The only thing I would say is that even when you get excellent services it does help if you have someone who can advocate for you if you are not up to dealing with all the appointment and letters. Sometimes there are slip ups with letters and appointments and you (or an advocate) need to be able to chase up and query where necessary. I suspect though that this is not unique to the NHS, but any busy healthcare system dealing with chronically ill patients.
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Old May 14th 2018, 4:26 pm
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Default Re: NHS - very impressed

Originally Posted by lansbury View Post
Scans here the result is emailed to you next day. I had a biopsy last month and the doctor phoned with the result 2 days later. The care you get from NHS staff is usually very good. But where the NHS falls down compared to the US is in getting appointments and scheduling tests.
Pretty much the same in Canada, just finding a doctor accepting patients can be near impossible. Hospital care is generally good, but not always, really depends where you are, post code lottery of sorts.

Specialist waits are long at times as well, I had to wait 9 months for a heart specialist and my wife a bit over a year for a specialist.
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Old May 16th 2018, 2:54 am
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Default Re: NHS - very impressed

Ah yes - the wonderful NHS. This was my stepsister's experience

Faulty machine delayed Cheryl Cope blood poisoning diagnosis - BBC News
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Old May 16th 2018, 6:58 am
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Default Re: NHS - very impressed

The NHS is imho, the finest health service on the planet. Why?

The bottom line is this, it costs the taxpayer 2500 pounds per user per year. Find me any private or public scheme that offers what it does for anything like that cost. Remember - it is very holistic treatment, with unlimited liability for life, free at the point of contact. There have to be financial decisions and limits and decisions on what should be provided so there will always be ‘winners and losers.’ Human error will always exist, and anything costing over 200 BILLION a year will sound ugly when you waste 5% and while economies of scale make stupendous things possible, that scale is also a big issue when managing things like it systems. [I was a senior it manager in the nhs for a number of years, we spent a lot, provided great services but eg imagine the nhs spine for patient records, as an application in europe its only matched by amazon, whose cloud infrastructure it uses [its an amazon ec2 app]]. Imagine a database getting 50,000 requests a second at times.

Its clinicians are normally very dedicated individuals, who do earn very well, but who are pretty much free to make clinical decisions hourly, based on real clinical need and priority, not pricelist.

Sure some drugs are not provided, but the important ones are, at fixed low cost. West london [ealing] is a TB hotspot, this is mainly because it is the home for lots of eastern european migrants who arrive with it because for some reason their countries dont treat it. Treating them costs a few thousand each normally, but up to 50000 for some resistant forms, and it just happens for free, and nobody bats an eyelid or actually has any idea what those tablets cost.
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Old May 16th 2018, 11:51 am
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Default Re: NHS - very impressed

Originally Posted by uk_grenada View Post
The NHS is imho, the finest health service on the planet. Why?

The bottom line is this, it costs the taxpayer 2500 pounds per user per year. Find me any private or public scheme that offers what it does for anything like that cost. Remember - it is very holistic treatment, with unlimited liability for life, free at the point of contact. There have to be financial decisions and limits and decisions on what should be provided so there will always be ‘winners and losers.’ Human error will always exist, and anything costing over 200 BILLION a year will sound ugly when you waste 5% and while economies of scale make stupendous things possible, that scale is also a big issue when managing things like it systems. [I was a senior it manager in the nhs for a number of years, we spent a lot, provided great services but eg imagine the nhs spine for patient records, as an application in europe its only matched by amazon, whose cloud infrastructure it uses [its an amazon ec2 app]]. Imagine a database getting 50,000 requests a second at times.

Its clinicians are normally very dedicated individuals, who do earn very well, but who are pretty much free to make clinical decisions hourly, based on real clinical need and priority, not pricelist.

Sure some drugs are not provided, but the important ones are, at fixed low cost. West london [ealing] is a TB hotspot, this is mainly because it is the home for lots of eastern european migrants who arrive with it because for some reason their countries dont treat it. Treating them costs a few thousand each normally, but up to 50000 for some resistant forms, and it just happens for free, and nobody bats an eyelid or actually has any idea what those tablets cost.
No EU Country is listed by the WHO as having a TB incidence rate of ≥ 150 / 100,000 (their highest risk criteria).

Some non EU Countries that have a rate ≥ 150/100,000 include India (211), Pakistan (268), Bangladesh (221), Nigeria (219), Guinea Bissau (374) and Phillipines (554).

In total 55 countries feature a rate ≥ 150/100,000 - this total includes some "eastern" Eastern European Countries (non EU, not qualifying for FOM & whose inhabitants require visas and possibly screening). These include Armenia (44/100,000), Azerbaijan (66), Belarus (52), Georgia (92), Kazakhstan (67) & Russia (66).

Eastern European EU members check out out as follows Hungary (9), Czechia (5), Poland (18), Bulgaria (27) and Latvia (37). Only Romania has a rate greater than 40 / 100,000.

For comparison, France (8), Germany (8), Austria (8), UK (10) & non EU Switzerland (8).

Demographic of London Borough of Ealing = Non white: 47%, British / Irish white 37%, non British/Irish white: 16%.

According to the Lancet UK TV rates have declined significantly in the last 5 years.

Sources: Public Health England, NHS, gov.uk, Ealing Borough Council, The Lancet.

Last edited by Expatrick; May 16th 2018 at 11:59 am.
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