How do you make the NHS Elephant dance for you?

How do you make the NHS Elephant dance for you?

At its best, the NHS is a wonderful service, but often its an grumpy deaf elephant going the wrong way.

Why is this so?

1. Admin of NHS is awful
2. Partly as its too big and complicated
3. Nothing (computers) and no one (people) talks to each other
4. The waiting lists are long and unacceptable.

Here are some Top Tips to make the NHS Elephant dance for you

Communication (and administration)

• The glue (connections) do not work well. It is important to remember that you are in charge of your own health, and (to an extent) responsible for the risks you take – not just the doctors.
• Do not assume the computers link up – and all NHS staff know all about you, your past mediccal history your current medication etc. Keep your own medical record and up-to-date drug list.
• Keep the contact details of all your NHS carers – phone numbers, email, the lot. Its OK to contact them. You are not bothering them. You pay their salary.
• Sequential administration. Administratively, too, things are done sequentially, and sometimes administration can be frustratingly slow, as you wait for each stage to happen. A must lead to C, via B – it cannot go straight to D. You can guide the elephant from A to D.

Hospital

• Time spent in hospital is risky – lying on trolleys in corridors, getting infections from other patients. Hence you need these to be as short as possible. The average length of stay is 6-7 days. So, you should be asking to leave on day 2 or 3.
• Excess caution. In hospital, the people caring for you are naturally worried about doing the wrong thing. This can sometimes lead to an excess of caution. Following guidelines etc. For example, if a doctor said you can do some activity – and the nurse says you must not, say firmly, ‘Doctor X said it was okay’.
• Beware long hospital stays. The consequence of excess of caution and slow administration can be hospital stays that are longer than they need to be. Long inactivity could be the greatest risk of all – particularly for the elderly.
  – Example 1. Chase, chase, chase. If the doctor says the next available scan is next week, ask them to go to x-ray and put your case that it should be done in next 24-48 hours (before the bank holiday weekend, when nothing happens for 3-4 days)
  – Example 2. Make sure you know the name of your consultant – and how to contact them after your admission
  – Example 3. If there’s something bothering you – speak to the ‘nurse in charge’ of the ward. Ask to see your consultant, or the manager in charge of the department your consultant works in. If that does not work, contact or go to the PALS department. It will be near the main entrance
  – Example 4. Anticipate the stages ahead. For instance, you can reassure staff, that you are able to return home safely (and when) – and ask them to work towards that day (in your dance routine!).

“I’m on a waiting list. How can I make it happen sooner?”

• There is quite alot you can do actually. Here are 5 top tips to get your operation/procedure done sooner
• For example, a regular call to your consultant’s secretary – reminding them a. who you are, and b. that you will take a slot at short notice if someone cancels – is a good idea.

GP

• Double appointments. At your GPs, ask for a double appointment (20 mins). 10 mins is not enough to deal with complex problems, especially for older people.

Hospitals and GPs

• Ask for a second opinion. If you took your car to a garage and it wasn’t fixed, would you take it back there? A good doctor will not be upset and arrange it for you.

Not hospitals and GPs

• Not all medical problems are best dealt with by hospitals and GPs.
• Examples include:
  – Midwife for pregnancy issues
  – Podiatrist – foot problems
  – Optometrist/optician – eye problems
  – Musculoskeletal physiotherapist – shoulder, back, hip, knee and foot pain
  – Urgent care (especially out of hours, i.e. 8am-8pm, 7 days a week) – Urgent Treatment Centre, Walk-in Centre and Minor Injury/Illness Units (find out what is available locally). You can see a doctor there today.

General points

• “Would you have this?” (operation, procedure or whatever). This is a simple but important question you should ask of your hospital consultant or GP. If there is any delay or uncertainty in answering, think again. Ask for other options.

Your responsibility

Is to be the glue in the system, and make sure all of the above happens in a timely fashion, to help your healthcare progress.

I.e. you ‘make the elephant dance’ for you.

Summary

We have described how to make the NHS Elephant dance for you. We hope it has been helpful. Give it a try!