UK Cardiology diagnostics

Not much forelock tugging in my personal experience

by crustyg - 2023-08-03 12:31:48

One (of the many) reasons why so many older GPs plan to retire on the day that their NHS pension is paid is that they are sick of being told what to do by non-medical personnel - don't order this, reduce the number of pathology tests, cut down on diagnostic medical imaging etc. - that there's no job satisfaction and just a seemingly never ending stream of abuse and criticism.  Not enough doctors with the skill to review and diagnose MRI/CT-scans, not enough echo-techs for the cardiac echoes being requested, not even enough blood tubes for the blood tests!  Just look at the number of unfilled NHS Consultant posts.

The hospital consultants that I've worked with are acutely aware that GPs influence who gets the private practice referrals and are generally polite and respectful of their primary care colleagues.

Doctors - whereever they work - are not slaves, or even indentured workers, and either vote with their feet (==leave) or, in desperation, go on strike.  At least one government minister has admitted that 'we can't afford to go back to 2008 levels' of pay for non-consultant NHS doctors.  Too much being spent on HS2, asylum seekers etc.

Even the Treasury had the sense to block expansion of UK doctor training, pointing out that when Jeremy Hunt was Sec of State for H&SC, less than 50% of recently finished F2 doctors (so, fully registered with GMC, not provisionally registered) signed on for further training!   First time it had ever happened. So, we import strike-breakers/blacklegs/cheap foreign doctors from poorer countries to avoid addressing the key issue: why do so many UK-trained nurses and doctors leave the NHS?

Fixing the NHS isn't easy, but it's not difficult either, once you acccept the terrifying concept that political decisions have consquences.  Responsibility.  Doctors, nurses, midwives all understand this.  Does your MP?

We have to learn to help ourselves

by Gemita - 2023-08-03 13:13:14

Piglet thank you for the link.  I guess both my husband and I are extremely fortunate to be under three main London Hospitals (two different hospitals for cardiology and one for urology).  I am able to communicate directly with some of the consultants/technicians (rare I know) and we are always seen promptly if we need help.  For example my husband needs ongoing urological care for urethral stricture disease and frequent urinary/kidney infections and we often bypass our GP completely when we need to.  I am in touch with the consultant urologist regularly and our care under the NHS has been exceptionally good.  

Last week my husband had a diabetic appointment locally followed by a dietician appointment.  We were seen for over 1 hour 30 mins and received some wonderful feedback and care + a new glucose monitor.   When this happens, it is the NHS at its very best. Even Michael commented on how nice it was not to feel rushed.  He is a very happy person by nature, despite all his health conditions and doctors/nurses find his gratitude for the NHS care he receives rather rare today and they warm to us both as soon as we enter the room.  There are still some very good doctors and nurses around and I hope we never lose them.

Back to reality, I know care is poor generally in our local hospitals and GP Surgeries and like everyone else it is worrying when we are faced with long waits to see a doctor/consultant for a new or continuing chronic condition.   I have had to learn to take direct action to help ourselves by having antibiotics in our medicine cupboard (on consultant’s advice) to give to my husband before he gets into difficulty with his respiratory condition (COPD) and urethral stricture disease.  We also have supplies of catheters to self catheterise when needed.  Even so he has had several urgent hospital admissions this summer already for infection but we are learning a lot about how to help ourselves get through any acute periods.  So far it seems to be working but it is exhausting to know what to do for the best sometimes and when to seek help.

I hope you are seen soon Piglet and that your symptoms can be addressed.  I presume you haven't heard from Cardiology?

NHS at its best

by atiras - 2023-08-03 14:02:39

I recently had cause to see the NHS at its best.  In heart transplant clinic I reported thst I had started having episodes of nesr syncope, manageable with the valsava manoeuvre.  They decided to organise a 48 hour heart monitor... which arrived via the post 2 days later (from a private company). I followed the instructions to stick it in place (much more comfortable than a holter monitor: 2 pads, one very small recording device and a very hort cable), wore if for 48 hours and sent it back. Three days later I got a call from my transplant team: you have intermittent high-grade heart block with ventricular standstills. We will be fitting a pacemaker thisaftternoon.  (Things didnt go exactly to plan after that but it wasn't for want of excellent care -:I finally left hospital after 11 days having had a temporary pacemaker for a couple of days before the real thing, and some investigations of unexpected kidney failure.

I fear that I may have got this level of service because I'm a heart transplant recipient but would hope it becomes standard.

NHS

by piglet22 - 2023-08-04 08:52:52

@atiras

You deserve and got exceptional treatment.

I hope you do do well for a very long time.

@Gemita

Wise words as ever and with all that have got on the go as well. Best wishes.

Have I heard anything? What do you think? The flags will be out when I do.

@crustyg

I can see you are well qualified to comment.

I've had a pacemaker in for quite a bit longer and have seen at firsthand how the service in my region at least has shrunk in the cardiology department, especially in the aftercare service.

I didn't think for one minute that things could go wrong after 18-years, but it did and now I need help, but it's not forthcoming.

To date, I have had 30 weeks, that's 210 days, of debilitating ectopic led bradycardia and every day wake up to a pulse of below 40 BPM. One blackout and three involuntary falls. Every day I have to watch how I get up just in case.

Help from the hospital so far? One increase of base rate, big increase in beta-blocker dose and all to no avail.

One consultant phone call with a promise of an urgent pacemaker check. That was five weeks ago. Another call from a registrar with a hint there might be a face to face and that was two weeks ago.

A lot of talk but not much action.

I haven't seen a consultant since mid-2005.

Perhaps I'm expecting too much, but when every letter I get starts off with "under the care of", I start to wonder what that really means.

Two GPs at my surgery have written to the hospital - yes, I do get to see all the correspondence - on my behalf to try and get something at least looked at, but both have failed and it's not their fault.

And yes, they have been very polite as well, "at your earliest convenience" and "preferably in person"

So their efforts and being nice didn't come to anything either.

I just hope you never get in the same situation.