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The NHS is the little old lady waiting for an ambulance

Copperfield

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Really annoying, isn’t it? You know, when a little old lady goes and trips over in the corridor outside your room, fracturing her hip. And lies there moaning gently, not having had the foresight to go and break her NOF where other patients don’t have to step gingerly around her, prompting inevitable enquiry and explanation, nor having had the courtesy to do it at a time when I’m not already running half an hour late. Christ, some people.

Except, of course, it isn’t annoying at all. Beneath that rough, tough exterior, we’re caring, sharing medical professionals. So any inappropriate hint of negativity is immediately swamped by the overwhelming urge to help. Cue receptionists providing blankets and pillow and nurses with serious analgesics. Thanks, I say, now how about something for the patient, ha ha!

Yes, that’s the patient whose elderly grey hair I’m gently stroking as she apologises for causing a fuss. ‘Don’t worry,’ I say, ‘the ambulance will be here in a minute.’ Ah. Big mistake. True, I’ve heard rumours of ambulances taking the scenic route to surgeries, as this Pulse investigation bears out. But, come on, this is a little old lady in a lot of pain.

Yet, no kidding, when I glance down the corridor well over an hour later, nothing has changed. OK, her moaning is a little weaker and our nurse kneeling beside her has developed her own wonky leg. Also, I swear the patient’s moved down the corridor a bit – presumably trying to drag herself and her broken hip out the exit, through the pouring rain and street detritus all the way to the doors of the local hospital, knowing that this will be quicker than dialling 999.

The ambulance crews are suffering the same horrendous constraints as the rest of us

It would, of course, be easy to hurl invective at the ambulance service for this apparent dereliction of duty. Hang on, though. They, after all, are merely suffering the same horrendous constraints as the rest of us, sitting impossibly between the rock of escalating demand and the hard place of inadequate funding.

The reason why we can’t get an ambulance in an acceptable time is the same as the reason why patients can’t get to see their GP for weeks, and why A&Es are in winter meltdown all year round, and why the CBT wait is beyond the natural history of most mental illnesses, the same as just about every other example of inadequacy in the NHS.

We’re all in it together, the problem being that what we’re in is the shit. I realise this is hardly breaking news. But there is something about an osteoporotic crack outside your surgery that brings it all into sharp focus.

So I will hurl invective. Not at those procrastinating paramedics. But at a system that can pat itself on the back for promoting instant digital, palm-top GPs for the worried well while leaving an elderly woman in a crumpled, fractured heap in my surgery corridor.

If that sounds dangerously like sanctimonious crap, it’s true sanctimonious crap.

The NHS needs a blue-light ambulance. And it has already waited ages.

Dr Tony Copperfield is a GP in Essex

 

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Readers' comments (13)

  • Yep but at least she was able to see you at 19:30 at night when you pay extra for staff compared to 12:00 when it is warmer, lighter and you can buy 3 appointments for the price of 2 in extended hours!

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  • You've finally arrived and 'woke', Tony. All you need to do now is say, the state needs to butt out as much as possible, out of most things really, but more relevantly, healthcare provision.

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  • Cobblers

    Or, as a basic minimum, charge for the ambulance service. It is, after all, a glorified taxi.

    In Australia my relatives showed me their ambo insurance card which (at the time) was 50 cents a day. Non presentation of said card resulted in a quite a large charge for the use of the ambulance.

    Might concentrate minds in the UK in terms of usage?

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  • Nice idea Cobblers. Mind, if patients paid 50 pence a day here for ambulance cover, it would cost more than is paid for GP services?

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  • Please read my comment on the Pulse investigation article highlighted in this column

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  • David Banner

    (“Procrastinating Paramedics”. Brilliant band name, think I’ll steal it)

    The issue here is that if she snapped her NOF in her own doorway, as my poor mother did, an ambulance would arrive pronto. But crack one off in the GP surgery then you wait for yonks. You don’t exsanguinate any slower in the Quack’s waiting room.

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  • Medical care is not free. there is a price to pay. Here,, we pay in TIME. TIME spent WAITING.
    in NI, neurology, dermatology, orthopaedic etc etc appointment waiting time 5 years sometimes, yes 5 years. People die on waiting lists without any treatment. They lie on trolleys for days [ if you are lucky ]. A colleague lay on the floor in A+E for hours.
    So, is this what we wish ? Or a fee on top of taxation? Or more taxation.
    Or just pay by lying on a floor with a broken hip. No nation can fund complete health and social care, I think. It needs top up payment by us in some form.

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  • Not always that quick at home either - my father in law fell in the garden and suffered a NOF. The initial estimate for the ambulance was for 4 hours - for an 89 year old outside!
    We managed to get him inside, though didn’t tell the ambulance service that when they rang back - and they eventually came after 1 3/4 hours.

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  • But Copperfield- are your Health and Safety policies up to date and regularly reviewed to ensure there are no reasons for her tripping up in you surgery? And also why didn't you diagnose her low BMD and have her on appropriate treatment to prevent this fracture? Or had you missed that metastatic deposit?

    Expect an enquiry from NHS England.

    And to David Banner- in 2019 the term "crack one off" means something very different to what I think you meant to convey. Crack one off in the GPs surgery and you will be waiting for the police, not an ambulance.

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  • I our local town an elderly woman waited over 3 hours in the street for an ambulance with #NOF. The ambulance service of course passed the CQC inspection because it had its paper work in order. Likewise our OOH service is woefully failing yet passed the CQC fine.
    The CQC are obviously measuring the wrong parameters.
    has anyone refused a CQC visit on the grounds that no doctor is in the team? I would be tempted.

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