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Would my best still be enough in today’s NHS?

Would my best still be enough in today’s NHS?

On the theme ‘A case I’ll never forget’, the winner of Pulse’s writing competition Dr Zoe Rog considers what would have happened to a patient she saw a decade ago had she seen her today

It was 2012, year of the Queen’s Diamond Jubilee and a triumphant London Olympics, and the health service was blissfully unaware of the havoc a decade of underfunding was about to wreak.

I was mid-morning surgery and my next patient was a young woman. She hoped she wasn’t wasting my time, she said. Having caught a cold from her baby daughter she had been briefly off work. While putting make-up on that morning for her return to work, she had noticed the whites of her eyes looked yellow. Otherwise, she felt much better.

I examined her and she did indeed look jaundiced. I suggested blood tests and sent her directly to the local phlebotomy department. Later that day, her tests were telephoned back. They were the highest readings I had ever seen outside a hospital setting. With two phone calls I sent her on her way to a bed on the gastroenterology ward.

Two days later, her mum called in with the news that my patient had been transferred to a specialist liver unit and was on the ITU. If a donor liver could not be found for transplant imminently, she would die.

It was a tense few days and I thought about my patient a lot. I had done my best; the phlebotomist, the biochemistry lab, the gastroenterology team, the ambulance team and the liver team had all done their best. All we could do now was hope and pray that our best was good enough.

A few days later her joyful mum passed on the news. My patient was recovering from a successful liver
transplant. She told me after she was discharged that she was incredibly grateful for the speed at which everything had happened, and that her transplant team had told her not all patients get to them in time. I was delighted. I was overjoyed two years later when she gave birth to another baby.

This was exactly why I became a GP. I hadn’t actually done anything clever, any GP worthy of a GMC number would have done the same. But I’d been a small cog in a healthcare machine that had done its best and a life had been saved.

More than a decade later, my patient remains well and rarely sees us. However, I still think about her. I wonder what would have happened if I had seen her 11 days ago and not 11 years ago. Would she have got through the 8am reception phone lottery to a same-day appointment? Probably not.

These days, the only way I could get a blood test done the same day would be to delay the rest of my surgery and do it myself. Would I have done that for this patient? I don’t think so. Even if I had, would she have seen the gastroenterology team immediately? Unlikely. Would she have got to the transplant team in time? I doubt it.

So many cracks have opened up now that our patients can fall down, and it has become so dizzyingly exhausting for us to keep hauling them out. I might instead be seeing the consequences of a patient who fell down the cracks. The distraught bereaved family, the child struggling to grow up without her mum and the overwrought work colleagues covering extra work while grieving a friend.

I truly love my job, and I’m still doing my best, but all we can do now is to hope and pray that our best is good enough.

Dr Zoe Rog is a GP in Runcorn, Cheshire



Please note, only GPs are permitted to add comments to articles

David Mummery 1 May, 2023 2:54 pm

Many congratulations Zoe. Absolutely fantastic! Sadly very true about the current state of the NHS. Despite all the managerial reorganisations, digital medicine etc etc undoubtedly things have got worse

David Wright 1 May, 2023 5:47 pm

Perhaps less “in spite of” and more “because of”? A great piece

Centreground Centreground 2 May, 2023 5:33 pm

Excellent work – I really enjoyed reading this.

Anonymous 5 May, 2023 8:55 am

Not entirely sure what you are trying to imply by writing this piece?

That you disagree with same day access lottery at your surgery?

Or that gastroenterology wouldn’t see your immediate/urgent referral?

I’m sorry there is a bit too much scaremongering in this piece if you ask me.

Of course we have more patient and less resources. That’s why you adapt your way of working. Leaving one extra slot for same day bloods with your HCA, or training up your receptionists to let you know if an unwell patients is on the line and there are no same day slots.

Cornelia Junghans Minton 8 May, 2023 10:37 am

I don’t think she is implying, she is stating the obvious.