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This is the NHS: live on the frontline from a GP surgery near York This is the NHS: live on the frontline from a GP surgery near York
(35 minutes later)
11.41am GMT
11:41
Laura Atherton, nurse
Jessica Elgot
By mid-morning, nurse Laura Atherton is doing a diabetes patient’s yearly review. The patient has been taking notes of their blood sugar levels, and has adjusted their medication dosage recently, which they say has been having a positive affect.
One thing they are concerned about is their weight. Atherton checks the patient’s BMI, but cautions that it is not an exact science.
I get a lot of patients who have seen things in the media about new diets or nutrition, so I really do have to keep on top of it. People ask me things like ‘should I do the 5:2 diet?’ so I do have to know what it actually is.
Her main guidance is on portion size and exercise. “I do tell them about BMI, but I’m far more concerned if they are getting active and eating healthy food than whether they have exactly the right numbers.”
Atherton says she tries to be sensitive when discussing weight with patients. “I’m not a bullying kind of nurse. Often, I do find people are self-aware if you bring it up sensitively.”
Though much of the discussion Atherton often has with diabetes patients is about diet, she checks their feet for signs of change to the nervous system, reminds them how to cope with a dip in blood sugar and talks to them about the new alcohol guidelines – particularly the recommendations that people should have at least a couple of days a week that are alcohol-free.
11.00am GMT11.00am GMT
11:0011:00
'Apparently I was in a coma, but I don’t remember it''Apparently I was in a coma, but I don’t remember it'
Jessica ElgotJessica Elgot
Cyril Reynolds, 78, used to swim three or four times a week. Early one Tuesday morning, he pulled himself out of the pool and into the showers to wash off. The next thing he remembers is waking up in hospital – on the Sunday.Cyril Reynolds, 78, used to swim three or four times a week. Early one Tuesday morning, he pulled himself out of the pool and into the showers to wash off. The next thing he remembers is waking up in hospital – on the Sunday.
“Apparently I woke up from the coma on Friday but I don’t remember it. I’d had a massive heart attack, and the doctors told me I’d actually had an earlier one, which I didn’t realise.”“Apparently I woke up from the coma on Friday but I don’t remember it. I’d had a massive heart attack, and the doctors told me I’d actually had an earlier one, which I didn’t realise.”
That heart attack was 16 years ago, but Reynolds is still coming for regular heart check-ups, as well as other matters that he says are a result of his age. He likes to see a regular GP, who knows his health history:That heart attack was 16 years ago, but Reynolds is still coming for regular heart check-ups, as well as other matters that he says are a result of his age. He likes to see a regular GP, who knows his health history:
I saw a doctor here for many years who retired, but he knew me. He once said to me ‘come back in four days’ so I did, and he saw me in the waiting room, took one look at me and said ‘you look better than you did’. A computer can’t tell you that. I believe you have to know a person, and I don’t have that here now, but it’s something I’d like to have again with a new doctor.I saw a doctor here for many years who retired, but he knew me. He once said to me ‘come back in four days’ so I did, and he saw me in the waiting room, took one look at me and said ‘you look better than you did’. A computer can’t tell you that. I believe you have to know a person, and I don’t have that here now, but it’s something I’d like to have again with a new doctor.
UpdatedUpdated
at 11.03am GMTat 11.03am GMT
10.34am GMT10.34am GMT
10:3410:34
Should fitness trackers be part of the data your GP holds?Should fitness trackers be part of the data your GP holds?
Samuel GibbsSamuel Gibbs
One key debate in the GP realm surrounds how to bring the NHS’s patient records into the digital era, such as using health data from personal smartphones and fitness trackers, and how to keep this data secure.One key debate in the GP realm surrounds how to bring the NHS’s patient records into the digital era, such as using health data from personal smartphones and fitness trackers, and how to keep this data secure.
One group, Patients Know Best, believes the solution is to put the patient in control of their data, collating it into one central place that plugs directly into NHS systems and pulls in data from other sources, including personal devices.One group, Patients Know Best, believes the solution is to put the patient in control of their data, collating it into one central place that plugs directly into NHS systems and pulls in data from other sources, including personal devices.
Dr Mohammad Al-Ubaydli, the founder and chief executive of Patients Know Best, said:Dr Mohammad Al-Ubaydli, the founder and chief executive of Patients Know Best, said:
Patient control improves safety, raises quality, cuts costs and makes patients happier. It saves time for both patients and medical staff allowing modern communications, while making sure privacy is at its heart through strict controls over who has access to what based on patient consent.Patient control improves safety, raises quality, cuts costs and makes patients happier. It saves time for both patients and medical staff allowing modern communications, while making sure privacy is at its heart through strict controls over who has access to what based on patient consent.
Giving patients access to their records, treatment plans and adding data from audited systems including the quantified self can more effectively guide their care. It’s a workflow for the medical team, but also for the patient to help them understand what’s happening and keep them informed about their treatment plan.Giving patients access to their records, treatment plans and adding data from audited systems including the quantified self can more effectively guide their care. It’s a workflow for the medical team, but also for the patient to help them understand what’s happening and keep them informed about their treatment plan.
But Beverley Bryant, director of digital technology for NHS England, rejected this proposal:But Beverley Bryant, director of digital technology for NHS England, rejected this proposal:
Frankly I think it’s a sad indictment of the NHS that the patient has to take control of their data in this way. I think citizens in England that use the NHS should reasonably expect that doctors and nurses that have treated them, hospitals, institutions and local authorities that have cared for them and their family, know stuff about them, like who they are, what treatments their on, what they’re allergic to.Frankly I think it’s a sad indictment of the NHS that the patient has to take control of their data in this way. I think citizens in England that use the NHS should reasonably expect that doctors and nurses that have treated them, hospitals, institutions and local authorities that have cared for them and their family, know stuff about them, like who they are, what treatments their on, what they’re allergic to.
NHS England has pledged to move the health service to be paperless at the point of care by 2020, to join up disparate systems and bring the health service into the 21st century. But with 90 regional groupings all tendering for new record management systems, compatibility and interoperability are far from guaranteed – particularly given the NHS’s record of IT projects.NHS England has pledged to move the health service to be paperless at the point of care by 2020, to join up disparate systems and bring the health service into the 21st century. But with 90 regional groupings all tendering for new record management systems, compatibility and interoperability are far from guaranteed – particularly given the NHS’s record of IT projects.
The NHS is still saddled with ancient computer systems, many of which still run the 14-year-old, unsupported and vulnerable Windows XP. But the NHS currently doesn’t know how many machines it has or what software they are running, which is what the Digital Maturity Assessment, due this month, will uncover and hopefully be able to phase out.The NHS is still saddled with ancient computer systems, many of which still run the 14-year-old, unsupported and vulnerable Windows XP. But the NHS currently doesn’t know how many machines it has or what software they are running, which is what the Digital Maturity Assessment, due this month, will uncover and hopefully be able to phase out.
For the immediate term patients should expect repeat questioning, testing and forgetting who they are each time they visit, but there is light at the end of the 2020 tunnel, should the joined-up system work.For the immediate term patients should expect repeat questioning, testing and forgetting who they are each time they visit, but there is light at the end of the 2020 tunnel, should the joined-up system work.
Updated
at 11.21am GMT
10.10am GMT10.10am GMT
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Chris Stanley, newly qualified GPChris Stanley, newly qualified GP
Jessica ElgotJessica Elgot
Chris Stanley, one of the Gale Farm practice’s newly qualified GPs, is seeing patients from 8.30am in the large office he was chuffed to acquire from a retired senior partner.Chris Stanley, one of the Gale Farm practice’s newly qualified GPs, is seeing patients from 8.30am in the large office he was chuffed to acquire from a retired senior partner.
“The variety is massive. On one day last week I did a home visit to a member of the House of Lords, and a few hours later I saw a man living on the streets, an intravenous drug user. That’s not unusual, to see that difference in just a few hours.”“The variety is massive. On one day last week I did a home visit to a member of the House of Lords, and a few hours later I saw a man living on the streets, an intravenous drug user. That’s not unusual, to see that difference in just a few hours.”
The practice holds 12-minute appointments, longer than the standard 10. A few years ago, the normal time was five minutes. “It still feels not long enough sometimes, especially when a patient has such long and complex list of problems.”The practice holds 12-minute appointments, longer than the standard 10. A few years ago, the normal time was five minutes. “It still feels not long enough sometimes, especially when a patient has such long and complex list of problems.”
Even in his short time as a GP, Stanley said he has learnt so much from patients:Even in his short time as a GP, Stanley said he has learnt so much from patients:
I once got a baby in, a few days old, with a chest infection, which is horrible in a tiny baby. I listened to the heart too and it didn’t sound quite right either. We called an ambulance and sent the family to hospital, just in case.I once got a baby in, a few days old, with a chest infection, which is horrible in a tiny baby. I listened to the heart too and it didn’t sound quite right either. We called an ambulance and sent the family to hospital, just in case.
I almost forgot all about it, but got a letter back saying the baby had gone into cardiac arrest in the ambulance and the hospital had saved the baby’s life; it has a really rare heart condition. I essentially saved the baby’s life by accident, just by checking a chest infection. Now I always check the heartbeat whenever a baby comes in with chest infection.I almost forgot all about it, but got a letter back saying the baby had gone into cardiac arrest in the ambulance and the hospital had saved the baby’s life; it has a really rare heart condition. I essentially saved the baby’s life by accident, just by checking a chest infection. Now I always check the heartbeat whenever a baby comes in with chest infection.
Stanley’s first patient of the day takes 15 regular medications, for conditions including asthma, blood pressure and arthritis. He’s here for the result of a blood test which he asked for because he’s concerned about memory problems, but the blood test rules out any obvious problems.Stanley’s first patient of the day takes 15 regular medications, for conditions including asthma, blood pressure and arthritis. He’s here for the result of a blood test which he asked for because he’s concerned about memory problems, but the blood test rules out any obvious problems.
The GP arranges to do a memory test, and checks various other concerns the man has about headaches. “You can see a patient who has had many different problems in the same 12 minutes, with several unrelated concerns you have to address,” he said. “And you also have to bear I mind each of the medications someone is on which might affect different symptoms.” The GP arranges to do a memory test, and checks various other concerns the man has about headaches. “You can see a patient who has had many different problems in the same 12 minutes, with several unrelated concerns you have to address,” he said. “And you also have to bear in mind each of the medications someone is on which might affect different symptoms.”
His second patient is worried about a lump they have found, which Stanley refers for more checks, and a third is recovering from a knee injury but wants get back to back to work so Stanley writes a note for him. His second patient is worried about a lump they have found, which Stanley refers for more checks, and a third is recovering from a knee injury but wants get back to work so Stanley writes a note for him.
Another patient has what initially appears to be a water infection. She tells Stanley that she has been treated for that already without any improvement, and is keen for an x-ray to rule out cancer. Stanley examines her, and says he is unsure of the cause of the pain, agreeing to send her to hospital for the scan to put her fears at rest, though he does not think cancer is the cause.Another patient has what initially appears to be a water infection. She tells Stanley that she has been treated for that already without any improvement, and is keen for an x-ray to rule out cancer. Stanley examines her, and says he is unsure of the cause of the pain, agreeing to send her to hospital for the scan to put her fears at rest, though he does not think cancer is the cause.
“I do always try to be reassuring – especially when I’m sure it’s isn’t actually what the patient thinks it is. But in other cases, you don’t want to be overly reassuring, because then the patient might not come back if it gets worse,” he said.“I do always try to be reassuring – especially when I’m sure it’s isn’t actually what the patient thinks it is. But in other cases, you don’t want to be overly reassuring, because then the patient might not come back if it gets worse,” he said.
UpdatedUpdated
at 10.45am GMT at 11.18am GMT
9.51am GMT9.51am GMT
09:5109:51
9.30am GMT9.30am GMT
09:3009:30
NHS Scotland's delayed IT system to cost even more than predictedNHS Scotland's delayed IT system to cost even more than predicted
Severin CarrellSeverin Carrell
Problems with a troubled new telecoms and patient information system for NHS Scotland have deepened, with costs due to spiral by a further £7.6m, the service has admitted.Problems with a troubled new telecoms and patient information system for NHS Scotland have deepened, with costs due to spiral by a further £7.6m, the service has admitted.
The system for NHS 24 – the call-in service for patients and the public looking for medical advice – was due to be up and running by the middle of 2013, but will not now be operational until the summer of 2016.The system for NHS 24 – the call-in service for patients and the public looking for medical advice – was due to be up and running by the middle of 2013, but will not now be operational until the summer of 2016.
Its launch in November last year, already much delayed, had to be quickly abandoned after it failed to work properly, in some cases preventing 999 calls from being transferred. NHS 24 staff were forced to revert to pen and paper.Its launch in November last year, already much delayed, had to be quickly abandoned after it failed to work properly, in some cases preventing 999 calls from being transferred. NHS 24 staff were forced to revert to pen and paper.
In a new submission to MSPs on the public audit committee at Holyrood before an evidence hearing tomorrow, NHS 24 said the IT project was now expected to cost around £125m, against an original cost of £75.8m.In a new submission to MSPs on the public audit committee at Holyrood before an evidence hearing tomorrow, NHS 24 said the IT project was now expected to cost around £125m, against an original cost of £75.8m.
It told the committee: “The original business case was inadequate, the program governance ineffective, commercial management was weak, too much reliance was put on suppliers’ promises and the organisation had insufficient understanding of call centre system implementation to successfully launch.”It told the committee: “The original business case was inadequate, the program governance ineffective, commercial management was weak, too much reliance was put on suppliers’ promises and the organisation had insufficient understanding of call centre system implementation to successfully launch.”
UpdatedUpdated
at 9.49am GMTat 9.49am GMT
8.30am GMT8.30am GMT
08:3008:30
GPs explained - the key data and chartsGPs explained - the key data and charts
My colleagues on the data team Delphine Robineau and Pamela Duncan have produced this revealing guide to the key statistics behind the UK’s army of family doctors, who account for 90% of all patient contact within the NHS – GPs really are at the frontline of Britain’s healthcare.My colleagues on the data team Delphine Robineau and Pamela Duncan have produced this revealing guide to the key statistics behind the UK’s army of family doctors, who account for 90% of all patient contact within the NHS – GPs really are at the frontline of Britain’s healthcare.
According to figures compiled by Deloitte for the Royal College of GPs, NHS England estimates that the average patient makes six GP visits each year. Exact figures on the number of patients a GP sees in a week are not routinely collected. However, it was estimated that in 2009, the average GP working in England saw 132 patients a week. In Wales that measure stood at 137 patients, while in Northern Ireland it was 126 and in Scotland it was 112.According to figures compiled by Deloitte for the Royal College of GPs, NHS England estimates that the average patient makes six GP visits each year. Exact figures on the number of patients a GP sees in a week are not routinely collected. However, it was estimated that in 2009, the average GP working in England saw 132 patients a week. In Wales that measure stood at 137 patients, while in Northern Ireland it was 126 and in Scotland it was 112.
The number of GP appointments in England is rising, up by an estimated 22% between 2009 and 2015.The number of GP appointments in England is rising, up by an estimated 22% between 2009 and 2015.
However, between 2010 and 2014 the number of GPs (excluding retainers and registrars) grew by just 4% in England and 2% across the UK.However, between 2010 and 2014 the number of GPs (excluding retainers and registrars) grew by just 4% in England and 2% across the UK.
With the NHS careers website advising that GPs can see between 30 and 40 patients a day, it is no surprise they report feeling the strain. The latest Commonwealth Fund survey of primary care doctors reported that six in 10 UK GPs found their work “very stressful” or “extremely stressful”, higher than in any of the other 10 countries surveyed.With the NHS careers website advising that GPs can see between 30 and 40 patients a day, it is no surprise they report feeling the strain. The latest Commonwealth Fund survey of primary care doctors reported that six in 10 UK GPs found their work “very stressful” or “extremely stressful”, higher than in any of the other 10 countries surveyed.
It also found that satisfaction levels among UK GPs had fallen: while 81% of GPs said they were “satisfied” or “very satisfied” with practising medicine in 2009, that fell to 67% in the latest survey.It also found that satisfaction levels among UK GPs had fallen: while 81% of GPs said they were “satisfied” or “very satisfied” with practising medicine in 2009, that fell to 67% in the latest survey.
The demographics of patients visiting their GP is also changing, with 43% of all GP visits in England now by people aged 60 or over. As recently as 2008 it was 38%.The demographics of patients visiting their GP is also changing, with 43% of all GP visits in England now by people aged 60 or over. As recently as 2008 it was 38%.
Salaries explainedSalaries explained
GP salaries differ depending on whether they are a partner in a practice or a salaried GP, and on the kind of practice they work in. The average taxable income for all UK GPs across the categories stood at £90,200 in the 2013-14 financial year.GP salaries differ depending on whether they are a partner in a practice or a salaried GP, and on the kind of practice they work in. The average taxable income for all UK GPs across the categories stood at £90,200 in the 2013-14 financial year.
A GP partner operating under a General Medical Services contract with the NHS had an average taxable income of £96,000, while those on a Primary Medical Services contract had an average taxable income of £106,800. The average taxable income for salaried GPs was lower, at £54,600.A GP partner operating under a General Medical Services contract with the NHS had an average taxable income of £96,000, while those on a Primary Medical Services contract had an average taxable income of £106,800. The average taxable income for salaried GPs was lower, at £54,600.
Patient satisfactionPatient satisfaction
The satisfaction levels of those on the other end of the stethoscope is measured by the GP patient survey. Most of the 854,000 patients who participated in the latest survey reported that they were satisfied with the attention they had received in their local surgery, with 85% reporting that their GP gave them enough time.The satisfaction levels of those on the other end of the stethoscope is measured by the GP patient survey. Most of the 854,000 patients who participated in the latest survey reported that they were satisfied with the attention they had received in their local surgery, with 85% reporting that their GP gave them enough time.
Half of people surveyed said they had sought to make their doctor’s appointment on the same day or the next working day. Overall, 85% of patients seeking an appointment managed to get one.Half of people surveyed said they had sought to make their doctor’s appointment on the same day or the next working day. Overall, 85% of patients seeking an appointment managed to get one.
However, 11% of patients surveyed in 2015 said they were not able to get an appointment at all the last time they wanted to see their doctor, a higher proportion than the 9% in mid-2012.However, 11% of patients surveyed in 2015 said they were not able to get an appointment at all the last time they wanted to see their doctor, a higher proportion than the 9% in mid-2012.
The majority of patients (55%) said they had waited between five and 15 minutes and one in four (27%) was left waiting for more than 15 minutes. A third of patients in the survey said they felt they had to wait too long to be seen by their GP.The majority of patients (55%) said they had waited between five and 15 minutes and one in four (27%) was left waiting for more than 15 minutes. A third of patients in the survey said they felt they had to wait too long to be seen by their GP.
Overall three-quarters of patients said they were satisfied with their GP’s opening hours.Overall three-quarters of patients said they were satisfied with their GP’s opening hours.
UpdatedUpdated
at 11.13am GMTat 11.13am GMT
7.55am GMT7.55am GMT
07:5507:55
Jessica ElgotJessica Elgot
This morning, we’re in York at Gale Farm surgery, which is part of the Haxby Group, 10 surgeries serving York and Hull with more than 49,000 patients.This morning, we’re in York at Gale Farm surgery, which is part of the Haxby Group, 10 surgeries serving York and Hull with more than 49,000 patients.
As well as the standard GP services, the practices offer minor surgical procedures, including vasectomies and contraceptive procedures.As well as the standard GP services, the practices offer minor surgical procedures, including vasectomies and contraceptive procedures.
We’ll be with GPs and nurses at different surgeries throughout the day, talking to patients and sitting with reception staff to get a feel for the complexity of the job and the variety of a day in a busy NHS practice.We’ll be with GPs and nurses at different surgeries throughout the day, talking to patients and sitting with reception staff to get a feel for the complexity of the job and the variety of a day in a busy NHS practice.
UpdatedUpdated
at 8.17am GMTat 8.17am GMT
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Tuesday's morning briefingTuesday's morning briefing
Mark SmithMark Smith
Welcome to day two of our unique NHS series – an ambitious attempt to get inside Britain’s most complex, cherished and criticised institution.Welcome to day two of our unique NHS series – an ambitious attempt to get inside Britain’s most complex, cherished and criticised institution.
The big pictureThe big picture
Already we have discovered that the health service plans to introduce a sugar tax on treats sold on its premises – but that our readers would rather it cut out the sticky stuff altogether.Already we have discovered that the health service plans to introduce a sugar tax on treats sold on its premises – but that our readers would rather it cut out the sticky stuff altogether.
In a wide-ranging interview with the Guardian’s deputy editor, Paul Johnson, NHS England’s chief executive, Simon Stevens, also called for a new political consensus on how to pay for elderly and social care.In a wide-ranging interview with the Guardian’s deputy editor, Paul Johnson, NHS England’s chief executive, Simon Stevens, also called for a new political consensus on how to pay for elderly and social care.
Our ambitious project also seeks to tell the story of the NHS in terms of the raw data – and some of the numbers are mind-boggling. The NHS is the world’s fifth largest employer, an operation so vast that it occupies one in 20 British workers. That is just one of an almost endless list of superlatives that are often forgotten in the daily shriek of claim and counterclaim about its performance.Our ambitious project also seeks to tell the story of the NHS in terms of the raw data – and some of the numbers are mind-boggling. The NHS is the world’s fifth largest employer, an operation so vast that it occupies one in 20 British workers. That is just one of an almost endless list of superlatives that are often forgotten in the daily shriek of claim and counterclaim about its performance.
Our piece 10 truths about Britain’s health service seeks to cut through some of the tabloid myths and present the raw facts – including the pay disparity between NHS staff and agency contractors.Our piece 10 truths about Britain’s health service seeks to cut through some of the tabloid myths and present the raw facts – including the pay disparity between NHS staff and agency contractors.
We’ve launched a series of diaries from secret NHS professionals, and a startling collection of dramatic life-saving stories called The day the NHS saved my life.We’ve launched a series of diaries from secret NHS professionals, and a startling collection of dramatic life-saving stories called The day the NHS saved my life.
And we’ve found some of you out with our fiendish quiz, which we are tentatively calling a Q&A&E. For those of you who scored poorly, our animated short video should provide some answers.And we’ve found some of you out with our fiendish quiz, which we are tentatively calling a Q&A&E. For those of you who scored poorly, our animated short video should provide some answers.
Today’s focusToday’s focus
Today we head to the north of England and Scotland and switch the focus to an indispensable group of medics described variously as generalists, gatekeepers and the essential glue in the NHS puzzle: GPs. There are about 43,000 in the UK and between them they get through 381m consultations a year – roughly 10,000 per GP. But would you recommend yours?Today we head to the north of England and Scotland and switch the focus to an indispensable group of medics described variously as generalists, gatekeepers and the essential glue in the NHS puzzle: GPs. There are about 43,000 in the UK and between them they get through 381m consultations a year – roughly 10,000 per GP. But would you recommend yours?
Like everywhere else in the health service, GPs are trying to work out how to operate more smartly. For other practitioners the average day quickly descends into “a whirlwind of a suspected forearm fracture, gallstones, viral illnesses, an alcoholic wanting help to stop drinking, and a young woman with a new diagnosis of diabetes” –as you will read in our secret diary post launching later.Like everywhere else in the health service, GPs are trying to work out how to operate more smartly. For other practitioners the average day quickly descends into “a whirlwind of a suspected forearm fracture, gallstones, viral illnesses, an alcoholic wanting help to stop drinking, and a young woman with a new diagnosis of diabetes” –as you will read in our secret diary post launching later.
The Guardian’s Scotland editor, Severin Carrell, has sent this special report from the Hillswick health centre in Shetland, one of the most remote surgeries in the UK. The piece paints an evocative picture of the challenges that face practices such as Hillswick in attracting the right staff (and the pictures, by the brilliant Murdo McLeod, really are something else. We hope to have a gallery of these coming separately).The Guardian’s Scotland editor, Severin Carrell, has sent this special report from the Hillswick health centre in Shetland, one of the most remote surgeries in the UK. The piece paints an evocative picture of the challenges that face practices such as Hillswick in attracting the right staff (and the pictures, by the brilliant Murdo McLeod, really are something else. We hope to have a gallery of these coming separately).
Severin writes:Severin writes:
There is a chronic shortage of new family doctors across the UK. Scotland, where a third of all GPs plan to retire in the next five years, is no exception. The Royal College of General Practitioners estimates between 563 and 915 new family doctors may be needed by 2020. Shetland alone has five GP vacancies.There is a chronic shortage of new family doctors across the UK. Scotland, where a third of all GPs plan to retire in the next five years, is no exception. The Royal College of General Practitioners estimates between 563 and 915 new family doctors may be needed by 2020. Shetland alone has five GP vacancies.
Related: On call in Shetland: a cliff-hanging GP at the NHS's northern limitsRelated: On call in Shetland: a cliff-hanging GP at the NHS's northern limits
Also online now, Will Self has written this almost elegiac piece about one Christmas night spent in A&E:Also online now, Will Self has written this almost elegiac piece about one Christmas night spent in A&E:
We don’t simply revere the NHS − we worship it. Why wouldn’t we, given it’s a nationwide public institution with branch offices in every town and hamlet; and a mechanism for the redistribution of the most precious resource known to us: the preservation of life itself? It goes further, though, because the NHS is for many of us what takes religion’s place when it comes to contemplating our end – for, if there’s one thing we devoutly wish, it’s to cease upon the midnight hour cosseted and with no pain whatsoever. The terminal is of the essence when it comes to healthcare anyway, given the vast majority of spending on any individual takes place in the last six weeks of their life.We don’t simply revere the NHS − we worship it. Why wouldn’t we, given it’s a nationwide public institution with branch offices in every town and hamlet; and a mechanism for the redistribution of the most precious resource known to us: the preservation of life itself? It goes further, though, because the NHS is for many of us what takes religion’s place when it comes to contemplating our end – for, if there’s one thing we devoutly wish, it’s to cease upon the midnight hour cosseted and with no pain whatsoever. The terminal is of the essence when it comes to healthcare anyway, given the vast majority of spending on any individual takes place in the last six weeks of their life.
Today, reporter Jessica Elgot will be liveblogging from the Haxby Group of surgeries around York and Hull, finding out from GPs the biggest rewards and challenges of the job.Today, reporter Jessica Elgot will be liveblogging from the Haxby Group of surgeries around York and Hull, finding out from GPs the biggest rewards and challenges of the job.
You can tweet Jessica and me – @jessicaelgot and @marksmith174 – and please join in the conversation with the hashtag #thisistheNHS and below the line. We’ll be monitoring your comments and will feature the best in the blog. And please sign up to our daily email here.You can tweet Jessica and me – @jessicaelgot and @marksmith174 – and please join in the conversation with the hashtag #thisistheNHS and below the line. We’ll be monitoring your comments and will feature the best in the blog. And please sign up to our daily email here.
What people are saying about our NHS projectWhat people are saying about our NHS project
Day 2 of the @guardian's 4-week focus on the #NHS and I'm hooked! Celebration + challenge combined #ThisIsTheNHS pic.twitter.com/BGbDsdTqAgDay 2 of the @guardian's 4-week focus on the #NHS and I'm hooked! Celebration + challenge combined #ThisIsTheNHS pic.twitter.com/BGbDsdTqAg
Clearly biased but I agree.Feel incredibly lucky to have been able to be part of it 1/2 @JoshFergeus @guardian @GdnHealthcare #ThisIsTheNHSClearly biased but I agree.Feel incredibly lucky to have been able to be part of it 1/2 @JoshFergeus @guardian @GdnHealthcare #ThisIsTheNHS
Good on the @guardian #ThisIsTheNHS I hope @Jeremy_Hunt and @David_Cameron subscribe!!! https://t.co/YUtpLNAnbzGood on the @guardian #ThisIsTheNHS I hope @Jeremy_Hunt and @David_Cameron subscribe!!! https://t.co/YUtpLNAnbz
Quite a scale of project for @guardian #ThisIsTheNHS https://t.co/wno9VQqxTOQuite a scale of project for @guardian #ThisIsTheNHS https://t.co/wno9VQqxTO
Monday’s most readMonday’s most read
UpdatedUpdated
at 11.10am GMTat 11.10am GMT
6.03pm GMT6.03pm GMT
18:0318:03
Mark SmithMark Smith
Monday’s liveblog closedMonday’s liveblog closed
That’s all from Jessica, Alicia and me for today’s blog. Thanks for all your great comments and personal stories below the line. And a very special thanks to all the staff and patients at St George’s hospital, Tooting, who gave us the access that made this liveblog possible.That’s all from Jessica, Alicia and me for today’s blog. Thanks for all your great comments and personal stories below the line. And a very special thanks to all the staff and patients at St George’s hospital, Tooting, who gave us the access that made this liveblog possible.
We’ll be back again tomorrow morning from 8am, when we’ll be concentrating on the issues to do with GPs, variously described as generalists, gatekeepers and the essential glue in the NHS puzzle. Jessica and Alicia will be posting from a surgery near York to find out what GPs think are the biggest rewards and challenges of the job.We’ll be back again tomorrow morning from 8am, when we’ll be concentrating on the issues to do with GPs, variously described as generalists, gatekeepers and the essential glue in the NHS puzzle. Jessica and Alicia will be posting from a surgery near York to find out what GPs think are the biggest rewards and challenges of the job.
We hope you join us again, and please remember to sign up here to get our morning briefing delivered directly to your inbox.We hope you join us again, and please remember to sign up here to get our morning briefing delivered directly to your inbox.
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There have been some great comments below the line on the Secret 999 call handler’s diary, so I’ll share a couple of the best with you here, including one caller who thought that catching their babysitter smoking in the house warranted an emergency.There have been some great comments below the line on the Secret 999 call handler’s diary, so I’ll share a couple of the best with you here, including one caller who thought that catching their babysitter smoking in the house warranted an emergency.
I worked in the control room for one of the smaller police forces a few years back and yes, people use 999 for the strangest things. Lost house keys, cars parked in dedicated parking bays, catching the babysitter smoking in the house when she had expressly been forbidden to do so. All of whom got shirty when advised that none of these consituted an emergency. The usual response was "we pay your wages". Oddly enough though, I received far more abuse over the phone when I went to work for a local council. I work for another one of the emergency services now. Yes, it can be challenging and it's not a job for everybody what with the long shifts but I love itI worked in the control room for one of the smaller police forces a few years back and yes, people use 999 for the strangest things. Lost house keys, cars parked in dedicated parking bays, catching the babysitter smoking in the house when she had expressly been forbidden to do so. All of whom got shirty when advised that none of these consituted an emergency. The usual response was "we pay your wages". Oddly enough though, I received far more abuse over the phone when I went to work for a local council. I work for another one of the emergency services now. Yes, it can be challenging and it's not a job for everybody what with the long shifts but I love it
I've had to make my fair share of calls to the NHS in the past year or two, sometimes on behalf of my own problems but occasionally on someone else's. And whether it's been 999 or 111 I've had to call, I have not once encountered a single problem. Far from it, in fact, I have nothing but absolute praise for the people at the other end of the line - who are coherent, concise, reassuring and above all in a job like this - human. Not every call is about a cardiac arrest, but every caller has different issues and different vulnerabilities especially under stress. They take every call with complete consideration and are as reassuring as they can possibly be, and are just one cog in the massive NHS machine.I've had to make my fair share of calls to the NHS in the past year or two, sometimes on behalf of my own problems but occasionally on someone else's. And whether it's been 999 or 111 I've had to call, I have not once encountered a single problem. Far from it, in fact, I have nothing but absolute praise for the people at the other end of the line - who are coherent, concise, reassuring and above all in a job like this - human. Not every call is about a cardiac arrest, but every caller has different issues and different vulnerabilities especially under stress. They take every call with complete consideration and are as reassuring as they can possibly be, and are just one cog in the massive NHS machine.
If any call operators happen to read these messages, thank you so much for a job well done. Thank you to the paramedics, doctors, nurses, surgeons, drivers, receptionists and emergency staff who I have been been unfortunately circumstanced enough to interact with, but fortunate enough to have been in the working company of.If any call operators happen to read these messages, thank you so much for a job well done. Thank you to the paramedics, doctors, nurses, surgeons, drivers, receptionists and emergency staff who I have been been unfortunately circumstanced enough to interact with, but fortunate enough to have been in the working company of.
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Jessica ElgotJessica Elgot
This year will be Margaret Flynn’s 20th year delivering babies at St George’s.This year will be Margaret Flynn’s 20th year delivering babies at St George’s.
Friends say to me, is there ever a time when all labour just seems the same? And I can genuinely, genuinely say ‘no, there isn’t’. Every baby, every family, every labour is different. I must have delivered four or five babies by the M&S at the entrance of the hospital. I delivered a baby for a mother on Sunday who remembered me from the time we delivered her first baby, in the corridor by the Grosvenor wing entrance.Friends say to me, is there ever a time when all labour just seems the same? And I can genuinely, genuinely say ‘no, there isn’t’. Every baby, every family, every labour is different. I must have delivered four or five babies by the M&S at the entrance of the hospital. I delivered a baby for a mother on Sunday who remembered me from the time we delivered her first baby, in the corridor by the Grosvenor wing entrance.
We got the call that a midwife was needed earlier and we found her on the flower bank outside, and she was really wanting to push. I had to tell her to stop because we couldn’t have her baby born out there in the freezing cold. So we managed to just get her into the entrance before she gave birth.We got the call that a midwife was needed earlier and we found her on the flower bank outside, and she was really wanting to push. I had to tell her to stop because we couldn’t have her baby born out there in the freezing cold. So we managed to just get her into the entrance before she gave birth.
Kerri Calthorpe, 31, has just arrived in the maternity ward after 12 hours in labour. She is halfway there, midwives have told her. She and her husband Harry were hoping the birthing suite would be free for their son’s birth, so Kerri could use the birthing pool. “As soon as I saw it, I knew that was what I wanted. I wanted to be free to move around, not sat getting hot in a hospital bed. That sounds like a nightmare.”Kerri Calthorpe, 31, has just arrived in the maternity ward after 12 hours in labour. She is halfway there, midwives have told her. She and her husband Harry were hoping the birthing suite would be free for their son’s birth, so Kerri could use the birthing pool. “As soon as I saw it, I knew that was what I wanted. I wanted to be free to move around, not sat getting hot in a hospital bed. That sounds like a nightmare.”
Luckily the room is free for the couple’s arrival. “You can’t plan when your baby will arrive so you just have to hope,” Harry said.Luckily the room is free for the couple’s arrival. “You can’t plan when your baby will arrive so you just have to hope,” Harry said.
Kerri is impatient now for her son’s arrival. “You can’t explain it, but I just need him here now, I just want more than anything to hold him and touch him, and have him next to me. It’s the most extraordinary thing.”Kerri is impatient now for her son’s arrival. “You can’t explain it, but I just need him here now, I just want more than anything to hold him and touch him, and have him next to me. It’s the most extraordinary thing.”
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Jessica ElgotJessica Elgot
Nellie Wilkinson last brought her 84-year-old mother Joyce Gordon to A&E just before Christmas, but wanted to make sure she was out by the big day itself. Now the pair are back at St George’s for Joyce’s CT scan.Nellie Wilkinson last brought her 84-year-old mother Joyce Gordon to A&E just before Christmas, but wanted to make sure she was out by the big day itself. Now the pair are back at St George’s for Joyce’s CT scan.
“I am glad she came out for Christmas, but in truth she probably should have stayed in,” Nellie said. “When you’re old everything is just so much harder for you, harder to cope with.”“I am glad she came out for Christmas, but in truth she probably should have stayed in,” Nellie said. “When you’re old everything is just so much harder for you, harder to cope with.”
Joyce said she prepares herself mentally before every hospital visit. “I don’t ask questions. I let them do the job and I just tell myself it’s going to be alright. I have been a church-going woman all my life. I believe God will keep me strong and you just have to believe.”Joyce said she prepares herself mentally before every hospital visit. “I don’t ask questions. I let them do the job and I just tell myself it’s going to be alright. I have been a church-going woman all my life. I believe God will keep me strong and you just have to believe.”
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Frances PerraudinFrances Perraudin
Simon Stevens, the chair of NHS England, has told the Commons public accounts committee that the £2bn of debt facing the NHS was largely driven by the increase in temporary staffing.Simon Stevens, the chair of NHS England, has told the Commons public accounts committee that the £2bn of debt facing the NHS was largely driven by the increase in temporary staffing.
“The increase in temporary staffing pretty much matches the increase in the deficit pressures in providers,” he said. “I believe we’ve had a collective action problem across the totality of the NHS and that has enabled individual agencies to play off one part of the health service against another at a time when there’s been understandable desire to increase staffing levels at just the same time as supply is being constrained. So it’s a perfect storm in terms of our workforce.”“The increase in temporary staffing pretty much matches the increase in the deficit pressures in providers,” he said. “I believe we’ve had a collective action problem across the totality of the NHS and that has enabled individual agencies to play off one part of the health service against another at a time when there’s been understandable desire to increase staffing levels at just the same time as supply is being constrained. So it’s a perfect storm in terms of our workforce.”
He called for hospitals to collectively exercise some “downward pressure” and “bargaining power” on the prices being paid to agency staff.He called for hospitals to collectively exercise some “downward pressure” and “bargaining power” on the prices being paid to agency staff.
MPs on the committee questioned whether it would be fair and legal for the world’s fifth-biggest employer to behave as a monopoly and impact the market in which doctors and nurses work.MPs on the committee questioned whether it would be fair and legal for the world’s fifth-biggest employer to behave as a monopoly and impact the market in which doctors and nurses work.
Stevens said he was satisfied that it would not be illegal and said it would be “making use of the N in the NHS, which stands for national”.Stevens said he was satisfied that it would not be illegal and said it would be “making use of the N in the NHS, which stands for national”.
Asked whether it really matters that the NHS is in so much debt, Stevens replied: “The deficit does matter a great deal because when you see big unplanned deficits, then we might not be getting maximum value for money, which is clearly what is happening to temporary staffing. It does matter for another reason because potentially it skews the investment decisions that the National Health Service wants to make.”Asked whether it really matters that the NHS is in so much debt, Stevens replied: “The deficit does matter a great deal because when you see big unplanned deficits, then we might not be getting maximum value for money, which is clearly what is happening to temporary staffing. It does matter for another reason because potentially it skews the investment decisions that the National Health Service wants to make.”
Dame Una O’Brien, the permanent secretary at the Department of Health, said that she agreed with Stevens on the last point, arguing that the NHS had “extremely capable finance professionals who want to do a good job and want to be able to plan their finances properly”.Dame Una O’Brien, the permanent secretary at the Department of Health, said that she agreed with Stevens on the last point, arguing that the NHS had “extremely capable finance professionals who want to do a good job and want to be able to plan their finances properly”.
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at 6.50pm GMTat 6.50pm GMT
5.14pm GMT5.14pm GMT
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Jessica ElgotJessica Elgot
“The absolute worst thing about working here are the fire alarms,” says Steven Sonner.“The absolute worst thing about working here are the fire alarms,” says Steven Sonner.
His colleague Dave Watts agrees: “Hands down. That’s the worst, because you have to move everyone out, and it is normally a false alarm.”His colleague Dave Watts agrees: “Hands down. That’s the worst, because you have to move everyone out, and it is normally a false alarm.”
Both men are waiting in A&E for a patient who is having a CT scan. Watts was Sonner’s mentor when he first came to work at the hospital as part of Project Search, which finds employment for people with learning disabilities.Both men are waiting in A&E for a patient who is having a CT scan. Watts was Sonner’s mentor when he first came to work at the hospital as part of Project Search, which finds employment for people with learning disabilities.
“He’s had a great chance working here after not a great start in life,” Watts said. Sonner agreed, especially his time on 24 Hours in A&E, the Channel 4 series that made stars of some St George’s staff. “I’ve got a job and I’m on TV,” he said.“He’s had a great chance working here after not a great start in life,” Watts said. Sonner agreed, especially his time on 24 Hours in A&E, the Channel 4 series that made stars of some St George’s staff. “I’ve got a job and I’m on TV,” he said.
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A wonderful, personal tribute to the staff at St George’s hospital from one of our commenters, Benefic, whose daughter was treated for acute lymphoblastic leukaemia.A wonderful, personal tribute to the staff at St George’s hospital from one of our commenters, Benefic, whose daughter was treated for acute lymphoblastic leukaemia.
St George's saved my then ten year old daughter's life in October 2014. She was rushed from our local hospital to the Paediatric Intensive Care Unit (PICU) with a huge mass in her chest that was pushing on her windpipe - they reckoned at that point she had less than two days to live without serious medical intervention. She was diagnosed with Acute Lymphoblastic Leukaemia the following morning and started on chemotherapy. She was in PICU for nearly two weeks before she was stable enough to move to the children's cancer ward upstairs. The teams on both PICU and Pinckney Ward were just capable and supportive. They didn't just care for my daughter, but for us as a family, from psychological support to a room at the Ronald Macdonald House (we were a long way from home). My daughter's care was then transferred across to the wonderful children's unit at The Royal Marsden Hospital in Sutton and along with our exceptional local hospital, my daughter continues to make great progress. My daughter's leukaemia was so aggressive and her prognosis was so dreadful that she proceeded to a bone marrow transplant last March.St George's saved my then ten year old daughter's life in October 2014. She was rushed from our local hospital to the Paediatric Intensive Care Unit (PICU) with a huge mass in her chest that was pushing on her windpipe - they reckoned at that point she had less than two days to live without serious medical intervention. She was diagnosed with Acute Lymphoblastic Leukaemia the following morning and started on chemotherapy. She was in PICU for nearly two weeks before she was stable enough to move to the children's cancer ward upstairs. The teams on both PICU and Pinckney Ward were just capable and supportive. They didn't just care for my daughter, but for us as a family, from psychological support to a room at the Ronald Macdonald House (we were a long way from home). My daughter's care was then transferred across to the wonderful children's unit at The Royal Marsden Hospital in Sutton and along with our exceptional local hospital, my daughter continues to make great progress. My daughter's leukaemia was so aggressive and her prognosis was so dreadful that she proceeded to a bone marrow transplant last March.
She's had, and I don't doubt will continue to have, absolutely first class care in all three hospitals. I've always been grateful to grow up with the NHS, but now I have no words left to express my gratitude to the amazing people that work in the NHS and the society that allows for this system to be in place. I hope that this unique, battle-weary yet exceptional institution continues to to be in place for more generations to come.She's had, and I don't doubt will continue to have, absolutely first class care in all three hospitals. I've always been grateful to grow up with the NHS, but now I have no words left to express my gratitude to the amazing people that work in the NHS and the society that allows for this system to be in place. I hope that this unique, battle-weary yet exceptional institution continues to to be in place for more generations to come.
3.23pm GMT3.23pm GMT
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Jessica ElgotJessica Elgot
Matthew Parkin has one of the hospital’s toughest jobs. As a senior intensive care nurse on the cardiothoracic ward, he is with patients and families at some of the most distressing moments in their lives, just after major heart attacks or heart surgery.Matthew Parkin has one of the hospital’s toughest jobs. As a senior intensive care nurse on the cardiothoracic ward, he is with patients and families at some of the most distressing moments in their lives, just after major heart attacks or heart surgery.
Today all 18 beds in the dimly lit ward are full, apart from some that are earmarked for patients currently in surgery.Today all 18 beds in the dimly lit ward are full, apart from some that are earmarked for patients currently in surgery.
It’s in the name. It’s intense. I have met these people at some of the hardest times in their lives. I remember there was one young girl I met when I was on general intensive care just after she was in a major car accident. There was something about her that really brought home to me how precious life is. You can be having fun with your friends, out having a great time and in a split second your whole life can change forever, because of one decision, one accident.It’s in the name. It’s intense. I have met these people at some of the hardest times in their lives. I remember there was one young girl I met when I was on general intensive care just after she was in a major car accident. There was something about her that really brought home to me how precious life is. You can be having fun with your friends, out having a great time and in a split second your whole life can change forever, because of one decision, one accident.
Parkin’s day shift starts just after 7am when he makes his first rounds to check on patients. “We do 12-hour shifts, seven days a week. I worked on Christmas Day and Boxing Day. Health doesn’t wait for anyone. People think the hospital closes, but we are here all the time.”Parkin’s day shift starts just after 7am when he makes his first rounds to check on patients. “We do 12-hour shifts, seven days a week. I worked on Christmas Day and Boxing Day. Health doesn’t wait for anyone. People think the hospital closes, but we are here all the time.”
He is a fierce believer in the NHS: “We treat everyone here: rich, poor, any race, any sex, and we don’t have to ask them to pay a bill. We are so lucky here in England to have that. Who knows what political changes there will be in the future, but for now I really value that, it’s a wonderful thing.”He is a fierce believer in the NHS: “We treat everyone here: rich, poor, any race, any sex, and we don’t have to ask them to pay a bill. We are so lucky here in England to have that. Who knows what political changes there will be in the future, but for now I really value that, it’s a wonderful thing.”
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Mark SmithMark Smith
#ThisIsTheNHS isn’t the only hashtag worth following today. There has been a backlash against Dominic Lawson’s column in the Sunday Times that appeared to blame the current travails of the NHS on the rising number of female doctors.#ThisIsTheNHS isn’t the only hashtag worth following today. There has been a backlash against Dominic Lawson’s column in the Sunday Times that appeared to blame the current travails of the NHS on the rising number of female doctors.
@sarahwollaston What is your reaction to @thetimes blaming the troubles of the NHS on female docs? #likealadydoc pic.twitter.com/XaCoBZ7d91@sarahwollaston What is your reaction to @thetimes blaming the troubles of the NHS on female docs? #likealadydoc pic.twitter.com/XaCoBZ7d91
Lawson refers to the “the feminisation of medicine” and its impact on the NHS. He quotes Brian McKinstry, a former senior research fellow at the University of Edinburgh, who in 2008 said that “fewer women than men choose to work out of hours, and the increase in women doctors may have partly influenced the recent abandonment of out-of-hours work by general practitioners in the UK”.Lawson refers to the “the feminisation of medicine” and its impact on the NHS. He quotes Brian McKinstry, a former senior research fellow at the University of Edinburgh, who in 2008 said that “fewer women than men choose to work out of hours, and the increase in women doctors may have partly influenced the recent abandonment of out-of-hours work by general practitioners in the UK”.
Lawson goes on to argue:Lawson goes on to argue:
When you consider that it costs roughly £50,000 to bring each medical student up to the status of fully trained professional, it becomes obvious why governments have been reluctant, especially at a time of vast sector deficits, to increase the number of medical degrees to fill staffing shortfalls created by the swelling number of ‘part-time’ female doctors.When you consider that it costs roughly £50,000 to bring each medical student up to the status of fully trained professional, it becomes obvious why governments have been reluctant, especially at a time of vast sector deficits, to increase the number of medical degrees to fill staffing shortfalls created by the swelling number of ‘part-time’ female doctors.
In response, the hashtag #likealadydoc has sprung up to ridicule Lawson’s assumption that women turn up for a few hours, go to a nail bar over their lunchbreak and are all home in time to pick up the kids from the school gate.In response, the hashtag #likealadydoc has sprung up to ridicule Lawson’s assumption that women turn up for a few hours, go to a nail bar over their lunchbreak and are all home in time to pick up the kids from the school gate.
Dominic, does my tinsel look straight in this? No? That'll be the 30mins CPR I just did. #likealadydoc @thetimes pic.twitter.com/lZdkFBbwByDominic, does my tinsel look straight in this? No? That'll be the 30mins CPR I just did. #likealadydoc @thetimes pic.twitter.com/lZdkFBbwBy
I can scrub up 👉🏾 both the DISHES and for an OPERATION #likealadydoc @thetimes pic.twitter.com/CB8FAFnLgYI can scrub up 👉🏾 both the DISHES and for an OPERATION #likealadydoc @thetimes pic.twitter.com/CB8FAFnLgY
The Channel 4 News anchor Jon Snow even lent his support to the Twitter protest:The Channel 4 News anchor Jon Snow even lent his support to the Twitter protest:
@doctor_oxford wait till Dominic Lawson finds a woman doctor at his bedside - he may finds he needs her!@doctor_oxford wait till Dominic Lawson finds a woman doctor at his bedside - he may finds he needs her!
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The Guardian’s Scotland correspondent, Libby Brooks, has been tweeting in response to fears that our coverage will be England-centric.The Guardian’s Scotland correspondent, Libby Brooks, has been tweeting in response to fears that our coverage will be England-centric.
For readers asking about #ThisIsTheNHS, there will be plenty of reporting from Scotland by myself and @severincarrell in the coming weeksFor readers asking about #ThisIsTheNHS, there will be plenty of reporting from Scotland by myself and @severincarrell in the coming weeks
Indeed, our Scotland editor, Severin Carrell, has filed a special report from the most remote GP surgery in the UK, in Shetland, which will be launched tomorrow morning as part of our focus on GPs.Indeed, our Scotland editor, Severin Carrell, has filed a special report from the most remote GP surgery in the UK, in Shetland, which will be launched tomorrow morning as part of our focus on GPs.
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Jessica ElgotJessica Elgot
Two days before Christmas, Cassie took her horse out for a short ride. Four hours later she woke up in A&E after being airlifted to St George’s. She had fallen off her horse and broken her neck, damaging her spinal cord.Two days before Christmas, Cassie took her horse out for a short ride. Four hours later she woke up in A&E after being airlifted to St George’s. She had fallen off her horse and broken her neck, damaging her spinal cord.
It is the start of a long road to recovery for the once-active 26-year-old, who has no feeling in any of her body below her chest and is waiting to go to a spinal rehabilitation centre. “I remember very little about the first few hours,” she said. “I heard I was going into surgery, and I was terrified, though the doctor was very reassuring, I couldn’t really work out what had happened and what was going to happen to me.”It is the start of a long road to recovery for the once-active 26-year-old, who has no feeling in any of her body below her chest and is waiting to go to a spinal rehabilitation centre. “I remember very little about the first few hours,” she said. “I heard I was going into surgery, and I was terrified, though the doctor was very reassuring, I couldn’t really work out what had happened and what was going to happen to me.”
Since the surgery she has been closely monitored in the neuroscience unit, which can mean long and boring days in bed.Since the surgery she has been closely monitored in the neuroscience unit, which can mean long and boring days in bed.
“The staff know me now. They know I’m not a morning person, they let me sleep in. They adapt to what I need to do. There are times when I have been very low, not about any specific worry, but just generally having a hard day. And they are still there for me to talk to, to reassure me. To make it as easy as it can be, which isn’t easy.”“The staff know me now. They know I’m not a morning person, they let me sleep in. They adapt to what I need to do. There are times when I have been very low, not about any specific worry, but just generally having a hard day. And they are still there for me to talk to, to reassure me. To make it as easy as it can be, which isn’t easy.”
Cassie has had a stylus attached to her hand to help her write, and a phone that reads out messages from friends on a speaker so she doesn’t have to use the touchscreen. Food is her only complaint. “I don’t like the food. Others seem to disagree, but I don’t like it,” she said. “But my taste buds have changed. I used to live on tea, but now I don’t like the taste at all.”Cassie has had a stylus attached to her hand to help her write, and a phone that reads out messages from friends on a speaker so she doesn’t have to use the touchscreen. Food is her only complaint. “I don’t like the food. Others seem to disagree, but I don’t like it,” she said. “But my taste buds have changed. I used to live on tea, but now I don’t like the taste at all.”
“I bring in hot dinners for her,” says Cassie’s mother Brewer, who comes in every day from Reading to be by her daughter’s bedside. “It has been absolute hell, there is no word for it. But I have to say, from the moment we got in the air ambulance we have been looked after. And there’s no need for them to look after us. We’re the family, not the patient, but nothing is too much trouble. It is very, very hard for us too.”“I bring in hot dinners for her,” says Cassie’s mother Brewer, who comes in every day from Reading to be by her daughter’s bedside. “It has been absolute hell, there is no word for it. But I have to say, from the moment we got in the air ambulance we have been looked after. And there’s no need for them to look after us. We’re the family, not the patient, but nothing is too much trouble. It is very, very hard for us too.”
“I can’t do anything for myself,” Cassie said. “It is awkward, of course, when they clean me or change me, but that has to happen, so they don’t make me feel bad about it. It’s done with dignity, that’s all you can ask for.”“I can’t do anything for myself,” Cassie said. “It is awkward, of course, when they clean me or change me, but that has to happen, so they don’t make me feel bad about it. It’s done with dignity, that’s all you can ask for.”
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The latest article in our “The NHS saved my life” series features a junior doctor who became a patient after a terrible car crash caused by black ice. You can see the severity of the crash from the picture below.The latest article in our “The NHS saved my life” series features a junior doctor who became a patient after a terrible car crash caused by black ice. You can see the severity of the crash from the picture below.
My car skidded on black ice, swerved 180 degrees, hit the opposite kerb, went down a ditch and hit a tree. An off-duty paramedic saw what happened and got the emergency services to me really quickly. I’m told there were three fire engines, two ambulances and a helicopter at the scene.My car skidded on black ice, swerved 180 degrees, hit the opposite kerb, went down a ditch and hit a tree. An off-duty paramedic saw what happened and got the emergency services to me really quickly. I’m told there were three fire engines, two ambulances and a helicopter at the scene.
Related: The day the NHS saved my life: I should never have made it out of my car aliveRelated: The day the NHS saved my life: I should never have made it out of my car alive
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My colleague Matthew Holmes has been compiling some of our readers’ experiences as patients that have been submitted through GuardianWitness.My colleague Matthew Holmes has been compiling some of our readers’ experiences as patients that have been submitted through GuardianWitness.
Dylan Roberts says he is forever grateful to the NHS doctors who saved him from cancer after he was rushed to hospital on a bank holiday:Dylan Roberts says he is forever grateful to the NHS doctors who saved him from cancer after he was rushed to hospital on a bank holiday:
I was told eight weeks after my operation that my appendix had been analysed and an aggressive tumour had been discovered, 0.2mm away from the point it had ruptured. Although the tumour was technically removed I was referred to a specialist consultant at the Western General, in Edinburgh.I was told eight weeks after my operation that my appendix had been analysed and an aggressive tumour had been discovered, 0.2mm away from the point it had ruptured. Although the tumour was technically removed I was referred to a specialist consultant at the Western General, in Edinburgh.
It is such a body blow to be told you have cancer, but I felt at a loss as I had been told that I’d had cancer – but that the tumour was out of me. Good news, I thought! Never been so wrong in all my life …” (click here to continue reading)It is such a body blow to be told you have cancer, but I felt at a loss as I had been told that I’d had cancer – but that the tumour was out of me. Good news, I thought! Never been so wrong in all my life …” (click here to continue reading)
Reader “Waylay” has praised the care after a ruptured disc in his spine:Reader “Waylay” has praised the care after a ruptured disc in his spine:
The NHS saved my life, not with a heroic surgical intervention or a transplant or anything dramatic, but with continuing care that was some of the best in the world. My pain was cut in half by various interventions, medicine, and expert physiotherapy, and my mobility is now much better.The NHS saved my life, not with a heroic surgical intervention or a transplant or anything dramatic, but with continuing care that was some of the best in the world. My pain was cut in half by various interventions, medicine, and expert physiotherapy, and my mobility is now much better.
I will be disabled for the rest of my life, and I suffer from chronic pain, but thanks to the NHS, I function well enough to have a part-time job in research, a limited social life, a wonderful relationship, good friends, and the chance to continue to improve.”I will be disabled for the rest of my life, and I suffer from chronic pain, but thanks to the NHS, I function well enough to have a part-time job in research, a limited social life, a wonderful relationship, good friends, and the chance to continue to improve.”
Whether you’re patient or a health worker, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you. Share your stories in the comments or via GuardianWitness.Whether you’re patient or a health worker, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you. Share your stories in the comments or via GuardianWitness.
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Mark SmithMark Smith
Did you know that the respected US health thinktank the Commonwealth Fund ranked the UK top of the pile in its most recent study of healthcare in 11 rich countries?Did you know that the respected US health thinktank the Commonwealth Fund ranked the UK top of the pile in its most recent study of healthcare in 11 rich countries?
The UK came out best in eight of the 11 areas studied, including safety and effectiveness of care and for overall efficient use of resources. It came only 10th out of 11, however, for health outcomes and overall death rates.The UK came out best in eight of the 11 areas studied, including safety and effectiveness of care and for overall efficient use of resources. It came only 10th out of 11, however, for health outcomes and overall death rates.
For more tabloid-headline-busting facts and figures, read our data-focused piece that’s just launched.For more tabloid-headline-busting facts and figures, read our data-focused piece that’s just launched.
Related: 10 truths about Britain's health serviceRelated: 10 truths about Britain's health service
One commenter, Virverax, has raised the omission of relative GDP spending figures as a useful comparison of value for money between countries’ healthcare systems. This hasn’t been forgotten. Remember this is a month-long series, and we will be delving into every aspect of the NHS in depth over the next four weeks. Rest assured, though without giving too much away from a very important upcoming story, we will certainly be dealing with the GDP issue in some detail.One commenter, Virverax, has raised the omission of relative GDP spending figures as a useful comparison of value for money between countries’ healthcare systems. This hasn’t been forgotten. Remember this is a month-long series, and we will be delving into every aspect of the NHS in depth over the next four weeks. Rest assured, though without giving too much away from a very important upcoming story, we will certainly be dealing with the GDP issue in some detail.
In the meantime, one of the Guardian’s data journalists, George Arnett, has sent this clarification:In the meantime, one of the Guardian’s data journalists, George Arnett, has sent this clarification:
The latest OECD international comparison showed that the UK spent 8.5% of its GDP on health in 2013. This is marginally below the OECD average of 8.9% and considerably less than France (10.9%), Germany (11%) and the US (16.4%). Countries who spend proportionately less on healthcare than Britain include Hungary (7.4%), Poland (6.4%) and Turkey (5.1%).The latest OECD international comparison showed that the UK spent 8.5% of its GDP on health in 2013. This is marginally below the OECD average of 8.9% and considerably less than France (10.9%), Germany (11%) and the US (16.4%). Countries who spend proportionately less on healthcare than Britain include Hungary (7.4%), Poland (6.4%) and Turkey (5.1%).
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My colleague Phillip Inman, the Guardian’s economics correspondent, has some personal experience of St George’s that offers a nuanced assessment. The core treatment was of high quality, but associated care and staffing levels showed the strain. There also seemed to be a problem with gravy.My colleague Phillip Inman, the Guardian’s economics correspondent, has some personal experience of St George’s that offers a nuanced assessment. The core treatment was of high quality, but associated care and staffing levels showed the strain. There also seemed to be a problem with gravy.
My mother-in-law is in an acute ward at St George’s after suffering a deterioration in her heart condition. She was an emergency admission and in many ways has had the best care possible. But it was obvious there was a chronic shortage of nurses, which coincidentally the South London Press highlighted in its front page story last week. They were clearly exhausted from running between patients.My mother-in-law is in an acute ward at St George’s after suffering a deterioration in her heart condition. She was an emergency admission and in many ways has had the best care possible. But it was obvious there was a chronic shortage of nurses, which coincidentally the South London Press highlighted in its front page story last week. They were clearly exhausted from running between patients.
On the ward, doctors visit her at random times, making it impossible for close family members to communicate and find out first-hand how the treatment is progressing.On the ward, doctors visit her at random times, making it impossible for close family members to communicate and find out first-hand how the treatment is progressing.
The hospital food was not to my mother-in-law’s liking because it was always smothered in gravy. It took two weeks before the meals provider presented her with food minus gravy. In the meantime we have brought food, but it is clear that her situation has improved since she began eating the hospital food at more regular intervals.The hospital food was not to my mother-in-law’s liking because it was always smothered in gravy. It took two weeks before the meals provider presented her with food minus gravy. In the meantime we have brought food, but it is clear that her situation has improved since she began eating the hospital food at more regular intervals.
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