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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)
3.39pm GMT
15:39
UK's family doctors are most stressed in western world
We’ve just launched another important news story from Denis Campbell, the Guardian’s health policy editor.
Stress levels are so acute among British GPs that almost 30% plan to quit in the next five years, new research by the world’s most influential health thinktank reveals.
Campbell reports:
Just under six in 10 GPs (59%) find their work stressful, with 39% of these saying it is very stressful| and 20% extremely stressful, which is higher than any other leading western nation in the triannual study. Researchers surveyed 11,547 GPsin 11 countries, including France, Germany and the United States.
“These worrying findings reveal the scale of the challenge facing general practice,” said Dr Jennifer Dixon, chief executive of the UK-based Health Foundation thinktank, which helped with the study.
Researchers found that family doctors in Britain spend less time with their patients than anywhere else. In all, 92% of the 1,001 GPs surveyed said they spent less than 15 minutes talking to patients, while internationally in the survey just 27% of GPs spent less than this time. Similarly, only 8% of NHS GPs are spending more than 15 minutes with patients; on average, almost three-quarters (73%) of patients get at least that long.
You can read the full story here.
Related: NHS has the west's most stressed GPs, survey reveals
Updated
at 3.40pm GMT
3.20pm GMT
15:20
'We do home visits every day'
Jessica Elgot
The doctors are out on the road at lunchtime, making home visits. Gale Farm’s staff average more than 40 trips to patients’ houses each day.
“People think we don’t do this any more, but we do, every day,” says Dr Chris Stanley. “The majority are older patients who can’t get to the surgery. We can travel quite a distance, sometimes to the villages outside York.”
The first stop is Audrey Shillitoe, who is struggling with lung disease and sounded breathless on the phone. Stanley, seeing this patient for the first time, said he was concerned he would have to convince her to go to hospital, but when he arrives at her home, his checks found she was doing a little better than expected.
“I hate going to hospital,” Shillitoe said. “Once they put me in a ward with alcoholics and drug addicts, and I thought to myself, I don’t ever want to go back.” Stanley prescribes her medication but told her to get in touch quickly if things get worse.
Shillitoe was full of praise for the doctors, but said she was feeling the loss of a regular case management nurse visit, which cannot continue because of funding cuts.
Stanley asked her to call him to ask for extra help at home if she needed it. “Everyone criticises the NHS, but it isn’t their fault, the doctors and nurses; it’s others that are trying to cut things,” she said. “If these doctors weren’t here, I wouldn’t be here.”
The second stop on Stanley’s list of home visits is 87-year-old Valerie Winter, who needs a check-up after a spell in hospital with pneumonia. She is keen to get better quickly so she can get back to her hobbies, drawing classes, tai chi, singing in a choir and a sequence dancing class, though she no longer does the dance steps and just attends for the company.
Stanley checks her blood pressure, listens to her chest, and checks her oxygen levels, as we as discussing her medication and organising prescriptions to be delivered tomorrow.
Winter rejects the need for any extra help around the house. “I’m going to get a cleaner in because I was doing it all myself.” But she doesn’t need help with dressing or cooking. “I do all the cooking, vegetables, everything. I can manage.”
Though she seems lively, she said her time is hospital was bad. “It was the worst I’ve ever felt. But I always want to get better. It’s silly giving up, really.”
Updated
at 3.36pm GMT
3.12pm GMT3.12pm GMT
15:1215:12
We have our first Guardian live blog baby!We have our first Guardian live blog baby!
Those of you who were following the live blog yesterday may be anxious to hear news about Kerri Calthorpe, 31, who was described by nurses at St George’s hospital, Tooting, as being “halfway”, through her labour after 12 hours.Those of you who were following the live blog yesterday may be anxious to hear news about Kerri Calthorpe, 31, who was described by nurses at St George’s hospital, Tooting, as being “halfway”, through her labour after 12 hours.
We are now pleased to announce that baby Rex has been safely delivered. Congratulations to Kerri, husband Harry, and all the staff at St George’s maternity unit!We are now pleased to announce that baby Rex has been safely delivered. Congratulations to Kerri, husband Harry, and all the staff at St George’s maternity unit!
We are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQPWe are delighted to say that Kerri had a baby boy, Rex. Kerry was featured on the live blog @guardian @jessicaelgot pic.twitter.com/8q33EXxKQP
For those who may have missed yesterday’s post – here’s how we last saw Kerri:
UpdatedUpdated
at 3.14pm GMT at 3.25pm GMT
2.28pm GMT2.28pm GMT
14:2814:28
Dr Claire Anderton and Dr Bhavesh Desai, GPsDr Claire Anderton and Dr Bhavesh Desai, GPs
Jessica ElgotJessica Elgot
The shortage of up-and-coming GPs is a major challenge for the profession, with many newly qualified doctors preferring to work in hospitals.The shortage of up-and-coming GPs is a major challenge for the profession, with many newly qualified doctors preferring to work in hospitals.
Some might be daunted by the heavy workload of a GP, including out of hours paperwork, says Dr Claire Anderton. She is mentor to registrar Dr Bhavesh Desai, who is in his last year of GP training at Gale Farm. “I think some consultants can try to tempt good junior doctors away from general practice – they think it’s just prescribing antibiotics all day,” Desai said. Some might be daunted by the heavy workload of a GP, including out-of-hours paperwork, says Dr Claire Anderton. She is mentor to registrar Dr Bhavesh Desai, who is in his last year of GP training at Gale Farm. “I think some consultants can try to tempt good junior doctors away from general practice – they think it’s just prescribing antibiotics all day,” Desai said.
Anderton agrees there is a misconception that “it’s just coughs and colds”:Anderton agrees there is a misconception that “it’s just coughs and colds”:
It is an incredibly complex and varied job, but it is a huge workload, and I think that is starting to be addressed. There is an awful lot of burnout. Other than that it is the best job on Earth: I have patients who feel like friends, and when two of them died recently, I felt like I had lost two friends.It is an incredibly complex and varied job, but it is a huge workload, and I think that is starting to be addressed. There is an awful lot of burnout. Other than that it is the best job on Earth: I have patients who feel like friends, and when two of them died recently, I felt like I had lost two friends.
Desai made up his mind to pursue general practice after his third year, and has taken a particular interest in palliative care – particularly after looking after one patient for the last six weeks of his life. “We probably see more people die working here than a hospital doctor would,” he said.Desai made up his mind to pursue general practice after his third year, and has taken a particular interest in palliative care – particularly after looking after one patient for the last six weeks of his life. “We probably see more people die working here than a hospital doctor would,” he said.
Anderton, who has been a GP for more than 20 years, said she was constantly learning. “I have learned particularly to always trust mothers when they say something is wrong with their children,” she said. “But Bhav has taught me so much too, because he’s newly trained, particularly about new technology, he’s downloaded apps for me on my phone that help enormously with different aspects of patient care.” Anderton, who has been a GP for more than 20 years, said she was constantly learning. “I have learned particularly to always trust mothers when they say something is wrong with their children,” she said. “But Bhav has taught me so much, too, because he’s newly trained, particularly about new technology, he’s downloaded apps for me on my phone that help enormously with different aspects of patient care.”
Aside from the workload, the only complaint Anderton has about her work is the effect of national politics:Aside from the workload, the only complaint Anderton has about her work is the effect of national politics:
The NHS is a huge organisation, and it is adaptable. But we have had to deal with a horrendous amount of change, and we have to have some stability as well. We employ people here; and we ask them to do a job and if policies change it might change people’s jobs and we might have to make people redundant. The cuts have been happening for the last eight years, and we have to constantly try to innovate in order to keep ahead.The NHS is a huge organisation, and it is adaptable. But we have had to deal with a horrendous amount of change, and we have to have some stability as well. We employ people here; and we ask them to do a job and if policies change it might change people’s jobs and we might have to make people redundant. The cuts have been happening for the last eight years, and we have to constantly try to innovate in order to keep ahead.
UpdatedUpdated
at 2.47pm GMT at 3.24pm GMT
12.56pm GMT12.56pm GMT
12:5612:56
Lorraine Rankin, healthcare assistantLorraine Rankin, healthcare assistant
Jessica ElgotJessica Elgot
In her practice room, healthcare assistant Lorraine Rankin is carefully dressing her patient’s foot. Rachel has had surgery after falling down the stairs and developing a bunion-like lump on the side, near her toe.In her practice room, healthcare assistant Lorraine Rankin is carefully dressing her patient’s foot. Rachel has had surgery after falling down the stairs and developing a bunion-like lump on the side, near her toe.
She has been having the wound dressed at the surgery every few days, but is keen to be rid of her crutches. “It’s only a couple more weeks now, I’m seeing the surgeon next week so I want it to look good for that.”She has been having the wound dressed at the surgery every few days, but is keen to be rid of her crutches. “It’s only a couple more weeks now, I’m seeing the surgeon next week so I want it to look good for that.”
Rachel had an allergic reaction to one of the dressings so Rankin calls in practice nurse Laura Atherton for her advice on dressings to use.Rachel had an allergic reaction to one of the dressings so Rankin calls in practice nurse Laura Atherton for her advice on dressings to use.
It is a new role for Rankin, with healthcare assistants now trained to take on a huge expansion in tasks, including not only dressing wounds but procedures such as ear syringes, flu jabs, NHS health checks and aiding surgical teams in vasectomies – jobs traditionally done by a practice nurse.It is a new role for Rankin, with healthcare assistants now trained to take on a huge expansion in tasks, including not only dressing wounds but procedures such as ear syringes, flu jabs, NHS health checks and aiding surgical teams in vasectomies – jobs traditionally done by a practice nurse.
Both Rankin and Atherton sort through the dressings, showing Rachel different kinds. “I know the orange and the blue packets, and the orange ones were what I thought worked,” Rachel said. She prefers to remove the old dressing herself, to ease it over the most painful spots. With the dressing on, she hobbled out of the surgery. “It’s not too painful,” she winced.Both Rankin and Atherton sort through the dressings, showing Rachel different kinds. “I know the orange and the blue packets, and the orange ones were what I thought worked,” Rachel said. She prefers to remove the old dressing herself, to ease it over the most painful spots. With the dressing on, she hobbled out of the surgery. “It’s not too painful,” she winced.
“If I was 10 years younger, I’d definitely train to be a practice nurse,” says Rankin. “But it’s the practical side that I like: if you do an ear syringe then it seems like not such a major procedure. But it can make a huge difference to someone – you see their face change and they are so grateful they can hear again.”“If I was 10 years younger, I’d definitely train to be a practice nurse,” says Rankin. “But it’s the practical side that I like: if you do an ear syringe then it seems like not such a major procedure. But it can make a huge difference to someone – you see their face change and they are so grateful they can hear again.”
Rankin is planning to do a foundation course at York University to help her advance as a healthcare assistant. And this week she will be trained to administer shingles vaccinations – her first live vaccine. It is a major shift in her role from what she was doing initially, but Rankin said the practice is keen to give healthcare assistant more responsibility for simple procedures. “I’d like to train now so I can be at the top level of everything I’m allowed to do.”Rankin is planning to do a foundation course at York University to help her advance as a healthcare assistant. And this week she will be trained to administer shingles vaccinations – her first live vaccine. It is a major shift in her role from what she was doing initially, but Rankin said the practice is keen to give healthcare assistant more responsibility for simple procedures. “I’d like to train now so I can be at the top level of everything I’m allowed to do.”
UpdatedUpdated
at 2.04pm GMTat 2.04pm GMT
12.39pm GMT12.39pm GMT
12:3912:39
Dan Hurley, pharmacistDan Hurley, pharmacist
Jessica ElgotJessica Elgot
Dan Hurley has an unusual role – but it is one that could become far more common.Dan Hurley has an unusual role – but it is one that could become far more common.
He is a pharmacist based in the Haxby Group’s GP practice, not in a separate chemist. The clinic has trialled the position for about 18 months, getting Hurley to deal with repeat prescriptions, manage patients with chronic conditions such as asthma, and monitor the drugs that patients take to make sure different medications are not conflicting with each other.He is a pharmacist based in the Haxby Group’s GP practice, not in a separate chemist. The clinic has trialled the position for about 18 months, getting Hurley to deal with repeat prescriptions, manage patients with chronic conditions such as asthma, and monitor the drugs that patients take to make sure different medications are not conflicting with each other.
We might have someone on 20 or 30 medicines a day, with heart disease; then they might be overweight and that leads to diabetes and hypertension; they could have asthma on top of that, and chronic ulcers as a side-effect; then mental health problems caused by ill health. All this can add up when it comes to medication – and they might be seeing three different specialists. I can be there to keep track of what they are taking and spot conflicts.We might have someone on 20 or 30 medicines a day, with heart disease; then they might be overweight and that leads to diabetes and hypertension; they could have asthma on top of that, and chronic ulcers as a side-effect; then mental health problems caused by ill health. All this can add up when it comes to medication – and they might be seeing three different specialists. I can be there to keep track of what they are taking and spot conflicts.
Hurley deals daily with patients who have seen miracle drugs and cures in newspapers or on the internet, or have concerns about their medication because of what they have seen in the press, or what their neighbours have told them.Hurley deals daily with patients who have seen miracle drugs and cures in newspapers or on the internet, or have concerns about their medication because of what they have seen in the press, or what their neighbours have told them.
“It’s really hard. Take statins for example: professors of cardiology are divided over the minutiae of it so it’s very hard to explain in the lay press. And they read about some cures too, say for dementia, and that is really hard sometimes for family to cope with, especially if they read there’s a cure.”“It’s really hard. Take statins for example: professors of cardiology are divided over the minutiae of it so it’s very hard to explain in the lay press. And they read about some cures too, say for dementia, and that is really hard sometimes for family to cope with, especially if they read there’s a cure.”
The NHS is keen to have more pharmacists like Hurley in GP practices around the country. “We don’t have to be separate, which I think has been the tradition, it makes sense for us to work together.”The NHS is keen to have more pharmacists like Hurley in GP practices around the country. “We don’t have to be separate, which I think has been the tradition, it makes sense for us to work together.”
UpdatedUpdated
at 1.26pm GMTat 1.26pm GMT
12.32pm GMT12.32pm GMT
12:3212:32
Your Tuesday lunchtime reading listYour Tuesday lunchtime reading list
76 prescriptions, 38 consultations, 55 lab results, 11 phonecalls, one home visit – all in one day: The latest in our secret diary series has launched, revealing the ups and downs of a single GP’s working week, from a patient aggressively demanding antibiotics to praise from a relieved mother.76 prescriptions, 38 consultations, 55 lab results, 11 phonecalls, one home visit – all in one day: The latest in our secret diary series has launched, revealing the ups and downs of a single GP’s working week, from a patient aggressively demanding antibiotics to praise from a relieved mother.
The NHS saved my life: ‘I was pregnant, alone and bleeding, but didn’t realise the danger.’ Read one woman’s account of how the quick and calm actions of staff at a GP surgery may have saved her and her baby.The NHS saved my life: ‘I was pregnant, alone and bleeding, but didn’t realise the danger.’ Read one woman’s account of how the quick and calm actions of staff at a GP surgery may have saved her and her baby.
UpdatedUpdated
at 12.42pm GMTat 12.42pm GMT
12.02pm GMT12.02pm GMT
12:0212:02
Your comments on our NHS series so farYour comments on our NHS series so far
Elena CresciElena Cresci
Readers have been getting involved with the project in a number of ways, whether below the line, on Facebook or via GuardianWitness. Yesterday’s 10 truths about the NHS piece led to this personal story from MysteryMachines:Readers have been getting involved with the project in a number of ways, whether below the line, on Facebook or via GuardianWitness. Yesterday’s 10 truths about the NHS piece led to this personal story from MysteryMachines:
As someone who nearly died age 28, I am thankful for our amazing NHS every bloody day. They have saved my life and all I can really offer is its ridiculously comforting to know that throughout my treatment and rehab from a traumatic brain injury i would not receive a bill in the post for it.As someone who nearly died age 28, I am thankful for our amazing NHS every bloody day. They have saved my life and all I can really offer is its ridiculously comforting to know that throughout my treatment and rehab from a traumatic brain injury i would not receive a bill in the post for it.
But that's the least of your problems as a patient, there are the countless nurses, doctors and staff keeping you going through what is undoubtedly the worst time of your life also for free. How dare they.But that's the least of your problems as a patient, there are the countless nurses, doctors and staff keeping you going through what is undoubtedly the worst time of your life also for free. How dare they.
I had a 10-15% chance of instant death from my injury, I lived and received excellent care throughout my 3 month stay. I had brain surgery on 1st May to correct my problem, I was back at work 3 weeks later happy to pay my tax bit back in to help fund the NHS and help others help themselves.I had a 10-15% chance of instant death from my injury, I lived and received excellent care throughout my 3 month stay. I had brain surgery on 1st May to correct my problem, I was back at work 3 weeks later happy to pay my tax bit back in to help fund the NHS and help others help themselves.
Underneath our piece about funding elderly and social care, janeinalberta shared her experiences as a relative providing unpaid care for the elderly:Underneath our piece about funding elderly and social care, janeinalberta shared her experiences as a relative providing unpaid care for the elderly:
I'm one of the small army of relatives providing unpaid care for the very elderly and frail. I don't mind doing it, but it is challenging and I no longer have confidence that there will be back-up from social services and the NHS if I can't cope. I also worry about what will happen to myself and my husband in our extreme old age, since we do not have children of our own, and our own financial resources will be less because of the money being spent on my mother's care.I'm one of the small army of relatives providing unpaid care for the very elderly and frail. I don't mind doing it, but it is challenging and I no longer have confidence that there will be back-up from social services and the NHS if I can't cope. I also worry about what will happen to myself and my husband in our extreme old age, since we do not have children of our own, and our own financial resources will be less because of the money being spent on my mother's care.
I'd be quite happy to forgo the fuel allowance and the 'triple lock' if it guaranteed that whatever my savings and income I'll get adequate care in my old age. But, I do not trust the government on this issue. The Care Act was supposed to solve the problem, but implementation turned into a farce.I'd be quite happy to forgo the fuel allowance and the 'triple lock' if it guaranteed that whatever my savings and income I'll get adequate care in my old age. But, I do not trust the government on this issue. The Care Act was supposed to solve the problem, but implementation turned into a farce.
The index linking of my local government pension, and my husband's civil service and teacher's pensions has been reduced from RPI to CPI and recently we've discovered that part of my husband's pensions will lose their index linking altogether when the flat rate pension comes in -- and that is despite my husband not benefitting from the flat rate pension increase. So suggesting that we should lose further benefits, supposedly to pay for care, just adds further insecurity and uncertainty.The index linking of my local government pension, and my husband's civil service and teacher's pensions has been reduced from RPI to CPI and recently we've discovered that part of my husband's pensions will lose their index linking altogether when the flat rate pension comes in -- and that is despite my husband not benefitting from the flat rate pension increase. So suggesting that we should lose further benefits, supposedly to pay for care, just adds further insecurity and uncertainty.
You’ve also been submitting your stories to our GuardianWitness callout. Hannah Harris wrote to us about how St George’s, the hospital we were liveblogging from yesterday, saved her six-week-old daughter:You’ve also been submitting your stories to our GuardianWitness callout. Hannah Harris wrote to us about how St George’s, the hospital we were liveblogging from yesterday, saved her six-week-old daughter:
St George's saved my baby's lifeSt George's saved my baby's life
My daughter was blue lighted from Margate QEQM to St George's on New Year's Eve 2011. She was 6 weeks old and suffering with RSV Bronchiolitis. I remember feeling terrified and numb all at once in the ambulance sitting next to my tiny baby who was connected to all sorts of wires and machines. It was like some sort of out of body experience. This wasn't really happening I kept thinking. She'd had a bad turn on the ward at Margate and was rushed to the ICU where a room full of brilliant doctors and nurses managed to get her breathing again via mechanical means. There was no Paediatric Intensive Care Unit there though so she had to be transferred.My daughter was blue lighted from Margate QEQM to St George's on New Year's Eve 2011. She was 6 weeks old and suffering with RSV Bronchiolitis. I remember feeling terrified and numb all at once in the ambulance sitting next to my tiny baby who was connected to all sorts of wires and machines. It was like some sort of out of body experience. This wasn't really happening I kept thinking. She'd had a bad turn on the ward at Margate and was rushed to the ICU where a room full of brilliant doctors and nurses managed to get her breathing again via mechanical means. There was no Paediatric Intensive Care Unit there though so she had to be transferred.
When we arrived at St George's in the early hours the ward was quiet, warm and peaceful. Not what I expected I suppose but then at the time I'm not sure I knew what to expect. More wonderful doctors were ready waiting to receive our little girl by a specially heated bed. They warned us things were going to get worse before they got better but they'd seen it all before and instilled such confidence in us over the time we spent there that it was all going to be ok. Our daughters case was a rare one, she was in the 1% of kids who react to the virus in the way she did but the doctors and nurses treated her and cared for her and watched her closely and after a long, hellish week she got better. Just like that. Just like they said she would. She is 4 years old now. She is at school, she has friends, she is thriving. I still can't believe how lucky we are to have our little girl sometimes. We were so close to losing her it seemed. A tiny 6 week old baby. 2 collapsed lungs. Non responsive. What if we weren't in that hospital at that time with the support and resources from both Margate and St George's? Well, it doesn't bear thinking about really, does it?When we arrived at St George's in the early hours the ward was quiet, warm and peaceful. Not what I expected I suppose but then at the time I'm not sure I knew what to expect. More wonderful doctors were ready waiting to receive our little girl by a specially heated bed. They warned us things were going to get worse before they got better but they'd seen it all before and instilled such confidence in us over the time we spent there that it was all going to be ok. Our daughters case was a rare one, she was in the 1% of kids who react to the virus in the way she did but the doctors and nurses treated her and cared for her and watched her closely and after a long, hellish week she got better. Just like that. Just like they said she would. She is 4 years old now. She is at school, she has friends, she is thriving. I still can't believe how lucky we are to have our little girl sometimes. We were so close to losing her it seemed. A tiny 6 week old baby. 2 collapsed lungs. Non responsive. What if we weren't in that hospital at that time with the support and resources from both Margate and St George's? Well, it doesn't bear thinking about really, does it?
Sent via Guardian WitnessSent via Guardian Witness
By Hannah HarrisBy Hannah Harris
18 January 2016, 16:0818 January 2016, 16:08
And we haven’t just been receiving stories from patients: we’ve also heard from NHS staff too. Greengables1, a ward sister, wrote about her concerns with staffing levels on hospital wards for GuardianWitness.And we haven’t just been receiving stories from patients: we’ve also heard from NHS staff too. Greengables1, a ward sister, wrote about her concerns with staffing levels on hospital wards for GuardianWitness.
As always, you can get involved with our journalism below the line on this liveblog and on other selected pieces. You can also join the conversation using the hashtag #ThisIsTheNHS – that is, once Twitter is properly back on its feet.As always, you can get involved with our journalism below the line on this liveblog and on other selected pieces. You can also join the conversation using the hashtag #ThisIsTheNHS – that is, once Twitter is properly back on its feet.
UpdatedUpdated
at 12.19pm GMTat 12.19pm GMT
11.55am GMT11.55am GMT
11:5511:55
Junior doctors' strike suspendedJunior doctors' strike suspended
Next week’s strike by junior doctors has been suspended as talks continue with the government over new contracts, the British Medical Association has said.Next week’s strike by junior doctors has been suspended as talks continue with the government over new contracts, the British Medical Association has said.
For the full story on this breaking news, click here.For the full story on this breaking news, click here.
11.41am GMT11.41am GMT
11:4111:41
Laura Atherton, nurseLaura Atherton, nurse
Jessica ElgotJessica 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.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.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.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.”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.”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.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.
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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 in 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 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.
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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.”
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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.
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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.
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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
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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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at 8.46am GMTat 8.46am GMT
5.40pm GMT5.40pm GMT
17:4017:40
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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at 6.50pm GMTat 6.50pm GMT
5.32pm GMT5.32pm GMT
17:3217:32
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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at 6.50pm GMTat 6.50pm GMT
5.28pm GMT5.28pm GMT
17:2817:28
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
17:1417:14
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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at 6.51pm GMTat 6.51pm GMT