Misuse of emergency ambulances

I agree DaisyAnne. The whole healthcare in the community sector needs to be expanded with better co-ordination and communication.

I can't ever remember having a home visit, not even as a child
Perhaps you were lucky and never had anything wrong with you?

I was about eight and had tonsillitis and can still remember the doctor coming and producing some enormous white tablets out of his bag which did cure my tonsillitis but my mother had to crush them with jam because I'd never have been able to swallow them.

Surgery was in the morning but if you needed a home visit for some reason, it was in the afternoon.
Home visits were fairly routine in those days.

Even in the 1970s, as Dickens says.
There could be locums on at night and weekends by then, I think, but presumably organised by the surgery.

I can remember the doctor visiting at home for all kinds of reasons. I was born at a time when many childhood illnesses had no vaccinations to give protection and measles, whooping cough could be serious and even fatal diseases.

I can rmember the doctor calling when both my sisters, one only 2 months old, developed whooping cough badly. The doctor did not want them in his surgery. The doctor called when it was thought I had appendicitis. He then called an ambulance. people did not have cars then, ambulance was the only way to get me to hospital.

I have once called a doctor out for myself and once for DH. I was so ill, I was not fit to drive, nor could I walk to the surgery and my DC were just pre-teenagers and was worried about leaving them alone in the house. DH was in Brazil (or Sudan, or Egypt) at the time. I did the same when he returned from a trip with a very high temperature and nearly delirious.

I see no virtue in not having calling doctors out. That was how the system worked then. All our lives are different. My children both managed only one visit each to A&E in their childhoods, both with broken limbs. Other people seemed to be at A&E at least once a year with their children.

Perhaps you were lucky and never had anything wrong with you?

Don't ever assume!

I was born with a deformed tibia, had an op as a young child and spent many hours in outpatients' clinics until I was a teenager.

I had bacterial meningitis and was in hospital isolation for weeks.

I also broke my arm badly and went straight to "casualty".

A GP couldn't have contributed to any of that.

And I had regular tonsillitis too until I eventually had my tonsils removed. I still don't remember any home visits.

Don't ever assume!
No, I shouldn't assume, you're right.

But I do remember the GPs making house calls.

Oh yes, I can remember those nights, when children were little, and the phone rang several times a night, and off he went. And I had to wait by the phone in case other calls came, and I had to make the decision, having no qualifications whatsoever- to wait for him to return, or call an ambulance, or ....

Sometimes a long way away in countryside, for things like 'I have go a headache, and no paracetamol. I thought you'd bring some. Or 'I've made a decision, I want to stop drinking', 'I am worried because I am losing a bit of hair lately' - and of course, for serious things that could not wait, and he never minded!

And even if he had had to do several visits in the night, and not got much sleep, he would be at the surgery to see patients- and then finish morning with home-visits, to the elderly, the long-term sick and terminal patients, mothers who had just given birth, or whomever required a visit. Then more visits after a quick sandwich and cup of coffee- finishing with normal surgery from 4-6.30 (often extras too at last minute) and the home visits on way home.

1 night in 4, and 1 week-end in 4- on top of 'normal day' and home visits. And this until 2004, so for 35 years. It takes a toll, I can tell you. On the GPs, but also on their families. The wives who had to be there, tied to the phone, unpaid of course.

Callistemon21

^Don't ever assume!^
No, I shouldn't assume, you're right.

But I do remember the GPs making house calls.

I don't - that's all I was saying. Maybe a doctor visited when I was a baby and/or I have a bad memory. I've never called out a GP as an adult or for my children. As I wrote earlier, I was told I wasn't eligible after my heart attack, but managed to cobble something together. That's the only time I could have done with a home visit.

Nowadays, more people have cars and can get to a GP surgery. I still think that home visits aren't the best use of a GP's time. While he/she is driving around, four or five people are missing out on potential surgery appointments. The question has to be asked whether a home visit by a GP achieves anything which a telephone appointment or a community nurse visit couldn't.

GPs are a scarce resource and expensive to train. Even if more money was invested in training and employing them, the demand would probably outstrip supply and I seriously wonder if home visits are an efficient use of their time.

I feel the same about ambulance call outs. Paramedics are well-trained and can spot "red flags". It's a very inefficient use of their time to have them queued up outside A&E or with patients who could be treated at home, if only community healthcare were better.

Fleurpepper That's ridiculous! Nobody can operate efficiently with so little sleep, apart from the toll on the family. I want to know anybody treating me has had enough sleep and is clear-headed enough to make the right decisions.

PS. I also want anybody treating me not to think I'm a time-waster.

Fleurpepper I remember calling the GP at 11pm at night when DC1 was small; DH away, DC2 (a couple of months old) asleep. The doctor who came gave a bottle of medicine and advice but he was a locum who must have been employed by the surgery to do night calls. I still wonder if she should have been hospitalised as a neighbour's child was (it was RSV and she was very poorly).
Thst was before 111 of course.

I do think that direct service was better and probably cost less than the present 111 service.

Yes, people do call ambulances or go to A&E for spurious reasons and are wasters of valuable resources. The phone triage system should sort out those who genuinely need an ambulance.
The First Responder system seemed to work well.

However, all of that doesn't mean that the service is not seriously underfunded and that lack of funding resulting in lack of resources is costing lives.

growstuff

Fleurpepper That's ridiculous! Nobody can operate efficiently with so little sleep, apart from the toll on the family. I want to know anybody treating me has had enough sleep and is clear-headed enough to make the right decisions.

You tell me! But that is how it was for GPs in those days.

OH qualified in 1969 (UCH), and joined his first practice in 1973. When a partner was sick or on holiday, it went from 1 in 4 (nights and w.ends) to 1 in 3. OH did that from 1973 until they opted out of out of hours in 2004. And until we had mobile phones, and even more so mobile phones which did not lose cover when out in countryside- the spouse (and let's face it, in those days, the 'wife') was on call too. Unable to leave the house, and unable to get any sleep either. And unpaid.

It was also expected that GPs had wives who were nurses or doctors. I was NOT! But still I had to pick up the phone when he was out, and somehow give advice and make life saving decisions- the stress, especially when we had babies/young children, and later taught full-time, and quite a way from home- was at times unbelievable.

When OH worked in hospital as Junior Doctor, it was a working week night and day, of 140 hours.

I don't know whether this link will work:

www.dropbox.com/s/9mighhx76avmzm7/Cottage%20to%20Digital.docx?dl=0

It's an article called "From Cottage Industry to Digital Revolution" by Dr Clare Gerada, who is a GP and the President of the Royal College of General Practitioners.

Fleurpepper I'm not sure if you're advocating a return to the "good old days" or not.

growstuff

Fleurpepper That's ridiculous! Nobody can operate efficiently with so little sleep, apart from the toll on the family. I want to know anybody treating me has had enough sleep and is clear-headed enough to make the right decisions.

If you go into hospital currently, there must be a chance that your doctor or nurse is in exactly that position.

Last night my daughter arrived home from work and as she came in she called out " Why is there an ambulance outside?" She was relieved it wasn't for me and I had no idea it was there. I went out 5 minutes later and the ambulance was still, there with its crew sitting chatting in the front. I was surprised to see it there still, though it did drive off while I was still scraping my car windscreen but didn't seem in any great hurry. Were the crew on a break? No idea, but one gets the impression that the crews are flat out all the time so I was certainly puzzled! I'll probably never know.
Clearly the ambulance service is struggling at present and there are definitely those who make unnecessary calls. I can't think of an easy answer unless much more funding is made available for the NHS so that waiting outside A&E becomes a thing of the past. But the unnecessary calls have always been a problem. There needs to be some sort of system for filtering calls made regularly by people with mental health issues. I realise they can't simply be ignored in case, as in the case of 'the boy who cried wolf', it actually is an emergency this time. When there are calls stacking up they probably need to be put at the end of the queue.

DaisyAnne

growstuff

Fleurpepper That's ridiculous! Nobody can operate efficiently with so little sleep, apart from the toll on the family. I want to know anybody treating me has had enough sleep and is clear-headed enough to make the right decisions.

If you go into hospital currently, there must be a chance that your doctor or nurse is in exactly that position.

Or other staff, like radiographers - they are so short staffed in some hospitals they often have to work extra hours until late then be back at work very early the next morning.

A friend was telling me about her DD who is a paediatric oncology nurse - she regularly works an extra 3+ hours a day on top of her normal hours.

DaisyAnne

growstuff

Fleurpepper That's ridiculous! Nobody can operate efficiently with so little sleep, apart from the toll on the family. I want to know anybody treating me has had enough sleep and is clear-headed enough to make the right decisions.

If you go into hospital currently, there must be a chance that your doctor or nurse is in exactly that position.

I'm not disputing that. It was ridiculous in the past and ridiculous now.

When I was in hospital overnight last summer, the night nurse at the station just outside the bed bay I was in spent three hours of her shift asleep on her desk and the rest of the time playing with her mobile phone and talking to family/friends.

I was awake all night because I was in excessive pain and expecting to go down to theatre at any momeat and had nothing else to watch.

This makes very disturbing reading.

www.msn.com/en-gb/health/medical/the-nhs-is-on-life-support-and-as-an-emergency-doctor-i-m-terrified-we-won-t-make-it/ar-AA16ydXH?ocid=msedgntp&cvid=25fcd82fddbd4c59ab02c303c6a3886b

Very disturbing; thanks for posting it Dickens.

growstuff

Fleurpepper I'm not sure if you're advocating a return to the "good old days" or not.

No I am not. But we have gone (as for so many things) from the sublime to the ridiculous. It nearly killed my OH twice- and it certainly did affect our family life an awful lot, in so many ways. As said, it tied me to the home and the phone day and night for so many years, unpaid and totally unqualified- until deputising services came about, and reliable mobile phones.

The fact is, we are very short of doctors- and if those who used to work such long hours, and provide such amazing services, no longer do- then you need three times more doctors.

and it does put huge pressure on emergency Dept and ambulances!