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To Gladys and Apple:  I agree with both of you.

What this place needs is a ‘code of best practice’ to replace the current complaints procedures, which are not fit for purpose, IMHO. The current process risks legitimate complaints being whitewashed. The prevailing ethos seems to be to defend the system no matter what, and try to make out that whatever happened was never due to negligence. When they do grudgingly admit that there was something wrong then there seem to be only two possible types of interpretation: a) it was somehow patient’s fault, or b) minor mistakes were made and lessons have been learnt.  

On this Island, one gets the impression that some medical practitioners view treating NHS patients as doing them favours, as opposed to doing their (well-paid) jobs. It goes without saying that the attitudes quickly improve if you are a private patient.  Whoever is going to be the next Health Minister must address this stark inequality in delivery of health service, and also the deficiency in accountability among the medical staff of all ranks.

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2 hours ago, John Wright said:

And have you chased, did the acknowledgment give a time scale?

When I chased I was told we will get back to you asap, sorry but covid causing delays... (Paraphrase)

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2 hours ago, John Wright said:

And have you chased, did the acknowledgment give a time scale?

In my opinion (and personal experience), having to chase things is one of the biggest problems in healthcare on the island. 

For example, a family member has cancer. He's under the care of his GP, a consultant at Nobles, and a consultant in Liverpool.

Although he's given them all permission to communicate with each other, they don't. He has to chase results and inform the three parties himself or it doesn't happen. He then has to gather the opinions and care suggestions and disseminate them to all parties as well. If he complains, they all point the finger at one another. 

No, he hasn't made an official complaint because he's frightened of alienating one or all of them and compromising his care further. 

He's an intelligent and articulate man (biology at Oxford) so he's just about managing, but it's hard for him when he's not well so his daughter helps keep him on track. I dread to think what others who are sicker, less educationally equipped, and/or without family support go through. 

I think if he did make an official complaint and had to keep chasing that as well, it would break him. 

I'm going through something similar myself at the moment, and if I can't get it resolved soon I'll run out of meds. Missing doses of these meds quickly leads to resistance and that's a road I really don't want to go down. It's like pulling teeth trying to get my GP and Nobles to communicate lab results with each other or my consultant in Liverpool. I've spent the past week chasing this up. 

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17 minutes ago, snowman said:

When I chased I was told we will get back to you asap, sorry but covid causing delays... (Paraphrase)

Similar to my experience today. I was chasing for cryo therapy that was prescribed three weeks ago for a disfiguring keritosis on my forehead and a few on my back.. (Makes me look like a Klingon), Nah it's not that bad.lol.

Was told, they are still trying to catch up from last October but I can try private if I'm desperate.

Sorry Zarley, my problem is insignificant compared to yours but I hadn't read yours when I posted.

Edited by doc.fixit
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10 minutes ago, doc.fixit said:

 

Sorry Zarley, my problem is insignificant compared to yours but I hadn't read yours when I posted.

Your problems are no less significant than mine if it's something that's causing you upset. Something like what you're dealing with can cause feelings of isolation etc and that's no good for anyone. Hope you get it sorted soon.

Covid is behind my problem as well, as I haven't seen my consultant in Liverpool since November 2019. I usually go every six months. He doesn't want me to travel due to covid and has been posting my meds. However, he won't/can't send any more without seeing new labs (usually done across) and while I've had the labs done here, getting the results and getting them to Liverpool is proving difficult.  

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40 minutes ago, Zarley said:

For example, a family member has cancer. He's under the care of his GP, a consultant at Nobles, and a consultant in Liverpool.Although he's given them all permission to communicate with each other, they don't. He has to chase results and inform the three parties himself or it doesn't happen. He then has to gather the opinions and care suggestions and disseminate them to all parties as well.

I fully understand, and you have my sympathy. It exactly mirrors my experience. It’s 3 years since my leukaemia was active. I get follow up bloods and genetic testing every 8 weekend. But my GP, local consultant and Liverpool really don’t talk. The genetic tests should take 10-15 days. This time it was 7 weeks 1 day. So the cycle is never ending. I chase after 15 days, here and Liverpool. The results were available on 4 June. So why they didn’t reach my specialist nurse until 13 July ( and still haven’t reached my GP or the Nobles Haematologist ) no one knows, or can explain, and appears not to care less.

The blood forms originate in Liverpool and are posted to me. I know two patients in Liverpool, same tests, results reported in Liverpool, 10 days max. For some reason my samples are sent to London. Their’s are done in Liverpool since the new Clatterbridge laboratory opened. For some reason Liverpool hadn’t updated my form last year.  Can the specialist nurse do that? No, I’ve to see, and ask the consultant. That’s exasperating. 

40 minutes ago, Zarley said:

If he complains, they all point the finger at one another. 

No, he hasn't made an official complaint because he's frightened of alienating one or all of them and compromising his care further. 

I’ve complained, as and when required. It’s always been resolved. It’s never affected treatment. It’s been slow. That’s because, like many service industries, they don’t identify it as a complaint. Type things like “This is not a complaint, but if it is not resolved I will escalate it” or “This is a complaint and you should deal with it in accordance with your complaint resolution process

40 minutes ago, Zarley said:

He's an intelligent and articulate man (biology at Oxford) so he's just about managing, but it's hard for him when he's not well so his daughter helps keep him on track. I dread to think what others who are sicker, less educationally equipped, and/or without family support go through. 

I think if he did make an official complaint and had to keep chasing that as well, it would break him.

I'm going through something similar myself at the moment, and if I can't get it resolved soon I'll run out of meds. Missing doses of these meds quickly leads to resistance and that's a road I really don't want to go down. It's like pulling teeth trying to get my GP and Nobles to communicate lab results with each other or my consultant in Liverpool. I've spent the past week chasing this up. 

I empathise. I normally give 14 days for a response or an explanation for failure and a time estimate. I agree the system, process and personnel are not customer focussed.

one thing I’ve learned it to hold enough spare meds for a lock down.

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1 hour ago, code99 said:

To Gladys and Apple:  I agree with both of you.

What this place needs is a ‘code of best practice’ to replace the current complaints procedures, which are not fit for purpose, IMHO. The current process risks legitimate complaints being whitewashed. The prevailing ethos seems to be to defend the system no matter what, and try to make out that whatever happened was never due to negligence. When they do grudgingly admit that there was something wrong then there seem to be only two possible types of interpretation: a) it was somehow patient’s fault, or b) minor mistakes were made and lessons have been learnt.  

On this Island, one gets the impression that some medical practitioners view treating NHS patients as doing them favours, as opposed to doing their (well-paid) jobs. It goes without saying that the attitudes quickly improve if you are a private patient.  Whoever is going to be the next Health Minister must address this stark inequality in delivery of health service, and also the deficiency in accountability among the medical staff of all ranks.

That wouldn’t work.

You need a code of best practice for each specialism, as the bench mark. Then you need the internal, local resolution, complaints procedure, then the independent review procedure.

You know, the majority of complaints are low level, due to lack of communication on both sides, or expectations being mismanaged, and are resolved quickly. There’s another sizeable group that aren’t justified. There’s very few that are intractable.

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29 minutes ago, John Wright said:

I fully understand, and you have my sympathy. It exactly mirrors my experience.

It's a relief to know it's not just him. He's always had the suspicion that they neglect his care because of - for want of a better term - past lifestyle issues. I've always leaned toward it being a systematic problem and if someone who knows law goes through this as well, I suppose I'm closer to the truth than him. (And I'll let him know - not that I'm right but that it's not just him.) 

29 minutes ago, John Wright said:

one thing I’ve learned it to hold enough spare meds for a lock down.

I get a six month supply at a time, and they built-in a two and a half/three month buffer when I first started. That was plenty pre-pandemic.

They know I no longer have that buffer but they're reluctant to build it up again due to the whole covid-no-labs-no-check-ups situation. I thought I might be able to go across for an appointment this summer but with the way things are going, I don't think it will happen. 

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25 minutes ago, Zarley said:

It's a relief to know it's not just him. He's always had the suspicion that they neglect his care because of - for want of a better term - past lifestyle issues. I've always leaned toward it being a systematic problem and if someone who knows law goes through this as well, I suppose I'm closer to the truth than him. (And I'll let him know - not that I'm right but that it's not just him.) 

I get a six month supply at a time, and they built-in a two and a half/three month buffer when I first started. That was plenty pre-pandemic.

They know I no longer have that buffer but they're reluctant to build it up again due to the whole covid-no-labs-no-check-ups situation. I thought I might be able to go across for an appointment this summer but with the way things are going, I don't think it will happen. 

Two things.
 

I’m happy to chat with him and share my experiences and solutions.

I’m off to see my consultant on 4/8. Last saw him in Feb 2020. Booked 2 months ago when everything was clear here and low in England. But 14 day average here is higher than Liverpool, I’m double vaxxed. I may as well.

I negotiated bloods being taken here, rather than going over to Liverpool, for bone marrow biopsies every 3 months, just before lockdown. Blood test result  is slightly less sensitive than bone marrow. But it’s good enough. If it spikes I get whisked in for BMB and started on ATRA within 48 hours.

Im hoping that if I see the consultant, and sort out analysis of the samples at Liverpool, it’ll be my penultimate consult.

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52 minutes ago, John Wright said:

I’ve complained, as and when required. It’s always been resolved. It’s never affected treatment. It’s been slow. That’s because, like many service industries, they don’t identify it as a complaint. Type things like “This is not a complaint, but if it is not resolved I will escalate it” or “This is a complaint and you should deal with it in accordance with your complaint resolution process

There is nothing different to what we already have being proposed for the complaints process itself. We know about the merging of the IRB's (good move) but this is not about that. 

@John Wright A complaint from a barrister carries a lot more weight and attention than many others especially one with a high profile.  That is not a criticism but just a fact. Many people do not have the savvy or the acumen or knowledge around the systems and people or indeed the confidence to pull such things off. Especially if they are ill (see above).

@Zarleyand @doc.fixit. I am sorry that these are experiences of today's health and social care systems. In fact, it makes me angry (yes I know it is identifiable) when so many resources are spent and are available to achieve something so much better. 

This is an important debate to have. We need change, not more of the same. Given the circumstances we already know about that change has to be made now. Once it is installed it will not be pulled back. It smacks of the DHSC yet again taking steps protecting itself. 

There have been some interesting comments from the CM this morning about the needs for public engagement with policies and procedures that directly affect people. Pity this was not one of them, or seen as a high enough priority for this administration to grapple with.

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8 minutes ago, Apple said:

@John Wright A complaint from a barrister carries a lot more weight and attention than many others especially one with a high profile.  That is not a criticism but just a fact. Many people do not have the savvy or the acumen or knowledge around the systems and people or indeed the confidence to pull such things off. Especially if they are ill (see above).

Except I don’t pull the “don’t you know who I am” card, and I doubt they know who I am, over in Liverpool, or, if they do, that it counts for anything there.

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I already accept that JW and I don't remotely suggest that that is the not the case. I often get asked by clinical staff about my current job, career, positions etc  and of course it is in their records now from long ago and was in fact even referred to this morning in a letter copied to me by a Consultant doing a referral to another service. It's human nature.

2 hours ago, code99 said:

The prevailing ethos seems to be to defend the system no matter what, and try to make out that whatever happened was never due to negligence. When they do grudgingly admit that there was something wrong then there seem to be only two possible types of interpretation: a) it was somehow patient’s fault, or b) minor mistakes were made and lessons have been learnt.  

 

I'd say that was a fair assessment in some if not most cases. It shuts down taking anything to the next level. No doubt this debate will continue in the Tynwald when the "new" system gets debated. Much noise to achieve very little change. 

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6 hours ago, John Wright said:

 

I’m happy to chat with him and share my experiences and solutions.

 

Thank you for the offer, John. Much appreciated. I'm hoping to speak to him this evening or tomorrow. 

 

7 hours ago, John Wright said:

I normally give 14 days for a response or an explanation for failure and a time estimate. .

Yes, same here. I've learned patience over the past 20+ years of living with my condition.

I had bloods done at Nobles on 24 June and at my GP's on 29 June and haven't had results from either and also not on Patient Access. (Wouldn't expect the Nobles results to be on there to be fair) 

I was supposed to hear back from both after chasing them, but I'm still waiting. I understand they're busy but c'mon.

Results were supposed to go out to Liverpool via email as soon as they were in, (cc'd to me so I knew it was done) but nobody seems to know what's happened. Or not happened,  to be precise. 

6 hours ago, John Wright said:

Im hoping that if I see the consultant, and sort out analysis of the samples at Liverpool, it’ll be my penultimate consult.

Good luck John, hope it goes to plan for you. 

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https://www.manxradio.com/news/isle-of-man-news/operations-cancelled-at-nobles-hospital/

I wonder it they are using the Private Patients Unit.  

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29 minutes ago, Apple said:

https://www.manxradio.com/news/isle-of-man-news/operations-cancelled-at-nobles-hospital/

I wonder it they are using the Private Patients Unit.  

“Manx Care has confirmed a number of elective orthopaedic procedures have been shelved due to a lack of beds. It's blamed it on a rise in people attending the Emergency Department who were then admitted for further treatment. We're working with all of the patients affected by this to reschedule their surgery as soon as this can be done." 

Who knew when Neil Kinnock made that speech “I warn you not to fall ill…” all these years ago he was right not only about the UK then, but that he was also prophesising about the IOM health system in 2021? I hazard a guess that these latest cancellations/postponements cannot be solely attributed to Covid. Or maybe they are? Because if this situation is an indirect consequence of Covid, then surely a question must be asked, ‘Is IOMG Covid mitigation strategy working?’

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