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1 hour ago, 2bees said:

OMG I totally didn't mean you! I meant ones that are brought in... oh that might mean you - oops, sorry. If it eases the pain, I'm not talking about your area :)

There is a problem though. The 'SIK' has seen 2 different people about a very obvious problem and the resolutions are totally simple & could be started without further delay, but no, sent back to see someone else (again) and told we'll see you again in 6 months blah blah blah & then maybe progress with some treatment.

 

I have identified issues with patients that go across for treatment, but I don't think it's due generally to consultants ripping off our NHS.  It's more like that in the middle of a busy clinic in Liverpool they don't necessarily check a patient's postcode before determining onwards referral or need for follow up.  For example, say I send someone across for a complex op that we can't handle.  It gets done, patient goes back for follow up, and then mentions another, more simple problem that we could easily sort out here.  Instead of referring back, which is what should happen, the team across will often follow their usual referral pathways and send to their colleagues, resulting in more off-island travel and procedures and cost.

This is being looked at, actively, by Manx Care to try and repatriate patients who don't need to go across.

I don't know what 'SIK' is, but if it's a very obvious problem that you seem to understand and know how to sort, why has he/she had to be seen more than once?

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Someone I know 😉

The “more than once” question is exactly what I’m going on about. They were seen by doctor A last year, he recommended x,y,z then come back and treatment will happen, x,y & z have been done.  Doctor A has gone so they saw doctor B who asked the most obvious questions (if you have eyes you will see the problem & as it is your field its expected that you know the effect) and then said “Go away do l,m,n then come back”. Which is why I’m questioning the processes.

 There are many things that could be done to help ease congestion and multiple appointments for single issues and I’m glad they are being actively looked at :)

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59 minutes ago, 2bees said:

Someone I know 😉

The “more than once” question is exactly what I’m going on about. They were seen by doctor A last year, he recommended x,y,z then come back and treatment will happen, x,y & z have been done.  Doctor A has gone so they saw doctor B who asked the most obvious questions (if you have eyes you will see the problem & as it is your field its expected that you know the effect) and then said “Go away do l,m,n then come back”. Which is why I’m questioning the processes.

 There are many things that could be done to help ease congestion and multiple appointments for single issues and I’m glad they are being actively looked at :)

Feel free to PM me with details of SIK, A, xyz, B etc and I’ll see if I can help. 

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1 hour ago, 2bees said:

Someone I know 😉

The “more than once” question is exactly what I’m going on about. They were seen by doctor A last year, he recommended x,y,z then come back and treatment will happen, x,y & z have been done.  Doctor A has gone so they saw doctor B who asked the most obvious questions (if you have eyes you will see the problem & as it is your field its expected that you know the effect) and then said “Go away do l,m,n then come back”. Which is why I’m questioning the processes.

 There are many things that could be done to help ease congestion and multiple appointments for single issues and I’m glad they are being actively looked at :)

Currently having very similar issues myself, every time I see someone new with regards to my injury I have to start the story from scratch, go through all the issues/problems again, describe the pain etc I said last time ‘have my notes not been sent through?’ nope, very little information sent through. If what I said in the very beginning was actually recorded and on my notes it would cut out so much of the bullshit, my last appointment with a consultant lasted about 15 minutes, 10 minutes of that was me telling the repeat story, the rest was him checking me over. He disagrees with the last diagnosis though which will be interesting to say the least.

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2 hours ago, Annoymouse said:

Currently having very similar issues myself, every time I see someone new with regards to my injury I have to start the story from scratch, go through all the issues/problems again, describe the pain etc I said last time ‘have my notes not been sent through?’ nope, very little information sent through. If what I said in the very beginning was actually recorded and on my notes it would cut out so much of the bullshit, my last appointment with a consultant lasted about 15 minutes, 10 minutes of that was me telling the repeat story, the rest was him checking me over. He disagrees with the last diagnosis though which will be interesting to say the least.

I could have written the above. Had the same problem for years with respiratory. Different personnel, having to repeat the same story, etc. Terrible continuity, though the new guy, al-Aidi, does his best. 

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9 hours ago, Annoymouse said:

Currently having very similar issues myself, every time I see someone new with regards to my injury I have to start the story from scratch, go through all the issues/problems again, describe the pain etc I said last time ‘have my notes not been sent through?’ nope, very little information sent through. If what I said in the very beginning was actually recorded and on my notes it would cut out so much of the bullshit, my last appointment with a consultant lasted about 15 minutes, 10 minutes of that was me telling the repeat story, the rest was him checking me over. He disagrees with the last diagnosis though which will be interesting to say the least.

 

6 hours ago, quilp said:

I could have written the above. Had the same problem for years with respiratory. Different personnel, having to repeat the same story, etc. Terrible continuity, though the new guy, al-Aidi, does his best. 

I’m sure it’s happened to all of us. But patients ( and clients ) are often poor at history and facts and doctors ( and lawyers ) poor at recording them.

Things get recorded wrongly and misunderstandings occur.

Its safer to refresh ( whether you’ve pre read or not ).

Not only that but symptoms, conditions and focus of patient/client change with time.

And, Annoymouse, you’ve hit the nail. If he’d blindly read and accepted the notes and previous diagnosis would have become self fulfilling.

Its a conundrum.

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10 hours ago, wrighty said:

Feel free to PM me with details of SIK, A, xyz, B etc and I’ll see if I can help. 

Thank you. On one of the occasions when the person was seen by the other doctor before the consultation at nobles, the doctor was asked if there was anyway of moving things along as the referral had taken a long time (allowances made for Covid included), the doctor said unfortunately not and to interfere may cause more harm than good.
The course is set and will take as long as it takes. Thanks for the offer but I’d rather not rock the boat for my friend.  

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8 hours ago, quilp said:

I could have written the above. Had the same problem for years with respiratory. Different personnel, having to repeat the same story, etc. Terrible continuity, though the new guy, al-Aidi, does his best. 

I'm with that consultant! the past history mirrors yours Quilp and for the same reasons. The Spanish lady consultant a few years ago cut through the bullshit, thank goodness and put my drugs regime on the right path. I feel I owe her my current existence. It was a shame Baghmani went though, a good man.

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My experience with one of the consultants mirrors those mentioned here.  Two appointments in three years, over 30 cancelled appointments for various reasons, not sure how one doctor can have that many family funerals.

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1 hour ago, John Wright said:

Not only that but symptoms, conditions and focus of patient/client change with time.

And, Annoymouse, you’ve hit the nail. If he’d blindly read and accepted the notes and previous diagnosis would have become self fulfilling.

Its a conundrum.

Yes, I do understand that, it just sometimes feels like an uphill battle before you even begin. The background on how the injury occurred for example has never changed. 

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Manx Care have their work cut out. 

Given the comments already made above clearly there are problems with the current processes and procedures, and I think if a wider survey was done there would be many more people with their stories of problems coming to light. But, no-one seeks those views and therefore the DHSC attitude seems to be "well that is how it is so just suck it up'.

There are solutions. Systems can be improved to reflect what a good health and social care service provides effectively and efficiently, for the good of the patient and the public. 

It was interesting to see at the Manx Care Board meeting how different people reported on different aspects of the services. Are we creating more or different silos ? 

There were 14 Board members on very, very good salaries on that Board. They are starting behind the line and facing more difficulties than was envisaged or expected. 

Can they even start to turn things around ? Probably in a longer time frame than what they think, but they are going to need more and better than what they currently have, and learn a lot faster about how to engage with the public in the right ways than what they have shown so far. Nowadays the co-operation and  participation of a receptive public can be crucial  and can often be underestimated. Bad news travels fast.

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1 hour ago, doc.fixit said:

I'm with that consultant! the past history mirrors yours Quilp and for the same reasons. The Spanish lady consultant a few years ago cut through the bullshit, thank goodness and put my drugs regime on the right path. I feel I owe her my current existence. It was a shame Baghmani went though, a good man.

Coincidentally, I had a phone consultation with her yesterday and am quite satisfied at the outcome. 

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Whilst I agree that Manx Care has a lot to do in terms of improving services and reform, I've always felt that more should be done to manage expectations.     I worked in a patient facing role at Noble's  for quite a few years and patients were phoning a few days after referral by GP, asking when they were to be seen, not having been informed that there was a wait.       There are still quite a few no-shows and again, little is being done to manage these.   Patients were also quite surprised and sometimes taken aback at being discharged from a consultant's clinic when there was no need for them to be seen again.   It was as though they needed to be looked after by a consultant rather than a GP.     

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1 hour ago, Blackajah said:

Whilst I agree that Manx Care has a lot to do in terms of improving services and reform, I've always felt that more should be done to manage expectations. 

Agreed. Communications to patients between different aspects of the organisation are less than clear sometimes, and can lead to frustrations and confusion for many.

One of the reasons for what is have described above can the fitting in appointments around other personal arrangements, with off island travel being one of them. 

The point was referred to at the Board meeting, which I totally subscribe to, was that if the emphasis is on the highest standard of care being the focus of all interactions, then the right actions and procedures will emanate from that. That will require a new form of commitment and practice not only from those in the systems, but also from the organisation itself.

That is a tall order from an organisation used to operating from mainly behind closed doors, mostly in secrecy, and with, in my view, a different position on accountability both personal and organisationally than is healthy for the public.

The Duty of Candour does not fulfil all that is needed to achieve this, nor does the ineffective Charter. 

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58 minutes ago, Blackajah said:

Whilst I agree that Manx Care has a lot to do in terms of improving services and reform, I've always felt that more should be done to manage expectations.  

I’ve had my last appointment cancelled/rearranged 3 times, I never get angry or annoyed, I just accept it for what it is and take whenever the next available appointment is. I’ve worked within similar customer facing roles and I know exactly what it’s like, I’d never take it out on a receptionist or admin staff, but I will tell the consultant or whoever I see that it’s been cancelled 3 times and that I’m relieved to be finally able to see them.

I have witnessed those who do demand to be seen, cause no end of grief and are just downright rude, the GP surgery is normally full of them types and they do unfortunately seem to get their own way a lot of the time.

The length in waiting for an appointment does also mean they get easily forgotten, I’ve had appointments booked 2 or 3 months ahead and a lot can happen within that time frame, particularly when booking other appointments, it’s easy to find yourself double booked!

 

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