IOM DHSC & MANX CARE

[finlo]

5 minutes ago, Anyone said:

Our GP practice won’t accept calls or email because they are ‘too busy’ . I drive past it most days , it’s got big open windows and there is nobody there. Have to book on some online system. Today got a message saying due to sickness we can’t - click here for more info - so clicked to a link that was blank. Also refusing to to flu jabs due to overwork. So got one at the local chemist instead. She was scathing about GP’s. Said she was redressing wounds because GP surgeries refused because of ‘covid risk’.

Indeed, it would seem that all the islands GP's  have retired on full pay by hiding behind "COVID"!

[FSM]

6 hours ago, finlo said:

Indeed, it would seem that all the islands GP's  have retired on full pay by hiding behind "COVID"!

It might seem so, but we haven’t.

Several surgeries are struggling to recruit doctors and demand is far higher than I have ever known it (in 23 years as a GP).

The surgery is open from 8 to 6 and we often have 50 and sometimes 60 patient contacts per day, each. A mixture of face to face, phone/video calls and emails, but all need detailed evaluation. Thats one person every 10 minutes for 10 hours, to take a history, examine, decide a management plan, prescribe, sometimes refer and complete all the paperwork. 
 

Plus we have up to 150 lab reports and imaging results to deal with every day. And up to 90-100 medicine management queries. And around 100 incoming clinical letters.

And we’re doing flu jabs, and covid boosters. 

Not complaining BTW, I enjoy my job, just trying to explain why it can sometimes be difficult to provide the level of service we’d like to.
 

 

 

 

Edited December 11, 2021 by FSM

[Andy Onchan]

39 minutes ago, FSM said:

It might seem so, but we haven’t.

Several surgeries are struggling to recruit doctors and demand is far higher than I have ever known it (in 23 years as a GP).

The surgery is open from 8 to 6 and we often have 50 and sometimes 60 patient contacts per day, each. A mixture of face to face, phone/video calls and emails, but all need detailed evaluation. Thats one person every 10 minutes for 10 hours, to take a history, examine, decide a management plan, prescribe, sometimes refer and complete all the paperwork. 
 

Plus we have up to 150 lab reports and imaging results to deal with every day. And up to 90-100 medicine management queries. And around 100 incoming clinical letters.

And we’re doing flu jabs, and covid boosters. 

Not complaining BTW, I enjoy my job, just trying to explain why it can sometimes be difficult to provide the level of service we’d like to.
 

 

 

 

That's interesting to know. To put that in context are you able to share how many GPs there are in your clinic and the total number of patients on your register?

[FSM]

6 minutes ago, Andy Onchan said:

That's interesting to know. To put that in context are you able to share how many GPs there are in your clinic and the total number of patients on your register?

I could. But that would identify the surgery and probably me 😀

Suffice to say we have about 1800 patients per whole time GP. (I think this is about average for the island).

[code99]

Thank you for your posts @FSM

I really do empathise with our GPs and other medical professionals, but the situation for many resident patients is still dire. On social media, some posters are going ballistic about delays in getting fancy dining furniture delivered for Christmas, and yet a lot more people are suffering pain and discomfort (physical and mental) for months on end, waiting for proper health care services to be delivered. Regrettably, at times, basic human compassion for patients can be in short supply, even by medical professionals who are under stress.  

Another aspect of this is that while the UK NHS have serious staff shortages, long waiting lists etc., their needs will be major obstacles to attracting people with the appropriate skills to come here. If the private sector on this Island is to flourish economically, then we must have well-functioning public health services too.

[philwebs]

Asking out of ignorance, can other branches of medicine be tapped to spread the load?

How about nurse practitioners, osteopaths, chiropractors, naturapaths. acupuncturists, TCM, local chemist/pharmacist.

Of any of those are competent (how do you judge that?) how about someone with say a weight/diet issue to a naturapath, someone with pain maybe try an acupuncturist.

Would this be covered by the NHS. (I think not)

In essence use doctors for what they are good at and divert people to other areas. Who would decide? How would it work and be monitored. Customer decides?

Say you need medical attention, think you know what you need, do not want to bother a doctor, simple issue, who can decide or direct you (with the doctors appointment necessary if needed as backup).

There have been issues where the gateway is no good and mistakes are made, do not know when to defer.

Or does this already happen?

 

 

[finlo]

14 minutes ago, philwebs said:

Asking out of ignorance, can other branches of medicine be tapped to spread the load?

How about nurse practitioners, osteopaths, chiropractors, naturapaths. acupuncturists, TCM, local chemist/pharmacist.

Of any of those are competent (how do you judge that?) how about someone with say a weight/diet issue to a naturapath, someone with pain maybe try an acupuncturist.

Would this be covered by the NHS. (I think not)

In essence use doctors for what they are good at and divert people to other areas. Who would decide? How would it work and be monitored. Customer decides?

Say you need medical attention, think you know what you need, do not want to bother a doctor, simple issue, who can decide or direct you (with the doctors appointment necessary if needed as backup).

There have been issues where the gateway is no good and mistakes are made, do not know when to defer.

Or does this already happen?

 

 

Didn't the chemists recently get saddled with people being told to inundate them? Except no one thought to tell them.

[FSM]

1 hour ago, philwebs said:

Asking out of ignorance, can other branches of medicine be tapped to spread the load?

How about nurse practitioners, osteopaths, chiropractors, naturapaths. acupuncturists, TCM, local chemist/pharmacist.

Of any of those are competent (how do you judge that?) how about someone with say a weight/diet issue to a naturapath, someone with pain maybe try an acupuncturist.

Would this be covered by the NHS. (I think not)

In essence use doctors for what they are good at and divert people to other areas. Who would decide? How would it work and be monitored. Customer decides?

Say you need medical attention, think you know what you need, do not want to bother a doctor, simple issue, who can decide or direct you (with the doctors appointment necessary if needed as backup).

There have been issues where the gateway is no good and mistakes are made, do not know when to defer.

Or does this already happen?

 

 

Yes… and no.  The minor ailment pharmacy scheme has been running for a few years now. Some surgeries have nurse practitioners, we have a prescribing nurse, who deals with a lot of chronic disease management- diabetes, asthma etc. 
we’re moving towards mental health and physiotherapy in primary care. Some doctors and physios use accupuncture.

The problem is, practitioners seeing unselected/self selected patients have to have a really broad based training, they need to know what they don’t know. These people are in short supply.

I don’t think the NHS will be funding the “alternative” stuff (osteopathy, chiropractic TCM, homeopathy, naturopathy etc.)

[FSM]

3 hours ago, code99 said:

Thank you for your posts @FSM

I really do empathise with our GPs and other medical professionals, but the situation for many resident patients is still dire. On social media, some posters are going ballistic about delays in getting fancy dining furniture delivered for Christmas, and yet a lot more people are suffering pain and discomfort (physical and mental) for months on end, waiting for proper health care services to be delvered.

Agreed. Waiting lists for (some) secondary care services are unacceptable. Manx Care has said so publically and are taking steps to try to improve things. The situation is a big driver for GP workload. I can refer somebody who needs to see a specialist and then see them another 5-6, or more, times to try to help their symptoms, before they get seen by a consultant. (This isn’t unique to the island, I worked in the Uk for 13 years before moving here and the issues were similar, especially after 2010)

Edited December 11, 2021 by FSM

[Boris Johnson]

Waiting lists on the island are CRIMINAL

We should send most patients off island for the best care.

Some of our docs/ surgeons are competent but from personal experience of several disciplines in Nobles, most seem to be here to take the money. FFS.

If you have the misfortune to be ill enough to be sent to a UK hospital you would see for yourself. Nobles is SH1T. 

Simple things like the cleaning of the curtains around beds, look at nobles curtain's nice 3 legs designs, when were they last cleaned? Who the FCUK knows because it is not written on the curtains as it is in every proper hospital I have been to in the UK

I could go on and on about it but unless you have properly experienced first world NHS care in the UK you wont appreciate how bad it is here.

As I said, its CRIMINAL how bad it is here.

[Numbnuts]

I think our NHS is actually great and certainly lots of the staff are. Is the management in all areas up to the task though? Sadly have to think not. Which is more than a pity as potentially we do have a ideal situation here , with correct funding and recruitment , to have a far better service. Our mental health services though are lacking in every way, our waiting lists in some areas are not acceptable but lots of our hospital functions very well.  I have first hand experience of mental health services , not fit for purpose , and recently two issues came up with me regarding cataracts and another issue with osteoathritise in my ankle . Doctor said 2 years for eyes and up to 5 years wait for what he described as a very bad issue with ankle. With the best will in the world those timings aren't acceptable . Yet other procedures are carried out quickly and efficently with very pleasant staff. They need to up there game as far as waiting lists goes I feel and recruitment if thats possible.

Edited December 12, 2021 by Numbnuts

[hissingsid]

My doctors surgery is great, have had face to face appointments and a referral to Nobles came in three weeks, non urgent, I suspect it depends on the individual clinic or consultant.    The thing that annoys me is the number of missed appointments there are each month, no excuse it does not take long to make a phone call, our surgery shows how many on the call sign and it is unbelievable and selfish when people are waiting for an appointment.

[Numbnuts]

2 minutes ago, hissingsid said:

My doctors surgery is great, have had face to face appointments and a referral to Nobles came in three weeks, non urgent, I suspect it depends on the individual clinic or consultant.    The thing that annoys me is the number of missed appointments there are each month, no excuse it does not take long to make a phone call, our surgery shows how many on the call sign and it is unbelievable and selfish when people are waiting for an appointment.

I agree , my doctors surgery is very good and always been very supportive and efficent. However as my new doctor said last time I was in they are massively disheartned as referrals often just bounce back or are delayed etc and in the mean time they have to deal with same issues time and time again. Missed appointments annoy me so much also as in these days of mobiles and the likes theres no real excuse for most of them. Mind you the receptionist messed up with my last one as said I'd get a call but put me down for a face to face appointment. So I was a no show which they later admitted was there fault . Happens I'm sure often. 

[Roger Mexico]

3 hours ago, hissingsid said:

The thing that annoys me is the number of missed appointments there are each month, no excuse it does not take long to make a phone call, our surgery shows how many on the call sign and it is unbelievable and selfish when people are waiting for an appointment.

Providing they remain at a reasonable level (and in percentage terms they can be very low) the truth is that missed appointments don't make much difference, especially at GPs.  Because the time given to see each patient and do the associated admin is so short (10 minutes), they always run late, queues always build up and there will always be someone else to move up the queue.  And it's not as if GPs are short of things to do in the office.  It's not good manners to miss an appointment, but it's not a big strain on resources.

Whenever NHS admin starts going on about missed appointments (even ignoring they're responsible for quite a few of them) I always reckon it's more about blaming the public for their own shortcomings.  

[asitis]

13 hours ago, Numbnuts said:

I think our NHS is actually great and certainly lots of the staff are. Is the management in all areas up to the task though? Sadly have to think not. Which is more than a pity as potentially we do have a ideal situation here , with correct funding and recruitment , to have a far better service. Our mental health services though are lacking in every way, our waiting lists in some areas are not acceptable but lots of our hospital functions very well.  I have first hand experience of mental health services , not fit for purpose , and recently two issues came up with me regarding cataracts and another issue with osteoathritise in my ankle . Doctor said 2 years for eyes and up to 5 years wait for what he described as a very bad issue with ankle. With the best will in the world those timings aren't acceptable . Yet other procedures are carried out quickly and efficently with very pleasant staff. They need to up there game as far as waiting lists goes I feel and recruitment if thats possible.

My wife was referred to a pain clinic for severe pain, waiting time nearly three years ! We paid for as much of the interim treatment we could afford privately, but after a wait of 2yrs and 8 months she had a procedure at Nobles to assist with the problem. As others have said Nobles was actually great, the problem is getting there and seeing the right people !

I wonder if 70 million would have helped eh Alf !!!!!!