Health
Personal Experience
Medical
Healthcare
Personal Reflection
Emergency Services
Emergency Medicine
Healthcare System
Medical Profession
NHS
The NHS is broken, perhaps beyond repair: a thread.
*this is an n=1 reflection on my experience as an OOH doctor over the BH weekend. It is therefore subjective, and clearly cannot relay details that may risk patient ID. But it is honest and heartfelt.
*this is an n=1 reflection on my experience as an OOH doctor over the BH weekend. It is therefore subjective, and clearly cannot relay details that may risk patient ID. But it is honest and heartfelt.
I am an experienced OOH doctor. I’ve worked OOH continuously since I qualified as a GP, alongside day job, in remote/rural GP. I am used to dealing with emergencies. This is my experience of working 6pm Friday until - 9am Sunday. The only period not on call was Sat 0900-1200. /2
I arrived on duty 6pm Friday. There were 8 patients waiting to be seen, some of whom had waited over 24hr for appts. This was due to day shift being unfilled before me, so all stacked up. Over 200 patients in triage queue, lots breaching the response time /3
Some were quick - those who had run out of medications, needing prescriptions. Still taking up slots however, preventing me speaking to those waiting in triage queue. Others very complex and sick. 3 required hospital admission for potentially life threatening conditions. /4
In each case, relatives had to transport to hospital - some as far as 2 hours away. These included sick children & patient with stroke. Ambulances had reported 8hr waits for response. All services I spoke to under incredible pressure, staff feeling significant strain. /5
Shifts before/after mine unfilled, so volunteered to extend to cover gap, 6 more hours. Rota gaps everywhere, so sent over 100 miles out of area to see cases that couldn’t wait safely - own area left uncovered. Triage queues still horrendous. Firefighting all the time 6/
Seriously ill patients needing hospital to hospital transfer left for hours without ambulances able to respond. One I saw at 2pm in one hospital, still there at 10pm when I returned again to see different patient - who also needed an emergency ambulance. Nurses close to tears. 7/
Tired staff under pressure making mistakes including me. Tempers frayed. 15 mins downtime in 12 hr continuous working. Work moving from heartbreaking palliative case, to ‘no chance we can get NICE recommend same day scan’, to elderly person needs social care that’s not there. 8/
End of shift 0001, should be standby for 9 hours, but told as no GP to cover population of 70,000 in neighbouring area, would need to prepare for callout if visit that couldn’t wait until next filled shift start at 0800. So tired driving home, driver would have to collect me. 9/
Not enough staff. Not enough ambulances. Not enough pharmacies. Lack of electronic record transfer/red tape creating work that gets in way of seeing ill people. Staff exhausted. Hard to remain caring, feeling at times close to being overwhelmed. 10/
Lying here unable to sleep, shocked by it. Never seen it so bad, and I’ve worked in some tough spots worldwide. Waiting for phone to ring to call out, dreading it. Ashamed I felt unable to cope at points, or help patients. Vowed never to work OOH again. Will do though. 11/
My experience won’t be unique. Being unable to provide timely good care to sick patients is heartbreaking for NHS staff - all of us. Need more beds, ambulances and bodies on ground. Waiting to hear what I might have missed, or got wrong. Waiting for politicians to sort it. /ends
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