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| Watchdog looks at 'confusing' NHS | Watchdog looks at 'confusing' NHS |
| (about 4 hours later) | |
| A finance watchdog is asking NHS patients in Wales to tell them of their experiences in booking emergency GP appointments and using A&E services. | A finance watchdog is asking NHS patients in Wales to tell them of their experiences in booking emergency GP appointments and using A&E services. |
| The Wales Audit Office said the system can be complex and "can be confusing". | The Wales Audit Office said the system can be complex and "can be confusing". |
| It will also look at experiences of GP out-of-hours services and the NHS Direct phone-line advice service. | It will also look at experiences of GP out-of-hours services and the NHS Direct phone-line advice service. |
| Earlier this week, a coroner in mid Wales found a "systemic failure" after a patient died after trying to call an ambulance and reach her local surgery. | Earlier this week, a coroner in mid Wales found a "systemic failure" after a patient died after trying to call an ambulance and reach her local surgery. |
| Ruth Hedge, 60, died of natural causes at her home in Borth, Ceredigion in April 2007, but her cause of death was "aggravated by neglect" said the coroner. | Ruth Hedge, 60, died of natural causes at her home in Borth, Ceredigion in April 2007, but her cause of death was "aggravated by neglect" said the coroner. |
| There is confusion at the present time, there's no doubt about that Carol Jones, board of Community Health Councils in Wales | There is confusion at the present time, there's no doubt about that Carol Jones, board of Community Health Councils in Wales |
| Michael Howells said at her inquest, Mrs Hedge's death could have been avoided. | Michael Howells said at her inquest, Mrs Hedge's death could have been avoided. |
| An ambulance had been stood down because her case was not seen as serious enough but it also emerged she had experiences difficulties in contacting her local surgery and using an out-of-hours service. | An ambulance had been stood down because her case was not seen as serious enough but it also emerged she had experiences difficulties in contacting her local surgery and using an out-of-hours service. |
| Mr Howells said Mrs Hedge would have been "thoroughly confused" after her series of phone calls. | Mr Howells said Mrs Hedge would have been "thoroughly confused" after her series of phone calls. |
| The Wales Audit Office said patients may go to one particular service when it would have been better for them to have gone somewhere else. | The Wales Audit Office said patients may go to one particular service when it would have been better for them to have gone somewhere else. |
| It said it is taking what it calls an "unusual step" in asking for people's help in assessing how easy it is to use emergency health care and also NHS care in the home. | It said it is taking what it calls an "unusual step" in asking for people's help in assessing how easy it is to use emergency health care and also NHS care in the home. |
| Ruth Hedge tried to contact a GP and also called an ambulance before her death | Ruth Hedge tried to contact a GP and also called an ambulance before her death |
| The survey will also look at handover targets in A&E departments. | The survey will also look at handover targets in A&E departments. |
| Although it cannot investigate individual cases, the study team said it is interested in hearing people's views and experiences of so-called "unscheduled care" - such as emergency hospital treatment, or where patients need help to care for themselves at home. | Although it cannot investigate individual cases, the study team said it is interested in hearing people's views and experiences of so-called "unscheduled care" - such as emergency hospital treatment, or where patients need help to care for themselves at home. |
| Auditor general Jeremy Colman said: "It's actually rather unusual for us to issue a consultation of this kind but what we're looking into is all the various ways in which people can get unscheduled care in the NHS, and there are a great many ways in which unscheduled care arises. | Auditor general Jeremy Colman said: "It's actually rather unusual for us to issue a consultation of this kind but what we're looking into is all the various ways in which people can get unscheduled care in the NHS, and there are a great many ways in which unscheduled care arises. |
| "We want to hear directly from citizens, the people who experience it, what it's like, good experiences and some less good experiences. | "We want to hear directly from citizens, the people who experience it, what it's like, good experiences and some less good experiences. |
| "This will help us design a study which we hope will lead to big improvements in the way unscheduled care operates in Wales." | "This will help us design a study which we hope will lead to big improvements in the way unscheduled care operates in Wales." |
| Carol Jones, director of the board of community health councils in Wales, said she believed there were "too many points of contact" between patients and the health service. | Carol Jones, director of the board of community health councils in Wales, said she believed there were "too many points of contact" between patients and the health service. |
| "The Welsh assembly government and public health department need to work together to look at how the members of the public can learn what they need to do to get either a GP appointment or when it's appropriate to phone for an ambulance. | "The Welsh assembly government and public health department need to work together to look at how the members of the public can learn what they need to do to get either a GP appointment or when it's appropriate to phone for an ambulance. |
| "There is confusion at the present time, there's no doubt about that." | "There is confusion at the present time, there's no doubt about that." |
| Patient experiences will form part of a study to assess where bottlenecks and problems are occurring and to make improvements. | Patient experiences will form part of a study to assess where bottlenecks and problems are occurring and to make improvements. |
| The audit office also wants ideas on how the current system could be improved. | The audit office also wants ideas on how the current system could be improved. |
| It is asking people to contact them with their views by filling in an online Unscheduled Care questionnaire or by calling through on 029 2032 0610. | It is asking people to contact them with their views by filling in an online Unscheduled Care questionnaire or by calling through on 029 2032 0610. |
| Here are a selection of some of your experiences of using NHS doctors or A&E services in an emergency. | |
| As a qualified nurse, in a particular home, a patient had pulled their feed tube out at 8pm. In order for my patient not to be admitted to hospital for an operation to have the tube re-inserted,it needed to be replaced within the hour at the home (a procedure now carried out routinely by Rapid Response). | As a qualified nurse, in a particular home, a patient had pulled their feed tube out at 8pm. In order for my patient not to be admitted to hospital for an operation to have the tube re-inserted,it needed to be replaced within the hour at the home (a procedure now carried out routinely by Rapid Response). |
| I contacted Rapid Response, as we had been instructed to do. They were unable to attend - only one person in the county and she was at the other end of the county. Asked me to Prime Care - they would phone back within 30 minutes. One and a half hours later, I contacted Prime Call again, to no avail. They stated that all the ambulances were backed up at the local general hospital, patients were being treated in them, and even if I were to dial 999 - no ambulances were available! My patient was eventually 'admitted' at about 2 a.m.Jane, wales | I contacted Rapid Response, as we had been instructed to do. They were unable to attend - only one person in the county and she was at the other end of the county. Asked me to Prime Care - they would phone back within 30 minutes. One and a half hours later, I contacted Prime Call again, to no avail. They stated that all the ambulances were backed up at the local general hospital, patients were being treated in them, and even if I were to dial 999 - no ambulances were available! My patient was eventually 'admitted' at about 2 a.m.Jane, wales |
| We seem to forget that the 999 ambulance service is for life threatening emergencies and not a free taxi service or as an alternative to the GP services. If emergency ambulances are sent to all those who dial 999 who are not emergencies then those with life threatening conditions will have to wait even longer for emergency ambulances and we will have more deaths. | We seem to forget that the 999 ambulance service is for life threatening emergencies and not a free taxi service or as an alternative to the GP services. If emergency ambulances are sent to all those who dial 999 who are not emergencies then those with life threatening conditions will have to wait even longer for emergency ambulances and we will have more deaths. |
| The reason why GPs were in ambulance control assessing calls is because there are so many people call the 999 services when it is inappropriate to do so. There needs to be more public awareness on who to contact and when, phoning 999 for non-emergencies creates this problem and costs lives. | The reason why GPs were in ambulance control assessing calls is because there are so many people call the 999 services when it is inappropriate to do so. There needs to be more public awareness on who to contact and when, phoning 999 for non-emergencies creates this problem and costs lives. |
| In my three decades of nursing, including working in A&E for many of those, I have seen first hand the misuse of A&E services, the 999 services and the emergency out of hours GP services for situations and conditions that are not emergencies and can be seen by the GP as a routine case. | In my three decades of nursing, including working in A&E for many of those, I have seen first hand the misuse of A&E services, the 999 services and the emergency out of hours GP services for situations and conditions that are not emergencies and can be seen by the GP as a routine case. |
| A high percentage of people attending A&E don't need to be there, again a high percentage of people arriving at A&E via an ambulance can walk off the ambulance, if you can walk off an ambulance by definition you do not need an emergency ambulance! | A high percentage of people attending A&E don't need to be there, again a high percentage of people arriving at A&E via an ambulance can walk off the ambulance, if you can walk off an ambulance by definition you do not need an emergency ambulance! |
| Again the out of hours GP service is there for emergency and urgent cases and not to be used because you cannot see your own GP or have minor symptoms. By using these services incorrectly this is causing long waiting times in A&E, delaying ambulances going to true emergencies and delaying the out of hours GP from seeing people who need them. | Again the out of hours GP service is there for emergency and urgent cases and not to be used because you cannot see your own GP or have minor symptoms. By using these services incorrectly this is causing long waiting times in A&E, delaying ambulances going to true emergencies and delaying the out of hours GP from seeing people who need them. |
| It is easy to blame the A&E's, GP's, ambulance service and NHS Direct for these problems (often done by those who do not understand these services or want to jump on the 'bandwagon' of blame) when it is due to the public misusing the out of hours and emergency services. | It is easy to blame the A&E's, GP's, ambulance service and NHS Direct for these problems (often done by those who do not understand these services or want to jump on the 'bandwagon' of blame) when it is due to the public misusing the out of hours and emergency services. |
| We need to educate the public to the correct use of these services and how to access the correct medical services at the correct time for the correct reason. | We need to educate the public to the correct use of these services and how to access the correct medical services at the correct time for the correct reason. |
| Marc, South Wales | Marc, South Wales |