Idiot Filter

Todays post has been inspired by Nee Naw

The G.P. surgery I use has improved massively since the introduction of Dr Idiot Filter.

It works like this:

Patient calls and wants same day appointment. Reception takes the patients number and Dr I.F. calls back, taking a history of the current complaint while reviewing the notes on screen. Dr I.F. then decides whether the patient needs an appointment that morning.

Despite this slowing things down a touch (Dr I.F. is a slow and considered one-finger typist), it's done wonders for the surgery. I've got a chronic condition, so I do sometimes need a short notice appointment. In the two or three times I've been in this year, the waiting room has been magically free of rattling addicts coming for replacement methadone prescriptions because they've 'lost' their last one.

In addition, although the phone line is still busy, it's not uncommon to be able to get through to book an appointment these days.

Nee Naw, it's a shame you and your colleagues aren't allowed an Idiot Filter.

Waiting III

The next line is outside the prison gates. I'm rubbish at estimating height, but these things are higher than the second day of Woodstock.

The names are called again, and we are led through a smaller door inset in the main gate. And into a small building to join the next queue. This queue is for searches and photographing of male visitors. Once photographed, male visitors are issued a bar coded card which they must keep with them at all times during the visit. This is to prevent attempts at cunning identity swap escape schemes.

The three of us go in to be searched together. I'm surprised by how cursory it is. The officers carrying out the searches are pleasant and friendly.

Officer "Don't loose that card"
My Mate "I won't"
Officer " We accidentally scared a lad half to death last week. He couldn't find his card when it came to the end of the visit. So I told him we'd have to find him a cell overnight while we verified his identity. I was only joking, but he believed me. Took us ages to calm him down..."

And so we pass though the last door to the visit room. But it's not a room, it's a a place the size of two tennis courts, full of faces hoping their visitors have made it in.

Waiting II

I'm standing outside the visitors reception centre. We've been waiting for an hour, arriving long before the door will be opened, but that's the protocol.

The high green gate to my left shudders as a smaller gate set into it is opened. The officer walks to the front of the line and opens the door.

We're fifth in line - this is good. It means we'll be taken across to the prison in the first group, meaning we will get the full two hours of the visit. There's a rough depreciation - first group - no time lost, second group - 15 minutes lost, third group, 30 minutes lost and so on.

We follow the officer through the door and join the second queue. There isn't enough space, so everyone is crushed against a stranger. We get to the little window, hand in the Visiting Order and proceed to show our I.D. We are nodded on to wait in the holding area and use the lockers and toilets.

To pass the time while we wait to join the third queue, I begin to count the notices on the wall. I loose track at 44. A lot of them are addressed to prisoners - given that no-one serving will ever step in here, it seems that the dire warnings are just there to fill space.

It's coming up to 1pm, so we put bags, coats, hats, phones and so on into the locker. We are allowed to enter the prison only in indoor clothers and shoes, carrying only £5 in silver and the key to the locker.

The names of eight prisoners are shouted and there's a shuffle as people in different parts of the room stand, collect their kids. Then we all wait to join the next line.

Innerspace - part I

First off, call me daft, but this made me really quite sad: Pharmacists Defence Association

How have things got so bad that pharmacists have a union with a name like that? I know that unions are there to attempt to defend workers in all fields, but seriously, how under attack must they feel to need the word 'defence' as part of a name.

I'm aware that in recent years pharmacists have been pushed into taking on more and more duties, having consultation rooms on premises and so on - see The Welsh Pharmacist for a few cracking examples - but the name of the union says it all.

I had a capsule endoscopy last week. I think this is fantastic, non invasive relativley low risk test. But it's damn expensive, so my PCT view it as something of a last resort of all other methods have failed.

The first hiccup came with the instructions for the pre-test preperation regime. It would appear that a member of non-clinical staff has taken it upon themselves to amend this information.When I say 'amend' what I mean is 'balls-up'. Basic prep for any kind of internal camera is roughly breakfast the morning before test, light snack mid morning, clear fluids from midday and nil by mouth from midnight. It's a good job I know that, as the new leaflet advised me to have breakfast on the morning of the test and then go clear fluids during the test and nil by mouth after the test.

So I'm guessing there will have been a few people sent home recently, because good as the capsule technology is, it can't stand up to a full english.

So I turn up at the unit, get wired up and ingest the camera. So far so good. On checking with the nurse, she thinks that as I am off all meds, transit time should be fairly rapid, 6 to 8 hours.

So I settle down and wait.

Hospital Pharmacy (1)

The hospital pharmacy is interesting. For the past two years, one of the chairs in the waiting area has had a notice tied to it with a bit of string. The notice says 'Do not sit on this chair'. None of us do. I only think about this later, and resolve, on my next visit, to push the bounds of Englishness and disobey the notice. Now there's something to look forward to...

You arrive at the counter, avoiding the gaze of the waiting people, some of whom have been waiting for so long that they have begun to turn the same colour as the jaundiced walls owing to the lack of natural light. Most of the others are folk that you wouldn't want to sit next to if they were beside the only vacant seat on the last rocket off the terminally burning Earth. And there is always an angry middle class woman, usually in a royal blue suit who is on her mobile loudly complaining that she is STILL waiting after 4 minutes*.

Seasoned NHS patients like me are easy to spot, as we always have a book with us, sometimes a flask and sandwiches. Most of us are used to waiting, and don't mind, because we know that we are about to get hundreds of pounds worth of medication for either a fraction of the true price, or, if you're an official cripple like me, nothing at all.

Not blue suit woman, who is now building up a real head of steam about 'going private' 'never again' 'bloody farce' 'late for meeting' and finishing off with 'well, I don't mind telling you Colin, it's like the third bloody world. We're going private. We'll sell one of the children's ponies'.

By the shouting, agitiated pacing and arm waving, I make a laymans diagnosis that there probably isn't much wrong with her. She is what Dr Crippen calls 'the worried well' (15th October Post)

NHS Blog Doctor: The Crippen Diaries 2007 (Week 42)

But when her demanding nature, internal stress, arguments with Colin and two bottles of chardonnay a night habit cause her chest pains at 2am, I hope she rings her private hospital. They will tell her to ring the (NHS) emergency ambulance. The (NHS) paramedics will then convey her to an (NHS) hospital in an (NHS) ambulance where (NHS) staff will tend to her and give her the medication she needs, all without a flourish of the gold card in her wallet. Her private hospital will tell her to ring the NHS, because they don't have a defibrillator or a resident heart specialist or experience in dealing with emergencies. Nope, they chopper all serious cases to the (NHS) hospital up the road.

I know I do moan about the NHS, but I genuinely believe that this large, unwieldy public organisation does a damn good job, despite the constraints put in place by clueless, faceless 'managers'.


*As far as the '4 minutes', it's worth remembering that this is the only pharmamcy in a hospital that seves a city of just under 1 million people. It dispenses all the prescripitions required by over thirty in-patient wards and also serves over a thousand out-patients per day. There are eight staff - not all on shift at the same time.

Can I make an appointment to make an appointment?

It's been a few months I know, but I'm back at work and it's all been a bit special. Helped by the following turn of events....

I receive an appointment for my specialist on 19th October, bang in the middle of the day, so I duly book the day off work.

I then receive another letter saying that due to unforseen circumstances, the appointment is changed to 25th October. I suck my teeth a bit, but shove the letter on the pin board with the rest of the stuff I can't find a home for.

I get a third letter advising me that the appointment has been changed to December. This is meant to be a six monthly check, and December stretches it to nine months. I do not suck my teeth this time, this time I say a bad word quite loudly. And ring the hospital.

Kelly seems like a nice girl, but over the phone, I can her her tongue curling over the corner of her mouth as she attempts to enter my details into the computer with evenly spaced clunks. I am kind and patient, and explain that changing an appointment three times really isn't acceptable to me, and that my nice employers are struggling to keep up with the holiday chart.

She is polite, and explains there isn't anything she can do. I ask to speak to her supervisor, she says she will put me through. And the phone rings and rings......

I call back and ask for the supervisors' direct dial number, which I get, because I am kind and patient. I ring the supervisor. Natalie the supervisor is not kind or patient, and I begin to feel sorry for Kelly. Natalie says that appointments are cancelled because consultants 'just go off on holiday whenever they feel like it'. Although she doesn't say it, I think the next part of the sentence was probably 'and leave me to clear up the mess'. I explain that I must have an appointment in October. There is some thudding of keys and she says all clinics are cancelled at that time. I offer to call the Patient Liaison (wonderful people who get things done, and report to the Board). There is a pause, and then suddenly an appointment pops up on screen.

It is my original appointment on 19th October.

So why was it cancelled in the first place? The clinic is running, the consultant is not on holiday, and the NHS have wasted quite some money writing to me three times.

And...

Further to the below, work called at 1.30pm to say that, owing to transport problems, they couldn't come and would need to reschedule AGAIN.

So, next time I fancy a random day off, can I give them a call and say that I can't make it to work today because of transport problems?

Bah and double humbug.