NHS revisited

For someone used to working in hospitals, being a patient and recipient of attention is strange – though this is the second time I’ve blogged on my experience. The last time was 4 years ago, concerning my appendectomy at Colchester hospital; this time it’s arthrodesis in Chelmsford.

In the ensuing period the government-inspired NHS crisis has reached record proportions and patient numbers have never been higher.  However, this is not a whinging blog at all, but rather a celebration of all that is good in our magnificent universal healthcare system and how, despite everything you’ve heard, it continues to improve.  Horror stories notwithstanding, I’d argue the NHS is very fit for purpose, subject to resources and funding, plus integrated systems ready for the 21st Century and therefore an end to the prodigious paperwork that still rules the roost.

In my case, the issues began years ago thanks to explosive pain in my right ankle that went up through the gears regularly.  It took some while to get properly diagnosed, largely because I first saw physios who wanted to give me exercises, but eventually I was given hydrocortisone injections, and when that didn’t make any difference, an MRI and a consultation with an orthopaedic surgeon.

On that occasion I chose to hold off the only surgical option and retain full mobility until such time as the joint became too painful and life too restricted, whereupon I got to see my final surgeon, Ms Hilary Bosman, and eventually scheduled the op.

The only real problem came with the urgent care bed shortage.  My op was cancelled due to the volume of emergency admissions in January, and rescheduled by a month.  Having put up with osteoarthritis for years, one more month wasn’t going to make that much difference, so it was on 7 Feb I made my way to Broomfield hospital, courtesy of a friend giving me a lift, arriving at the unfeasibly early hour of 6:30am.

The surgery itself (inserting two 7mm titanium rods to pin my right ankle bones together by keyhole incision) was very prompt and professional.  My Italian anaesthetist proudly told me I was getting the very best cocktail of drugs they had, resulting in a faster recovery and fewer side effects – and so it proved.  Granted there might be a risk of miscalculation, though I’d say he got it just about spot on.

I woke some hours later mildly uncomfortable but without needing all day to come round. The temporary cast and bandage looked fine and before I knew it I had been wheeled back to my (single) room and left to snooze happily for the afternoon. True, nurses were checking my BP (automatic machine), temperature (automatic and in the ear) and blood sugar (minimally invasive and automated) at regular intervals, but that was only an issue when they woke me so to do.  Later visits by Ms Bosman and, separately, her registrar William, provided good bedside manner and a good appreciation of the practicalities of dealing with post-op and recuperation.

The following day, physio helped me with the realities of walking with crutches, doing stairs, loo and so on – all fine and good, but disguising the reality that thanks to funding cuts community services to help in the home are no longer available.  The only obvious sign of budget cuts in the hospital was one porter wheeling the bed down to theatre, where once you would have had too.

To the amusement of friends and family, I chose a black lightweight fibreglass cast, which is a massive improvement on the old fashioned plaster casts, which would crumble as soon as you looked at them.  Over a week later it has no damage and feels quite comfortable with no irritation.  It’s an encumbrance, to be sure, but sooner 8-10 weeks in a cast than the years of excruciating pain suffered with my arthritic ankle.  I’m in no pain at all and am learning to get about the house with crutches.

My next appointment is on 24 Feb, for which, surprisingly, I have transport arranged. The problem is not Acute services but the fact that the community services to back it up are underfunded and difficult to come by, so I am grateful for the fact that my living alone and being housebound is recognised and supported in this way.

Everything about my stay was successful, including catering.  On coming back to the ward I got a tasty egg sandwich served on a plate rather than in a carton, plus good strong coffee that did not taste as if it had been dredged from the river Chelmer.  Later, my dinner menu arrived, unusually in the form of a laminated card with around 15 choices, all photographed and covering most tastes and dietary requirements.  I selected a lamb stew with lentils, followed by apple crumble and custard.  Both proved a distinct improvement on previous hospital visits, both in terms of choice and quality.

Yes, I know they will have brought in chilled or frozen meals rather than making in-house, contrary to the Millward ethic on food, but at least there was clear evidence that efforts had been made by the catering department to eke out the minute budget allocated per patient meal and provide something truly appetising on our plates.  The following day, this extended to a good quality yogurt and toast with marmite for breakfast (no full English but I wasn’t in the mood anyway) and chilli with rice for lunch.

In short, this stay demonstrates how the NHS is still hugely effective at meeting needs in a functional, utilitarian way, and for the most part no lavish private care could have done the clinical job any better.  But the service still runs on the dedication of the staff, many of whom are underpaid and overworked.

At no point did I feel even the lowest paid member of staff was disrespectful, unhelpful, lazy, arrogant, uninformative or patronising.  They all did their best to make me feel comfortable, to answer my questions, to follow their professional duties and to get me fit and well without delay.  This is entirely what the NHS is all about.

So, to Ms Bosman, to her team, to the Executive of Mid-Essex NHS Trust, to the nurses, porters, theatre staff, caterers, cleaners and everyone associated with Broomfield Hospital, thank you – and keep up the good work for generations to come!

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