National Health Ombudsman - re NHS/Private Health Initiatives.

[citizenB]

I would appreciate some advice, please

 

 

50 + years ago - OH was involved in an accident whilst playing football. He was a goalkeeper - took a dive to save a ball and was kicked in the top of the spine.

 

 

He was taken to hospital with a suspected fracture. X-rays didn't show anything seriously damaging although there were some problems with his back / walking. Was kept in hospital for a couple of weeks and was then sent home.

 

 

Over the years, because of the pain, he contorted his body to alleviate this and developed a kind of weird posture.

 

 

30 years ago, he was taken into hospital with a suspected heart attack. After many tests it was discovered that he hadn't had a heart attack as such - the way in which he had held his body to spare himself pain - his spine had curved inwards and was pressing on his heart and lungs.

 

 

Further investigation found that he had some crumbled discs. He had an operation to hoover out all the bits that were messing with the nerves and after a couple of weeks was sent back home.

 

 

He developed a paraplegic leg because of this and was fitted with a brace to help with walking.

 

 

He was retired on the grounds of ill health.

 

 

About 12 months ago, his other leg started to weaken. His GP referred him to a Neurologist at our local hospital and this is where things started to go pear shaped.

 

 

The Consultant referred him onto something called One Health, which is apparently a NHS/Private Health initiative.

 

 

He was sent an appointment to a clinic some miles away - took us over an hour to get there. All that happened here was a fact finding mission on OH's health (which surely they should have been provided with from either the GP or the hospital)? So that visit was purely taken up with getting OH's medical history !

 

 

He was then sent an appointment to go to a private hospital in Grantham (over 80 miles away). Problem here was that :

 

 

He wasn't to drive himself home after the treatment - I could have driven him home, except the idea was that he would go to the appointment early as a day patient - he would have the procedure and then would not know for 4-6 hours afterwards whether he was going to be discharged or ambulanced to another hospital in Sheffield which was another 40 mile journey. So, had I gone with him - I would have had to wait around with 2 dogs and then not know if he was coming home or not and if not, I would have had to drive home on my own - a journey I had never done before.

 

 

Fortunately a friend offered to do this for us - the procedure was done and he was discharged 5 hours later - and told that he would have a follow up telephone consultation in August.

 

 

We had believed that they were going to be injecting him with something that would support and cushion any damaged discs - this wasn't so, although we didn't know this until a few days ago.

 

 

OH was still in considerable pain and on Thursday he took a tumble. We contacted his GP only to be told we had to make contact with the Consultant who did the procedure. As he, the GP, was not aware of what was going on.

 

 

When we finally tracked someone down - were told OH could either go to Ossett, in West Yorkshire for an immediate consultation or wait until the following day for a telephone consult ! The journey was out of the question.

 

 

When the Consultant phoned the following day - we were more or less advised that OH could be sent to anywhere in the Country - Scotland even, if that is the place they have a space or consultation time ?

 

 

It was in this call that we learned that the procedure that had taken place was some kind of dye had been injected into him to see where the problem was ! Surely at this point they should have realised what the problem is/was and made an appointment for the surgery which it is obvious is going to have to take place. The Chap we spoke to on the phone has said that an appointment to see a Consultant Neurology Surgeon will be made and sent to OH !

 

 

Has anyone else been put on this type of NHS/Private Initiative and what is their opinion please ?

 

 

Is it likely the National Health Ombudsman will look at this. Do we have a complaint even, or is this the way forward with the NHS of the future ?

Edited July 25, 2016 by honeybee13
OH's real name removed.

[Sali]

I think the question is, as always, what outcome are you looking for?

 

 

So what is One Health? It looks as though it is a private company staffed by NHS-trained medics. Surely though it is not obligatory for patients to be referred to them by their GPs. Was your OH offered a choice? Who pays for transport/overnight stays/expenses for the patient (and possibly their carer) if the location is the other end of the country?

 

 

One Health say they get the same fees per patient as they would in the NHS, so it must be down to working hours/conditions or maybe they are moonlighting. I see what's in it for them, but what's in it for the patient? Quicker referral, but how much quicker?

 

 

I also think the GP should 'own' this problem. If he doesn't know what is going on in your OH's case, he should make it his business to find out.

 

 

Before you can complain to the Ombudsman you must exhaust the local complaints process, but where to start? Do you complain to the GP, One Health or your local hospital? If you are not satisfied with their final response, you can take it to the PHSO who, perhaps months after receiving your information, may reject it as 'not for further investigation.'

 

 

A fragmented health service is not ideal. It'll be like the trains, when you complain to one company, they blame another and you end up going round in circles and eventually give up. The NHS complaints process is bad enough as it is.

 

 

I'll be interested to know what happens next. In the meantime, I wish your OH well. Constant pain must be draining.

 

 

At any future appointments it may be worthwhile recording, covertly or otherwise. It will help you keep track of who says what and replaying can enable you to pick up things you missed at the time.

[citizenB]

I think the question is, as always, what outcome are you looking for?

 

OH is hoping at the very least for a reasonably pain free existence - perhaps some halting of the degeneration or some proper advice on how to deal with things moving forward.

 

 

So what is One Health? It looks as though it is a private company staffed by NHS-trained medics. Surely though it is not obligatory for patients to be referred to them by their GPs. Was your OH offered a choice? Who pays for transport/overnight stays/expenses for the patient (and possibly their carer) if the location is the other end of the country? No choice offered - he went to see his GP about the problems he was having - was told that he would receive an appointment in post and received this from One Health.

 

 

One Health say they get the same fees per patient as they would in the NHS, so it must be down to working hours/conditions or maybe they are moonlighting. I see what's in it for them, but what's in it for the patient? Quicker referral, but how much quicker? Any transport costs to and from appointments would be down to OH - had he been kept in the hospital overnight - then they would have ambulanced/transported him to Sheffield which is the nearest hospital dealing with Spinal issues (assuming that is an NHS hospital). Fortunately that didn't happen.

 

He has just received an appointment for the Consultant Surgeon - 22nd September 2016 at the same private hospital (John Coupland Hospital at Gainsborough, he went to for the injections. I have no idea if this is quick or not. I think the main problem is that there doesn't appear to be any Surgeons/Consultants who deal with back/spine issues in the hospitals locally - by locally I mean Peterborough/Lincoln/Boston and most of the Neurology Surgeons/Consultants there are in these, appear to specialise only in MS.

 

 

I also think the GP should 'own' this problem. If he doesn't know what is going on in your OH's case, he should make it his business to find out.

 

 

Before you can complain to the Ombudsman you must exhaust the local complaints process, but where to start? Do you complain to the GP, One Health or your local hospital? If you are not satisfied with their final response, you can take it to the PHSO who, perhaps months after receiving your information, may reject it as 'not for further investigation.'

 

 

A fragmented health service is not ideal. It'll be like the trains, when you complain to one company, they blame another and you end up going round in circles and eventually give up. The NHS complaints process is bad enough as it is.

 

 

I'll be interested to know what happens next. In the meantime, I wish your OH well. Constant pain must be draining.

 

 

At any future appointments it may be worthwhile recording, covertly or otherwise. It will help you keep track of who says what and replaying can enable you to pick up things you missed at the time.

 

I will update the thread as and when - thank you for your input

[BazzaS]

He has just received an appointment for the Consultant Surgeon - 22nd September 2016 at the same private hospital (John Coupland Hospital at Gainsborough, he went to for the injections. I have no idea if this is quick or not. I think the main problem is that there doesn't appear to be any Surgeons/Consultants who deal with back/spine issues in the hospitals locally - by locally I mean Peterborough/Lincoln/Boston and most of the Neurology Surgeons/Consultants there are in these, appear to specialise only in MS.

 

https://www.ulh.nhs.uk/services/neurology/

 

This mentions a MS nurse. MS is "medical neurology", and what you are describing sounds like a "surgical neurology" issue, so spinal surgeons or neurosurgical opinion needed.

 

That page notes these are provided within Lincolnshire by visiting consultants from Sheffield or Nottingham Neuroscience dept's., and having been seen in Lincolnshire if there was an op / procedure needed then it would be done in Lincolnshire if possible, or at the respective tertiary centre if not.

 

Worth getting copies of the letters so far to your GP, getting any tests / imaging needed done (at whichever hospital!), and then pushing for a surgical neurology referral / appointment?

[citizenB]

https://www.ulh.nhs.uk/services/neurology/

 

This mentions a MS nurse. MS is "medical neurology", and what you are describing sounds like a "surgical neurology" issue, so spinal surgeons or neurosurgical opinion needed.

 

That page notes these are provided within Lincolnshire by visiting consultants from Sheffield or Nottingham Neuroscience dept's., and having been seen in Lincolnshire if there was an op / procedure needed then it would be done in Lincolnshire if possible, or at the respective tertiary centre if not.

 

Worth getting copies of the letters so far to your GP, getting any tests / imaging needed done (at whichever hospital!), and then pushing for a surgical neurology referral / appointment?

 

 

[Sali]

In parallel could your OH ask his GP to be referred to a pain clinic, so whatever the outcome, there is a way to manage any continuing pain.

[citizenB]

In parallel could your OH ask his GP to be referred to a pain clinic, so whatever the outcome, there is a way to manage any continuing pain.

 

 

He has already tried this last year - didn't help at all It seemed to consist mostly of form filling - broken appointments from self employed staff and staff terrified of "hurting him further" ?

[Sali]

Sounds terrible. It shouldn't be like that. I think of all those people who may be suffering constant, unbearable pain and wonder how they cope both physically and mentally.

[citizenB]

Sounds terrible. It shouldn't be like that. I think of all those people who may be suffering constant, unbearable pain and wonder how they cope both physically and mentally.

 

 

It would appear if it is something relatively simple that fits a tick box - they can handle it.

 

 

I can actually give you an example of how I was treated.

 

 

I have a problem with my shoulders/arms - I am unable to raise my arms above my head and for the specific treatment they were going to try - acupuncture - they needed me to raise my arms above my head !! and this was actually the reason I needed the acupuncture to perhaps enable me to finally be able to do this. Her remedy for this was to have me lay on my front on the couch - then physically yank my arms up above my head. At which point I fainted and a Registrar needed to be called to give cortisone injections !! Which was what I did NOT want ?

 

 

I would never recommend anyone to the Pain clinic after that

[Sali]

Now that sounds scary. Someone close to me had terminal cancer and I would have liked them to have been referred to a pain clinic as I could see how it was affecting them. It never happened, but from what you way, it probably wouldn't have made any difference or perhaps made them worse. I will do everything in my power to stay fit and healthy so I can avoid healthcare...forever hopefully.

[citizenB]

Now that sounds scary. Someone close to me had terminal cancer and I would have liked them to have been referred to a pain clinic as I could see how it was affecting them. It never happened, but from what you way, it probably wouldn't have made any difference or perhaps made them worse. I will do everything in my power to stay fit and healthy so I can avoid healthcare...forever hopefully.

 

 

MacMillan Nurses are the best people to ask about pain management for Cancer. They seem to have a whole different outlook and attitude.

[Sali]

Sadly, he did not get referred to Macmillan and none of us were aware that such a service was available. In desperation, I 'phoned the local hospice and, after all the horrors of the NHS, they were excellent. Unfortunately, he never came out.