Peter Viney's Blog

On Tuesday night Karen had a sudden sharp abdominal pain at 10 pm. It got worse. The next morning, we asked for a phone consultation and the GP phoned at 2 pm. She told us to come straight there and she’d see her at once. We were there at 2.15. That took an hour, half of it with the GP on the phone to Poole Hospital. She told us to go straight there to Accident & Emergency and that she was expected by the surgical team, and we arrived at 3.15. It’s a Triage system.

So experiences of NHS 2023. 

Everyone we met was kind, helpful and working hard. I was told to go and get a bag with nightclothes and essentials. I was in the car park on the very top floor. The man at the car park pay desk in the hospital said, ‘Thirty minutes is free. You’ve got ten minutes to leave.’ So, I’m on Floor J. It starts at A. The long walkway to the multi-storey car park had people in wheelchairs and people with small kids, all slow. You don’t push past. Then I had to go up stairs to my floor and walk the length to the car. Then someone with a large SUV was trepidatious about the steep exit turns and ramps and very slow. By the time I reached the exit machine, I was one minute over and the machine demanded payment. I pressed the button, the same guy answered and just opened it for me. All nice people.

Massive thanks to all the medical staff, but the NHS is fundamentally in need of rebuilding from the bottom up. 

Our diary …

We arrived at 3.15 p.m. We finally departed at 3.15 a.m. Twelve hours. I’ll list the process.

3.15 Triage nurse,. Blood pressure, temperature.

5 pm Doctor. Surgeon. In his 20s examined her. Suspected diverticulitis. Said he’d take blood and arrange a CT scan.

5.10 Very nice final year medical student took blood.

7.00  They said blood sample hadn’t worked. Took more blood.

8.00  Joy! We’re going in. They weighed her. Back to waiting room.

10.30 Back in. Blood pressure and temperature. We’re told that means we’re close to seeing a surgeon. Very lovely Hispanic nurse who gave her a hug and told her not to worry. 

11.00 Saw surgeon. She examined (as at 17.00) said there would be a CT scan, then there were either the possibilities, stay overnight for IV antibiotics, or home with oral antibiotics. Back to waiting room.

1 a.m. We asked triage nurse if the CT scanner worked all night. Only for emergencies, she said. You’ll probably get it in the morning. We said that’s not what the doctor had said and if it was the morning, we’d rather go home and rest, as standing and sitting upright in hard chairs was getting difficult. She came back and said, ‘The porter’s coming to take you now. There’s a bed for you.’

SUBTEXT: They were being ‘unalarming.’ We knew from online there was a third possibility, immediate surgery. We understand in retrospect, that they were delaying scanning until they had a bed in the surgical area available. Just in case. That explains our long wait.

1.15 scans. Then to a single room. Undress. Go to bed.
They told me the surgeon reviewing the scans could be one hour or seven hours depending on emergencies. They said I should go home, but as people were waiting for beds, could I come back if she was able to be discharged?

2.pm I got to bed. Couldn’t sleep. Phone rang at 2.55. Come and collect her.

3.15 we left the hospital with a prescription – no pharmacy so first dose had to wait until I went when we woke at 9.30.

Basic fact: many people were there in A&E because they couldn’t see a GP. GPs don’t see people. We were totally amazed at Karen seeing one right away, as our grandkids experiences and ours at a practice known locally as ‘the call centre’ have been fundamentally different. Until yesterday, we hadn’t managed to see anyone about anything since Covid started. This is the greatest problem, vastly overstretching NHS A&E resources. They need GPs to start seeing people again, or some interim stage (just as they need an interim system at the other end for discharging older people who still need care, but not hospital care).

They need more hospital staff. Doctors, nurses, ancillary. The wait times are appalling. No wonder the staff are overworked, over-stressed, as well as being grossly underpaid. The majority of people who helped us were not British. We need to get far more welcoming to the people who keep the system going.

We saw a mother with a  feverish child discharge themselves after eight hours waiting. A young couple (she was ill) wanted to do the same. By 9 p.m. the waiting area was packed with probably a dozen people standing. 

Next basic fact. The admin / architects need replacing now.  Architects or senior building internal designers, and administrators? Go home. Do not pass Go. Do not collect a salary. Just fuck off. 

When Poole Hospital was built in the 1960s, I was in Hull. The hospital was the same date and design. Probably the same architects. Over fifty years ago they were lampooned in Private Eye as both were designed so delivery trucks for the kitchen and in general could drive down a ramp into a dry unloading area. However, A & E (or “Casualty” as it was then called) unloaded on an open-air ramp exposed to the elements. Patients on stretchers were unloaded in the rain, pens and papers for the army of administrators were unloaded safely in the dry. Nothing much has changed … just an open canopy over the unloading area.

The waiting room is a small L-shaped area with maybe 16 seats, maybe 20. It has a water cooler. Period. As you wander the halls of the hospital there are vast atriums, large empty areas between sections, any of them larger than the waiting room area. My GPs’ waiting room (in two areas) is larger and more spacious than the main hospital A&E waiting room. Theatres and cinemas boast that they have high ceilings and air filtration changing the air four times a second over everyone. That’s Poole Lighthouse, 500 metres from the hospital. So why are we waiting in a crowded room with a conventional ceiling height, no sign of air conditioning and filtration, with people who are coughing and feverish?

I hadn’t been in A & E at Poole since about 15 years ago. Then it was a very large room, three or four times the size. It had a separate children’s area at one side with nice play equipment.  It had a vending machine with chocolate, savoury snacks and hot drinks. It had a TV running Sky News, sound off but you could read the subtitle text. I remember this because I went twice with my oldest grandson, taking my daughter while my son-in-law looked after his older sister. I remember when he was two, and fascinated by the vending machine, and pointed at the chocolate bars. My daughter said, ‘No, I haven’t got any money.’ He thought, looked at me, and said, ‘Grandad got lots of money!’ which sent the whole waiting room laughing.

So what happened to the space, the vending machine, the TV, above all, the separate children’s area? Who decided to eliminate them? Was it to make it discouraging?

One woman was diabetic and at midnight asked where she could get food. She was directed to the BP petrol station 300 metres away in the rain. Isn’t there space in one of the many large connecting and atrium areas for a vending machine, or several? Surely it doesn’t cost anything. The vending machine company gets the profits. I assume they would pay the hospital to site the machine. W.H. Smith and Costa sell food and drink in working hours, but you have to exit into the open air and walk back in to get tothem. Has some idiot done a deal saying ‘we won’t have a vending machine to compete’?

We went through the double door to the medical area about seven times. Then back out. With so many standing, we lost our seats most times, though younger people were kind and sat on the floor and gave up their seats mostly.

My son also recently waited there for twelve hours. He had been in A&E in China and said, ‘Why don’t they have rows of cubicles with benches instead of seats, like China, so people can lie down?’ He described it as benches with partitions but no doors. Most people are accompanied by one other person. Two can sit on the bench, or one can lie and the other perch on the end.

Around 11 to midnight, all over people were muttering that their phones had run out of charge. I think they need phone charging points. Luxury? Well, there were two very poor people in there, both sounding like recent Middle Eastern immigrants, and both had Smart Phones. There’s only one bar of phone signal so phones eat up charge quickly. Why don’t they have a wifi possibility? We noted that no one was reading or had reading matter. Most had phones – in an emergency you don’t think ‘I’ll be waiting hours, I’ll take a book’ but you do think, ‘I need my phone to text / contact family and friends.’

The lack of a children’s area is appalling. I’m going back three years, and I hope it hasn’t changed, but I went to the Eye Department at Bournemouth Hospital several times, to look after an under-five while my daughter had appointments. There was a separate children’s waiting room with books, and fascinating play tables with lots to do. I was usually there about an hour and it was fun for both of us. Back to Poole: It is distressing for children to see adults in pain, groaning. One man was groaning loudly, holding his chest and praying (I assume) in Arabic. I watched them watching. They looked worried. At Poole, one very elderly man was lifted up from his wheelchair and his trousers and pants fell down exposing his genitals to all. It was not a pleasant sight for adults, but certainly children should not have to see that.

Bournemouth Eye Department also has a voluntary service counter selling food and hot drinks very cheaply in the waiting area. That is of course possible for a facility open ten hours a day, but more difficult for one open 24 hours like A&E.

It sounds extremely simple. It needs space, but not much more. It’s a one-off cost too. They’ve got space elsewhere. So why have they decreased the area, just when the need has grown so extensively? The patients are incredibly patient. There were people with bags who were awaiting admission. Two were there almost as long as us and they were still there when we were finally beckoned through. People are nice. A lot were uncomfortable, in pain, feeling ill. No one was aggressive or complaining. Mostly people sat quietly and glumly, just waiting.

A doctor I used to know said ‘The healing should begin as soon as a patient walks through the outer door. The waiting area should be welcoming and pleasant.’ I agree. A few photos of Corfe Castle and Mudeford Sandspit on the walls are pleasant enough for a short wait. They pall when you’re in the room nine hours or more. When we got to the actual ward, there was a large TV in the reception with an ambient film of landscapes, sound off. That should be replicated in the A&E waiting room. How much does a modern TV screen cost? A decent administrator would be approaching manufacturers and retailers for contributions.

I’m told they’re running it down (deliberately) while they transfer A & E to Bournemouth Hospital. Poole is large enough on its own, let alone there were people from Swanage and other nearby towns without A&E. So the administration are the villains in this story.

We’ve escaped with a week of antibiotics. That’s a blessing. We had tickets for the Royal Shakespeare Company in Stratford-Upon-Avon and hotel tonight. When I phoned to cancel both the RSC and hotel were kindness itself, and rebooked us for another date at no loss.