Managing multiple doctors & NHS intractability
Managing multiple doctors & NHS intractability
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Discussion

Steve H

Original Poster:

7,513 posts

224 months

Yesterday (08:30)
quotequote all
I’ll try to avoid too many personal details here, it’s not about me but does involve a real situation.

If someone has a number of conditions that require different specialists and the priorities of each can conflict or overlap, or can cause excuses to be given for lack of treatment or progress, how do you coordinate or compel the various people who are involved in the case? Assume there is a combination of long term conditions and some recent/critical issues that are not being dealt with at the normal pace and the delays are likely to make the final outcome worse.


In an ideal world I would want one medically qualified professional who could oversee, prioritise and direct the different specialties, someone who understands the NHS system well enough that they would know how to push things forward when encountering unreasonable delays. In truth I could see this being a useful service for a lot of NHS patients.

Ideally I suppose this would be the job of a GP but that’s not a realistic thing to hope for, is there a private option for overseeing the entire medical care of someone with multiple conditions? I can’t imagine it would be a very popular job as it would involve a doctor who is broadly qualified and experienced telling specialists how to do their job, but that’s what is actually needed.


I’d welcome any professionals view on this, or anyone who has found a solution for themselves/a loved one.

dobly

1,612 posts

188 months

Yesterday (09:06)
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The usual situation is that the specialists meet weekly as a multi-disciplinary team - for example general surgery, radiology, oncology, imaging, etc. to discuss those cases which cross specialisms.

Biglips

1,442 posts

184 months

Yesterday (09:23)
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GP will be the only clinician with oversight of all the different threads of care and the only person in a position to do this.

If your GP is either crap or overwhelmed then your options are to go to a private GP or the patient to drive it themselves. The latter is difficult and involves contacting secretaries and chasing results and outpatient appointments but in my experience is the only real way unless you have a gem of a GP. Good luck

Dean4200GT

6,396 posts

274 months

Yesterday (09:32)
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We did have some success using PALS, we made a detailed but very polite report of the issues and did get 2 departments working better together afterwards. Your case sounds more complicated that just 2 departments, but might be worth a try!

Bill

58,543 posts

284 months

Yesterday (10:07)
quotequote all
Biglips said:
GP will be the only clinician with oversight of all the different threads of care and the only person in a position to do this.

If your GP is either crap or overwhelmed then your options are to go to a private GP or the patient to drive it themselves. The latter is difficult and involves contacting secretaries and chasing results and outpatient appointments but in my experience is the only real way unless you have a gem of a GP. Good luck
Or possibly an elderly care (I'm assuming age from the number of issues) specialist.


Steve H

Original Poster:

7,513 posts

224 months

Yesterday (16:16)
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Thanks for the ideas chaps. The GP is ok but not up for getting consultants in a neat line unfortunately and hoping they would do it on their own for the benefit of their mutual patient is a pipe dream.

We have been doing the chasing and legwork ourselves but all you get is secretaries and admin staff who will pass messages on but when the answer comes back all they can say is “that’s what the doctor said”.

There’s some great people in the NHS but as an organisation it’s utterly self-serving and in many ways just unfit for purpose banghead.

Brainpox

4,311 posts

180 months

Yesterday (17:56)
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Lots of complex patients and not enough staff to manage them all. You have to advocate for yourself. Complaining to PALS can help if there's a particular hold up, but there's no 'project manager' role out there.

Yahonza

4,016 posts

59 months

Yesterday (18:20)
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That's what their GP is for - as they are generalists. However, GP's nearly always defer to hospital specialists.
Specialists in hospitals don't always talk to each other, unless it is a referral, or if they work together in a multidisciplinary group, and the next treatment may well be held up by the ongoing previous one.

Multimorbidity is a thing but there is no specialist covering this, as it isn't really a recognised medical condition. So unless their GP is offering advocacy they are stuffed - so to speak.

Derry Rhumba

305 posts

20 months

Yesterday (20:19)
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Back in 2016 I was involved with both Neurosurgery, (who wanted to operate), and Neurology, (who didn't).

They just liaised with each other effectively; it wasn't rocket science.