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NHS Diary: Beat them at triage and win a bed


This is the latest instalment in Nick’s diary about his treatment for cancer and other issues.

WE should try to look on the bright side of this corona crisis. It will teach us things we didn’t know. That’s what I tell myself about cancer in the hope that some enlightenment will come from all this.

Maybe switching off the economy, waiting for 12 weeks and then switching it back on again will make it work much better. That’s what I spent 90 per cent of my time telling people when I worked in IT. It usually worked.

Will it work for the NHS? Will it waste less time and process us more efficiently and fairly now it’s been forced to rethink how it deals with outpatients?

Corona made them tell us to stay away and get managed remotely. Fair enough under the current circumstances. It’s the radical measure nobody dared try before.

After two attempts, my remote dermatology consultations haven’t worked yet.

Still, I’ve upgraded everything as instructed and hopefully my online dermatology consultant will work tomorrow. I’m still puzzled why they can’t use the regular pictures, videos and patient notes I post here (warning: these are seriously unpleasant). 

Meanwhile, at another hospital they took my PICC (Peripherally Inserted Central Catheter) line out, so I won’t have to visit them to have the skin cleaned and attachment flushed. The absence of a plastic wire inside my veins means that blood clots won’t form around it, so I’m no longer in danger of another deep vein thrombosis scare.

So I shouldn’t have to keep injecting myself with Fragmin – an anticoagulant – every morning and night. But I’ve had no definitive answer on whether I should stop.

I emailed the clinic, but nobody replied on Monday. Someone rang from the hospital – but they always block their number and never leave a message. So you waste time constantly chasing mysterious missed calls.

I don’t understand the communications culture in the NHS. It’s not deliberate, but they have ended up using technology to waste as much time as possible. That won’t be changed by corona.

I wonder if the triage process will improve?

Half the people who bother A&E in Croydon don’t need to be there. One ambulance crew got called out to a man spooked by his first dandruff. Another was in the waiting room because his local pharmacy was closed for the evening.

An injection of corona has cleared these coagulations out of A&E. But will they come back? What will happen to people getting triaged now?

With too many patients and not enough beds, many genuine patients will be on the outside. Admission will depend on your triage skills. Only the pushiest patients and those used to gaming the triage system will get admitted.

I don’t think I’m very good at that game. I couldn’t get referred by my first practice nurse, back in Kingston, to save my life. She seemed to relish telling me how long the waiting list was and never offered to put me on it.

It’s the self-scoring that’s so tricky. When asked to rate my pain on a scale of one to ten, I usually go for a low number as I’ve never pushed a baby out. How can my pain go above five?!

What a ridiculous question. Everything is relative and since it’s usually a woman who asks me that question, I’m guessing childbirth is the benchmark they expect.

Still, I need to raise my triage game. A fellow cancer sufferer told me that if I get coronavirus I’m definitely doomed.

There are three reasons for this. My immune system has turned traitor and has started forming wounds, blisters and ulcers in my skin wherever it can. Two: Chemotherapy has killed off any white blood cells that might have given their lives to kill off an invading virus. Three: He knows me and knows I’m dying to get out there and tend to my various guerrilla gardens.

So I will have to give up potting seedlings and start working on my Top Triage Game.

I’ve got to give the answers that will open the door to my old bed in the Acute Medical Unit. If I get this right, I can re-acquaint myself with my old friend Violet, if she’s still working there.

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Nick Booth
Nick Booth
Nick Booth is a freelance writer.

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