[Closed] Worth complaining or should I not expect anything more from the NHS?

Hey feel free to go private if you aren't happy with the free service the NHS provides. Edit: yes I know it's not "free" per se, MY TAXES etc.

Doctors can only make their best guess, no?

Hey feel free to go private if you aren't happy with the free service the NHS provides

Sorry, did you say "free"

How is it Free??

Hmmmmm

It would have been nice to have got to where you are in a few weeks less for sure. Unfortunately medicine is not an exact science and there is rationing - so you cannot send everyone for every test just in case - the docs try to decide who needs the tests.

I'd chase up the MRI -make a bit of a nusience of yourself might help - its an unfortunate thing but those who shout loudest get the best treatment on the whole.

If three docs all had a prop and poke my guess is one was a senor bod and if they can't find an obvious issue then that may be the best they can do - hence the MRI. If you haven't seen the orthopaedic consultand yet then I would have thought you should have done

So - try to make a gentle fuss and see if you can get the MRI more quickly - tell them you are unable to work and losing money or something that is not too far from the truth.

As regards making a formal complaint - wait until you actually have a diagnosis because it may be that the path you have been on is reasonable for what your injury is

Ah, I see you edited it

If you'd been that worried you wouldn't have cluttered up A&E with a 3 day old injury, what harm did you do walking around on it for three days?
Personally 2-3 weeks for an urgent knee MR scan sounds pretty good, ask a private provider how long it would be before they can fit you in, then go and see the same ortho consultant privately. When the private hospital messes any surgery up, your local NHS can then take over and repair the damage (same consultant again).

such injuries are sometimes *relatively* hard to diagnose. Every person/affliction is different; medicine is sometimes an art rather than a science.

How do you think you are being 'fobbed off'? I understand your frustration, but your wait sounds perfectly reasonable for an urgent but not emergency condition

cheers TJ. Like I say, usually I'm not given to making complaints and I work in the public sector myself so I know how it can be. I just thought that after eight weeks I would be somewhere further along towards a diagnosis.

If its any help I was waiting for an MRI scan last year. I phoned them and said if they had any cancellations I could get to the hospital at very short notice. Got one the next day.

Bregante are you paying for the service at the NHS? If not I'm confused by your comment?

In my experience the interpretation of X-rays is very difficult and can be contraversial between doctors, and they can be used for rough looks at tendons and ligaments, they just don't show up very well.

My two penny worth is to say that doctors in the NHS are generally trying pretty ahrd to make the most of the resources they have available whislt dealing with a wide variety of ill informed public, who thanks to the internet think they know the answer before they even see a doctor. Not suggesting you fall into this catagory but I can definitely understand why they don't send everyone off for all the tests straight away!

How do you think you are being 'fobbed off'? I understand your frustration, but your wait sounds perfectly reasonable for an urgent but not emergency condition

That was my question.

missingfrontallobe - Member
If you'd been that worried you wouldn't have cluttered up A&E with a 3 day old injury, what harm did you do walking around on it for three days?

So I should have gone immediately I felt it? It could have cleared up in an hour. I went because on day 3 I got up and couldn't walk on it.

j-me has the best idea here. worked for the mrs a while back, seen next day.

Bregante are you paying for the service at the NHS? If not I'm confused by your comment?

I'm not getting all "I pay my taxes" (as I say - I work in the public sector). My original question was. Is this normal service, or should I expect more from the NHS. If it's about right, then clearly there's no point complaining.

cheers j-me. I'll ring them now 🙂

I understand that there is a theory of RICE for sports injuries?

Rest, Ice, Compression, Elevation?

I'd wonder if the OP in the process of "walking it off" thought of this as a means of self treatment? Or has there just been an overdeveloped sense of MTFU?

[edit] Your treatment process has been fairly normal, in fact probably better than a lot of people could have expected. Which part of the public sector do you work for?

feel free to wonder

Knees are totally hard to diagnose - if something is wrong with the boney bits thats easy to spot. But the squishy bits and the fluidy bits - if they start acting up and there hasn't been an obvious trauma to have caused it then get ready for a long process of stabs in the dark. Could be an injury or wear and tear, could be an infection, could be, could be, could be.....

I had my knee suddenly swell up 15 years ago, 10 years of appointments, blood tests, physio, hydrocortazone injections, tests on the fluids in the knee, xrays, cat scans of my knee (and an xray of my spine), crossing off injury, arthritis, wear and tear, rheumatoid arthritis, lyme disease, cancer and more other things that I can't remember I was non the wiser (although reassured to learn I didn't have RA or Cancer or anything else). During this time the knee continued to sporadically swell up, and inbetween times would always have at least some fluid around it, but with less severity and less frequency. In the end I just stopped having it looked at.

If a group of joints act up - that gives some leads as to a cause, and it also eliminates a lot of potential causes. If one joint acts up it doesn't really indicate or eliminate anything.

10 years?
I'll STFU then 😳

I had an x-ray (which doesn't show tendons or ligaments)

It does show ligament, though nowhere near like an MRI does.

I've had to wait on average 6 weeks on the 3 MRI's I've had over the past 2 years. Hope you get yours sooner.

Bregante, that makes sense, sorry I was just a bit confused by your comment.

Hope the diagnosis, treatment and recovery go well for you.

One suggestion, make sure your shoes/cleats/pedals are set up right when you get back on the bike, I nearly re-ruined my knees with bad shoes!

I'll STFU then

In the end the only indication I got out of all the tests was that I appear to be of an genetic type that [i]can[/i] have rheumatic responses as a result of the presence of other infections. But theres been no further detection of any lurgy.

Sorry you're in a bad way but I don't see that they did much "wrong". Nothing wrong with chasing up but getting yourself pushed up the MRI list might be hard work

Your story starts out with a short-term knee problem that arguably you could've gone to GP with rather than A&E. However, they confirmed no emergency & offered a clinic appt

Clinic reassessed and still felt no major problem (OK, seems they were wrong but you were still walking at this point it seems - "keep walking on it normally...").

Significant problems begin at physio appt. You're referred back and they escalate investigation now that things have deteriorated. Shame maybe that you couldn't have ultrasound there & then but I guess the system does what it has capacity for. MRI's expensive so they won't have loads of machines and hence have long waiting lists and reserve it for significant problems (unless you're on BUPA I guess).

I don't think you have any reasonable grounds for complaint. They X-rayed you the first time you presented and then continued to try to diagnose and give treatment as the situation deteriorated.

I can see why you're frustrated with the most recent wait, but the only way you can have no waiting time to use expensive kit is if they buy so much of it that it stands idle half the time, and people keep complaining about that sort of thing in the NHS!

Your best bet is clearly to vote yes in the AV referendum and do your bit to try to stop the Tories from ever forming another Government.

(edit: or start paying for private health care)

If its any help I was waiting for an MRI scan last year. I phoned them and said if they had any cancellations I could get to the hospital at very short notice. Got one the next day.

good idea,

plan b if you are really unhappy is to actually turn up explain to the team the situation and sit there until a gap opens up. By day 3 you will be such a (polite) PITA that you will have been seen. Afterall the NHS spends a fortune advertising the fact that people fail to show to their appointments

My main issue is I spent two weeks after seeing the first doc at the fracture clinic trying to walk normally and having physio after having two xrays which wouldn't show damage particularly well in the first place. Then when I go back I'm given the exact opposite advice by being put in a splint which restricts all if the movements that I had been encouraged to do and am concerned - but accept I may never know, how much additional damage this has done.
Thanks for the advice maccruiskeen

but accept I may never know, how much additional damage this has done.

... or [b]if[/b]

Indeed

it's called getting old mate 🙂

Its all about the ifs unfortunately - trying one thing, then trying another thing - thats the process.

First of all there is no theory of RICE in sports injuries - it's PRICE (P is for Protect). Secondly there is no such thing as a sports injury, only injuries that occurred during sport. Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

aye, but who makes the assessment as to who the correct person to make an assessment is? And what if it isn't and injury - but just seems like an injury? ❓ ❓ ❓

Simple answer is you need an MRI - which is now being done.

In an ideal world it could have been done quicker but the flipside of that is if everyone who had a painful swollen knee went straight to MRI the wait would be massive.

Clinical judgement is necessary - and that is what it is - an opinion - which can sometimes be wrong.

It is highly unlikely much further damage done, although not 100% impossible.

MRI should give a diagnosis and a good idea of what needed for improvement.

aye, but who makes the assessment as to who the correct person to make an assessment is?

the person making the assessment? arguably this has happened hence the referrals

I'm still suffering issues with my wrist a year later due to a crap assessment by Dr 1 , rule no1, never, ever be the last person to be seen in a fracture clinic

I've had two similar experiences:
15 years ago partially tore the ACL in my right knee - very swollen, painful etc. 3 days later went to GP, sent to A&E, X-ray, referred to specialist, short wait of a couple of weeks, i think, for MRI. Then another short wait for arthroscopy, cant remember how long but less than a month. After follow up had a month wait for physio (this was classed as urgent), then physio for 6 months.

Currently: sprained left knee in early december, swollen, stiff and sore and not able to bear weight but not as bad as previous one. Self treated doing the RICE thing for a week, then flexing exercises from my previous physio in the second week, then gentle cycle machine, stair exercises from week 3. Think I tweaked it again stepping off a curb over Xmas as it swelled up again. treated as before but have a persistent soreness at the back of knee and around the knee cap so went to GP. Got an x-ray within 1-2 weeks, referred for an MRI with a one month wait (private clinic doing NHS work) and referred to a specialist with a potential 4 month wait. The waiting is frustrating but understandable as the referrals are triaged and I'm low priority - I can walk and cycle just can't run, play football or snowboard :(. Ultimately I'm just hoping for a more precise diagnosis so I make sure I'm doing the most effective physio.

Sorry to go on a bit but thought it might provide some comparable experience.

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

He's still a student - don't let the real world crush his dreams just yet 🙂

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

Guess it depends what you mean by assessment. Physical examination? and/or x-ray, MRI, arthroscopy? Took all of those to get a definite diagnosis for my first injury. I could have had a numpty specialist though.

RPRT - why is saying that knee INJURIES are easy to diagnose a load of twaddle?

well I might suggest that some thing looks like INJURIES but aren't. The OP is talking about something he thinks in and INJURY and describing to his docs as an INJURY, and it looks and feels like an INJURY. But he didn't have an ACCIDENT.

My symtoms suggest my body was reacting to an injury too, but time proved that it wasn't

Macruiskeen - going on the tiny wee bit of information that you gave us in your earlier post it does not sound like your body was reacting to an injury at all. Things do swell up randomly and when they do, it's a pretty damn good indication that it's not an injury. Was yours a bacterial infection by any chance?

Bregante on the other hand says that he felt a twinge or something similar - that could well be a tear or some such thing. The swelling could be bursitis from structures rubbing in places where they wouldnt normally be rubbing. Decent physio would be able to rule all that out pretty quickly and they may well have done that - and that's why they've referred them to some other discipline.

SBZ,

Because it's not "easy" that's why.

Admittedly some people will be better than others at diagnosis, but are you suggesting that there are doctors out there who never get it wrong?

The implication of what you said is that the OP has got cause for complaint, because whoever treated him in the first place might not have been a knee specialist. But that's not how healthcare works is it? Part of the "treatment" might well be the process of finding the right specialist.

And anyway, as every injury is going to be slightly different, no one can ever know for sure whether diagnosis and treatment were optimally effective in a particular case.

RPRT - do you have any training relevant to assessing knee injuries?

Nope.

But I read a lot.

OK seeing as you read a lot, tell me what is involved in a knee assessment then. Then tell me what's difficult about it.

No, I'm not jumping through hoops for you.

If you think the assessment of knee injuries is "easy" then that's fine, but from my personal experience of knee injury and those of friends of mine who have had ongoing problems despite involvement with a wide range of experts, I can't accept that it is "easy"

BTW, the "I read a lot" was just a throwaway line. I could have said "But my heart is pure".

Who said that treating knee injuries was easy?

If I might interrupt the squabbling...

SBZ, i'm guessing you're a physio, can I ask your opinion? - In my simplistic view I've been thinking knee specialist = diagnosis and possible treatment, physio = rehab. I was going to put off going to see a private physio until after getting the results of my MRI. Is it worth seeing a physio earlier if they have diagnostic skills? Is this something all physios can do or should i be looking for a particular type or qualification? I'm not sure I would have trusted the physios i had in the past to do this but I'm possibly being unfair. Genuine question, would be grateful for your thoughts.

Physios do diagnosis of musculoskeletal injuries then decide on the best course of action to treat them. They are also trained to look for signs of other pathologies and refer onto other suitable professionals.

Look for a good musculoskeletal physio and they will have the skills to diagnose and treat any injury that doesnt require surgery and tell you if they think it does or might require surgery.

I can't be bothered to argue with you, but plenty of experts get their diagnoses wrong. Ergo, it's not easy.

If you cant be bothered to argue then why do you keep posting?

I would regale the time I was sent home from A&E after being told I had indigestion, only to find out it was a collapsed lung, two weeks in hospital later & when I got out it really didn't matter any more.

Happy trails.

@SBZ,
Thanks.

[b]SBZ[/b]

I don't believe [i]anyone[/i] who says knee injuries are easy to diagnose because I see any number of cases where the clinical findings by sub-specialist Knee Surgeons, the MRI report and the final arthroscopy info provide different answers. And I have seen Orthopaedic Registrars and Physios get it wrong too. If [i]you[/i] believe [i]you[/i] can do it infallibly you are either self-deluding or only dealing with minor self-limiting problems. If you really do believe that - and really are a clinician - I think you have identified a need for audit and learning.

Back to the OP...

Have you seen your GP about any of this? They are (I believe) your Primary Care and should always be your first port of call (unless it's an emergency). Your GP should be aware of all your consultations, treatment, medication etc and if you feel unsatisfied, they are the first person you go to see to raise any concerns.

I'm having similar difficulties with waiting times - my problem is (apparently) very difficult to diagnose, and the department(s) taking my case is/are simply understaffed. But I raised this concern with my GP and she's been very helpful in listening to me and suggesting other things that could be done. She will now keep an eye on my case management and (hopefully) will fight my corner against any more waiting around.

Have you seen your GP about any of this? They are (I believe) your Primary Care and should always be your first port of call (unless it's an emergency). Your GP should be aware of all your consultations, treatment, medication etc and if you feel unsatisfied, they are the first person you go to see to raise any concerns.

I saw her after the first clinic appointment (when I was told to do the physio) because I wasn't happy with the advice at all. She got in touch with the physio, who referred me back to the knee clinic and stopped the physio. But no, not seen her since. Her other half is actually a knee specialist at another hospital (different trust, I believe) and she speaks highly of my consultant (Dr 3 in my first post).

I just love the fact that I have private health care yet I get taxed on that as well, that is all 🙄

get your check book out and pay for it.. loads of free time on MRI's my neighbours a technician and he says hes nowt to do at the 4 hospitals he covers as they dont get used enough.

SBZ, I'm with StoatsBrother on this one I'm afraid and have spent a fair few years looking at knee injuries at the front door as it were.... Knees are very complicated bits of kit (almost as complicated as shoulders)!

I just love the fact that I have private health care yet I get taxed on that as well, that is all

But sadly not enough. It's long overdue that people who use their money to poach medical staff who have been educated and professionally trained by the government, so that they can jump queues, causing other people to wait longer, at least started paying proper money to the government for the privilege. Although ideally, a stop should be put to the unacceptable racket. Healthcare = to each according to their need, not their money. That is all.

Obvious knee injuries are easy to diagnose, most aren't easy though.

So says my sports doc physio friend sitting here having a beer. I'd trust his judgement given his background and experience. And he also successfully fixed my long term knee problem that had been 'missed' by a variety of docs and specialists both private and public.

It's long overdue that people who use their money to poach medical staff who have been educated and professionally trained by the government, so that they can jump queues, causing other people to wait longer, at least started paying proper money to the government for the privilege.

Errrrr I wonder how many foreign trained medics work in the NHS.
I suppose that's wrong too?

get your check book out and pay for it.. loads of free time on MRI's my neighbours a technician and he says hes nowt to do at the 4 hospitals he covers as they dont get used enough.

My local hospital had to hire in a mobile MRI to help out because they have that many to do.

j_me - Member
If its any help I was waiting for an MRI scan last year. I phoned them and said if they had any cancellations I could get to the hospital at very short notice. Got one the next day.
POSTED 17 HOURS AGO # REPORT-POST

what a top tip! Rang them yesterday, explaining that I live 10 mins from the hospital and can be there any time. Just got a call and it's getting done at 1.30 today!!!

Cheers j_me and others who suggested this

ACE !!

Good luck bregante and I hope they get to the root of the problem.

SBZ - your really are wasted as you are obviously more talented than any of the 3 docs who have failed to make a definitive diagnosis. Just think of the good you could do with a bit more training and a few more letters after your name. 😉

Just got a call and it's getting done at 1.30 today!!

Just think of the good you could do with a bit more training and a few more letters after your name

D.Ust ?
M.See ?

😀

Nice one.

It'll probably still take a while for the results to make it back to the Doc, but I'm interested to know what the result is now. Maybe you can give us an update when you find out something?

It'll probably still take a while for the results to make it back to the Doc

Yes you might have to wait a while to see your consultant again, but in our "Health Board" the scan results are available on the network pretty quickly (c48 hours). Your GP might be able to access these. So you could get the results by calling your surgery in a couple of days without waiting weeks to see your consultant. Of course your GP might not be able to interpret them!

I had a similar experience with my knee.

A&E nurse (3 days after the initial crash it swelled up and locked and I couldn't move it). - no ligament damage, RICE, see GP in 2-4 weeks if no imporvements.

GP - RICE + NSAIDs, come back if no improvement

(back home for summer break from Uni, new GP's, lots off faffing, one useless physio, back to uni in september).

See GP, refered for physio again, saw a really good consultant physio, then fortnighltly appoitment with a good physio for almost 6 months. But all we could do is get it normal, i.e. I could fuction, but couldnt walk further than the bus stop, and excercise beyond swimming with a pull-bouy was impossible.

Refered to a consultant (I actualy tore the sack of fluid round the knee walking to his office!)

More x-rays.

Opperation scheduled to have a look.

Opperation.

Remove a chunk of inflamed tisue.

6 months later I was doing 100 mile sportives

3 years later I can ride pretty much as normal, it's not perfect but I can modulate the riding enough to keep it in check.

If it happened again, I'd pay the £90 see the consultant straight away, then he can either decide to opperate and you go on the NHS waiting list (or pay £3k and have it done pretty much there and then). Or you just go back into the NHS system with a note from the consultant saying you need XYZ treatment/tests. Thats what my neighbour did and he was back at work (manual work, not office work) in 6 months non the 18months it would have taken me.

You had a thread about this the other week didnt you? Good luck for your diagnosis but i suspect you are looking at 3mths with your legs up with no sport. If its a tear then they havent got much choice but to recommend rest.

I got moved into advanced knee group at hospital today 3ths and 2weeks following a complete rupture of the patella tendon. I wouldnt wish you carrying on exercising etc and then snapping it. Believe me, your current situation would be a pleasure

Errrrr I wonder how many foreign trained medics work in the NHS.
I suppose that's wrong too?

Well what do you think ? Try and work out for yourself whether poaching trained medical staff from third world countries is acceptable......bearing in mind that it isn't rocket science, and we should be able to train our own doctors, nurses, radiologists, etc.

So I pay my taxes, never missed a penny and decide to get private health care, how is it fair I get taxed again. If it was offered by your employer ernie I'm sure you'd turn it down hey??

may i suggest you request a copy of your medical notes from the nhs, being able to sit and read them may give you some answers. my wife has just done this and you need to fill out a form get your gp to sign it then it takes about a month after to arrive and they charge you £17.

how is it fair I get taxed again

So I pay my taxes, never missed a penny and decide to get private health care, how is it fair I get taxed again. If it was offered by your employer ernie I'm sure you'd turn it down hey??

I pay my taxes too, never bloody get ill, yet some of those really sick people who are too sick to work and pay taxes get loads of treatment, how is that fair?

And they spend all that money on neonatal intensive care for babies who've not done a stroke of work in their lives, how is that fair? Sheeesh!