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Foot care delays in Yarmouth and Waveney

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Dear All,

I worked for the succession of Trusts and organisations that comprised Great Yarmouth and Waveney Health Authority 1986 through to Waveney Primary Care Trust 2006 when i left to relocate to Sydney Australia. They are now called Great Yarmouth and Waveney Primary Care Trust from 2008.

In the years that i worked for them there were very few justified complaints regarding quality of treatment and care.

The vast majority of complaints were about:

1: SIMPLE NON ESSENTIAL NAIL CUTTING

2: Frequency of above

3: Massive demand over and above ability to meet demand.

4: Eligibility Criteria which ensured that those that wanted nail care had restricted access to the service.

This has been a bone of contention for very many years for Pod Depts when they try to propritise their service to the needs of the AT RISK FOOT and those pts at risk of hospital admission due to advanced foot pathology.

Simple non essential nail care has NO PLACE IN NHS PODIATRY IMHO.

So how does one provide a PODIATRY SERVICE when the population want a free Toe Nail Cutting Srvice every 6 weeks.

Recruitment and retention of staff is easy.

Have a well designed innovative Pod Dept invest in latest technology and treatment modalities provide CPD relevant to modern practice.

NO SOCIAL NON ESSENTIAL CLIPPY CLIPPY COME AGAIN .

THis will ensure you have interested and motivated staff who want to work for you.

Failure to do this will result in staff moving to a PCT that provides what i have suggested.



The use of Private Practice to provide t/t is used here in Aus. Medicare is not perfect and is abused by many but it does provide Pod TT for many who no longer attend the Govt Hospital Pod service and who have a Medical Clinical Need.

Private Health ins is used to provide Pod care too.

So there are other models of care.

But the HIGH DEPENDENCY HIGH RISK FOOT should always be in the Health Care System.

Just my humble opinion

regards David

Davo,

Its the same old same old......

I have worked for 3 PCts since 1996. All 3 have undertaken audits on patient satisfaction, and the results are always the same.

1.patients like the service they get
2.patients like the quality of service they get
3.patients like the Podiatrists who treat them

4.Patients want more treatment
5.Patients want the treatment on their doorstep rather than catching a bus (which is free!)

Usually, those patients who are 4 and 5 are those with social footcare needs.

We are public servants, but the public wants us to be PUBLIC SLAVES

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“Body: A thing of shreds and patches, borrowed unequally from good and bad ancestors and a misfit from the start”

Ralph Waldo Emerson

David,

To keep you up to date, the Great Yarmouth and Waveney NHS Community Services Podiatry Department has implemented the strategies you suggested.

The team is positive, motivated and moving forward,

Regards

Su

Sadly, patients don't always seem to realise that the NHS provides what is needed (as per its own assessment), which isn't necessarily the same as what the patients want.

What the news report doesn't tell you is the scale of the caseload - 4 complaints out of 100 patients is rather more worrying than 4 complaints from a caseload of 1,000; & I suspect we're talking several thousand!

Sarah

Dear Sue,

May i refer you to a post on here 22 May 2008 regarding complaints about the pod dept.

This was from the Lowestoft Journal.

Recruitment and retention of staff is a difficult and expensive exercise.

I would consider retention of staff is preferable to retention of an unpleasant and objectionable member of the public/patient.

I have been a party to extremely unjustified and unpleasant complaints from aggrieved patients who will accuse staff of everything including stautory rape in order to get their way ( a bit of an exageration i know ).

One patient took months to go through the complaints process as they would not accept a polite no to their request for social non essential nail care.

Complaints cost a fortune in time and money and lead to disillusion for the member of staff whom the complaint is against and today the complaints procedure is such that management rolling over and kicking member of staff is easier and cheaper.

That is until staff resigns and moves away to another area.

Then one has to advertise and recruit all over again.

Also clinics fall behind and waiting lists build leading to even more complaints.

So it is a lose lose situation.

This is a problem not unique to your emplyer but i am very familiar with that area as i worked there for 20 years, also ran a PP for 10 years in the area as well.

Here in Aus we have different problems as the way things work here is different.

The formal health care provider only provides Acute Health Care to the at risk foot.

All else is in PP with some help via partial rebate system for those defined as being at risk. Private Health Insurance picks up most of the rest with rebates.
Many have to pay the full fees with no assistance.

So as you can imagine there are problems here too with provision of care to those who need it.

One of my local Hospitals Means Tests High Risk patients before admission to the at risk foot clinic. The other does not so guess which one we refer to ?

I understand one of your colleagues will be joining me here in Sunny Sydney sometime soon.

Best wishes

David

As an aside and spoiler it is about time GtYWPCT changed its structure again.

So will it revert to 2 PCT's along County boundaries or will it be absorbed into Norwich/Norfolk and Ipswich/Suffolk along county boudaries ?

David

I don't really see how one can comment authoritatively on the current situation in an organisation with which one has had no ongoing connection for over 2 years.

In the last 6 months alone the department has undergone some considerable changes, and as a result of those staff morale has generally improved. We now worker closer than ever with specialist teams and other disciplines.

In common with all NHS Trusts, NHSGYW separated commissioning from service provision in 2008. This in itself constitutes a structural change, and appears to be successful for those of us involved in patient care. There are further changes ahead, and we will have to wait to see what the outcome of those will be.

We receive very few complaints relating to specific staff members, and I don't think that it's a major factor in anyone's decision to leave the department.

By the way, I won't be 'joining you' as such in Sydney - I intend to work in the public sector, closer to where we'll be living.

And just to be completely clear, I will be sad to leave my current job (& my colleagues, with whom I get on very well); my reasons for migrating are nothing at all to do with my employer, and are all about my feelings for Australia & the life we can have there.

Sarah

David

I was speaking about the PRESENT situation. I feel there is no value in going over what has been only in a sense of learning from it and going forward.

Individual situations will always arise in any work place, that's life and not altogether representative of the whole picture.

Glad to hear you are finding Australia more to your taste, it is a shame we didn't meet up when I was over there last year but never mind this is an excellent way to keep in touch with your thoughts and opinions,

Su

Dear Sarah,

You will probably miss the pod conference here in may which is on the Gold Coast south of Brisbane.

I will be going and so will a couple of my colleagues.

Should be fun.

We have had strange weather here, Turramurra had the highest rainfall recorded in 24 hours here last Sunday. I believe it was 112mm.

Where do you hope to be living?

I have enjoyed living here and am currently applying for permanent residency so i hope to be allowed to stay here.

regards david

David

Yes, looks I'll miss the pod conference, but never mind there'll be another next year I'm sure! I spent some time on the Gold Coast a few years ago - but the surf was rather crowded, so we headed North!

The weather's been a bit upside-down for the last year or so hasn't it?!

We'll be living a little way up the coast from Sydney itself. I'm so looking forward to catching up with everyone, not to mention living in my 'adopted homeland'. I'm looking forward to getting Citizenship - any country that eats the animals on its emblem has got to be one to sign up for!

Sarah

Dear Sarah,

Just remember that at the moment an animal not on the flag has been eating Surfers and Anglers foolish enough to venture into the oceans or stand on rocks too close to the ocean.

I have just booked up for the conference so i am a few dollars poorer.

But it will be the first time that i will have visited QLD and the famous Gold Coast.

So i am looking forward to it. Will drive up and stay over night somewhere to break up the 10 hour drive. So will make a small holiday of the drive.

The weather here is very good at this time.

The Govt today announced that it will be stopping the Skilled Migration Visa's for trades people. Health care workers not as yet affected by govt . So hopefully i will be successful with my perm residency application. Employers part approved now i have to submit my part of application.

So hopefully Australia will become my new home.

Hope to meet you sometime soon.

Another former colleague of yours is considering a job in South Australia.

What have i started with my former employer and its employees.

regards David

David

I'm not a water baby so the risk of being munched by a shark isn't too high for me! But the Surf Dude grew up in Aus so understands the risk & how to minimise it.

It should be a pleasant temp up on the Gold Coast in May - it's not too bad a road trip really. There are lots of lovely places on the way to stop - maybe Byron Bay?! There used to be a fab pie shop, I'm guessing it's probably still there. I'm not really into pies, but I had one of there's & it was excellent!

I don't think you started anything! I originally intended to migrate in 2005, and for personal reasons chose to delay it. In the meantime I changed job & moved house before finally submitting my 175 application. I know who you mean - we used to joke about opening a surf 'n' bike shack on the beach!!

As I understand it, they're not stopping the skilled visa - they are removing some trades from the Critical Shortage List, & possibly the MODL; and reducing the qota for the skilled migration programme. I'm glad I got my visa when I did...

I'm sure our paths will cross sooner or later - podiatry is such a small profession that it's bound to happen at some time!

Best wishes with your residence application.

Sarah