Up Close and Personal with the NHS

We had our first (only) encounter with Britain’s National Health Service yesterday.

Bob’s cough kept getting worse, despite the cough medicines and lozenges, and our granddaughter and her partner suggested we take him to one of the NHS’ Walk-In facilities. There were two nearby (we walked from our hotel).

When we got there, we took a number from a dispenser and sat in the waiting room. The system was that the people at the desk would call a number, and you would then register, explain what was wrong, etc., and wait to be called back to be seen. Our number was called almost immediately; when we described the problem, the very nice woman behind the desk put a monitor on Bob’s finger, pronounced his oxygen levels low, and said she was putting him at the “head of the queue.” (She also said that she very much regretted that she would have to charge us for service since we weren’t British. The cost was fifty pounds.)

Bob was called back within ten minutes to see a nurse practitioner. She took a history, examined him, and called an ambulance to take him to Nottingham University’s hospital. She said she might be “over-reacting a bit–I hope so” but “better safe than sorry.” The ambulance drivers were there almost immediately, and I went with him in the ambulance while our granddaughter and her partner drove separately. I can’t say enough about how efficient and caring the EMTs in the ambulance were. They were also very proud of the vehicle itself, which they explained was new, and certainly looked well-equipped to my untrained eye.

We were taken to emergency (they call it A and E, for Accident and Emergency). Again, we were impressed with the efficiency of the process; first, an evaluation and a number of lab tests, then further tests based upon the initial results. Throughout the (very long) day, personnel kept us informed of where we were in the process, why they were doing what they were doing, etc.

The concern was that he was having a pulmonary embolism. Thankfully, the scans ruled that out; however, what we thought was a bad cold (and what the ship’s doctor had shrugged off as a cold or allergy) turned out to be a heart problem that has evidently been developing for some time and had not been detected by his cardiologist on his visit a week before our trip. The doctor explained that his symptoms were the result of fluid accumulation–probably the result of unusual activity on the trip. He was admitted for a short stay so that they can eliminate the additional fluid and he can safely fly home. (Only then were we asked whether we had insurance; a nurse took our information and nothing more was said about payment.)

To say that we had a stressful day would be an understatement. I extended our hotel booking in Nottingham and my son managed to change our flight home from tomorrow to Saturday (unfortunately, we lost those first-class seats we’d used our frequent-flyer miles to secure..).  My granddaughter and her wonderful partner pretty much saved what sanity I managed to retain. So at this point at least, it looks to be an “all’s well that ends not so badly” situation.

When you live with an 80-year-old husband with heart problems, you see the inside of a lot of emergency rooms and hospitals. I don’t know whether my experience yesterday was representative, but I was very impressed with the efficiency and thoroughness with which Bob was treated. There were adequate numbers of personnel, and they were unfailingly pleasant and responsive. Our waits were for lab results. Doctors and nurses took time to ask questions and listen carefully…I really could not have asked for better or more reassuring care.

The systemic differences between my previous experiences at home and here really boiled down to two: 1) The clinic and hospital were both in old buildings and certainly didn’t have the physical amenities/decor of most American hospitals. They were clean and well-equipped, but not the sort of plush environments we generally encounter in the U.S.  2) At home, unless he was having a heart attack, treatment wouldn’t have commenced until payment had been arranged–I always check him in by providing insurance information, etc.

As academics like to say, anecdotes aren’t data. But my anecdote says lots of good things about the NHS.


  1. Please give Bob (and the Sarahs) our love. Hope everything goes well. So sorry the trip had to end on such a scary note.
    Eileen and Irwin

  2. Same here from me and Jerry…..looking forward to your returning safe and sound.

  3. Great to hear Bob is on the mend. Ivan got a fish bone caught in his throat on one of our trips and we had the same experience — great. And when I went to present his passport and medical info while he was being treated the lady at the A&E desk looked at me, smiled and said “you are a guest in our country. This is an emergency. We do not need a card.” He was treated so quickly I barely had time to use the loo and he was out, all of which many of my friends refuse to believe is possible as all they have heard are the right wing and Republican lies about national health, long waits, poor service etc etc….. Glad to hear I did not experience a fluke!

  4. Thank you for sharing your story. It is scary to be so ill so far from home but fortunately you have family with you. That makes a big difference. Your story reminded me of Jay Lenos story. I think it was his mother in law that had a serious illness while they were in England. They were so sorry to bill him for a minor amount of money for a major illness. He was stunned at how great the experience was. We have much to learn from the Brits and the Canadians. As you noted, it is NOT about the building. It is all about the people.

  5. Sheila, I’m glad the situation was resolved for you and Bob, even with all that you both had to endure. I hope he soon makes a full recovery! The NHS system proves that it can be done. One can only hope. . .Nah, probably won’t happen here.

  6. Safe trip home and full recovery for Bob; as you can see, many of us are thinking about both of you and keeping you in our prayers.

  7. So happy that you were treated so thoroughly! Thanks for the report and send my regards to your spouse. May the rest of your visit go smoothly. Safe travels.

  8. Maybe anecdotes aren’t eligible for research citations, but, so far, all the personal anecdotes I’ve heard (from real human beings) tend to be positive NHS experiences. Now, on the other side, people like to use aprocryphal negative NHS experiences, presumably as evidence to show, in a big cognitive jump, that our current level of crazy medicine is a good thing. Thanks for your report that medicine can be practiced in caring and competent ways outside our own hallowed halls, and the report that your husband was cared for in such a caring way.

  9. The only American institution that I believe gets respect for health care are the Mayo Clinics (Cleveland clinic too) and Hospice. Now those organizations know what they are doing and I’ve never heard a bad thing about them. I’ve experienced the ‘socialist’ health care system in Germany and it’s far superior to ours. Just my 2 cents.

  10. ALG’s terminology regarding Bob being “treated thoroughly” reminded me of my “thorough” treatment six weeks ago in a local hospital. I spent two days hospitalized for a month, repeatedly answering questions about chest pains and breathing problems I did NOT have and have never had. My daughter-in-law and I arrived at 4:30 p.m. Sunday to find the ER parking lot full; she dropped me off to be admitted and parked in the garage. ER staff acted quickly performing basics before the questioning began. They were determined to give me heart disease; I had a viral flu, dehydration and bladder infection. At 2:15 a.m. Monday I was finally admitted to a room where more specialists questioning and tests began. The cardiologist was not pleased at being called in because my tests were normal; he released me that day just one hour after other doctors said I needed to remain hospitalized for more heart tests. His diagnosis at the follow-up appointment was that severe dehydration was my primary problem.

    Explaining repeatedly that my deafness (beginning 37 years ago) and disability (21 years) were due to inner ear diseases went unheard (pun definitely intended); they were going to “help” my hearing problem and “do something” about my disability. More specialists and tests were ordered. My hospital in-patient co-pay is $250 per day; how many thousands of dollars will Medicare be billed for these unneeded doctors, specialists and tests? This is a good example of why the cost of medical care in this country is constantly going up; evidently NHS is interested in diagnosing and healing, not making money.

  11. Glad they caught it, and are treating him. Sounds like the medical staff weren’t trained at the same place as the people in Stratford Upon-Avon. Best wishes to you and Bob. I’ll keep you in my thoughts. Hope the extra time in England leads to a positive interesting experience, and you have a safe trip home.

  12. My thoughts are with both you and Bob. Long flights can be an ordeal (sigh . . . first class) without this added stress. Please take of yourselves.

    As for the topic . . . while in Australia for 9 months, I had to enter the medical system a time or two. My experience was very similar re decor, competence, speed and ease of delivery.

  13. So glad Bob is better. Of course, I am a believer. Which should we value more, great care at reasonable prices, or great care at unreasonable prices generated by frills and extras usually found only in 5 star hotels. The Brits and others know what’s important: care for all. We know what’s important: profits.

  14. I don’t think the role of profit in medical care is necessarily a bad thing per se. As in anything else, one needs to look as if the “free market” in any given situation is really that. But what does seem clear is that the bogyman of completely inefficient “socialistic” healthcare systems in other countries is largely simply that……..prone to depend on anecdotal “horror stories” and pointing elsewhere to draw attention away from real problems in the USA.

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