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.