'If things get worse...'

Viv is one of many people who have been given advice at outpatients clinics along the lines of 'if things get worse, come to the hospital as a matter of urgency'.

She had a bad couple of days at the start of the week so, after much consideration, we headed off to the Lister yesterday at 12 noon. We arrived there at 12.45, it was quiet, we were seen quickly, and by 3pm there was a plan to do a CT scan and admit her. The doctors (not neurologists, so not experts in her condition) asked all sorts of questions, but seemed especially concerned about how Viv manages at home - I told them I'd looked after her for a year, we have a bed downstairs and she can manage stairs normally, but didn't seem convinced. It was as if they have a mate running a care agency who is on the lookout for more business.

Apart from the CT scan at 5pm we then seemed to disappear into some sort of void until 10pm.

Her condition involves bladder problems ... messy ... and I did have the means to clear up, but she got through the two pairs of trousers I had with me by 6pm. She had nothing more to wear on her legs, and covered them with her coat to keep warm; there was no offer of help from staff. No offer of a blanket. The waiting area was filling up, undoubtedly some cases more urgent than hers, but the staff seemed to only interact with each other, and not with the patients, unless they had a specific task to perform. The presence of patients was almost an inconvenience getting in the way of running the department; nurses hid behind computers, chatted away in the 'clean utility' room, and took blood pressures periodically.

After she had been admitted to a ward it struck me that, once it had been agreed that she needed to be admitted and seen by specialists, we could have gone home, to go back in when a ward space was available. It wouldn't work in all cases, but she would have been able to rest better in a home environment, and I am perfectly capable of looking after her in the short term. Surely there must be opportunities for more flexibility in the way the NHS works that would free up space and staff and help ease the pressure that we all hear about all the time?

Next time a specialist says 'if things get worse come in to be seen' we'll know what we're in for; it'll have to be really bad to make us want to go through this again.