District nurses

Tiglath

Thanks everyone - they've now discovered something in her chest following an x-ray which doesn't sound great, so I've no idea when she'll be coming out now or what further treatment she needs. They've already said her kidney function is very poor. Will know more tomorrow.

margaretclare

Community nurses normally use the dressings etc which will have been prescribed for individual patients. Normally someone leaving hospital will have been given enough dressings from the hospital pharmacy until more can be obtained via a GP prescription in the usual way. Community nurses travelling in their own cars couldn't possibly carry enough for all the patients they meet on a daily basis, although obviously they will have some basic ones.

Amputation of toes for gangrene is a very common complication of poorly-controlled diabetes. Unfortunately it may not stop at one toe, or two....

Tiglath

She doesn't have diabetes, has never been a drinker or smoker, has eaten plain nourishing homecooked food all her life, has kept active - she's a textbook model for doing the 'right' thing, but she's 80 and things start to break down eventually. Anyway, we'll just do what we have to do and take it from there once we know more. The finance department of the hospital is liaising with her insurer to figure out what's covered and what isn't.

margaretclare

Tiglath wrote: »

She doesn't have diabetes, has never been a drinker or smoker, has eaten plain nourishing homecooked food all her life, has kept active - she's a textbook model for doing the 'right' thing, but she's 80 and things start to break down eventually. Anyway, we'll just do what we have to do and take it from there once we know more. The finance department of the hospital is liaising with her insurer to figure out what's covered and what isn't.

Hope you're not offended by what I wrote. It's just that I know it to be true. The guy across the road started with a toe ulcer and ended up with a leg amputation.

Your mum is a bit like me. I'm just being treated/investigated for diverticulosis/diverticulitis which is another thing that happens with advancing age. It happens also with 'Western people not eating enough fibre' - definitely not true of me.

PS: I used to be a community nurse.

Tiglath

No, not at all, Margaret. Anyway, x-ray is clear (she must've got confused when telling me) and her kidneys are now completely normal since she's properly hydrated. She's out of bed and going to try walking tonight. Tomorrow they're doing a heart echo-thing and a leg ultrasound to see what's happening with bloodflow and decide if they need to do an angioplasty. The occupational therapist is starting the care package thing on Monday with a home assessment, so if all goes well, she'll be out midweek and we'll all be based at my sister's where there's a downstairs bathroom and where I can work remotely for the rest of the week. So it's all looking pretty positive.

FBaby

Sounds like she is getting great care and using her stay to do a thorough investigation, which is a good idea as so many older people avoid going to their GP with any concerns, hence letting things get worse until it is too late. This way, they can ensure she is healthy and not requiring further medical care.

LondonDiva

Tiglath hope all is going well for your mother.

Your GP surgery is making things up - they cannot refuse a temporary registration as long as they have an open list (taking on new patients).

If there is any problems, speak to the Practice Manager and ask if the practice has somehow got a waiver to the national GP contract as you will want to follow up this poor decision by NHS England with them directly. Also note that this should have been flagged on their NHS Choices page and also (in my opinion) advertised to patients.

If they are still resistant, contact NHS England - all you should need to register is your mother's ID documents to prove who she is, details of her current GP (so they can access her records / seek advice as needed and send details of all care she's received once she goes back) and proof of your address - everything else is them trying to swerve a potentially high maintenance patient.

If you do complain (http://www.england.nhs.uk/contact-us/complaint/) make sure you frame it as a complaint about NHS England permitting a practice to drop key parts of the contract rather than the practice's decision. (one gets dealt with and responded to by the complaints team and commissioners at NHS England, the other gets passed to the practice)

Tiglath

Thanks - when she comes out, we'll be based at my sister's. Unfortunately we're not there yet - she's having the angioplasty on Monday and possibly a bypass later in the week. Don't know what happens if they don't work - possibly amputation to the ankle or above the knee maybe. Also got find out if her insurance will cover the angioplasty - if it doesn't, I guess they transfer her to the NHS somewhere.

silvercar

Your GP surgery is making things up - they cannot refuse a temporary registration as long as they have an open list (taking on new patients).

This could be the issue. I am near London and some of the local practices often close their lists for a few months at a time.

jackyann

silvercar wrote: »

This could be the issue. I am near London and some of the local practices often close their lists for a few months at a time.

Yes, I think that is what is happening.
The surgery did say she could be a patient if a permanent resident, but I suspect they were just shortening the explanation: that if a permanent resident, the health authority would be obliged to allocate her.
Happens a lot in some areas, and is another cause of A&E visits! But I am sympathetic to the GP practice: if they have too many patients and provide poor care, they are at fault; if the health authority allocate extra patients, it is clear where responsibility lies.

Unfortunately, modern life means that many families are in OP's position.