Author Topic: Jersey General Hospital  (Read 62126 times)

Offline man in the street

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Re: Jersey General Hospital
« Reply #180 on: November 09, 2013, 11:54:28 PM »
 i  had a camera  inserted the other day and can go  back  with in  three months for another check.
 and this was  rapid .
  my wifes   problems  ortho pedic   and   skelatal  for want of a discription ,  are at a total snails pace and a shambles .
  she has found out that she has a  appointment,    but  no letter to say she  has one ,  so will wait and see if the letter  arrives .
  and mr dunlop  at the general is a good  bloke,  his work is spot on . fixed  my wife ,  sadly  the  wait (    only  12 months)    for  phisio ,   was  a great  step back,  and still on going to day .

Online gladiator

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Re: Jersey General Hospital
« Reply #181 on: November 12, 2013, 05:18:27 AM »
TREATMENT of CANCER in JERSEY.

Ageofaquarius.
Speaking from experience I can say they move damn quick if there is a serious cancer going on, leave aside all the waiting times etc., the consultants work on facts and if a tumour is proved they don't hang around, all in all its a good service.

End.

It is very difficult to comment objectively on a hospital service based on anecdotal experiences. Like any other doctor, consultants should work on evidence-based facts and I am very pleased that you had good experiences. To state a high standard of care, it has to be evidenced by good quality data judging the outcome, such as survival rates , re-admission rates, infection rates, patient satisfaction, etc. and should be in the public domain, so the taxpaying public and everyone else should be informed about the results how well the hospital performs with their invested money  and not kept secret in my humble opinion.

However to collect good quality data is difficult, as for the same cancer type it can vary a lot depending on the age group, available treatment, equipment, medical, nursing and community expertise. Also as for Jersey whether the patient followed the private care pathway because recent reports indicate that the general public are having to wait overall unacceptably too long.

Diagnosing cancer early is the most important step in order to survive.

Now this is the main problem in Jersey, due to the terrible long waiting times on all levels and paying the GP £38 pounds per visit which a lot of people can’t afford. Again there would be an advantage for the private patients which shouldn’t be nowadays in my humble opinion. Also the provision of easy accessible expertise and equipment is vital.

There are some cancer statistics of cancer incidence and relative survival rates of Jersey and Guernsey in the Channel Islands Cancer Registration Report incorporating data 2007-2009 published July 2012. But the data is limited as not all cancer types are incorporated and the data is only compared to the Southwest and not to the UK.

https://www.gov.je/SiteCollectionDocuments/Government%20and%20administration/R%20CI%20Cancer%20Registration%20Report%202012%20MC%2013012013.pdf

As said before the UK cancer survival rates and care is in some cancer types poor, compared to other European countries and the rest of the world. However there are global world cancer studies published and on the way to objectify this.

Interestingly, Jersey’s neighbour France is very well known to provide excellent cancer care.

The health system in France is regarded as delivering a high quality service with freedom of choice and generally no waiting lists. People can get the treatment they need irrespective of their social or work status. However, this quality comes at a price: health expenditure in relation to GDP (Gross Domestic Product) is among the highest in Europe.
The costs of cancer diagnosis, treatment and surveillance are completely covered by the Sécurité Sociale.

Analysis of the relationship between health system organisation and cancer outcome is complicated and requires more information than presently available in particular in Jersey.

What are the investments into cancer care in Jersey which includes the community, Macmillan Nurses ,who do an excellent job, cancer screening programme, further cancer training for nurses and doctors, etc? What are the waiting times for oncology (cancer department)? What are the waiting times until the first diagnosis of cancer and first treatment? Are they comparable to the UK? Why is there no such data in the public domain as in the UK and the rest of Western Europe?

Why not be sensible and take advantage of the excellent cancer care by France and arrange a special contract with France to reduce waiting time and improve survival rates for the Jersey people? There should be enough civil servants on excellent salaries obviously adapted to their competencies to arrange this, or maybe not?

What is the responsible and accountable Health Minister Anne Pryke going to do about upgrading Jerseys’ cancer care?

Online boatyboy

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Re: Jersey General Hospital
« Reply #182 on: November 15, 2013, 12:15:34 AM »


It is always good to praise staff when they are working hard and coming up with positive results. So congratulations to the four teams for the awards given to by the panel, as reported of course they are highly trained.

The article in the JEP though, was dismal and reeked of spin.

Any half decent six form school reporter would have done better by asking some reasonable questions.

As this was an “ in house “ panel, who sat on the panel ? names please and position within the management of the hospital .
One would hope that the judges were not in any way connected to the departments being judged, as to be judged by one’s own management must arouse complaints of self interest and the judging being conflicted.

The three separate categories were – patient safety, customer care and value for money.

Were nationally recognised NHS standards used as benchmarks for the Jersey teams, or local standards bench marked against last years local achievements?

Again if it was local standards does this indicate that value for money means that “ private care “ has  reduced in cost, or that departments are running more efficiently with fewer staff ? It could mean that more islanders are being seen and treated sooner compared to last year, but the article on-line  does not make any of this clear.

The general view is that the waiting lists are too long unless you pay. There are obviously some excellent and professionally dedicated staff at the Hospital.

This JEP reporting is so devoid of real facts, all it achieves is to patronise the reader. Clearly the JEP feel we are close to stupid.

JEP  [ No comments allowed ]

TEAMS from across the Hospital have been recognised for their dedication and commitment to providing Islanders with good quality care.
The four winning teams were honoured in three separate categories – patient safety, customer care and value for money.

A total of nine groups of staff from Health and Social Services made presentations to a judging panel at the department’s annual Quality Improvement Awards.
On Friday, the bowel cancer screening team was announced as the overall winner and were presented with their award by Jersey’s Bailiff, Sir Michael Birt, and Health chief executive Julie Garbutt. They will receive an additional £1,000 to invest in their project.

http://www.thisisjersey.com/news/2013/11/13/bowel-cancer-screening-team-receive-hospitals-top-award/

BB

Online gladiator

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Re: Jersey General Hospital
« Reply #183 on: November 19, 2013, 03:42:21 PM »



You might find this interesting to read. I stumbled over this report in public domain from the GMC visit to the A&E department of the Jersey General Hospital on 23.01.2013 which was a targeted check:

Just to explain the background:

Due to the A&E crisis in the UK in view of overwhelming patient load and difficulties in recruiting A&E ( Emergency Medicine) doctors,  there is a lot of attention paid now on making A&E trainings post attractive and ensuring that A&E trainee doctors receive the best education and training  in order to provide patient safety and improve recruitment.
Within the NHS structure the Deanery is the responsible organization for postgraduate medical and dental training and commissions training from the employer ( Hospital ) normally through an educational contract with the unit providing postgraduate education. That means that the hospital is responsible to ensure that adequate training is provided otherwise they would loose the educational contract which means again they loose money.
Doctors are governed by the GMC. The General Medical Council is the independent regulator for doctors in the UK. Their statutory purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. The GMC has strong and effective legal powers designed to maintain the standards the public have a right to expect of doctors.

GMC ( General Medical  Council) VISIT TO JERSEY GENERAL HOSPITAL

GMC Quote:

These checks were prompted by an increasing number of concerns reported to the GMC about emergency medicine and particularly relating to very junior doctors in training working at night unsupervised. In April 2012 we completed an audit of emergency department rotas, which found 20 sites that did not clearly demonstrate on-site supervision from a senior doctor in the emergency department overnight. In particular our standards for the supervision of foundation Year 2 doctor’s were being breached.

My comment:

Recent qualified doctors are called Foundation doctors and Yr 2 means they are in their 2nd year of postgraduate training.

GMC Quote:

Core and foundation doctors in training we spoke to said they felt unprepared for their night shifts and out of depth due to the lack of middle grades and consultants available within the department overnight. Foundation doctors we spoke to said they have experienced problems in attending teaching due to the rota and being released for teaching.

Patient Safety
 
The emergency department does not have clear protocols for escalation of patient cases advising core and foundation doctors working alone at night regarding when to contact middle grades and consultants for advice.

Consultants review night time working and look over notes of patients remaining in the emergency department; however notes of patients that have been discharged or admitted to wards are not reviewed. Doctors in training are missing out on key learning opportunities and without senior review run
the risk of becoming more confident without necessarily becoming more competent.


http://www.gmc-uk.org/static/documents/content/Jersey_General_Site_Report.pdf

My Comment.

Most people in the NHS and Jersey’s health service have a vocation and are trying to do a good job. However there are serious problems arising from staff shortages in key areas and a chronic shortage of accountability and responsibility among some administrators and clinicians.
Nurses and midwives are governed by the Nursing & Midwifery Council (NMC) and doctors by the GMC who set the standards of practice. Any incidents of falling below standards should be reported to their respective professional bodies to be investigated.

However Managers do not have an overarching professional body to which they are answerable to. That means poor performing managers can move around hospitals or posts (often resigning rather than being fired) without impedance and even with golden hand shakes paid by the taxpayers.

Is there a two tier health service in Jersey of public care and private care making a difference between social and work status of the patient but all paid for by the taxpayers?

Where is the evidence that managers put patients’ safety as their highest priority, if they are not interested to report and publish the hospital’s performance and annual financial report to prove the public that they get high quality care and feel that their lives are in safe hands for their money ?

Has the Health Minister Anne Pryke followed the Mid Staffordshire NHS Foundation Trust Public Inquiry in particular the final report published 6 February 2013?

Quote:

“a story of terrible and unnecessary suffering of hundreds of people who were failed by a system which ignored the warning signs of poor care and put corporate self interest and cost control ahead of patients and their safety

http://www.midstaffspublicinquiry.com/sites/default/files/uploads/press_release_-_final_report.pdf

My Quote:

Considering that the Wessex Deanery also visited the Medical and Orthopaedic Department raising concerns regarding the supervision of the junior doctors and the experience level of the Medical middle grade doctors in 2012 and made recommendations is rather alarming.

So is Health Minister Mrs Pryke going to do her job and stand up for the public who elected her and pay her, and ensure that the hospital managers get a grip and don’t let people die unnecessarily?



Online gladiator

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Re: Jersey General Hospital
« Reply #184 on: March 02, 2014, 04:53:54 AM »
Interesting news in the Guernsey Press which should be given to the Jersey Health Minister and team as homework to read, review and follow.

March 1, 2014 1:29 pm
Watchdog tells doctors to justify their charges
DOCTORS will have to justify their charges in a landmark investigation by the regulator.

Quote:

‘One of the things we do as part of our competition focus is to look at whether a market is delivering good outcomes for consumers or whether there are recommendations to be made as to how the market could get better,’ he said.

http://guernseypress.com/news/2014/03/01/watchdog-tells-doctors-to-justify-their-charges/

First small  step in the right direction but excellent quality of health care should not be based on the size of your wallet. However what a remarkable change of attitude of Guernsey's authorities to start doing "checks and balances". Mrs Anne  Pryke and her colleagues might want to pay some attention to this. 

Offline ageofaquarius

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Re: Jersey General Hospital
« Reply #185 on: March 03, 2014, 04:55:12 AM »
Is this GP's or Consultants at the hospital?  GPs over here should justify their charges, £40 for taking your blood pressure and handing over our quarterly script is I think a tad excessive.

Consultants at the hospital don't charge if you are referred by your GP, if you don't mind the 12 week wait, in which case you go private, which does cost plenty - some are more reasonable than others. Some consultants will see you initially privately but if you don't have private insurance are happy to follow you up on the public sector. 

Online boatyboy

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Re: Jersey General Hospital
« Reply #186 on: May 14, 2014, 04:29:06 AM »
Thanks so much to a personal and close friend who forwarded the link below regarding another islander being let down by ridiculously long consultant appointments at Jersey's General Hospital.

Mr Colin Egr'e waited months to see a consultant when he eventually did, he was diagnosed with advanced prostate cancer.

Mr Egre being telling his side to the BBC.

Click on BBC link below, then click on resume box the interview will be found at 59minutes and 40 seconds along the lower bar which you can slide.

http://www.bbc.co.uk/programmes/p01y5cwf          —       

There are some excellent clinicians and nurses who are professional and caring in their work. However patient waiting lists have not shrunk under the management brought in by Anne Pryke and this is the result.

Anne Pryke should resign or be sacked by the Chief MInister as an incompetent, she has had long enough to do some good at this bloody hospital. As if a new building will make any difference when islanders are treated like this.

I am sure we all wish Mr Egre a full recovery.

Thanks to the BBC for keeping this on line for 6 days and to bother interviewing him.

Boatyboy.
« Last Edit: May 14, 2014, 04:57:44 AM by boatyboy »

Offline moot

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Re: Jersey General Hospital
« Reply #187 on: May 14, 2014, 04:49:31 PM »
BB Is this Colin Egre, the former deputy ? I agree with you that Anne Pryke is useless. She is weak, diddery, complacent and doesn't have a grip. She waffles when interviewed. She is not a boss..
She should go at the earliest to save lives. There are too many chiefs and not enough Indians at the hospital
I am sure there are many good stories but I have heard some horrific ones re misdiagnosis etc.  Some consultants are far too concerned with private patients and their money that others suffer. I was told one consultant who recently retired earned £1 million pa

Online boatyboy

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Re: Jersey General Hospital
« Reply #188 on: May 14, 2014, 11:41:31 PM »
Interesting Moot,

I don't know if it is the same Colin Egr'e, however this makes a complete nonsense  of the figures given out in answer to Deputy Higgins questions regarding waiting times to see consultants. I see pain is only nine weeks, I bet you my last pound that if you were a states member in pain that would not be the case.

Or how about,

Orthopaedics 1246    people   waiting    with a waiting time given as     21 weeks.

To try and be fair they say that if your GP says it looks serious they you can be fast tracked. The problem is with cancer and many other illnesses, you may suffer mild symptoms at the beginning but still have an aggressive condition, if it could be a killer illness straight in for proper and detailed tests. In the UK the NHS I believe have a maximum waiting time to see consultant of six weeks.

Consultants working for the Government ( NHS ) are only allowed to do see private patients on their days off or holidays there is a set stiff procedure that applies to them all. If they do not like it they go and join a private practice.

The question is so basic, HOW are consultants in Jersey managing to run their own private businesses after a busy 40 odd hour week attending to the public.
If they were doing a full week, they would be tired, as many people are -  after a normal week at work.

Answer they are not. They are not regulated anything like their UK opposite numbers.

I cannot speak for others but in all the job's I have had, if I had asked my boss for time off ( while being paid ) to go earn extra money working somewhere else they would have shown me the door.

Excellent questions from Deputy Mike Higgins. Can anyone really believe the answers are truthful ? Certaily not Colin Egre who said he waited months.

2.16 DEPUTY M.R. HIGGINS OF ST HELIER OF THE MINISTER FOR HEALTH AND SOCIAL SERVICES REGARDING THE WAITING TIMES FOR MEDICINAL PROCEDURES:

Question

1.  Further to the answer given on 19th January 2010 (5026) would the Minister provide an update, for each medical discipline/specialism (for example: cardiology, neurology, orthopaedics etc), of -

a.  the number of consultants employed on a full time and part time basis in each area?

b. (i)  the number of non-private health insurance people on waiting lists to see a consultant in each area; and

(ii)  the average waiting time for these to see the consultant?

c.  (i)  the number of private health insurance people on waiting lists to see a consultant in each area; and

(ii)  the average waiting time for these people to see the consultant?

2.  The total number of operations performed in each discipline at the hospital for each year from 1st January 2008 to 31st December 2013 stating -

a.  the number of private and non-private operations carried out in each discipline for each year;

b.  the cost of performing these operations in each area for each year for non-private health insurance patients and private health insurance patients?

3. The number, disciplines and costs of locums and agency nursing staff employed by the hospital for each year from 1st January 2009 to 31st December 2013?

http://www.statesassembly.gov.je/Pages/Hansard.aspx?docid=ab8634a49ff16b6be937e114733a68d4_StatesAssembly

BB




« Last Edit: May 15, 2014, 12:47:46 AM by boatyboy »

Offline ageofaquarius

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Re: Jersey General Hospital
« Reply #189 on: May 15, 2014, 01:43:59 AM »

Initial referral to the hospital would have been from his GP.  He would have taken a PSA reading which if it had been dangerously high, he would have been seen on a soon to urgent basis. 

We have an excellent if not overwhelmed urology department, as well as a regular UK visiting urologist specialising in prostate cancer. 

Perhaps the finger should be pointed at this GP for late referral.

GPs are often a bit slow at referral and would rather keep the patient on their books, after all patients are a cash cow - not so at the hospital.

I could write a whole dialogue on JGH and why it is failing us, perhaps after dinner I will add a chapter or two.  The biggest problem is staff shortages of clinical staff.

Offline Fritz

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Re: Jersey General Hospital
« Reply #190 on: May 15, 2014, 03:44:52 AM »
There is something seriously wrong with the health dept.
A few months ago I felt a little lump behind my ear. Felt like a little zit but when I had a look, with the aid of a couple of mirrors, i couldn,t see a head on it.
Over a couple of weeks i felt it getting bigger, not painful or itchy or anything, but decided to go and see my GP.
When I got there, he diagnosed it as a blocked sweat-gland. (Basically a zit by another name).
I asked him to lance it, (As GP,s used to do with boils etc), but he refused, telling me that it was a surgical procedure and could no longer be carried out by a GP.
He made an appointment for me to see a specialist a few weeks later at the General Hospital.
A few days later I was walking up the road and it was very hot. I felt behind my ear and a waxy substance was oozing from my ,"zit". It wasn,t pussie. My blocked sweat gland had un-blocked itself and, after a little bit of squeezing, the lump completely disappeared.
I informed the General Hospital, but they insisted that I keep the appointment so the consultant could confirm that I was ok.
I kept the appointment and explained what had happened to the consultant. I apologised for wasting his time, but he insisted on examining my ear.
He made a few notes, and mumbled something about a collapsed cyst. (IE: Burst zit).
I could not believe it when he made a further appointment for me to visit again six months later for a routine check up on my now non existent, "Zit".

Great service you might think. And I might agree if it were something serious. But how much money has my,"zit", cost the taxpayer to date, let alone its further appointment with a specialist?

It all boils ,(pun intended), down to whoever decided that GP,s are no longer qualified to lance boils, (Or blocked sweat glands).

The way I see it, the doctor is paid to see me. He then forwards me to a consultant who is also paid to see me, and doubles up by insisting that he is paid to see me again.
The doctor,s and consultants fees must be astronomical, let alone the administration costs.
I,m actually starting to feel guilty for not having the dexterity to deal with the problem myself.

 

Offline ageofaquarius

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Re: Jersey General Hospital
« Reply #191 on: May 15, 2014, 04:16:38 AM »
Well Fritz I'm happy to hear your zit was sorted out by yourself, however a visit to a specialist for peace of mind is priceless and in a perfect world that's what the hospital is there for, just in case your zit turns into something more serious a few months down the road.  Imagine if they had discharged you and 3 months later is showed its ugly head again and was something more sinister.


Online gladiator

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Re: Jersey General Hospital
« Reply #192 on: May 15, 2014, 05:55:53 AM »
Fritz

I agree with Ageofaquarius as the GPs are generalists and the consultant is saving you the £39 GP fee. You have certainly not wasted anyone's money or time for your health and future. The GPs pay usually tariffs to the hospital and just part of it funds the doctor's salary.

The Jersey's health service is utterly different to the UK in that way that the GPs are not under the responsibility of HSS. Therefore health minister Anne Pryke is not accountable for the GPs standard of quality of care and services provision. I am happy to be corrected, if I am wrong.

 In the UK the community care is usually shared between the hospital and the GPs but often commissioned and led by the GPs. As the UK GPs are commissioned by the government and the hospital services are commissioned by the GPs there is a certain mutual interest to provide a cost efficient integrated health service which is free for the people. That means the GPs want to keep their patients as healthy as possible ( health promotion), so they don't spend their money for unnecessary hospital referrals and the hospital services try to be cost efficient in order to encourage GPs to refer as early as possible in order to achieve a positive outcome for the patients's illness. Obviously this is the ideal picture which is often hampered by staff shortage and mismanagement of funds.

So I wonder who is accountable for the Jersey's GPs standard of quality of care and their services?

It can't be in the interest of a business clever GP to be accountable to HSS and hospital consultant who thrives on the unacceptable long waiting times by spending most of their working time in private care . Therefore there will be no change and no reform to  free healthcare for the Jersey population for GP / community care in the near future.

In the White Paper document which is endorsed by the States and Health minister Anne Pryke  is no mention about reforming the current status of the Primary Care ( GPs) apart from the consideration to possibly subsidising their fees for patients with long term conditions. See page 22 in the White Paper.

White Paper

http://www.statesassembly.gov.je/AssemblyReports/2012/R.082-2012.pdf

See also the Speech by the Minister for Health and Social Services, Deputy Anne Pryke, to the States Assembly, proposing the re-design of health and social care in Jersey
24 October 2012

http://www.gov.je/News/Speeches/HealthMinisterSpeeches/Pages/ANewWayForward.aspx

Considering some politicians are very proud to be living on an island which is an international finance centre, involved in legal tax avoidance schemes and some politicians able to spend taxpayer's money for their narcissistic oil paintings, Mace parties, jollies to the Caribbean etc., it is incomprehensible to me that their own people don't get a free health service of a high standard of quality of care.

Although a lot of good and important changes to the health and social care services have been proposed in the White Paper, why hasn't it been challenged to make Primary Care responsible to HSS which would have given free healthcare a chance?

http://www.statesassembly.gov.je/Pages/Votes.aspx?VotingId=2590
     
« Last Edit: May 15, 2014, 06:23:50 AM by gladiator »

Offline ageofaquarius

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Re: Jersey General Hospital
« Reply #193 on: May 15, 2014, 01:57:45 PM »
Good post Gladiator.

I would add that Ann Pyke is not as brave as her previous health ministers.  Stuart was a one off and look what happened to him.
Perchard didn't last long at all and neither did Shenton.

Taking on HSS is a poison chalice, you can't do right for doing wrong and anyway, I believe she has very little power and its more to do with the MD.

Like most large states/local government departments, efficiency is way down on the list of priorities and I am baffled by some of the decisions the hospital make.   The latest 'lean' attitude that all states departments are supposed to adhere to is a joke - they make cuts at the bottom and leave the top boys alone.

On a lighter note, but equally important is the cruellest cut of all - the change from 2 ply to 1 ply toilet paper in all hospital toilets.  A disgrace.


Offline Fritz

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Re: Jersey General Hospital
« Reply #194 on: May 16, 2014, 01:45:15 AM »
Well Fritz I'm happy to hear your zit was sorted out by yourself, however a visit to a specialist for peace of mind is priceless and in a perfect world that's what the hospital is there for, just in case your zit turns into something more serious a few months down the road.  Imagine if they had discharged you and 3 months later is showed its ugly head again and was something more sinister.

My GP assured me immediately that it was definitely not, "Something more sinister". But he was not allowed to carry out what are now classed as surgical procedures. Any ,"Surgical procedures", now have to be carried out by surgeons.
Not complaining about the service. I,m complaining about the total madness of the administration!! IE: A qualified Doctor cannot ,"Lance a boil", or sort out an ingrown toe-nail etc. for fear of recrimination.
The world has gone ,(Very expensively), mad.