11 Jun 2009
Posted in Rants, Work at 9:25 pm by alby
Work again.
There are large changes happening in the scenes behind the work I do.
I work for a Primary Care Trust. They organise local health care and they also provide it.
Now this is the source of the problem.
The thought from up high is that there’s a conflict of interest here. How can the people who spend the money also provide the services? Isn’t this unfair on alternative service providers?
The plan is to allow any group to tender for NHS work – IE private companies too.
So they’ve decided already that the commissioning arm of the PCT will have to separate from the provider arm. This will happen before next April.
So my employer will change in the next year.
The most favoured option is for us to become a “Social Enterprise”. NB this means us physios specifically, not the PCT providers as a whole.
In other words a kind of private company. In other other words, not NHS.
If this happens then the people who do the actual work will NOT be NHS staff. However the bureaucrats who organise what services get commissioned WILL be NHS staff.
I wonder how well that will sit with the general public. The cry already is that the NHS has too many managers. What about when the entirety of the local NHS trust is management and admin but no actual healthcare workers?
Ah well what do I know?
The issue for most staff is the terms and conditions of employment. About the only material benefits of NHS work are steady work and a decent pension. If I saw the number of patients privately that I see now then my salary would probably be about 3 times what I get now, but not as good a pension. If I get made to go private and thus lose the pension then I want the benefits of going private.
Can you imagine the hassle trying to hire good, experienced staff? There’s no way unless we can match existing salary and benefits.
So in conclusion: another round of changes done purely for the hell of it, wasting huge amounts of money on an unnecessary scheme which paves the way for privatisation, staff loss, staff morale declining, and which may well change some time next year when the tories get in (not that they’re going to be too fussed about the breakup of the NHS – last I saw they weren’t hostile to the idea of giving their old school mates lots of money – err “privatisation” sorry).
Sigh.
I do wonder why this hasn’t been in the news yet.
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28 May 2009
Posted in Rants, Work at 9:39 pm by alby
Had a patient this week with summat known as “ITB syndrome“.
She’s a runner and had had the pain for a while and whilst waiting for us she’d been to see a private physio.
Now then. There are certain things you’d expect to see in an ITB presentation. She had ALL of them.
Her hips were mildly rotated inwards, she had weak glutes, her feet flicked slightly outwards as she walked and ran, her adductors were overactive and on and on.
So solution is to change all of this by strengthening up some muscles and looking at gait and so on.
Not a quick fix but it works and is long lasting.
Her private physio mind you. Ooh this annoys me.
He did 8 sessions of ultrasound. And that was it.
Utter waste of time and money for her. Makes me so angry.
Sort the problem out rather than “try to tweak the symptoms” maybe.
Still 8 sessions of US would have netted him around £200-250, nice pay for doing nothing.
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19 May 2009
Posted in Self-indulgence, Work at 8:35 pm by alby
Well what a day!
Tuesdays are a long day for me at work. Start at 8 and finish at 5.30 with 30mins for lunch. Doesn’t sound too bad but when the diary is full it makes for a hectic time.
More so today as I’ve loads to do before tomorrow. Student diary to organise. Work out who’s going to have to have time booked off when for student supervision purposes. Letters that need to go out today, referrals to go through (which ones need to be urgent etc), dealing with late patients and problems of other staff. Oh yes and there was no receptionist today either. This means that if a patient is late then there’s no-one handy to let me know. This means multiple trips to the waiting area, just to check they’re not late.
Patients are allowed 10 mins before we can say we’re not going to see them.
So why, on the busiest days, does everyone show up 9 mins late?
It means there’s less time to see them, because of the 3 or so trips to the waiting area there’s been no time to do any of the other jobs I need to do either.
And that was me today. All day! Just hectic.
Failed to get a load of letters done and no time tomorrow either. Grr, they’ll have to wait until Tuesday (when naturally I have a full diary again so still may not have any time).
So that was the “fall”.
Got home to find that my dad has decided to get a new car; which means I get first dibs on his old one. Newer and comfier and more reliable than my current one. Huzzah.
Oh and I got my certificate from the Pilates people. I am now a qualified Pilates trainer. Whoot!
And an 80% on the exam (a mainly subjective exam it should be noted) and my droppy area was “you need to practice the movements a little more” so I can demo them better. But I sort of knew that one. Oh and apparently I “need to highlight positives as well as negatives”. Me negative and picky? As if.
A better end than beginning to the day.
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06 May 2009
Posted in Life, Reviews, Work at 7:22 pm by alby
I was sent another link at work today. It’s one of those “10 things” things where some under-employed journo has to come up with something to fill some pages up.
Anyway; it’s “10 pointless things“. One might argue that the article itself would count, but apparently not.
Now there’s some plenty banal rubbish on it (the pic of the male swan chorus on point 1 was a surprise though) but number 2 is rather intriguing.
Unicycle: As its name suggests, a unicycle is similar to a bicycle but it only has one wheel. The effects of removing a wheel are all negative. Balancing on a unicycle requires much more effort and leads to a much greater likelihood of falling off. Taking away a wheel is also much slower. The maximum speed reached on a unicycle is approximately 35 km/h (22 mph), while Chris Hoy (pictured above) has reached speeds of 70 km/h (40 mph) on his bicycle.
Now I’m no unicyclist but there does seem to be a lot of wrongness in there.
I know this is a light-hearted attempt at filling in dull days in dull office jobs but there’s some good points here.
“The effects of removing a wheel are all negative” eh? Not sure I’d agree.
One of my main contentions re the world is that stuff should be fun. Unicycling ticks that box for plenty of people, hence not useless.
Secondly, why measure such a random thing as speed as a measure of usefulness? In that case a transit van is more pointless than a Ferrari, after all it would be “much slower”. NB the claimed “40mph” is pretty far short of top speed on a bike anyway.
But what else is useful re unicycling?
As I can testify (and Clurb can corroborate), unicycling is much harder work (at least at first). They even mention this but apparently miss the significance of it. It gives you a harder workout, it works your core stability muscles, it helps your balance. All rather useful things from my work point of view. There was even a “unicycling for back pain” article in one of the charity publications from Back Care.
Not sure they thoroughly thought this one through.
Either that or they couldn’t be bothered either because they’re lazy or the article really didn’t need to be particularly thought through.
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28 Apr 2009
Posted in People, Travel, Work at 1:40 pm by alby
Sore this week.
I was in Harrogate again at the weekend for another Pilates course. And my word it was a tough one.
Got there to discover there was an exam at the end of the second day. Then spent 12 hours doing Pilates and learning how to teach it better etc.
So for the exam I was already about done in.
We were split into 2 groups of 6 and then we each had to teach the others 3 exercises with the whole demonstrating/explaining/tweaking and helping out stuff. So if you went first you then had to watch 5 other people do better than you; if you went last then you had more time to worry. And whichever you still had to do 18 exercises over the course of the exam. A normal class would have maybe 10 exercises. So that was physically hard work on its own.
But there was some excellent light relief.
On the Saturday I’d arranged to go to York and stay over with Mamph in return for a curry and company.
Got there to find others had been invited and we ended up in a pretty decent curry house with excellent beer from The York Beer and Wine Shop (excellent place).
This was followed by a trip to a local pub where a round of drinks for 6 cost £7.50ish. Most impressed.
We all headed back to Mamph’s to finish off the evening.
But an early start wasn’t welcome, sadly necessary tho’.
Exam done – think I did ok.
More Pilates requests coming soon (probly).
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18 Apr 2009
Posted in Life, People, Work at 10:41 am by alby
Friday started badly after a night of bad sleep interrupted by my house alarm randomly going off at 3am and then followed by me having a dream in which my toenails got manky (if you’re Clurb then “mankier”) and I pulled them off. Great.
So to work early and then a full diary. Was a little tired throughout the day but people were the same as always.
Until the last patient. And not even my patient.
I was at the PC doing some paperwork and the locum physio we have asked me if I could fetch her patient a glass of water. I disappeared off to get one. On my return I see a worried looking locum saying “my patient’s collapsed”.
Oh great.
Went into the cubicle to see the patient on her side on the treatment couch, eyes closed but breathing.
Pulse taken and normal. BP taken and normal. Patient responsive to questions but “unable” to open her eyes.
So emergency practitioner called (that’s not just jargon, he was a specialist nurse not a paramedic). He re-checked everything I’d checked as well as blood sugar (also normal). Cue lots of talking and waiting and talking.
Some frankly bizarre responses from the patient led him to call an ambulance. And now me and the locum could finally get to write up our experiences for the inevitable “incident form” on Monday.
When the ambulance man showed up he asked the locum for some more details about what happened and then managed to upset her horribly by saying “It’s all your fault then” (assumedly in jest). Really a bad idea as she was worried that she’d done something to prompt this incident.
So after doing the notes and sorting the room out I then had to spend a good half hour trying to talk through the incident with the locum and coming to the conclusion that she’d done nothing wrong. Not sure she thinks of it in that way yet though.
Will have to chat to the boss first thing on Monday now and it’s not as if there’s lots of available time for me on Monday.
The whole incident did bring back bad memories for me. When I was a little physio I was with a patient who’d just had cardiac surgery. My role at the point in rehab was to get her out of bed and walking again.
All the notes were clear that she could get up and move. I got her up and walked about 5m with her. When getting back to the bed she went a little confused and couldn’t follow instructions. So I sort of pushed her onto the bed and then plugged her into the monitoring system. Nothing horribly out of place. Asked her some questions – no response. Called a nurse. After a few mins we concluded she’d had a stroke (confirmed later).
My supervisor found me an hour later (probably in the loo) worrying that I’d been the cause of this. It took her an hour or so going through the notes and my treatments with me before concluding that I’d done nothing wrong; it was just “one of those things”.
That patient died a day later.
I think the current patient isn’t anywhere near as serious as that was but it’s still freaky when a patient you’ve touched goes “wrong”. Not good at all.
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03 Apr 2009
Posted in Work at 10:41 pm by alby
We occasionally get stuff at work that informs and educates but not often too much in the way of entertainment.
Today however we got the new edition of “Talkback“, the quarterly publication from BackCare – The Charity for Healthier Backs.
This is the only magazine I’ve seen at work that has included such lines as….
ooh I’m a tease. After the bump are some mildly mild NSFW wotsits.
Read the rest of this entry »
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02 Feb 2009
Posted in Life, Travel, Work at 8:11 pm by alby
After this morning’s lovely snow and a wonderful atmos all day with big blobby flakes falling outside my window I have now a major heart problem and have just made it home the 6 or so miles from the other side of Leicester.
It took me 90 minutes, give or take.
The east half of Leicester was appalling with people contributing to the mess by their impatience or just plain bad driving. Western Leicester by comparison was a haven of sense.
People do need a smack in the mouth if they think that trying to be the last person through a junction will help. Especially if they then block the other lane whilst sitting helpless in the middle of the junction.
Fools.
Ah well. I have already made plans for tomorrow which don’t necessarily involve getting to the furthest site there is (as per my normal Tuesday) but is within a walk (a long one mind) if I need to go by foot.
I think we might be cancelling one girl’s clinic though as she struggled to get in from Loughborough for the best part of 90 mins before we looked online re roads and suggested she give up and go home. And it should be worse tomorrow.
Fun fun fun.
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Posted in Travel, Work at 9:23 am by alby
Whoot.
It started to snow yesterday whilst we were all driving to Fieldhead for a smashing and yuge dinner with 2 guests (top dinner, lovely company, snow falling out the window – grand couple of hours).
Kept falling through the day and I woke up this morning to lots of it all nicely undriven on.
I thought I’d better leave for work a bit earlier and it did take a smidge longer and some drivers were clearly terrified but no major hassles. I did manage a slide whilst braking for some lights though. That was fun. Thankfully the margin of error I tend to build in was more than enough to stop me whacking the car in front. I just wish the guy behind used the same margin. He didn’t hit me but if I’d had say a fly sitting on the back of my car he’d have buckled its legs.
Now sat at work wondering how many no shows we’ll get.
Have fun.
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25 Jan 2009
Posted in People, Work at 8:19 pm by alby
at work.
Last weekend I had a 2 day course – the travel and effort much mollified by excellent Saturday evening company.
After another week at work it was yet another course.
This time was a doctor of physio doing some shoulder update wotsit. And for the second weekend it was a great effort. Loads of info and a grand and funny presenter. Really a good use of 2 days.
There was one specific bit that entertained me no end.
Right at the beginning of the weekend there was a series of 3 slides showing the evolution of the scapula from something like a chimp to us. He told a tale of using this in the US and someone stood up, shouted “That never happened” and stormed out.
He then went on to the next slide “Has evolution failed us?” to demonstrate that the shoulder blade is really not a good shape for us in our modern lives. So this idiot out-stormer missed the bit about how poorly the scapula fits our needs. So in other words, if you don’t believe evolution happened then you must therefore believe that the designer was so bloody useless that he gave us a stunningly badly worked out shoulder.
Ah the irony.
Only another 5 days to go before I’m allowed a day off.
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