Don’t go to Casualty – it’ll only make you sick

A split-second fall led to a nine-hour wait in Casualty. Earlier the same day a GP provided marvellous service. Why is the NHS so two-faced? asks Sean Brierley

Field research is a wonderful thing. Last week I got first-hand experience of why the NHS came simultaneously top and bottom of a CRM league table, according to CCC research presented at the Marketing Forum.

I had developed a throat infection and visited my new GP at an inner London practice. I rang on Tuesday and got an appointment for Wednesday. The doctor saw me after a five-minute wait. Like my previous GP she was friendly, caring and highly skilled at dealing with the symptoms of male hypochondria and paranoia. She prescribed some antibiotics, told me how pleased she was to have met me and gently chastised me for not visiting when the symptoms first appeared. Quick and effective treatment, carried out by someone who genuinely cares, and to top it all it was free. This was CRM paradise.

That evening, however, I was to experience the NHS’ dark side – a CRM version of Hell.

In the afternoon it rained heavily. I was in a rush and, on arriving home, I failed to wipe my feet properly before dashing up the stairs, from which we have recently removed the banister and carpet in a Terence-Conran-meets-Changing-Rooms refit of the flat.

You probably see what’s coming. I didn’t.

As I dashed back down the stairs, my legs shot from under me and I landed heavily on my back. To cut a long story short, a paramedic examined me and said that I had broken a couple of ribs. Because of the pain and the possibility that my lung might be damaged I was sent to hospital by ambulance to get an x-ray and some elephant tranquillisers.

I arrived at my local hospital at 10.30pm. I was wheeled into Casualty because it was too painful to walk. A nurse took my blood pressure and asked me if I was on medication, before disappearing.

The drinks machine in the waiting room was empty, and we were told that the nearest place to get a coffee was Tennessee Fried Chicken, outside the hospital and across the main road. Not a good sign. An hour later a male nurse came in and asked me if he could take the wheelchair, which was needed elsewhere. I obligingly shuffled onto one of the metal seats.

The waiting room looked like it had been designed to contain Hannibal Lecter. It had sadistic furniture – a cross between MFI and HM Prison – and a TV set playing that night’s ITV movie, Conan the Barbarian. There were no medical staff to be seen, so we (my wife was with me) sat resignedly watching a bewigged Arnold Schwarzenegger crack people’s heads open with a club.

By this time other unfortunates had begun to arrive in the waiting room, including a middle-aged drunk with swollen testicles who swore at the staff; a young woman who had taken an overdose; an older woman with blood on her face and a fractured wrist; and four homeless people, three of whom stretched out on the metal chairs to sleep. The other, Yaroslav, harassed the female patients.

After another hour my wife went to look for a nurse. She found one and asked how long it would be before a doctor could see me. Two hours, said the nurse, explaining that the emergency room around the corner was full of heart attack and stabbing victims and that there were only two doctors on duty for the whole night. For some reason I couldn’t get Tony Blair’s campaign song, ‘”Things can only get better”, out of my head.

After five hours a nurse dashed through the waiting room. My wife stopped him and asked how long it would be before we were seen (we had now been there for five hours). “Weren’t you told when you came in?” he sneered. “The waiting time to be seen is eight hours”.

So this was why the NHS still preferred the word “patient” to “customer”.

After almost nine hours my luck changed. Tiring of the lack of staff in the waiting room, the drunk with the swollen testicles and the young woman who had overdosed disappeared. No one could find them so I managed to jump the queue. Oh joy.

I was seen at 7.15am by a doctor who had bloodshot eyes, a grey face and tufts of stubble left where his razor had missed. He looked worse than I did. He apologised for our wait, but pointed out that we were lucky my accident hadn’t happened the previous Sunday. “That one was a 15-hourer,” he said with a nervous grin.

I had my x-ray and the doctor gave me the painkillers I had been craving. He then added that if I had been given the painkillers as soon as I had come in – at 10.30pm – my recovery period would have been reduced considerably.

That bit of information was nowhere near as annoying as the fact that we had spent eight hours being ignored. To most of the people in there the complete lack of interest was more upsetting than the lack of medical attention. It was a reminder of why perception is more important, in many ways, than reality and why being seen to care can be more important than actually caring.

How is it that my GP understands that good communication is an essential part of the treatment – not an inconvenient afterthought – but my hospital doesn’t?

Answers on a postcard please to Alan Milburn, Secretary of State for Health, HMG. Oh, and if your postcard does find him, ask him from me: when exactly will things get better?

Sean Brierley is a former deputy editor of Marketing Week and author of the Advertising Handbook

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