I didn't know before last week that 10% of all fractures occur to bones in the foot. Last Sunday I accidentally dropped a boulder (well 2 actually) onto my foot causing extensive bruising, pain, and an inability to walk very far. By last Tuesday the pain and swelling was severe, but according to my colleagues in the School of Health Sciences, who are experts on all things related to the foot, there was nothing broken and nothing needed to be done. As the week wore on, the swelling and discolouration has indeed reduced and my mobility increased.
That I chose to consult my colleagues in Health Sciences rather than go to Accident and Emergency Department (A+E) was the result of a couple of factors. Like my colleagues and despite the pain and bruising, I didn't think there was anything broken, but the other factor was my perception of the time it takes to be seen these days at your local A+E services. The thought of waiting for hours to be told something I probably already knew, was not motivation enough to attend the emergency department.
My local A+E department is at the Royal Bolton Hospital. This is a NHS Foundation Trust, which it’s fair to say has experienced a number of problems over the past few years, but now appears to be well on the road to recovery. In April 2012 the hospital was seen to be in ‘significant breach’ for failing to meet the 4 hour A+E waiting time. Every foundation Trust in England must meet a target where 95% of patients who go to A+E are assessed and either admitted, discharged or transferred within 4 hours. Last year Bolton only achieved 93%.
This year they were able to celebrate achieving 96.5%, beating the national target by 1.6% - and that was after seeing a 4.8% increase in attendance, some 115,920 patients in the year. This works out to be some 317 patients a day making Bolton the second busiest A+E department in Greater Manchester. The average time each patient spent in the department was 126 minutes, which is remarkable, and colleagues working in the hospital are to be congratulated on this turn around.
The Trust put in place a number of changes to bring about this achievement. There have been more medical staff available at the weekends, establishing a nurse led team to ‘see and treat’ minor injuries and illnesses, and improving community services in an attempt to reduce unnecessary visits to A+E by those who might be better seen at their local GP practice. All of which would have been music to the ears of Prime Minster David Cameron, who earlier in August visited Salford Royal Hospital, NHS Foundation Trust to announce £500m of additional funding over the next 2 years for A+E departments.
Possibly just as importantly, there is a separate £3.8bn fund that will be spent on treating more people in the community, rather than in hospitals and working towards there being 24 hour, 7 days a week social work care available to people. Such developments in the future delivery of health and social care services will need us to review and adapt our educational programmes so as to ensure we most effectively prepare the practitioners of the future.
As my battered and bruised toes started to recover I was struck down mid-week with Nigerian Flu, which is just as bad as Man Flu. I think I got it on the plane back from Nigeria last weekend (and many thanks for all your comments and emails I received about last weeks posting - I will respond!). Like my toes, there was no point seeking help at my local A+E department. However, my personal physician, Dr Moi prescribed that tried and tested old remedy, 20mls of Lagavulin, to be taken as required. Thankfully, the medication regime is beginning to have the desired affect and I started to feel much better yesterday.
So much so, that I was able to go to see Leonard Cohen at the Manchester Arena (not sure what its called now). He was magnificent. Aged 78 years old, he was able to bring the entire arena audience to their feet with his songs of love, longing, desire, and satisfaction. I was mesmerised and any complaints I might have had of my ailments or illness just faded away in sheer enjoyment of his celebration of life through music. It was a truly wonderful experience.