The NHS Long Term Plan


No one can have missed the news recently about the NHS Long Term Plan for NHS England. Even those of us not living in England can’t miss it!!! I know I live in Scotland so it does not impact me directly but I am pretty sure the Scottish Government will take on a lot of the plans for the Scottish Health Service that are talked about in the NHS Long Term Plan.

The biggest thing that I have noticed in the news, on social media from news agencies is surrounding smoking and the help that is going to be given to people who smoke that are admitted to hospital. Any time I see anything about the plan this is what I see and it just angers me so much. I know I am not alone either as have spoken to many people who are in a similar position to me with their lungs that are frustrated and angry about it to. For me what it me most was that along with the national news agencies and NHS health boards tweeting about it, my own local health board posted (once again) about how they were going to give smoking cessation help and advice to patients admitted to hospital.


I know this is a very good step etc and that people who smoke should be offered help to stop however on a daily basis just to get into work I run a gauntlet to try and avoid breathing in any smoke. The NHS made a huge deal about how their sites were to be no smoking sites and that smoking is banned on their sites yet nothing is done to enforce this. They have signs everywhere yet those who smoke just stand by them and light up. Some don’t even wait till they clear the door before they light up. This is not unique to me and the hospital I work in. I regularly see on different forums asthmatics saying they had to go to hospital but just trying to get into the hospital left them in a worse off state than they were when they arrived in the car park etc because of all the smokers they had to pass.

Until you have put up the fight of your life just to get a breath in you cant understand what it is like. It is one thing when you may have been a bit silly and done something stupid which provokes an asthma attack but when you have done nothing other than try and get into work and you end up in intensive care it can leave you feeling really angry and bitter.

What I would love to see and so many would love to see is the smoking ban being enforced or at least a shelter to provide those who smoke a place to go and then leave areas such as the main doors to the hospital as a safe zone. Also when there are the groups of people congregating outside the doors of the hospital- many of whom are patients why are the smoking cessation nurses not down there encouraging them to not smoke or at least smoke in an area which won’t risk killing people.

What is worse is that the main doors to the hospital I work in which are always flanked by people smoking, are over looked by 3 of the four bedded bays in the respiratory ward so during sweltering summer days you cant have the window open because you end up with a room full of seconds hand smoke.

I am not alone in how I feel and what I think which is why I am writing this. I am at a total loss as to what to do because everywhere I try and get the issue addressed cant give me any answers. Is it going to take someone dying from an asthma attack as a direct consequence of people smoking outside hospital doors for action to be taken?? I have got in touch with ASH, Unison, local MP none of whom could give me an answer or willing to take action.

My working hours are 9am to 3:15pm, I have a blue badge due to the severity of my asthma so can park close to the hospital however I have had to start arriving earlier and earlier so I can have the time to wait till the doors are clear of people smoking and then take my chance. This time is different each day but it shouldn’t need to be done. There is then the reverse when it comes to leaving work however I tend to end up just trying to get out and get to my car, once in the safety of my car I can have some nebulisers to alleviate the effects the smoke has had on my lungs. I just wish those who smoke understood what they were doing to others.

It is so hard to see so many struggle. I have read how people feel like turning back and missing their hospital clinic appointments because of people smoking at the doors and the risk this poses to their health. This should never be a choice that someone has to make.

It would be great if others could share this and try and get change to happen.

If the NHS are committed to help people stop smoking, then they need to be down there with those who are smoking not up in offices making plans. Smoke is not just effecting those smoking but also others around them and not only those with lung disease either.

Please lets try and get things changed. I don’t want to risk losing my job (which could be a real possibility) because I have once again ended up in the intensive care unit as a result of people smoking where they should not be smoking.


Back feeling confident

After a good few days feeling totally down in the dumps, sorry for myself and thinking the light that was at the end of the tunnel had totally gone out I am feeling more confident and the light is coming back and I don’t think all the hard work I have put in get better is wasted. It was still worth it and this was only a minor set back in a road to proper asthma control and good health.

To say I thought that I was back to square one would be an under statement. I had visions of spending more time off work and more time in hospital and even more time on high dose oral steroids. I was full of doom and gloom and felt the best thing to do was give up. I found it hard not to think like that given my past history for getting back on track and then it all going down the plug. I really didnt want that to happen again but almost felt it was inevitable.

I managed to change my mindset and think that this time I was stronger, fitter and mentally in a better head space that I can beat this and will get back on top and enjoying myself again. I can’t expect to not have set backs and unless I lived in a bubble I would not be immune to getting colds and infections so just need to get on with it and be sensible. After some vitamin C, early nights and anti biotics I am starting to feel better. I am finding my best time of day is the afternoon. First thing in the morning I am not so good and again last thing at night I get this hacking cough but nights are always a bit tricky for me anyway. For as long as I remember my asthma at night has always been bad so for it to be bad just now is not surprising.

I must add work I have done with a psychologist who looks in to coping methods for people with long term conditions has helped as well. Changing how I view set backs and not see them as failure has helped. I would often see a set back as failed to achieve control rather than a natural hiccup that comes with having a long term condition that probably won’t go away. Life is always going to have hiccups but it is how I deal with them is important to recovering and keeping well. Accepting that things happen and sometimes there is no control or no way to stop them but learn from what has happened and take positives from it.

It s easy for me to sit now and write this now but a few days ago I would never have been able to look to the good or rationalise this blip as I have today and I hope that I will in time be able to not see every dip as going back to square one but rather view it as it is.. a dip that will go up again and back to where I was and not a slippery downhill.

Its good to see things going the right way and changing the way I am thinking about it all. It has helped me cope a lot with it now.

Hospital Targets

A friend recently wrote a post about breaching a hospital time and therefore became one of the statistics.

I have been in this situation to and it was for exactly the same reason why I breached a hospital target time and reduced their good statistics!!!

The press focus so much on hospitals missing targets and patients breaching the four hour time you are to spend in A and E. Like my fellow asthmatic who also breached the four hour time in A and E I am glad I did breach.

I had had a bad asthma attack at home. I had to call 999. It had hit me out the blue which are the scariest ones. I had no option but to call 999. It was such a bad attack that the first responder travelled in the ambulance to A and E with us leaving the car at my flat. We had to stop on the way for me to be given adrenaline to try and keep the attack at bay. I was also cannulated and given IV hydrocortisone in the ambulance. This normally happens once in A and E.

Arriving at A and E I was taken straight to resus and jumped on. Not literally but it felt like it. I was attacked from all angles. I had both arms grabbed for ABGs and more access, stickers stuck on me for heart monitor, clothes cut off and gown put on. It was mental. They took 1hr 30mins in resus to get me to a point where I was good enough to be moved into the HD part of the A and E. After a while I started to get worse so was moved back to resus, stabilised again and then moved back to HD. It was decided I needed to go to HDU but they didnt want to move me there until I was going to be stable enough to be transferred safely.

By the time I was moved I had been in A and E for 7 hours. 3 hours over the specified time by the government. I am so glad that there are some people who acknowledge that targets can not always be met. I would prefer to breach a target and be safe than meet a target and be unsafe.

I wish all staff would see this. During the time in A and E the bed manager/ co-ordinator came several times and asked me why I had not been moved yet and also had conversations with nurses why I had not been moved yet. If I had the puff I felt like screaming that I was not well enough, could they not see it. It felt that their need to meet targets was more important than the health and safety of their patients.

I do think that targets need to be put in place but for those patients who require resus or other major intervention to stabilise them should be exempt from the targets. There are always going to be cases which do not meet targets but they are often those who have been very unwell but not unwell enough for ITU.

People who use A and E for Anything and Everything should also not be part of the statistics because many of these people do not need to be in A and E and should wait while those who are sicker  are seen. It is nurses and Drs who are having to see people for cut fingers etc that cause the breach and targets to be missed. If these people used the service properly and as it is meant to targets wold not need to set to try and get the best out our health service.

I see this from both sides of the coin- as a patient and as a nurse. It is a real frustration and one that is never going to change unless the health service is privatised but then as a patient privatisation of the health service would probably see me not being able to sustain my health and I would be in a worse state than I am.

It is a really tricky balance and no quick fix. But one thing I do know is that I am glad I breached the targets to ensure my own safety. If this were to happen again due to my health I wouldn’t complain.

You only get one life at the end of the day.