'NHS Direct’ offers confidential health advice and information over the phone, 24-hours a day, 365 days a year. The lines are staffed1 by nurses and professional advisors. Anyone at any time might need emergency2 or urgent care and they need to be sure that they are routed3 swiftly4 to the right place for the right treatment.
Secondary care – also known as acute5 care – usually takes place in a hospital. Except in the case of emergencies, hospital treatment is usually arranged through a GP. This is called a referral6. Appointments and treatment at NHS hospitals are free. I am hurrying to write this article because I have an appointment with a local hospital this afternoon!
Increasingly, patients are benefiting from quicker and more convenient services through, day surgery – where patients are treated and can go home on the same day. Many procedures can now be done this way, as a result of developments in minimally invasive (keyhole7) surgery, so patients are able to recover at home with less disruption to their life.
Other examples of secondary care services include specialist services for mental health, learning disability8 and older people.
Emergency care – also known as Accident and Emergency (A&E) – is when patients attend hospital as a result of an accident or trauma and require urgent treatment, perhaps as a response to a sudden chest pain or a road traffic accident.
NHS Trusts employ most of the NHS workforce: consultants, doctors, nurses, hospital dentists, pharmacists, midwives and health visitors, managers and IT9 specialists, as well as people doing jobs related to medicine – physiotherapists, paediatricians10, radiographers11, podiatrists12, speech and language therapists, dieticians13, counsellors, occupational therapists and psychologists. There are many other support staff including receptionists, porters, cleaners, engineers, caterers14 and domestic and security staff who all make a key contribution to the overall experience of patients.
NHS Ambulance Trusts are the local organisations responsible for responding to ‘999’ telephone calls for life-threatening15 and urgent conditions; transporting patients; and for providing out-of-hours16 care. If you call 999 for an emergency ambulance your call is prioritised17 and the control room staff decide what kind of response you need and whether an ambulance is required, eg a rapid response vehicle, crewed by a highly trained paramedic to assess the patient and to provide treatment at the scene18. Increasingly, paramedics are being trained in new skills, including the administration of clot-dissolving19 drugs to heart failure patients before they get to hospital – a treatment which can greatly increase their chance of recovery.
NHS Mental Health Trusts provide specialist care for mental conditions, normally by working in partnership with local council social services departments.
A person coming out of hospital following an operation may need assistance to ensure that they recover well in their own homes and maintain their independence. As well as ongoing health care by the NHS, they may need help with dressing and washing or they may need special equipment such as grab rails20 and walking frames21. These aspects of care are arranged by social services departments managed by Local Authorities.
As I have grown older, I have come to depend increasingly on the NHS services and I have found them to be excellent – competent and courteous – if not always prompt22 or efficient.
1 staffed – укомплектованный 2 emergency – неотложный 3 route – направлять 4 swiftly – без промедления 5 acute – экстренный 6 referral – направление 7 keyhole surgery – артроскопическая операция (хирургическая операция, которая проводится через небольшое отверстие в ткани) 8 learning disability – необучаемость 9 IT – информационная технология 10 paediatrician – педиатр (врач по детским болезням) 11 radiographer – рентгенолог 12 podiatrist – врач-ортопед (специализирующийся на лечении заболеваний стоп) 13 dietician – диетврач 14 caterer – поставщик провизии 15 life-threatening – опасный для жизни 16 out-of-hours – в нерабочее время 17 prioritise – определять приоритет 18 scene – место происшествия 19 clot-dissolving – тромболитический 20 grab rail – стеновой поручень лестничных перил 21 walking frame – ходильная рама; ходовая тележка 22 prompt – расторопный