It has been some time since I last posted on Talk Health, the delay has simply been down to pressure of work and also I suppose partly a dearth of decent topics on which to expound.

However I ended up (as I so often seem to do these days) in A & E yesterday afternoon and evening with an elderly relative. This time the hospital was different, Bradford Royal Infirmary as opposed to the Leeds General Infirmary, St James or Pinderfields in Wakefield. That notwithstanding the experience was largely the same and I have discussed some of the shortcomings of the whole A & E process in earlier blogs here and elsewhere ( so won’t go over the negatives again today, other than to mention the waiting …..

One thing that was interesting though was the support that we (and specifically the patient) received following the wait. Rather than seeing an array of nurses, junior medics gradually increasing in seniority until the registrar or consultant took charge of the case and made something happen we were seen by a senior nurse practioner who saw us following an initial triage by a more junior nurse. This practioner then took my relative on as a ‘case’ from start to finish : through initial consult, exam, standard history and tests (bloods, BP, blood ox etc), he ordered an X-ray and importantly came back and updated us at every step of the way which was useful as my relative is somewhat confused (even at the best of times). Within an hour of his appearing on the scene we had a fairly firmly confirmed diagnosis, IV fluids in with antibiotics (for pneumonia) on order and a bed ready and waiting for the patient + an idea of how long we were likely to be visiting the hospital for – around 3 to 5 days in all likelihood. The case was never interrupted or side tracked by another patient so it felt as though there was continuity of cover and although we still had a hefty wait (?) the information we were given made the wait far more acceptable.

All this without even mention of seeing a doctor. Now I hear you cry, do we trust the diagnosis from a ‘mere’ nurse ? Well, that’s a good question, regardless of whether the initial diagnosis ad treatment remain as described is in a sense irrelevant – all of this treatment was given with authority and confidence and even if the nurse practioner is subsequently proved wrong by more tests (although so far it all seems about right) at the time the treatment seemed reasonable and no one is harder to convince of competence in a medical scenario than I am and I was completely happy with the care.

Having experienced this specialist nurse role, I can only say, more …

What I wasn’t happy about as much was the handcuffed suspect sat outside my relatives cubicle moaning all evening nor the ten armed response officers milling about in the car park outside the hospital for some reason – but thats another story !





Phil Knight started work in the National Health Service in Leeds in 1989 before going to Hull University to read American Studies and then moved into private medical sales and marketing in 1994. He now owns two business focused in the private medical sector and works with senior clinicians and healthcare providers on a daily basis advising on a variety of healthcare issues. He is also a Member of the Leeds Teaching Hospitals NHS Trust. He is interested in all aspects of healthcare and regularly blogs on related medical, business and technology issues and also hosts the only podcast in the country focusing on private medical insurance. He is lives in Leeds, West Yorkshire but has clients across the UK and internationally. He is married to Hazel, a Senior HR Manager with two children : Megan aged 13 and Ryan, 7. His interests include technology, podcasting, science fiction and martial arts - he is a Second Dan Black Belt in Tai Sabaki Do Karate and 2nd Kyu Brown Belt in Shukokai Karate so health and fitness dominate both his business and personal life. Read his blog at and visit his websites : and

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