ska invita
back on the other side
of course
Are we really going to sit by while they destroy the NHS?
- Thread starter Bernie Gunther
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LDC
On est tous des pangolins
Oh fuck off if you think that's the problem rather than chronic underfunding, overwork, shit and unintegrated IT systems, etc. etc.
brogdale
Coming to terms with late onset Anarchism
Agree with your criticism of that last point, but the last (July) top-down re-organisation into ICBs (Integrated Care Boards to replace the former CCGs) does seem to accelerated the silo-mentality. From my own recent experience I am encountering increasing problems/blockages in care coordination as ICBs claim that they are not able to access medical records/clinical information held by other ICBs. I even had one phone operative explain to me that the other ICB was "a different company". I'm not entirely sure what this fragmentation heralds but it certainly is not patient centred.
From a cursory exploration of their role the ICBs purport to be a means of improving and co-ordinating health and social care but I suspect they represent a managerial layer that has more to do with accountancy than anything else. Looks like the bean counters will be examining 'cost centres' and ear-marking productive ones for internal privatisation and looking to close costly ones.
LDC
On est tous des pangolins
For sure there's huge problems with poor integration (especially IT, although that's also complicated with some patient resistance to record sharing - but also for some understandable reasons), but it was the tone of the problem they mentioned as being down to people not being patient-centred rather than the slow privatisation, terrible bureaucracy, government targets and re-organisations, etc. I'm totally the first to say the NHS is inefficient, slow and poorly intergrated in places, but it's not really down to anything but stuff I already said. I'm also really wary of anything at the moment that lays any public criticism of aspects of care anywhere but the government's doorstep, so maybe I jumped too much on that sentence.
E2A: The structure of the NHS and trying to understand it is a fucking nightmare. I had to spend some significant time recently trying to figure all the various aspects of it out, and ffs it wasn't easy, so totally agree with that.
bellaozzydog
rolling turds in glitter
My friend runs an IT company and one of his areas of business is looking after various NHS systems
He likens the NHS to a dead whale that is being eaten by a frenzy of private company sharks
He says he regularly loses tenders as he is seen as “too cheap” when he prices jobs up, the culture is so used to massive mark ups and profit margins that an honest budget in a tender (still
With healthy profit) is looked at with suspicion “can he do it for that price”
He likens the NHS to a dead whale that is being eaten by a frenzy of private company sharks
He says he regularly loses tenders as he is seen as “too cheap” when he prices jobs up, the culture is so used to massive mark ups and profit margins that an honest budget in a tender (still
With healthy profit) is looked at with suspicion “can he do it for that price”
Ming
I shot a man in Reno...
SpookyFrank
A cheap source of teeth for aquarium gravel
12 hour shifts doing intense, often physically demanding work cause a lot of chronic pain issues.
These kind of shifts are so ubiquitous in the NHS that getting rid of them and returning to a three-shift pattern doesn't seem to be on anyone's agenda. But it would improve recruitment and, crucially, retention of experienced staff no end.
kalidarkone
Bringing YOU round.....
Disagree! There is more flexible working g then there has ever been in order to retain staff. In my trust anyway.
My trust and my department have a range of shift patterns and although most people do 12 hour shifts ( three different 12 hour shift patterns) there are early shifts and late shifts (8 hours) mid early and mid latest (10 hours).
I prefer 12 hour shifts because it means I only have to get up 3 x a week.
Ming
I shot a man in Reno...
We just accept it unfortunately.
Goes with the territory.
My first nurse manager was a wonderful person.
Obviously for confidentiality I won't be too specific.
So I've rolled up straight out of university in my first job when I've actually got the keys.
I'm like '5 days 9-5pm'? Sweet. (courses we have to do).
She goes 'don't get used to this because if you do this you'll never have a regular working life ever again'.
She was right rofl!
kalidarkone
Bringing YOU round.....
Because of the crazy shortage of staffing - my trust will literally accept most hours or and tailor made shift patterns.
I work 34.5 hours and I have said I do not want to work nights or weekends. They have taken it on board because they have enough unregistered staff that love nights and weekends (obviously the money is better)
Occasionally I get the odd weekend day- which i take on the chin and I can request ( get 6 shift requests a month) to work a weekend if for whatever reason that suits me.
This is the only advantage to the lack of staffing- management aree more open to being flexible within reason so shifts are covered- it's very much give and take. Sometimes they contact me to ask if I can change the day I am working because they are having to juggle to make it work....and I'm usually happy to comply if it doesn't get in the way of my plans too much.
I work 34.5 hours and I have said I do not want to work nights or weekends. They have taken it on board because they have enough unregistered staff that love nights and weekends (obviously the money is better)
Occasionally I get the odd weekend day- which i take on the chin and I can request ( get 6 shift requests a month) to work a weekend if for whatever reason that suits me.
This is the only advantage to the lack of staffing- management aree more open to being flexible within reason so shifts are covered- it's very much give and take. Sometimes they contact me to ask if I can change the day I am working because they are having to juggle to make it work....and I'm usually happy to comply if it doesn't get in the way of my plans too much.
DaveCinzano
WATCH OUT, GEORGE, HE'S GOT A SCREWDRIVER!
In my last Trust as Band 2 A&C I worked 12 hour shifts, 13 per month on a four-weekly schedule. Shifts were either 'Early' (0800-2000), 'Late' (1000-2200), or 'Night' (2000-0800).
If I had been working Mon-Fri 9-5, I would have needed to have been a Band 5 to make the same money, due to Unsocial enhancements (evenings, weekends, Bank Holidays etc). Due to permanent swaps with other team members I only worked 3 out of every 4 weeks - one week would be 4 consecutive night shifts, the next week five day shifts, then a week off, then two day shifts and two night shifts. We could usually pick up Bank Shifts as well.
So whilst it was grim, hard work, you could pull in some cash. Personally I prefer longer shifts, I found it gave me more effective decompression.
kalidarkone
Bringing YOU round.....
Also for me the 12 hour shifts mean more continuity for day case patients. I admit them get them prepped for surgery recover them and discharge them.
My Trust (and my position) means I can work as much or as little, they’re just so desperate. I know lots of trainees LTFT and vast majority of GPs don’t work FT as it simply isn’t sustainable with the intensity of workload.
You can make an absolute killing as a locum hospital doctor picking up shifts. £50-£80ph isn’t unusual for junior doctors, much more for locum consultants, and they’re 12 hour shifts. I pick up a bunch.
I don’t think this is ‘right’ but you can’t blame the players when the game is fucked. Not doing them would cause an even bigger crisis. And quite often (and I’m talking every few weeks) you get called during your non-work time by medical staffing begging you to take the shift.
It’s a mess.
DaveCinzano
WATCH OUT, GEORGE, HE'S GOT A SCREWDRIVER!
One of the many jobs my team had outside of 9-5 (alongside Medical Records, Patient Transport and various other Band 3+ duties the Trust was averse to paying for properly) was doing the Bank Office's out-of-hours paperwork with locums arriving to do night shifts. Rates varied. Some that I saw were at £130ph. So more than £1500 for one shift, even after a digs charge was taken off.
Yet the Trust would not pay for Med Recs staff to look after notes outside of Mon-Fri 9-5, ditto Patient Transport (starting Band: 3), and no supervisors or managers in our department worked after 4pm on a Friday until 9am on a Monday (or any evenings).
But, you know, gotta make savings
I’m being paid £50 an hour right now. I’m in the bath. Non residential 24hr on call. Balances out tho- spent Christmas night all night on the wardsOne of the many jobs my team had outside of 9-5 (alongside Medical Records, Patient Transport and various other Band 3+ duties the Trust was averse to paying for properly) was doing the Bank Office's out-of-hours paperwork with locums arriving to do night shifts. Rates varied. Some that I saw were at £130ph. So more than £1500 for one shift, even after a digs charge was taken off.
Yet the Trust would not pay for Med Recs staff to look after notes outside of Mon-Fri 9-5, ditto Patient Transport (starting Band: 3), and no supervisors or managers in our department worked after 4pm on a Friday until 9am on a Monday (or any evenings).
But, you know, gotta make savings
I’ve heard of some Med reg shifts going for £100s/hr for hard to fill shifts or craft specialties. If you gave up the day job and just took locums you’d be really rich and have a fantastic work-life balance.
SpookyFrank
A cheap source of teeth for aquarium gravel
Mrs Frank's trust is also desperate for staff but they still give her no say in her shift patterns. Case in point; her shifts this week (all 12.5 hours) are Christmas eve, Christmas day, new year's eve and new year's day.
That’s a shitty rota coordinator there. Get hit for Christmas, get NY off. And vv.
LDC
On est tous des pangolins
"Call the med reg, they can sort it out."
LDC
On est tous des pangolins
I do 3 x 10.5 hours and a 7.5hr shift. I started here doing 3 x 13.5hrs and it nearly killed me. And probably the patients I saw in the last 2-3 hours of each shift. But I'd say most people prefer the longer shifts; nurses and junior doctors anyway, all the more senior staff do shorter shifts.
I think the thing to do would be to drop weekly hours more than cut the shift length across the board. And like kalidarkone my department is also so desperate and works 24/7 so most people (if the manager is decent) can just work what they want much of the time.
I think the thing to do would be to drop weekly hours more than cut the shift length across the board. And like kalidarkone my department is also so desperate and works 24/7 so most people (if the manager is decent) can just work what they want much of the time.
LDC
On est tous des pangolins
I would refuse to admit your “social admission”, your “off legs no known cause”, or your “new onset confusion”
Yeah, that's just me though, what about the patients?
LDC
On est tous des pangolins
Me with an AKI having not had chance to drink for ten hours writing “push oral fluids”
Collapse no fucking query as to the cause.
kalidarkone
Bringing YOU round.....
That fucking sucks!
Ming
I shot a man in Reno...
Totally. Couldn’t go back to just two days off a week. Much prefer a brutal 48 hours in four days and then 4 off. Makes more sense. When i was an office monkey I’d just get in at 6pm after the commute and get stoned and play video games mostly (nothing wrong with that obviously). With 4 days off you can actually do stuff and go places. We only get 148 hours in the week right?
Artaxerxes
Look out, he's got a gnu!
NHS dentistry, such as it was, has just gone hasn't it? It's not coming back
bellaozzydog
rolling turds in glitter
The only access to dentistry my mate has in the south west was getting practiced on by dental under-grad Students at local medical school
I’ve gotta see a dentist regularly because part of my certificates/tickets required for a job is dental health involving examination
And X-ray. This jumped from 65 quid last year to 175 quid this year. My auld dentist retired and someone took over and smashed up the prices
next step GPs
Jeremy Hunt needs a fuxking stake in his heart
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