The NHS is broken, what should happen?

[Brainaddict]

I'm told that the best way to solve the bed space issue - and quite a lot of other issues - is funding social care. They have nowhere to send people home a lot of the time, because they need help and people live alone - particularly elderly people. This is something that funding can easily fix.

 

[two sheds]

Isn't it relevant if someone's claiming insider knowledge? I've known sas almost 20 years and afaik he's not lived in germany in that time.

Yeh yeh, I-mentioned-the-war-once-but-I-think-I-got-away-with-it

 

[bellaozzydog]

I know there’s lots of urbs who work in the NHS. And all of us use it. So I think we’ve gotta acknowledge that it’s broken and no longer fit for purpose. Sure, bits of it are still functional and there’s plenty of examples where care is still timely and often outstanding, but enough of it is destroyed that as a healthcare system overall it’s fucked.

Examples off the top of my head:
Ambulance services are now routinely leaving old people on the floor for four hours plus. When my m-in-law had a spinal stroke last year, eventually after hours my f-in-law and a taxi driver dragged her (legs paralysed and doubly incontinent) into a taxi to ED.

Corridor medicine in our emergency departments is now almost normalised. In my trust, nurses can be assigned to the corridor instead of bays. Ambulances and paramedics queue. Four hour target going.

The “winter crisis” now lasts all year. Bed occupancy is 90% plus. Elective procedures are cancelled and it doesn’t make the news, it’s just accepted. Medical patients overspill onto surgical wards, and are seen as ‘outliers’ by medical teams (which is never as safe).

It takes four years to get an autism diagnosis for a child. MH patients who need a PICU bed are sent hundreds of miles away (Yorkshire to Kent anyone?). GPs essentially can’t refer to CAMHS, or rather, it’s pointless and most know it.

There aren’t enough nurses, there aren’t enough doctors, there aren’t enough physios, there aren’t enough OTs. Rota gaps mean staff are doing the work of two or three. Routinely. Staff being moved between wards sometimes on a day to day basis. Unsafe. Staff are leaving like a flood. No one wants to work under that much pressure, delivering substandard care despite superhuman efforts.

I could go on but I’m sure you all have similar tales.

So what’s to do urban? Underfunding is definitely a big part of the problem. But I don’t think money is the only problem. The whole system is too big. I suspect it’s massively inefficient. Other EU countries don’t have this problem. Many have a mixture of public and private insurance. Would we be better off switching to this? Cos we can’t go on. Someone needs to make a decision...

You do realise this is the plan and you are playing right into their hands don’t you?

 

[two sheds]

Yeh yeh, I-mentioned-the-war-once-but-I-think-I-got-away-with-it

Ah ok my mistake

 

[Edie]

I have received more than my fare share of treatment over the years and more recently sobs has Mrs T. The staff, though very stretched have in the whole been magnificent. All credit to them.

Before I say too much, I would like to ask are doctors and nurses still being paid a small fortune to provide cover on areas like A&E and are there still a lot of contract nurses being paid well over what NHS staff get paid?

I wouldn’t describe it as a small fortune but bank/locum staff do get paid more than regular staff per hour.

 

[bellaozzydog]

Text book stuff which will having us cheering for our health insurance saviour in future years

How to sell off the NHS – in nine easy steps

It won’t be easy, but with this handy step-by-step guide you too can privatise a health service

www.theguardian.com

 

[hash tag]

Thanks Edie, more staff would greatly reduce those costs then.
I also see a lot of waste. It is not uncommon for clients to have a collection of walking sticks, walking frames and the like, when one of each will do. They invariably get binned when the client dies or moves.

If more money were spent on social care, on meals on wheels, on day centres, if clients were better looked after and had more human contact, I am sure it would mean fewer hospital trips.

Because of pressure on beds and targets, clients are often discharged before they are ready or before social services are ready for them. I have lost count of the clients I have helped in the last year
who had been discharged from hospital and within 24 hours they are returning to hospital; more beds required.

Doctors, social services and hospitals often compete against each other to protect their much needed resources. People ring up doctors to be told they need to wait a few days for an appointment.
In the meantime, they get sicker and end up in hospital because their infection or what ever has deteriorated for want of early intervention. I have known doctors who have told clients we are too
busy to see you now, if you think you need treatment call an ambulance. Similarly, I have called 111 out of hours for a district nurse to sort out a catheter or similar, no other symptons, to be told
call an ambulance. I know they err on the side of caution but thats ridiculous.

Simply reiterating what others have said, more funding, more staff across the board and more hospital beds.

 

[Edie]

I'm told that the best way to solve the bed space issue - and quite a lot of other issues - is funding social care. They have nowhere to send people home a lot of the time, because they need help and people live alone - particularly elderly people. This is something that funding can easily fix.

This is certainly true to an extent. We still have an aging population, new procedures and medicines and improved treatments that use more resources and cost more, higher expectations and patient choice.

 

[kalidarkone]

I disagree. It’s not just funding.

The whole NHS needs to reorganised. Even if it had all the funding it needed the fucking muppets running it would continue waste it.
EVERYTHING from the cleaners and supply chains to the consultants and hospital managers needs to be renegotiated. Edie is right it is just too huge.

 

[two sheds]

One of the problems is the constant reorganization, though. The tories promised no top down reorganization and then .... errr ... made a top-down reorganization.

Government’s reorganisation of the NHS was its biggest 'mistake',

www.independent.co.uk

 

[weepiper]

More funding. Broken down into smaller units that can be properly managed. Safe staffing levels, proper financial incentives, free parking, free coffee. Bring back the nursing bursary and make nursing and other allied health degrees free of charge immediately. Review European health services and adapt our funding model as soon as possible.

I could go on.

But I’m not a manager. I’m not a leader. I also want to know what you all think.

You've pretty much described the Scottish NHS there.

 

[dessiato]

You've pretty much described the Scottish NHS there.

From what I’ve seen the Scottish system works very well. Is that the case?

 

[weepiper]

From what I’ve seen the Scottish system works very well. Is that the case?

I can only speak as a patient/patient's relative (Mr W is in fact in hospital right now following surgery) but I have no complaints. Fuck me the amount of healthcare he's needed over the past 18 months we'd be homeless or he'd be dead if we had to pay privately for it.

 

[Edie]

The whole NHS needs to reorganised. Even if it had all the funding it needed the fucking muppets running it would continue waste it.
EVERYTHING from the cleaners and supply chains to the consultants and hospital managers needs to be renegotiated. Edie is right it is just too huge.

The waste is something to behold. It’s not even necessarily anyone’s fault I don’t think. Maybe even the best managers out there can’t manage something this big with such complex and conflicting constraints. The span of control just doesn’t stretch that far.

 

[weltweit]

It could perhaps be interesting to work out how much of our taxes went to the NHS. Certainly I have benefitted a lot from it myself.

 

[kalidarkone]

I have received more than my fare share of treatment over the years and more recently sobs has Mrs T. The staff, though very stretched have in the whole been magnificent. All credit to them.

Before I say too much, I would like to ask are doctors and nurses still being paid a small fortune to provide cover on areas like A&E and are there still a lot of contract nurses being paid well over what NHS staff get paid?

Yes. In my department (surgery and recovery) almost a third of the recovery staff are Agency on £35 an hour. We are so strapped and short of staff that substantive staff are leaving -joining an agency and coming back and doing the same job as they were before but for £75K per annum (before tax) rather then 25-28K. Who can blame them? In fact becoming agency is the only reason I'd even consider becoming registered. I do not have any loyalty to the NHS any longer because they do not look after the patients or the staff. They have fucking shafted us all and the fucking managers are still playing along and facilitating the NHS collapse. The unions do nothing. Any care is down to individual people. The system is not fit for purpose.

livid

 

[kebabking]

I'm not sure what the solution to the size thing is - if you have the NHS divided up into trusts (or whatever local/specialist form you use) you get endless duplication and expensive variation, but if you keep it as a large, centralised organisation you get senior management and policy making that is completely divorced from the front line.

One is slightly reminded of the Red Army on the 1980's - it's senior leadership were on a different planet to what Majors in East Germany and Afghanistan faced, and this was an organisation that shot its own membership for failing to do as they were told....

 

[Athos]

The whole NHS needs to reorganised. Even if it had all the funding it needed the fucking muppets running it would continue waste it.
EVERYTHING from the cleaners and supply chains to the consultants and hospital managers needs to be renegotiated. Edie is right it is just too huge.

What would attract better managers?

 

[chemn]

This is certainly true to an extent. We still have an aging population, new procedures and medicines and improved treatments that use more resources and cost more, higher expectations and patient choice.

It's like you quoted that guardian article on how to privatise a health service...

 

[kalidarkone]

What would attract better managers?

No idea. It's not just about the managers. The whole system is sick and diseased.
I just know there is a systemic issue with communication and a huge culture of bullying and that would be the case with all the money in the world. Deeply fundamental changes need to be made as well.as funding. But where/how does that start?

 

[two sheds]

I think one reason is that managers are under pressure to reach targets while their departments are completely underfunded. They ignore the fact that they're completely underfunded and demand that the targets are met anyway. They pass that pressure down to the people who work for them who pass it down to .... nurses and cleaners and people who actually do the work. That means everyone's stressed.

 

[brogdale]

I disagree. It’s not just funding.

Close to the current vermin line that the problems of the NHS result from "growing demand" for its services.
As though the right party of capital doesn't understand that rising "demand" without commensurate increase in "supply" will lead to shortage/scarcity and rationing.
Can't see why anyone here would buy into this vermin guff; very sad to see it on urban.

 

[Plumdaff]

You need managers who have clinical experience and understanding. Currently you either promote clinicians who have no financial or managerial training or you have career management who don't actually understand a lot of what the organisation needs to do. Also ime a lot of senior management don't want to hear the truth about what's going on clinically and whistle blowers are relentlessly squashed. I have the skills and aptitude to get a more senior role but essentially it involves having to stop giving a shit and becoming a political yes man and already my face clearly doesn't fit. I don't know how you fix that, I suspect privitization would make it worse.

 

[Edie]

No idea. It's not just about the managers. The whole system is sick and diseased.
I just know there is a systemic issue with communication and a huge culture of bullying and that would be the case with all the money in the world. Deeply fundamental changes need to be made as well.as funding. But where/how does that start?

Couldn’t agree more.

 

[Edie]

It's like you quoted that guardian article on how to privatise a health service...

That’s because it’s widely recognised. I prob should read it though.

 

[BristolEcho]

I've recently started working for the NHS. It is broken, but after ten years of working the the private sector that is even more broken with both service users and staff being fucked over. It often seems though everyone wants to talk about the NHS, but this sector gets ignored.

 

[BristolEcho]

Beds are fucked right now btw. There is literally no where and the overspill into community is showing.

 

[kalidarkone]

Beds are fucked right now btw. There is literally no where and the overspill into community is showing.

The trust I work for paid for a day surgery patient to go to a hotel overnight (they lived a long way away) and then sent the hospital at home service to check on them in the morning.

 

[Proper Tidy]

how long ago?

75 - 87 years ago

 

[kalidarkone]

Yesterday a patient died in very undignified circumstances due to there being no beds. All the other patients,patients relatives etc could hear him dying. Also I believe they resuscitated him when he had a DNR. ....but it was missed..... he was 96 and should of been allowed to go with grace. Matron did not fight or advocate for his right to do so