Junior Doctor's contracts petition
Discussion
IanA2 said:
Seven day working. A breakfast explanation.
Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
That appears a pretty poor analogy. It implies that we're going to spread 5 days work over 7 days or that extra 2 days bring new workload.Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
Whereas the reality is that the NHS is currently doing 7 days work in 5 days in many areas. Such a 7-in-5 day service will require larger labs, more beds and more staff on duty in those 5 days to process the workload.
An example would be the fact that patients are admitted 7 days a week (emergencies) but typically discharged 5 days a week.
Look at Royal Mail. In the days of manual sorting, they could easily manage overnight demand by adding some more staff. But when they moved to sorting machines, they suddenly had huge amounts of capital expenditure involved just to add additional capacity. Furthermore, if they tried to sort everything overnight as they used to they would have to have many more machines which would then sit idle the rest of the time. Hence the Second Class post was brought in - this was designed to identify less urgent mail that could be set aside and sorted the following day (although often on quiet nights it could be processed overnight too). So instead of scaling for max overnight capacity and idle days, Royal Mail could scale for fewer machines but much more efficient use of them.
The same principle can be applied to NHS capital expenditure, particularly support services that do not provide same-day results. Build a smaller lab and instead spread the same staff over a 7 day or 24 hour shift system. Likewise they are probably hospitals that are larger than they need to be because the average length of stay is impacted by 7 day admissions but 5 day discharges.
Indeed, the NHS already applies the principle through centralisation of specialist services. Closing small departments and centralise the resources at large regional hospital to provide proper 24/7 staffing (e.g. 5 consultants from 5 hospitals doing 9-5 hours+oncall cover now on a 24/7 hour rota). It both improves patient safety and makes more effective use of resources.
ninja-lewis said:
IanA2 said:
Seven day working. A breakfast explanation.
Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
That appears a pretty poor analogy. It implies that we're going to spread 5 days work over 7 days or that extra 2 days bring new workload.Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
Whereas the reality is that the NHS is currently doing 7 days work in 5 days in many areas. Such a 7-in-5 day service will require larger labs, more beds and more staff on duty in those 5 days to process the workload.
An example would be the fact that patients are admitted 7 days a week (emergencies) but typically discharged 5 days a week.
Look at Royal Mail. In the days of manual sorting, they could easily manage overnight demand by adding some more staff. But when they moved to sorting machines, they suddenly had huge amounts of capital expenditure involved just to add additional capacity. Furthermore, if they tried to sort everything overnight as they used to they would have to have many more machines which would then sit idle the rest of the time. Hence the Second Class post was brought in - this was designed to identify less urgent mail that could be set aside and sorted the following day (although often on quiet nights it could be processed overnight too). So instead of scaling for max overnight capacity and idle days, Royal Mail could scale for fewer machines but much more efficient use of them.
The same principle can be applied to NHS capital expenditure, particularly support services that do not provide same-day results. Build a smaller lab and instead spread the same staff over a 7 day or 24 hour shift system. Likewise they are probably hospitals that are larger than they need to be because the average length of stay is impacted by 7 day admissions but 5 day discharges.
Indeed, the NHS already applies the principle through centralisation of specialist services. Closing small departments and centralise the resources at large regional hospital to provide proper 24/7 staffing (e.g. 5 consultants from 5 hospitals doing 9-5 hours+oncall cover now on a 24/7 hour rota). It both improves patient safety and makes more effective use of resources.
RYH64E said:
IanA2 said:
Oh dear:
I can only conclude that you keep returning to the same random quote because you have no actual answers? It's a very poor response."We must not only cease our present desire for the growth of the state, but we must desire its decrease, its weakening"
RYH64E said:
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?
To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Oh, is it just doctors that make a hospital run? Someone's crackalackin'!To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
arp1 said:
RYH64E said:
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?
To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Oh, is it just doctors that make a hospital run? Someone's crackalackin'!To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
I'm out, right out.
arp1 said:
RYH64E said:
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?
To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Oh, is it just doctors that make a hospital run? Someone's crackalackin'!To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
For the all coverage of Junior Doctors, it has been somewhat overlooked that the NHS Pay Review Body also reported at the same time last summer. Both the DDRB and NHS PRB suggested that plain time should be extended to 10pm on weekdays, bringing the NHS into line with other comparative 24/7 industries) and that Saturdays and potentially Sundays be brought into plain time.
The Agenda for Change negotiations are on-going, presumably there isn't a hard deadline for AfC changes as there is with August new starts for junior doctors.
So it would seem that doctors would have plenty of company at weekends.
arp1 said:
RYH64E said:
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?
To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Oh, is it just doctors that make a hospital run? Someone's crackalackin'!To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Surprising how many supposed PH Multi Directors struggle with basic economics.....
IanA2 said:
ninja-lewis said:
IanA2 said:
Seven day working. A breakfast explanation.
Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
That appears a pretty poor analogy. It implies that we're going to spread 5 days work over 7 days or that extra 2 days bring new workload.Let me make this simple.
You have 5g of marmalade and five pieces of toast. Marmalade is spread in equal amounts on each piece of toast. Ergo, one gram per slice.
You then decide you want seven pieces of toast, all with marmalade, but you still have only 5g of marmalade. To do this equitably, each piece of toast will have 0.714g of marmalade.
However, if you want to have all seven pieces with the same marmalade spread as when you had five pieces and only 5g of marmalade, you will need a further 2g of marmalade.
Over to you Mr Tolstoy.
Whereas the reality is that the NHS is currently doing 7 days work in 5 days in many areas. Such a 7-in-5 day service will require larger labs, more beds and more staff on duty in those 5 days to process the workload.
An example would be the fact that patients are admitted 7 days a week (emergencies) but typically discharged 5 days a week.
Look at Royal Mail. In the days of manual sorting, they could easily manage overnight demand by adding some more staff. But when they moved to sorting machines, they suddenly had huge amounts of capital expenditure involved just to add additional capacity. Furthermore, if they tried to sort everything overnight as they used to they would have to have many more machines which would then sit idle the rest of the time. Hence the Second Class post was brought in - this was designed to identify less urgent mail that could be set aside and sorted the following day (although often on quiet nights it could be processed overnight too). So instead of scaling for max overnight capacity and idle days, Royal Mail could scale for fewer machines but much more efficient use of them.
The same principle can be applied to NHS capital expenditure, particularly support services that do not provide same-day results. Build a smaller lab and instead spread the same staff over a 7 day or 24 hour shift system. Likewise they are probably hospitals that are larger than they need to be because the average length of stay is impacted by 7 day admissions but 5 day discharges.
Indeed, the NHS already applies the principle through centralisation of specialist services. Closing small departments and centralise the resources at large regional hospital to provide proper 24/7 staffing (e.g. 5 consultants from 5 hospitals doing 9-5 hours+oncall cover now on a 24/7 hour rota). It both improves patient safety and makes more effective use of resources.
wings_over said:
And see how better things are up here in scotland now we have removed ALL tory controls
Both red and blue
You lot will be begging to come into scotland once the NHS is privatised
A report from a couple of years ago http://www.heraldscotland.com/opinion/herald_view/...Both red and blue
You lot will be begging to come into scotland once the NHS is privatised
But nothing has changed since. Private health provision and contracts within the NHS is greowing faster in Scotland than any other UK region.
SNP say one thing yet always do the tartan tory thing.
Countdown said:
No. We'll obviously need all the ancillary services and support staff. And the fixed assets that are currently under-utilised will need more maintenance and replacing more often. But there's nothing to worry about. Jeremy Hunt will be able to do this without it costing the taxpayer any more.
Surprising how many supposed PH Multi Directors struggle with basic economics.....
As above, spending on the NHS up and the potential for massive efficiency savings.Surprising how many supposed PH Multi Directors struggle with basic economics.....
The economics seems fairly straightforward...
sidicks said:
Countdown said:
No. We'll obviously need all the ancillary services and support staff. And the fixed assets that are currently under-utilised will need more maintenance and replacing more often. But there's nothing to worry about. Jeremy Hunt will be able to do this without it costing the taxpayer any more.
Surprising how many supposed PH Multi Directors struggle with basic economics.....
As above, spending on the NHS up and the potential for massive efficiency savings.Surprising how many supposed PH Multi Directors struggle with basic economics.....
The economics seems fairly straightforward...
RYH64E said:
IanA2 said:
I refer you to both Mr Tolstoy and the Marmalade.
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
To go back to the toast analogy - 1g of marmalade is a doctor - how are you going to get a thinner doctor or cut one into thirds to redistribute ?
Countdown said:
No. We'll obviously need all the ancillary services and support staff. And the fixed assets that are currently under-utilised will need more maintenance and replacing more often. But there's nothing to worry about. Jeremy Hunt will be able to do this without it costing the taxpayer any more.
Surprising how many supposed PH Multi Directors struggle with basic economics.....
Seriously? You appear to be saying that it's better to not use expensive equipment because it wears out if you use it? That's the kind of logic that I use when buying cars, it's better to have three cars on the drive because it saves on servicing costs...Surprising how many supposed PH Multi Directors struggle with basic economics.....
George111 said:
RYH64E said:
IanA2 said:
I refer you to both Mr Tolstoy and the Marmalade.
I see you've made no attempt at all to address the points I've made, where's the sense in having expensive equipment housed in expensive hospitals and not using it outside of normal working hours because all the doctors have gone home?To use your marmalade analogy, the current situation is like having all the marmalade on the first couple of slices of toast and nothing at all on the rest.
Also 'the NHS' is a bit broad. Equipment and related accommodation were under discussion, in particular their restricted use over time and the waste of assets this represents.
RYH64E said:
Countdown said:
No. We'll obviously need all the ancillary services and support staff. And the fixed assets that are currently under-utilised will need more maintenance and replacing more often. But there's nothing to worry about. Jeremy Hunt will be able to do this without it costing the taxpayer any more.
Surprising how many supposed PH Multi Directors struggle with basic economics.....
Seriously? You appear to be saying that it's better to not use expensive equipment because it wears out if you use it? That's the kind of logic that I use when buying cars, it's better to have three cars on the drive because it saves on servicing costs...Surprising how many supposed PH Multi Directors struggle with basic economics.....
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