Discussion
best part is the management and director double standards, phone up over the christmas holiday to tell clinical staff to work harder, but do so from home, because although A&E is busy isn't not important enough to come and and ruin their holiday or tell them to stay late because we're busy but be out the door at 5
it's going to get worse people, either people need to pay more or the nhs do less
where organisations have unilaterally offloaded their responsibility to the nhs, the the nhs should be able to charge for them, big organisations where the trained first aider is just someone to call an ambulance, old peoples homes with a no lift policy, so any old person who is found on the floor, they don't check them out just call an ambulance and get a&e to do it. If the person is becoming too much work, refuse to have them back and leave them in hospital waiting for the council to arrange a new home for them.
we also need to stop being tied to one gp, they should be paid for seeing patients, not for just having them on their books
the people in it all know what it will take to make it work, sadly the politicians and the self interest of certain groups prevent this
it's going to get worse people, either people need to pay more or the nhs do less
where organisations have unilaterally offloaded their responsibility to the nhs, the the nhs should be able to charge for them, big organisations where the trained first aider is just someone to call an ambulance, old peoples homes with a no lift policy, so any old person who is found on the floor, they don't check them out just call an ambulance and get a&e to do it. If the person is becoming too much work, refuse to have them back and leave them in hospital waiting for the council to arrange a new home for them.
we also need to stop being tied to one gp, they should be paid for seeing patients, not for just having them on their books
the people in it all know what it will take to make it work, sadly the politicians and the self interest of certain groups prevent this
BlackLabel said:
Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
This really pisses me off when the NHS gets portrayed as a third world service or a humanitarian crisis etc, just because surgery waiting times have shot up or doris has to spend 5 hours in A+E."A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
Yes things are bad but let's not get carried away here. Syria and Yemen would be classed as a humanitarian crisis. The NHS is just over stretched, and extra funding never really seems to help things. It probably gets pissed away on locum staff anyways.
Main problem I see is every party has a different plan for the NHS, but a 5 year term doesn't allow any meaningful change to take place, and of course any significant reform is political suicide so we just keep throwing vast sums of money at it, which does nothing for the service long term. Politics somehow needs to be removed from the equation.
dazwalsh said:
BlackLabel said:
Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
This really pisses me off when the NHS gets portrayed as a third world service or a humanitarian crisis etc, just because surgery waiting times have shot up or doris has to spend 5 hours in A+E."A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
Yes things are bad but let's not get carried away here. Syria and Yemen would be classed as a humanitarian crisis. The NHS is just over stretched, and extra funding never really seems to help things. It probably gets pissed away on locum staff anyways.
Main problem I see is every party has a different plan for the NHS, but a 5 year term doesn't allow any meaningful change to take place, and of course any significant reform is political suicide so we just keep throwing vast sums of money at it, which does nothing for the service long term. Politics somehow needs to be removed from the equation.
Stuff like the health service, energy, education and infrastructure would benefit from longer term thinking, not the short term political gains that currently happen.
eccles said:
I do wonder if some of the big decisions by the state should be made by a separate, cross party committee that is not tied by the length of the term of the current government.
Stuff like the health service, energy, education and infrastructure would benefit from longer term thinking, not the short term political gains that currently happen.
That would be sensible, but unless they are answerable to the political bit of our governance, they'd just get pulled apart, and if they are answerable, they'd just get pulled from pillar to post.Stuff like the health service, energy, education and infrastructure would benefit from longer term thinking, not the short term political gains that currently happen.
eccles said:
dazwalsh said:
BlackLabel said:
Another winter, another NHS crisis.
"A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
This really pisses me off when the NHS gets portrayed as a third world service or a humanitarian crisis etc, just because surgery waiting times have shot up or doris has to spend 5 hours in A+E."A&E doctor sorry for 'third world conditions' as NHS winter crisis bites"
https://www.theguardian.com/society/2018/jan/02/ae...
Yes things are bad but let's not get carried away here. Syria and Yemen would be classed as a humanitarian crisis. The NHS is just over stretched, and extra funding never really seems to help things. It probably gets pissed away on locum staff anyways.
Main problem I see is every party has a different plan for the NHS, but a 5 year term doesn't allow any meaningful change to take place, and of course any significant reform is political suicide so we just keep throwing vast sums of money at it, which does nothing for the service long term. Politics somehow needs to be removed from the equation.
Stuff like the health service, energy, education and infrastructure would benefit from longer term thinking, not the short term political gains that currently happen.
anonymous said:
[redacted]
https://fullfact.org/health/do-we-have-fewer-hospital-beds-most-europe/https://en.wikipedia.org/wiki/List_of_OECD_countri...
To put the reduction in beds due to improvements in medical technology into perspective, my uncle had a heart attack a week or so before Xmas. He was released from hospital, having had three stents inserted - without even a local anaesthetic, let alone a general - within 30hrs of the heart attack happening. Amazing stuff.
dazwalsh said:
This really pisses me off when the NHS gets portrayed as a third world service or a humanitarian crisis etc, just because surgery waiting times have shot up or doris has to spend 5 hours in A+E.
Yes things are bad but let's not get carried away here. Syria and Yemen would be classed as a humanitarian crisis. The NHS is just over stretched, and extra funding never really seems to help things. It probably gets pissed away on locum staff anyways.
Main problem I see is every party has a different plan for the NHS, but a 5 year term doesn't allow any meaningful change to take place, and of course any significant reform is political suicide so we just keep throwing vast sums of money at it, which does nothing for the service long term. Politics somehow needs to be removed from the equation.
Yes. Yes. Yes. Yes. Yes.Yes things are bad but let's not get carried away here. Syria and Yemen would be classed as a humanitarian crisis. The NHS is just over stretched, and extra funding never really seems to help things. It probably gets pissed away on locum staff anyways.
Main problem I see is every party has a different plan for the NHS, but a 5 year term doesn't allow any meaningful change to take place, and of course any significant reform is political suicide so we just keep throwing vast sums of money at it, which does nothing for the service long term. Politics somehow needs to be removed from the equation.
I'm also of the [probably unpopular] opinion that people need to start taking responsibility for their own health before they rely on the NHS providing care unconditionally e.g. heavy smokers who are told again and again and again that they should stop but continue shouldn't be given access to the NHS for free. I'd apply the same rule for heavy drinkers and VERY fat people although only after they've had a number of warnings about the risks their behaviour brings.
The Dangerous Elk said:
Yep, he would of been able to clear his Private List at the local Nuffield at least.
Would HAVE.Plus, it's hardly his fault that he's got free time is it? What's he supposed to do? Roll up his sleeves and go to ED?! He's not trained in that specialty.
This thread is incredible, so many people not actually in the system commenting on the ins and outs of the crisis. As a doctor who is witnessing this day in, day out I can literally see the conditions deteriorating year on year.
Of course we know there are more patients in Winter. That's why there are things called "Winter Wards". But year-on-year things are getting busier and busier. Where one ward used to be a Winter Ward, now we have one and a half. That's still not enough so we have patients sleeping in corridors overnight. There are literally nurses responsible for "the corridor". Patients do not have a call button, they shout down the corridor if they need a nurse. If that's acceptable to you then I have nothing more to say.
Plus we have got ridiculous suggestions like "we also need to stop being tied to one gp, they should be paid for seeing patients, not for just having them on their books". What happens if the patient has a multitude of long term medical conditions, requiring many consultant specialists seeing them? The GP will then need to allocate lots of their time reading the letters, arranging prescription and referrals and such-like. How is their time going to be recompensated? Similarly a patient may see their GP once in 20 years, and have taken their GP 5 minutes of their time for a cough / cold in 20 years - how should that be recompensated? Please think before saying stuff like that.
I work on the ground and I see things that shouldn't be happening in the first world. I have no suggestions how to improve - I am a doctor NOT a politician / manager, so don't ask me what I want. I only want our patients to get better and be discharged appropriately and at the right time with the right social support.
ks.Coventry and Warwick today cancelled all operations as there was no beds for recovery. My Daughter had just prepped a patient to be told that.
Emergency surgery was taking place only.
As the Dr said, they have plans but no one wants to pay for any slack in the system, just look at the comments on here for confirmation of that, but how do you plan for the volumes they have had to cope with. We also have not yet been hit with the flu out break which will add even more pressure.
For once Hunt was right when he said that the staff have been fantastic during this emergency, without them and the extra they have put in it would be even worse.
Emergency surgery was taking place only.
As the Dr said, they have plans but no one wants to pay for any slack in the system, just look at the comments on here for confirmation of that, but how do you plan for the volumes they have had to cope with. We also have not yet been hit with the flu out break which will add even more pressure.
For once Hunt was right when he said that the staff have been fantastic during this emergency, without them and the extra they have put in it would be even worse.
anonymous said:
[redacted]
At least one paper willing to confront the elephant in the room. Yes we have an ageing population but GP registrations have been consistently growing at 4% a year I believe. All other things remaining equal funding would also need to be rising at 4% a year in real terms just to keep up with the growth.Today I received a GP Patient Survey questionnaire from NHS England and Ipsos MORI. About 1m are sent each year, this being the 12th year of surveying.
I had a quick look on the gp-patient.co.uk website which said the survey would help the NHS to improve GP practices and other local NHS services so they better met patient needs. However I couldn’t see any details of specific improvements made following other previous surveys, nor if these resulted in any cost savings (after MORI’s fees had been included).
My strong suspicion is there aren’t any tangible benefits from this specific survey and this is just a nice little earner for MORI.
Not wanting to add to MORI’s fees I called the freephone number to tell them not to send me any reminders as I wasn’t going to complete the survey. The nice lady (who answered immediately - how many phone operators do they have??) said that was fine but I would probably receive a postcard reminder next week as this is already in the system!
Whereas my local CCG have set up a Community Involvement Panel who come up with a number of service improvements, and publish an Engagement Annual Report that details all these, which seems a far more relevant and cost effective way of improving local services.
I had a quick look on the gp-patient.co.uk website which said the survey would help the NHS to improve GP practices and other local NHS services so they better met patient needs. However I couldn’t see any details of specific improvements made following other previous surveys, nor if these resulted in any cost savings (after MORI’s fees had been included).
My strong suspicion is there aren’t any tangible benefits from this specific survey and this is just a nice little earner for MORI.
Not wanting to add to MORI’s fees I called the freephone number to tell them not to send me any reminders as I wasn’t going to complete the survey. The nice lady (who answered immediately - how many phone operators do they have??) said that was fine but I would probably receive a postcard reminder next week as this is already in the system!
Whereas my local CCG have set up a Community Involvement Panel who come up with a number of service improvements, and publish an Engagement Annual Report that details all these, which seems a far more relevant and cost effective way of improving local services.
Actually as someone who works in the system, I can assure you that the GP patient survey is one of the most important means of gauging overall performance of GP practices and the results are taken very seriously by GPs and health service planners. The survey is pretty comprehensive and comparative across the country as the same questions are asked everywhere and where problems are highlighted it creates a lot of pressure to make improvements. So please do complete the survey if you get sent one!
anonymous said:
[redacted]
"Sensible" and "Daily Wail" aren't words that I normally associate as going together so I was intrigued to see the author, only to be let down that it was Meirion Thomas who is about as sensible as a chocolate teapot. True the population is increasing both through migration and babies being born, but most of those migrating here are relatively fit, young and contribute to the system with taxes, employment etc and if they were ill they either wouldn't make the journey in the first place and if they did they would be turned away by hospitals except in emergency. A very small fraction of the total NHS budget is spent treating illegal, non-contributing migrants in hospital.Just visit the wards in your nearest NHS hospital if you want the proof. There are lots of foreign born people there admittedly, possibly more foreign born than UK born. But almost all the foreign born people in hospitals are working there, not patients being treated there. On the wards the patients being treated, and who are costing the NHS money, are almost entirely elderly people with multiple medical conditions who in the past would have died much sooner but live longer now in poor health thanks to medical advances. I suggest you will struggle to see any non-British born patients on many wards. Yes, primary care will see its fair share of migrants with relatively minor health complaints, but that's not what costs the NHS its money.
The fact that as a country we spend far less per capita than almost all other G20 countries on healthcare seems to be conveniently overlooked. For all those complaining that we are chucking the supposedly obscene figure of £120 billion into the NHS every year, just be aware that if we were spending at the rate Germany spends the NHS bill would be something like £160 billion a year. That's how far the NHS is underfunded compared to Western European neighbours. Calls to privatise the NHS or move to a social insurance based system have never got very far because they are inherently less efficient than tax-based funding, and if we did decide the NHS had hade its day and it was time to move on and push for health insurance, most of us would end up paying rather more from our own pockets in health care than what we pay from our tax bills.
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