Waste in the NHS
Discussion
968 said:
The hospitals/GP surgery already do this but patients don't care. .
In fairness there is a poster which says 'wasted medicines cost the NHS £X per year' in the GP waiting room. Trouble is, like virtually any spare bit of NHS wall there are a hundred other posters jumbled around it which means the message (of any of them) gets lost.PurpleTurtle said:
Every appointment I have I get a reminder text saying 'non-attendance costs the NHS £XXX.XX'... good to see them doing this.
That's the sort of thing I'm talking about. I get a reminder text but no associated cost on it.technodup said:
968 said:
The hospitals/GP surgery already do this but patients don't care. .
In fairness there is a poster which says 'wasted medicines cost the NHS £X per year' in the GP waiting room. Trouble is, like virtually any spare bit of NHS wall there are a hundred other posters jumbled around it which means the message (of any of them) gets lost.PurpleTurtle said:
Every appointment I have I get a reminder text saying 'non-attendance costs the NHS £XXX.XX'... good to see them doing this.
That's the sort of thing I'm talking about. I get a reminder text but no associated cost on it.There's a lot of simple waste and mismanagement though. One GP doesn't use choose & book - she always sends people to the same local hospital. They have a 20 week waiting list to get an appointment for ENT (that's to get notified of the date, not the actual appointment) whereas the other local hospital gave me an appointment within 8 days of being referred there.
Mrs BC received a letter from our local NHS hospital with an appointment date & time. She couldn't make that day as we would be on holiday so phoned the number given in the letter to re arrange. It was on ansafone so she left a message. A few days went by with no response so she called again and left another message. Still no response.
When we got back from holiday there was a letter from our GP saying she had failed to attend her appointment.
No doubt Mrs BC's will be part of the missed appointment stats.
When we got back from holiday there was a letter from our GP saying she had failed to attend her appointment.
No doubt Mrs BC's will be part of the missed appointment stats.
bad company said:
Mrs BC received a letter from our local NHS hospital with an appointment date & time. She couldn't make that day as we would be on holiday so phoned the number given in the letter to re arrange. It was on ansafone so she left a message. A few days went by with no response so she called again and left another message. Still no response.
When we got back from holiday there was a letter from our GP saying she had failed to attend her appointment.
No doubt Mrs BC's will be part of the missed appointment stats.
At least they had an answerphone - one department at Colchester didn't and were only part time. Unfortunately their hours weren't on the website and hospital switchboard didn't know when they operated...When we got back from holiday there was a letter from our GP saying she had failed to attend her appointment.
No doubt Mrs BC's will be part of the missed appointment stats.
Gave up trying to reach them, so now I have to go to Papworth instead - 150 mile round trip instead of 20. They're running over capacity too. I had an appointment in August and they wanted to see me again 6 weeks later.. just had that appointment through and it's for 22nd December!
I did some consultancy work for a chap that had invented a device to be used when taking a urine sample.
It 99.9% prevented the patient contaminating their own mid-stream sample. This is a major issue with around 30% of samples tested having to be re-done or giving a wrong result, resulting in the incorrect presecription of medication (as one example) and massive amounts of re-tests.
Simple addition to the usual collection procedure. Very cheap device that could save the NHS millions each year.
Cutting a long story short - NHS Innovation loved it but they only had the power to instruct hospitals to assess it not to force purchasing groups to buy it. It was estimated that many Pathology labs could be scaled down by a third to fifty percent because of the massive reduction in re-testing.
Nett result was he sold not one unit - because it would mean hospitals reducing the pathology workforce and losing budget.
He has gone on to sell this device in the USA, Canada, Saudi...etc...
It 99.9% prevented the patient contaminating their own mid-stream sample. This is a major issue with around 30% of samples tested having to be re-done or giving a wrong result, resulting in the incorrect presecription of medication (as one example) and massive amounts of re-tests.
Simple addition to the usual collection procedure. Very cheap device that could save the NHS millions each year.
Cutting a long story short - NHS Innovation loved it but they only had the power to instruct hospitals to assess it not to force purchasing groups to buy it. It was estimated that many Pathology labs could be scaled down by a third to fifty percent because of the massive reduction in re-testing.
Nett result was he sold not one unit - because it would mean hospitals reducing the pathology workforce and losing budget.
He has gone on to sell this device in the USA, Canada, Saudi...etc...
attempting to save money in the NHS can have some unintended consequences.
i am a diabetic. i need to test my blood glucose several times a day before i administer my medication.
the problem that i had was using the lancets available , i could not draw blood. i searched online but could not find any. although hospitals use them , my gp refused to prescibe them for me.
as a result of not being able to monitor my blood sugar level . i ended up in A&E two days running. blocking up a bed , not to mention having to use an abulance and occupying the time oif two paramedics for an hour.
simply because my GP would not allow me any of the more sophisticated lancets. i have them now.
i am a diabetic. i need to test my blood glucose several times a day before i administer my medication.
the problem that i had was using the lancets available , i could not draw blood. i searched online but could not find any. although hospitals use them , my gp refused to prescibe them for me.
as a result of not being able to monitor my blood sugar level . i ended up in A&E two days running. blocking up a bed , not to mention having to use an abulance and occupying the time oif two paramedics for an hour.
simply because my GP would not allow me any of the more sophisticated lancets. i have them now.
jdw100 said:
Cutting a long story short - NHS Innovation loved it but they only had the power to instruct hospitals to assess it not to force purchasing groups to buy it. It was estimated that many Pathology labs could be scaled down by a third to fifty percent because of the massive reduction in re-testing.
Nett result was he sold not one unit - because it would mean hospitals reducing the pathology workforce and losing budget.
He has gone on to sell this device in the USA, Canada, Saudi...etc...
I think you have overthought the issue. The simple issue is that at trust level, people tend not to have adequate large-scale vision.Nett result was he sold not one unit - because it would mean hospitals reducing the pathology workforce and losing budget.
He has gone on to sell this device in the USA, Canada, Saudi...etc...
Purchasing will see this new device as a new cost line on the consumables budget, and some low-level ward department manager will say "no. We can't afford this". The other problem is then that there is little immediate cost saving on the pathology budget line, because the staff can't necessarily be made redundant immediately, or transferred to new development projects, and the whole project stalls.
I can give you another example. I recently found one of our senior radiographers doing some paper work after a complex radiology case, where a number of special implants were inserted using X-ray guidance. Normally, the implants are paid for by the hospital, and the hospital gets a fixed per case fee, to cover all costs related to the procedure. However, for rare procedures using very high-cost implants, instead, the hospital gets an implantation/treatment fee, and NHS England pays for the implants. However, they need an invoice to be forwarded to them.
The way they were doing this paperwork was to pick up the box of each implant, copy down the number on the bar code, and enter it into a invoice template word document. They would then look up the device in an excel spread sheet and and copy/paste each description/price line into the invoice. At the end of this, they would then total up the invoice and e-mail it out. Then they would go to another excel document and adjust the stock levels for the various devices.
Of course, barcode based invoicing and stock-control software is hardly rocket science, and is an off-the-shelf product from any number of business suppliers. It turned that there was no simple way in which this could be procured - none of the software suppliers were an "accredited supplier", and we couldn't get custom development (in house or contractor) funded because there is a long-term national strategic plan for the to introduce barcode based stock/tracking on a large scale within the next 5 years; and any development we did on this, would be "duplicated effort" (nevermind that payback time would probably have been on the 3-6 month time scale, rather than the 5-7 year deployment scale for the national project).
bad company said:
Mrs BC received a letter from our local NHS hospital with an appointment date & time.
My wife has had a few of these. She received the letter either on the day of the appointment - or on the Saturday morning for a first thing Monday morning appointment - giving her no time to rearrange the appointment (as the NHS department is closed weekends) or make arrangements with work to have the time off.
There really should be a better way by now.
Smollet said:
I’ve often wondered why food is free in a hospital. It isn’t free outside of it
Because good nutrition aids recovery and speeds it up so it’s both counterproductive and stupid to prevent people from getting food. Also a lot of in patients are elderly and in relative poverty so don’t have the ability to fund their food requirements whilst in hospital.968 said:
Because good nutrition aids recovery and speeds it up so it’s both counterproductive and stupid to prevent people from getting food. Also a lot of in patients are elderly and in relative poverty so don’t have the ability to fund their food requirements whilst in hospital.
3 days a week I attend all day rehab/physio sessions (10-2) at an NHS facility. At lunchtime we are given a brown paper bag with "food" in it. Apart from the piece of fruit (an apple or an orange) every other item in the bag is poor quality and packed with sugar/salt and additives. Many opt not to eat it. Nobody (esp. clinical staff) knows why this unhealthy rubbish is provided. Strangely enough, 500 metres away in the main hospital building there's a top class canteen/restaurant which staff patients and visitors can use and at very good prices.
drainbrain said:
3 days a week I attend all day rehab/physio sessions (10-2) at an NHS facility. At lunchtime we are given a brown paper bag with "food" in it. Apart from the piece of fruit (an apple or an orange) every other item in the bag is poor quality and packed with sugar/salt and additives. Many opt not to eat it. Nobody (esp. clinical staff) knows why this unhealthy rubbish is provided.
Strangely enough, 500 metres away in the main hospital building there's a top class canteen/restaurant which staff patients and visitors can use and at very good prices.
I can’t comment on the food you’re given. However hospitals are required to provide food for patients largely through private logistics companies contracted to provide to nhs hospitals. A large number of patients, particularly the elderly cannot afford to buy food and are unable to access it being immobile.Strangely enough, 500 metres away in the main hospital building there's a top class canteen/restaurant which staff patients and visitors can use and at very good prices.
968 said:
I can’t comment on the food you’re given. However hospitals are required to provide food for patients largely through private logistics companies contracted to provide to nhs hospitals. A large number of patients, particularly the elderly cannot afford to buy food and are unable to access it being immobile.
Well, on the topic of "waste in the NHS", what do you call providing inappropriate (and largely shunned) snacks full of salt and sugar to a roomful of amputees many of whom are elderly and most of whom are there because of diabetes or vascular illnesses? Bit like giving a cigarette ration to post-op lung cancer patients. I've a good idea where the (many) rejected food-bags go too.
Nobody would complain if it wasn't provided. And nationwide not providing it (only for most of it to be tossed in a skip) would save a good few bob I'm sure.
drainbrain said:
Well, on the topic of "waste in the NHS", what do you call providing inappropriate (and largely shunned) snacks full of salt and sugar to a roomful of amputees many of whom are elderly and most of whom are there because of diabetes or vascular illnesses? Bit like giving a cigarette ration to post-op lung cancer patients.
I've a good idea where the (many) rejected food-bags go too.
Nobody would complain if it wasn't provided. And nationwide not providing it (only for most of it to be tossed in a skip) would save a good few bob I'm sure.
Again, I can’t comment on what you report however, why have you not raised this concern with the PALS department with the hospital? If the content is so poor then you should complain about it and a more appropriate alternative should be offered.I've a good idea where the (many) rejected food-bags go too.
Nobody would complain if it wasn't provided. And nationwide not providing it (only for most of it to be tossed in a skip) would save a good few bob I'm sure.
968 said:
Again, I can’t comment on what you report however, why have you not raised this concern with the PALS department with the hospital? If the content is so poor then you should complain about it and a more appropriate alternative should be offered.
What prevents YOU commenting on it? I can give you the name of the clinic. And should the concern not be more appropriately be raised with this "PALS Dept." by any of the many staff of all types and grades aware of the issue, especially those involved with handing it out and/or dumping it? From a personal perspective I'm just a patient who can observe a waste scenario. And I can also see why for those who do consume it, it's "better than nothing" and "free" even tho' it's clearly inappropriate for most from a dietary/nutritional perspective.
In fact, it's probably NOT been brought to the PALS department's attention because of that culture of "I'm not prepared to comment" that's so prevalent whenever problems are highlighted. Or worse, it HAS been reported but there's nothing that can be done about it because of some regulation that insists SOMETHING has to be provided but there's no money to provide anything better.
So Catch 22. Not allowed to provide nothing. And no funding available for something better.
(By the way my clinical contact with NHS would be impossible for almost any private facility to improve on, although why the NHS won't work in tandem with private sector also illustrates a type of waste).
The quality of food in hospitals is variable, to say the least. My FIL was in Southmead, good choice of well prepared food which was good to look at and tasty.
He has also spent time in Barnsley and the food there was awful to look at tasted like crap and was sandwiches at lunch time which many did not want. They got food brought in instead. In defence of those who were handing out sugar laden food to diabetics, they are just people who deliver what they are given, they are not going to look at is it suitable.
The PALS groups in hospital do take everything seriously and I did make contact over the food in Barnsley as it was a waste. As for the comment that the NHS doesn't work with the private sector, it does and in some cases very well.
There are thousands of stories of waste in the NHS, but I have never worked anywhere where there is not waste always for private companies. The NHS does a million things well and a few thousand wrong we only concentrate on the things it gets wrong, sadly.
He has also spent time in Barnsley and the food there was awful to look at tasted like crap and was sandwiches at lunch time which many did not want. They got food brought in instead. In defence of those who were handing out sugar laden food to diabetics, they are just people who deliver what they are given, they are not going to look at is it suitable.
The PALS groups in hospital do take everything seriously and I did make contact over the food in Barnsley as it was a waste. As for the comment that the NHS doesn't work with the private sector, it does and in some cases very well.
There are thousands of stories of waste in the NHS, but I have never worked anywhere where there is not waste always for private companies. The NHS does a million things well and a few thousand wrong we only concentrate on the things it gets wrong, sadly.
drainbrain said:
What prevents YOU commenting on it? I can give you the name of the clinic. And should the concern not be more appropriately be raised with this "PALS Dept." by any of the many staff of all types and grades aware of the issue, especially those involved with handing it out and/or dumping it?
Quite simply because I have no idea what you were given and have your side of the story to go on, hence it's utterly ridiculous for you to expect anyone to take it further than face value. No the issue is not best dealt with by the clinical staff. It's best escalated by patients complaining about the issue, because they are the most important person in the whole process. So, if it's a major issue for you, then make a complaint.drainbrain said:
From a personal perspective I'm just a patient who can observe a waste scenario. And I can also see why for those who do consume it, it's "better than nothing" and "free" even tho' it's clearly inappropriate for most from a dietary/nutritional perspective.
In fact, it's probably NOT been brought to the PALS department's attention because of that culture of "I'm not prepared to comment" that's so prevalent whenever problems are highlighted. Or worse, it HAS been reported but there's nothing that can be done about it because of some regulation that insists SOMETHING has to be provided but there's no money to provide anything better.
No, you're not just a patient, you're the reason that department functions and if it's not functioning satisfactorily then it's up to you to make that clear to the management of the trust. You're seemingly stuck on trying to make me responsible for your issue, but to educate you the PALS department is the PATIENT LIASON service, not for staff to make complaints. Staff regularly complain about problems within departments on a variety of levels and as a clinician I have to write many of these each week. But in your case it's sheer speculation to suggest any of the above paragraph.In fact, it's probably NOT been brought to the PALS department's attention because of that culture of "I'm not prepared to comment" that's so prevalent whenever problems are highlighted. Or worse, it HAS been reported but there's nothing that can be done about it because of some regulation that insists SOMETHING has to be provided but there's no money to provide anything better.
drainbrain said:
So Catch 22. Not allowed to provide nothing. And no funding available for something better.
(By the way my clinical contact with NHS would be impossible for almost any private facility to improve on, although why the NHS won't work in tandem with private sector also illustrates a type of waste).
Again sheer speculation. The last bit is absurd and demonstrates you haven't got a clue as the NHS regularly works in tandem with private sector companies to deliver services and care, utilising private hospital facilities to provide additional capacity for NHS patients, hiring private sector companies to provide additional staff to address outpatient and theatre waiting lists, utilising private companies providing MRIs and other services for NHS patients.(By the way my clinical contact with NHS would be impossible for almost any private facility to improve on, although why the NHS won't work in tandem with private sector also illustrates a type of waste).
968 said:
drainbrain said:
What prevents YOU commenting on it? I can give you the name of the clinic. And should the concern not be more appropriately be raised with this "PALS Dept." by any of the many staff of all types and grades aware of the issue, especially those involved with handing it out and/or dumping it?
Quite simply because I have no idea what you were given and have your side of the story to go on, hence it's utterly ridiculous for you to expect anyone to take it further than face value. No the issue is not best dealt with by the clinical staff. It's best escalated by patients complaining about the issue, because they are the most important person in the whole process. So, if it's a major issue for you, then make a complaint.drainbrain said:
From a personal perspective I'm just a patient who can observe a waste scenario. And I can also see why for those who do consume it, it's "better than nothing" and "free" even tho' it's clearly inappropriate for most from a dietary/nutritional perspective.
In fact, it's probably NOT been brought to the PALS department's attention because of that culture of "I'm not prepared to comment" that's so prevalent whenever problems are highlighted. Or worse, it HAS been reported but there's nothing that can be done about it because of some regulation that insists SOMETHING has to be provided but there's no money to provide anything better.
No, you're not just a patient, you're the reason that department functions and if it's not functioning satisfactorily then it's up to you to make that clear to the management of the trust. You're seemingly stuck on trying to make me responsible for your issue, but to educate you the PALS department is the PATIENT LIASON service, not for staff to make complaints. Staff regularly complain about problems within departments on a variety of levels and as a clinician I have to write many of these each week. But in your case it's sheer speculation to suggest any of the above paragraph.In fact, it's probably NOT been brought to the PALS department's attention because of that culture of "I'm not prepared to comment" that's so prevalent whenever problems are highlighted. Or worse, it HAS been reported but there's nothing that can be done about it because of some regulation that insists SOMETHING has to be provided but there's no money to provide anything better.
drainbrain said:
So Catch 22. Not allowed to provide nothing. And no funding available for something better.
(By the way my clinical contact with NHS would be impossible for almost any private facility to improve on, although why the NHS won't work in tandem with private sector also illustrates a type of waste).
Again sheer speculation. The last bit is absurd and demonstrates you haven't got a clue as the NHS regularly works in tandem with private sector companies to deliver services and care, utilising private hospital facilities to provide additional capacity for NHS patients, hiring private sector companies to provide additional staff to address outpatient and theatre waiting lists, utilising private companies providing MRIs and other services for NHS patients.(By the way my clinical contact with NHS would be impossible for almost any private facility to improve on, although why the NHS won't work in tandem with private sector also illustrates a type of waste).
The thread isn't about "what to do about waste in the NHS". The thread is about 'WASTE IN THE NHS'. And you can stamp your foot and gnash your teeth all you like but it won't change that and it won't change the particular waste I have illustrated. If the issue is important to YOU then report it. It isn't important to me. It is of no consequence to me. I do not attend the clinic for food. And if they do offer me food I can perfectly easily reject it like most people do and I expect it gets binned.
If there is no resource management which picks up on this waste then it will go on unaddressed forever. It has been going on long before I encountered it and it will no doubt continue to go on into the far distant future. The waste is well known to the suppliers of the food and its distributors. These are not clinicians of any description although clinicians (who, like all the various disciplines in the clinic have interminable meetings about clinic-related matters) are also well aware of the paperbag food issues.
My "role" in the NHS is 'patient'. Not resource manager, nor catering administrator, nor even 'secret shopper'.
My "role" on this thread is to offer an observation on an example of "waste in the NHS". I have done that.
There is always moaning about this food. The moaning is likely to have been going on since it ever was first handed out. It is occasionally spoken about in conversations between clinical and non-clinical staff and patients. The daily pile of rejected foodbags is not invisible either. It is a great big very visible elephant in the room marked "waste".
You may believe if you wish to that this is my (or some other patient's) responsibility to address. And if you and every other jackass of similar opinion continues to believe that this waste of resources is somehow the 'fault' of a patient, or a patient's failure to take up via the appropriate channels then believe me, please believe me, this (and I imagine a hundred other wastes of one kind or another) will NEVER be addressed and will continue unabated until whoever is i/c or responsible for the management of catering supplies addresses it.
Refusal to work in tandem with private sector . My particular circumstances mean I am attended by both NHS and private clinicians. And I have a problem. I wear NHS supplied state of the art micro-processor 'controlled' hi-tech legs. Attached to 1950's (?) technology sockets which haven't been state of the art for 60 years. This is a problem. A very big problem. But is easily addressed.
I'm in contact with Jay Martin at Martin Bionics. Martin Bionics was solely established to address the manifold issues the 'traditional' sockets create for the wearers. And it's safe to say that there is not a single AK amp on the planet who doesn't struggle with traditional sockets. So Jay said, "No problem. Try my well researched and highly developed state of the art sockets. Because the problems you are having are very very common and are exactly what my sockets were designed to address". 4 grand, by the way. And so monkey simple that no more than one video-link training session is required to allow even a user never mind a clinician to set them up properly.
Meanwhile my private sector prosthetist pays a visit. Just at a point where I've become unable to use the legs because the sockets are way into the pain zone. Doesn't even have to ask what the problem is. He can tell just by my stance that the issues are from the sockets. "You need a completely different kind of socket" he says. I tell him about Jay Martin's sockets (which he and his colleagues all know about anyway) and he adds a couple of other suggestions as well.
Next clinic appointment I tell the lead prosthetist the good news. That we'll soon have a set of Martin Bionics sockets to play with. And much to my surprise I'm told that on no condition will any sockets other than those authorised and supplied by the NHS be used. Yes they know about them (and others). But they have not been tested or approved for use by NHS so they won't be getting used. And if I do get them they won't be allowing them to get fitted to my hi-tech legs nor will the physios be allowed to work with me wearing them.
My private prosthetist just laughed. Didn't seem surprised. Yet another example of refusal to work in tandem with private sector regardless of the best interests of the patient and also regardless of the assistance and benefit it would bring to the NHS clinicians work too. .
Well mate. You're an eye surgeon with a very high opinion of your opinions. So who should I take this one to? The PALS department? Don't make me laugh.
I've been sitting in a wheelchair now for six weeks waiting for "new" 1950's sockets to get made. It's too painful to wear even my training legs for more than a couple of hours a day. And the new ones? Well the way they're made they're based on a snapshot in time of what my stumps were 6 weeks ago. And of course no-one knows if the remade ones are going to be any good. Often they're not. So guess what? They get dumped in the bin and the whole process starts again. This is just lunacy. One email and a bank transfer and a set of state of the art sockets designed to deal with changes in stump shape/volume etc could be here in a couple of days. But oh no. Absolute prohibition by NHS. Crazy. Won't even try them.
So are you telling me I'm wrong? And there's some department just waiting for me to say "stop being so f
king stupid and let me get (and pay for) the kit I need to save wasting the enormous amounts you've spent on my hi-tech legs and training over the last two years which are currently lying propped against a wall" Because if they won't straighten up and co-operate with this private sector prosthetic solution, like their inedible food, all that expended resource will end up alongside it in the skip. What a WASTE.
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