Mumsnet members get a 10% discount from Boden (including free returns and free delivery), The White Company, sweaty Betty, Luxury Family Hotels, JoJo Maman Bebe, Siblu, Blooming Marvellous, GLTC, Bump to 3 (the official online shop for Grobags) and more. Click here for more info Join mumsnet here.
Just had a read of this LOrd D's responses. It was all partyline stuff with regard to what the gov't has been trying ot sell recently. nowt more than a political broadcast.
He tried to use MN. <disappointed> glad I never bothered to log on that day.
As a student nurse, I would really hope to see the end of two tier funding for student nurses. The students who survive on a bursary often struggle to make ends meet and more often then not have to take a part time job to support themselves through the course, alongside working shifts on the wards full time and studying at home. The students who have been seconded are often paid more than the bursary students because they are being paid by the hospitals. Student's placements and studies suffer because of the financial problems that they face.
Please pay us better so we are not too exhausted to care for our patients efficiently. Scrap the busaries and give us a training salary that is appropriate to the work and learning that we do. You may even get to keep some of the students who are forced to leave their course because of the financial aspect of the course.
As a student in 1992 at a small rehab hospital in birmigham all staff were screened when a case of MRSA was found on the ward. The reason that MRSA proliferates is bad management, poor hygenie, the stopping of staff uniforms being washed and ironed in the in house laudry and high bed occupancies.
Please could please you add my response (well paragraphs 2 and 3 of it anyway) to Lord Darzi's non answer to the transcript summary as I'd hate anyone to think he even remotely answered my actual question.
I posted again at 14.57
By AbbyMumsnet on Wed 11-Jun-08 11:58:16
(from MNHQ)
Read it twice, if you must.
By AbbyMumsnet on Wed 11-Jun-08 11:58:01
(from MNHQ)
Hi all, just to let you know that you can read the transcript of this chat here
By AbbyMumsnet on Wed 11-Jun-08 11:58:00
(from MNHQ)
Hi all, just to let you know that you can read the transcript of this chat here
he made passing ref to mine at least on demoralised NHS workforce due to constant change. However, it was extremely "on message", spouting all the usual stuffon change management, change only for good reason etc etc. Didn't really get a proper answer, it's an important concern, without the staff onside none of this reform is going to work
disappointed that this is at least the 2nd politician who has been uninterested in dealing with issues regarding speech therapy, clearly this is a bit of a cinderella topic.
I'm really disappointed too, Poobah. Even though a number of us raised it, Lord Darzi didn't give us a satisfactory answer on enforcing good hospital cleanliness which leaves me with the impression that he doesn't see it as an important issue. (I'm going to be induced at C&W in a few days time - I hope that toilet you mentioned has been repaired. I've packed some Dettol wipes in my hospital bag!)
You talk of "top hospitals" (in London naturally). The NATIONAL health service is funded by the nation; I and a great many others funding your little empire live a long way from London 50 miles or so from a teaching hospital of any kind. It seems we have to settle for lower standards as the powers that be are not interested in implementing a best practice HAI reduction strategy across the health service.
I don't know why you skillfully "misinterpreted" my belief that under reporting HAI numbers is achieved by staff following guidelines from on high when it comes to issuing death certificates. I think we both know I wasn't talking about strategies to tackle HAI being issued from on high, don't we ?
I do know that to get ahead and stay ahead in the management of the NHS requires fancy footwork of which it seems you are capable.
He didn't answer one single question I asked. He briefly mentioned the issue of cleaning but failed to acknowledge that the main problem with cleaning is that cleaners are contracted out and are not assigned to wards/areas. The NHS is unlikely to improve with the efforts of this man. it is the same old problem and I've heard all this stuff [new initatives] before as I'm sure many of us working the the NHS have aswell. How dissappointing.
By carriemumsnet on Tue 10-Jun-08 14:08:14
(from MNHQ)
Thanks so much to everyone for all the questions and thanks Lord Darzi for taking the time to consult with us. Good luck with the report - we'll look forward to seeing it.
My children see a specialist here in France whose secretary sends a text message, 48 hours before the appt. It works on two levels - as a reminder and secondly, it seems so personal_ one wouldn't dare miss the appt!
I don't think everyone does know (or agree on) what the NHS is meant to do. For example, there are huge heated debate on here as to whether a woman is entitled to a casarean. Some people think every woman should get to choose, others think NHS resources should go elsewhere. What can I expect? If I have a document that outlines what is and is not offered by the NHS I can better make my choices.
Also, Lord Darzi, what about patients being kicked out of the NHS because they sought and paid for top up treatments privately. Is this allowed? I think it is outrageous.
ggglimpopo - non-attendance at appointments is a big issue, you are right. It would be wrong to somehow try to force people to attend - in the end it's up to them - but there are things that the NHS can do, like sending reminders and making sure people understand the implications of not turning up on other patients. Also, many non-attenders are vulnerable patients who may have good reason for not attending, and it's important we remember that.
What will a constitution actually achieve ? We all know what the NHS is there for, and what the principle is, so I don't see the point.
What the NHS needs is less words, more action - and more centralised administration so that what is effectively a huge company isn't left under the management of non professional managers with huge replication of administration.
the constitution will only be helpful if a copy can be seen by all NHS users -but more importantly if it's actually stuck to by the NHS and all who work for it. Plus of course, if a vast amount ISN"T spent on branding it etc.
Yes, I would like a constitution. My hope is that it will define what the NHS does so that doctors can know what they are meant to deliver and patients can know what they can expect to receive.
Communication is always a good thing, in my opinion.
There is enough money in my view, but we can use it better. I would like to see all maternity services run in line with best practice evidence. That might mean more staff for some local services and fewer for others. Looking at the evidence is what the local clinical working groups have done to inform the regional vision documents that I mentioned earlier, and I expect we will see improvements as the visions are implemented.
The PM announced in January that there will be an NHS constitution. I can't say what will be in it yet but I'm expecting to publish a consultation paper on it with my final report. Do you think a constitution will be helpful to patients?
If it is true that the NHS has enough money then why are maternity wards closing? Why are there so few midwives that post-natal care is virtually nonexistent? Why are many women left to labour alone sue to staff shortages? If it is not a question of money then what is it?
artichokes - i think we have enough money being invested in the NHS now (£100bn+) and we need to make sure it's spent as well as possible, to improve the quality of care and the patient experience.
I have thought more about putting records online. It is a nice idea but it would be expensive and time consuming. The NHS has very limited resources and I would much prefer those resources to be used on emloying more midwives, doctors and nurses. I would prefer money to be spent on incentives to hospital cleaners to acutally clean (unlike the one who took 5 hours to clean the blood from the floor of my hot ward in St Thomas' hospital). The NHS needs less radical new thinking and more effort spent on getting the things it already does right.
Well, the majority seem to understand that a child might be nervous or anxious or upset and they work to deal with that. They talk to the child in a sympathetic manner, and they tend to be more reassuring to the parent. Only one experience recently where i had to intercept as the guy making a mould of DD's ear for her hearing aid just went ahead and started doing without explaining what he was about to do etc. I had to jump in quickly and pre-warn DD what was about to happen (cold gunk to be squirted in her ear!).
But, I think its normal for ALL patients to feel like child patients. A great many folk havent been to hospital before. They dont know the layout, they dont know what to expect at the appointment and it can be very disconcerting - that WITHOUT the added worry about whatever health problem it is that they are going for in the first place.
Yes, most of us are not daft, but, that's not the point really, is it?
At the risk of going on about polyclinics, Lord Darzi -
could you comment specifically on the 'may offer enhanced prenatal care' issue, which the briefing doc for Ashford, Middx hospital polyclinic states -
on what basis can the private bidder choose whether to offer this - and why should one GP patient (using polyclinic) receive enhanced care because they have made the switch to the polyclinic?
I think this is a real sweetener to encourage people to swap - and then it may / may not happen but either way will lure people from their current GP who can't offer onsite midwives / antenatal care (mine do at present but I suspect the point is that this will change / be stopped).
Grateful for your confirmation on a wider basis - I'm sure this isn't unique to my PCT. Thanks :-)
Thats a good point actually - why is it that paeds generally is in pretty good shape - food is better, enviroment better (ok, thats prob because its easier to get money for the little kiddies from charitys), generally nicer place.
It is all just the 'sexy' cash flow issue ? Or is it that people think that children deserve to be treated well
Lord Darzi, I appreciate you have lots of questions and not much time, but it would be great to find out your thoughts on the issue of raising awareness of plagiocephaly. Is it something which could be talked about to every new mum (in order to address current situation of around half of all newborns having some degree of skull deformity). I appreciate babies need to be slept on their backs, but I do think the 'tummy time' message is being missed and little awareness of the condition generally. Many thanks for reading, Dawn.
Sometimes I feel that the NHS instigates new systems for its own benefit and not the benefit of patients. Some may seem like small internal administrative changes but they really impact on the patient experience. For example my materniy hospital has just speerated the antenatal department and the sonography department for admisntrative reasons. As a result your 12 week booking appt and your scan are not donw together anymore and instead they are arranged about three days apart. This means two mronings off work, two mornings of waiting around, two mornings of car park fees.
Could there be a requirement that all administraive changes are put to a patient representative body before they are approved?
And I too agree about GP receptions who think I am a fly to be swatted away. In fact the receptionist doesn't like me because I live in Sunbury (North Surrrey PCT) but managed to register at the GP in Hampton (Richmond and Twickenham Trust). She thinks I should leave the practice. I told her I didn't want to because I get a better service in HAmpton, and she said "We can always have it the way we want" in a terribly condescending snooty sort of manner.
But, I'm still there, and she still treats me like a fly. The Gp, however, is lovely.
I hate visits to the hospital that you'd rather not have to make, only to be greeted by a miserable old trout, or someone who makes you feel like you are an utter pain in the arse/incredibly stupid because you don't know what you are supposed to do/where to go.
I've experienced better service in all Paediatric clinics though.
re the IT project, wouldn't this be dependent upon a successful NHS computer database for the doctors first? my understanding is that this is something not yet achieved, and certainly not without faults and security issues..? Definitely well over budget.
Good idea in principle, but even the EBIS repeat prescription thing / appointment booking system offered by some GP's is problematic. Patients health records online is not an easy hit and I don't think you should imply that this would go hand in hand with a polyclinic system, certainly not immediately.
I think it would be great to have just one medical record that the patient could view - when I saw my maternity notes just before discharge they were factually incorrect (in that at one point they stated that my baby had been transferred to SCBU from the ward in midafternoon, when in fact he had never been to the ward and was transferred at 6am immediatly after birth). I couldn't be bothered to get a copy to complain, partly as I'd already complained at that hospital after my recurrent miscarriage fiasco, and not got much joy.
But if the patient had access to their full notes they'd know exactly where they stood with everyone.
I know that a vast amount of money was spent investing in the new computerized systems for the NHS - far more than ought to have in the circumstances. I don't think I'd like to see more money wasted trying to find a way for patients to access details online.
I must say, the last 2 years it has been vastly easier to get an appointment at my local GP clinic. Can't fault them at all actually. They are brilliant.
Well, except for the locums....and the people who regularly seem to lose specimen samples......I digress
Veni - I don't know about a malaise but I do know that the way you are welcomed in the health service is very important and could often be improved and I'm working on this.
Part of me is very tempted by the idea of access to my medical records online. That ease of access would be great. I would have concerns about teh security of my inforamtion though. The Goveernmetn does not have a great record at keeping electronic personal data safe! If safety could be guaranteed then free electronic access to records would be desirable.
Agree BigEmma. Having experienced NHS receptionists and having been a receptionist in a private hospital, the gap between service provision is HUGE in my opinion.
The hospital was cleaner (and the cleaning staff weren't better paid or had better hours and there never seemed to be enough staff on duty), but, the service provided was better.
Do you think there is a malaise in the NHS and it's workers?
What about the medical records, can the usual GP access records from the polyclinic? For example, if I get a prescription filled at the polyclininc, will my GP know about it?
When I was pregnant with my second child in 2004, I tried to get my medical records from Epsom Hopsital of my emergency caesarean in 2003. They asked my to send them £50, and then they would let me know if I needed to send them more money. I was astounded that I had to pay anything for MY records and amazed at the price they thought was reasonable. I said forget it and just told Queen Charlotte my version of the events. I find it unbelievable that this information is not readilty available to all across the nation (although I work in Information Management so perhaps my standards are higher than the average patient).
I agree with BigEmma. The receptionists at my local gps act like we are ruining their day by coming in. Like we are giant flies that need swatting away.
There is some transparent reporting already and it is possible to see the information on the NHS Choices website. But we need much more transparent information about the quality of care in its various aspects and I am looking at how we can get that and then get it onto the Choices site so that everyone can see it.
My concern is about the proposed polyclinic at Ashford Hospital. Call me cynical, but I find the fact that there is to be a super duper new pharmacy in the adjacent Tesco store rather mutually beneficial to Tesco and the PCT. I hardly think that Tesco need any help in boosting their customer levels - if the mobile public in the North Surrey PCT mainly switch to using a polyclinic at Ashford AND pop next door for prescriptions, then surely in time this will have a knock on effect on chemists locally to the smaller GP's. Meaning those of us who choose / need / are reliant on staying put have to put up with reduced service from chemists aswell (driven out of business by Tesco).
I appreciate convenience when it truly is, but suspect that once the polyclinic reaches a certain level of patient enrolment, pressure will mount for local GP's, who have to cut budgets, hours even. And the choice of local GP and / or polyclinic will go - meaning everyone is stuck for hours queueing for anonymous care.
The suggestion that there will be a parallel system will surely be a temporary situation - moving to a two tier system and then just the one option - polyclinic.
Flexibility around what patients actually need is the whole point of my Review. The new GP-led health centres will provide over 2.5 million extra GP appointments a year for a start, and my final report will say more on how we will make services more flexible.
Most people ignore the hand washes outside each ward - including some staff.
My father was recently put in a contagious diseases ward because the general ward was full.
A patient in the bed opposite him vomited on the floor.
A nurse did her best to clear up most of it. A cleaner didn't arrive for over an hour. On a contagious diseases ward.
We raised the points with the Chief Exec, who paid the relevant lip service, but tales from patients who have stayed in the same hospital since show no improvements.
Great to hear that. I'll look forward to reading what you have to say.
And what do you think about the PFI building programme ? It still doesn't make sense to me that the hospitals are built and equipped on 20 year contracts with money borrowed at bank rates, as well as allowing companies to set the rates for maintenance etc - I've heard that in one PFI hospital it cost 500 pounds to have a shelf put up.
Patients are clients, customers, consumers, users - call them what you like. But in the end they are the people who should decide how services should be set up to meet their needs. It's good that we have transparent reporting of the quality of care - that's how change happens - because patients can exercise choice based on information.
Are the government going to stop closing maternity wards?
Nearly every week there is a story of yet another one closing. My nearest is about 45 minutes away. My friend had her baby in a layby due to Malton Maternity ward being closed. I'm lucky and have family that can take me to the hospital but what about people who have no family nearby to take them to the hospital in labour. I was told that an ambulance wouldn't come out to take a woman in labour, they only go out when the baby is about 10 minutes away from being born.
Re the polyclinic, sorry I don't see how the idea that you can get treated near work and keep your local GP reconciles with the well known fact that it's difficult even to 'register' to have your baby at a hospital in another Trust's area. Are you saying that GP's either will be happy or should allow and not penalise patients to receive some care in a different trust OR is your answer to AtheneNoctua based on her working/living in (relatively) close proximity (although I'm sure her GP and a Polyclinic serving Chiswick area) would fall within different trusts.
I can't quite believe that things are going to be made flexible to allow this without patients or GP centres losing out in some way..?
In my experience, the what you are offered isa ll about what PCT you live in. If you try to cross the boundaries, they say "Sorry your not in our catchment. Bugger off." So, who will be in charge of developing thses poly clinics, and can they discriminate against who can use them?
Your first entry point will always remain the GP, whether that's your local GP or the GP in the polyclinic or health centre if there is one in your area and that's where you choose to go. In due course, patients and public will know and decide what types of services are available locally.
Why is there such a discrepancy in service, waiting times, cleanliness, hygiene and performance across the country, and even across boroughs?
I was also interested to know how the results of a recent survey conducted on maternity services at my local hospital - Chase Farm - had come back with 4 stars (out of 5 I think), and yet anyone I've EVER spoken to who has had a baby at Chase Farm has always had a less than positive experience, or has in fact had a very negative experience? I've had two babies there (no choice to go elsewhere - other hospitals were 'full' at booking in) and I was disappointed with my treatment both times. Surely this isn't a coincidence?
Is someone fudging the figures or aren't the right people being asked?
And what will happen to ensure this ? As I mentioned earlier, we've seen the govermnent overrule NICE decisions for no good economic reason, but based on media coverage and pharmaceutical company campaigning.
BigEmma - we need to make sure the principles are followed in practice for just the reason you give. Change should happen for its own sake. These principles have sprung out of the local clinical work rather than something invented in Whitehall.
Do you have any ideas for tackling the problem of non-attendence at booked appointments? When I worked in the NHS, no shows were a huge problem - as many as one in three at some clinics.
Athene - The new health centres will allow you to attend near work if you wish without having registered advance and without having to give up your local practice near home.
There's a feeling I think that in recent years government has made changes to policy in the NHS and in education too often and often in response to the latest Daily Mail tirade in attempt to look like they are doing something - and instead it looks like they are meddling. I think it's important that we give any long term proposals time to succeed - hard, I know, with an election looming - but your principles seem like the right ones to me.
Where are the polyclinics planned? I live in Sunbury and work in Chiswick. I would much prefer to nip out to a clinic in Chiswick at lunch time then have to leave work early to drive back to my local GP (who is in HAmpton, not Sunbury). When I was pregnant I would have loved ante natal appointments near work, but they were not on offer.
Sitdownpleasegeorge you asked about the NHS taking health care acquired infections seriously. The NHS shouldn’t need directions from on high to tackle problems like MRSA and C Diff. It should be done because it’s the right thing for patients. I would like to see every clinical team taking pride in the service they provide and doing everything possible to tackle infection because they want to provide a service that is among the best.
Some of the top hospitals do screen staff, e.g. the Royal Marsden in London where I work.
The other important point is that change should not just be driven by the clinicians and nursing staff, but also by all the professions allied to medicine - who are often overlooked as minority groups.
I had a question last week from MissChief who was concerned about a demoralised workforce being hit with more reorganisation. NHS staff don’t like upheaval and rightly so, but I don’t accept that they’re tired of change as long as the change is for the right reasons. If we think about it, innovation in clinical care and scientific developments are always moving on, so we are always going to have to change the services we provide and the way we provide them over time in order to give patients the best possible care. I think we have to apply 5 principles whenever we want to change services in the NHS:
• Change will always be to the benefit of patients • Change will be clinically driven • All change will be locally-led • You will be involved • You will see the difference first
Hello everyone and thanks for taking the time to send in your questions.
This is a very exciting and busy time for the NHS. In the last month each regional strategic health authority has published its vision of how healthcare will be delivered in the next ten years. If you haven’t seen your SHA’s vision go to their website and take a look. I think you’ll be pleasantly surprised at the ambitious plans they set out. Doctors, nurses, allied health professionals, patients and voluntary sector workers in each SHA have spent the last seven months looking closely at how they deliver care across the NHS and how this could be improved. These plans are ready to be rolled out and you will start to see a difference soon.
Many of you have sent in questions and I’m going to try to answer as many as possible in the next hour.
A lot of you have asked about polyclinics. It is not our policy to introduce polyclinics across the country. Last year I carried out a review of the NHS in London and polyclinics were one proposal to meet London’s specific health care requirements. Since then we have been able to fund 150 new GP services around the country using £250 million extra cash. This was our response to what I heard at a large number of local deliberative events where I met patients and members of the public to find out what they wanted to happen. They all suggested extended hours and this is why we suggested that these should be open 7 days a week from 8 til 8.
Dearbeatrice, Sidge and Edam were among many who expressed their concern that we were underestimating the value of community GP practices.
I know exactly what you mean and it is not my goal at all to spoil successful local GP practices. On the contrary, I want to see the best possible GP services. Every part of the country is different and what might be right for a big city like London might not be right for a small rural town or village.
So I look to PCTs to find out what local people want and what the clinical evidence shows leads to the best care, and get on and make it happen in the best way for local people.
Ara
By carriemumsnet on Tue 10-Jun-08 13:05:03
(from MNHQ)
Hi all and welcome
There've been heaps of advance questions and I know Lord Darzi has been working hard to prepare some answers, so I'll save time on the intro and just say over to you ...
All I really want to say is that the government needs to stop closing maternity wards. My nearest maternity ward is Scarborough which is about 45 minutes to an hours drive away. It is further for some people I know who that live in the small villages around her. This could be solved by re opening Malton maternity ward and many many others around the country.
Polyclinics - rubbish. Don't foist London-centric practically private solutions on the rest of us. Stupid extended hours - if you're that ill you'll be off work anyway....
Ditto centralised hospitals - most of us only require a GOOD CLEAN local hospital - not ultra super high tech we can repair you with nano technology.
Don't continue down this ridiculous road of backdoor privatisation - WE ARE NOT STUPID - and even those of us who don't work in the NHS can see what you're up to!
My message/query is along the same lines as nappybaglady - I am a medical registrar, nearing the end of my training, currently on my second period of maternity leave. I have been qualified for 11 years and have worked hard, including through two pregnancies. I love the NHS, it used to feel like family, I'd been brought up in it and never thought I'd leave it. But sometimes I don't recognise it any more.... But anyway.
Women in medicine - not a minority any more. A highly motivated, highly skilled majority. How are you going to retain the >50% of medical graduates, particularly in hospital medicine? What can you do within this restructure to ensure that they are not marginalised, and that women working flexibly can take on positions of responsibility too without having to essentially work full time for part time pay?
The colleges have faffed about with this for years, and the people on the front line are getting frustrated. Please, please try and make some provision for flexible training and working, bring back the hospital retainer scheme, improve on site childcare especially for rotating registrars and send a message to the thousands of female graduates who could be the hospital doctors of the future that things are getting brighter.
Otherwise they will keep saying to me 'I like working in hospital but I don't think I could do it AND have a family....'
. 
