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Winter Crisis in the NHS

(336 Posts)
MakeMisogynyAHateCrime Tue 02-Jan-18 20:24:13

Is anyone else incredibly upset by the news coming out of hospitals at the moment?
- All non urgent operations cancelled/pushed back
- Paramedics unable to discharge into hospital care.
- Suspension of no mixed ward policy
- Doctors apologising for “third world conditions”

I used to work in an ED and have been there when we had to close to ambulances and when we had more patients in corridors than in bays but what I’m reading from HCP on Twitter about this situation is distressing.

I couldn’t take working in the NHS as it was a few years ago but God only knows how the staff (and patients) are dealing with this at the moment. Staff in the ED I used to work in are tweeting in an official capacity about the unprecedented conditions they are facing. Most Emergency Departments in England are tweeting that they cannot currently handle the volume of patients.

Our local ED is directing people via social media to urgent care centres (for non-emergency but urgent - broken bones etc) which I would agree with but they we don’t have at all in this town and people (in a deprived area) will have to travel to a nearby city.

All of this without a mass flu outbreak.

Heartbreaking.

Clovertoast Tue 02-Jan-18 20:25:11

Just got home from a 12 hour shift. It's hell.

SomedayMyPrinceWillCome Tue 02-Jan-18 20:26:45

I left A&E after 15 years this summer. I couldn't face another winter, I'd been sick with anxiety and depression.

ChoccyJules Tue 02-Jan-18 20:31:06

In addition to the, what is it, 7 year pay freeze I am now on the happy pills and have a bite-guard to stop me grinding my teeth during my work-filled nightmares.
Despite this the staff trudge on doing super-human stuff every day.
I firmly believe the Tories want it to go under.

shouldnthavesaid Tue 02-Jan-18 20:32:32

Upset but not surprised. I was an auxiliary for acute and critical care and was relieved to leave after 3 years, no time, no staff, no resources - relying on charity and goodwill to get stuff done, it's insane.

I'm training as an AHP but only because I know I'm not limited to acute sector or public sector even (as much as I don't think my conscience could handle that).

As a relative/patient it is a nightmare. I've been 14 months waiting on urgent surgery with life changing effects from it not being done... DM had 9-10 seizures yesterday several patrial then 3 generalised.. wasn't sure to phone 999 as she wasn't unconscious until last 3 just not right (that and I'm very used to her seizures) - 45 minutes it took me to even speak to an NHS call handler. When later I asked if she could talk to a CPN as she was disassociating (part of her seizures) they said unless suicidal they can't help and to phone a charity helpline.

Timefor2 Tue 02-Jan-18 20:32:39

So worrying, the NHS truly is at breaking point and the incredible people who work for it are no doubt leaving in droves too which will only exacerbate the problem moving forwards. There are long queues of ambulances unable to drop patients at A+E at our large local hospital. Praying that my family don't need urgent medical help over the next few months.

MakeMisogynyAHateCrime Tue 02-Jan-18 20:35:27

Clover I can only imagine. I bet you’re exhausted.

Someday
That is exactly why I left, in fact I left medicine altogether. I was incredibly depressed and barely slept.

Choccy
Yes they want it to go under.
Have you tried anything for the bruxism? You can’t live like that.

TunaSushi Tue 02-Jan-18 20:36:55

Not good at all.

OddBoots Tue 02-Jan-18 20:41:22

"All of this without a mass flu outbreak." - There is a mass flu outbreak.

This is something I adapted from the WHO reporting on flunet for the UK - it is only for week 51 of each of these past 3 years but look at the scales, there is 10x as many positive samples in 2017 compared to 2015. Flu usually peaks in mid January so I am hoping this is an early peak rather than following the usual pattern because if things go as they usually do then it is going to be a rough ride for the next month.

(www.who.int/influenza/gisrs_laboratory/flunet/charts/en/)

MakeMisogynyAHateCrime Tue 02-Jan-18 20:45:31

Thanks for that clarification @OddBoots
That’s really useful actually.

OddBoots Tue 02-Jan-18 20:45:55

Sorry, I was wrong, peak is usually later, around week 8-11 - a long way to go.

annandale Tue 02-Jan-18 20:47:45

Certainly felt pretty scary today and I was on ordinary wards not the front door.

RafaIsTheKingOfClay Tue 02-Jan-18 21:03:22

Have they changed the rate at which they sample Oddboots, because that doesn’t seem to fit with what I have read in the DoH flu updates. It looks to be largely in line with Week 51/52 last year.

OddBoots Tue 02-Jan-18 21:15:58

Possibly, I can't see a mention of sample rates on the site but I might not be looking in the right place. I hope that is the case, if the DoH have different figures it seems probable.

RafaIsTheKingOfClay Tue 02-Jan-18 21:26:11

Who knows.

Here’s the DoH report for last week. www.gov.uk/government/uploads/system/uploads/attachment_data/file/670931/Weekly_report_current_1718.pdf

It might be up from last year and it has hit the threshold for an epidemic, but fortunately not as high as x10 usual though.

I think that might actually break the NHS. We could muddle though but we shouldn’t really have to.

muminmanchester Tue 02-Jan-18 21:29:51

DS had elective surgery today. I was half expecting it to be cancelled, but all went ahead swimmingly. Goes without saying that all the staff are heroes and treated him as kindly and attentively as if he was their own son and I remain, as ever, utterly floored by this previous service and everyone working within it.

I’m curious, having never worked in the NHS, what do you consider to be the major issues that could be solved? There’s a lot of talk about inappropriate A&E attendances just now but surely that can’t account for everything. Is it all rooted in cuts? What has been cut too far - too few staff, lack of investment in equipment and buildings, etc.? What could the average person do to help, if anything?

muminmanchester Tue 02-Jan-18 21:30:29

Precious, not previous!

GingerbreadMa Tue 02-Jan-18 21:35:30

I’m curious, having never worked in the "NHS, what do you consider to be the major issues that could be solved? There’s a lot of talk about inappropriate A&E attendances just now but surely that can’t account for everything."

Its not just about the people coming IN through a&e, its getting them discharged when well. So many more of our patients are now homeless or from horrible housing that OTs cant make suitable. Unpaid carers are broken and often literally "break" when their relative is admitted and end up ill in hospital too. No nationalised care homes. Not enough carers. Not enough funding..

ThePortlyPinUp Tue 02-Jan-18 21:43:51

From my short time working on a medical ward I see that understaffing and lack of adequate social care to discharge to is what causes us the most crisis. I have recently qualified and was certainly protected from the grim reality of being a registered nurse. It's been a huge culture shock as to go from supernumary status to being one of two registered nurses working on a night shift and being in sole charge of 27 patients when the other has to take their break. Nights like tonight will be spent anxiously wondering what will await me when I go in for my shift tomorrow.

RafaIsTheKingOfClay Tue 02-Jan-18 21:49:44

The inappropriate A&E attendances aren’t the root of the issue. They don’t help an overstretched ED but if they don’t need to be there then they probably get seen last.

It’s partly cuts to health and social care, but an aging population means more illness so there’s an increase in demand. That needs an increase in funding to provide the same service to more people. Social,care funding hasn’t really kept up with that at all. So you end up with people in hospital beds, who could be at home if the right care packages were put in place.

This has a knock on effect in ED because you need beds to admit people into. There’s a subsequent knock on effect to the ambulance service. Because if ED beds are full because people are waiting to go elsewhere, then the ambulances end up queuing outside and aren’t available to take other calls.

If there’s enough give in bed occupancy then it’s busy (which is expected) but you don’t hit crisis point.

GingerbreadMa Tue 02-Jan-18 21:52:47

What could the average person do to help, if anything?

Tell your relatives that you will pick them up or pay for their taxi home if you can.
Subsidised discharge transport is essential for those who need it but it gets massively backed up by people who insist theyre entitled to it despite having multiple family members who drive in to visit them daily.

Dont sit quietly rolling your eyes in a "what can you do eh" way while the relative youre visiting has a loud rant about immigrants in earshot of overseas staff. It might be the straw that breaks the camels back: hearing someone stick up for them could make all the difference.

GingerbreadMa Tue 02-Jan-18 21:56:26

Help us to plan discharges from the day you/your relative is admitted: if there are issues getting home/with house keys/with the accomodation/with concerns about carers, we can help! But please dont leave it until the day they're due to go home. Give us a heads up.

AntiHop Tue 02-Jan-18 21:56:34

We live in a rich country. The NHS should be funded properly. Makes me so mad.

BumpowderSneezeonAndSnot Tue 02-Jan-18 22:00:21

Sort the care out before they go home! Go to the red cross and rent OT equipment (on advice of what to get from the duty OT), if you can afford care you're in a fortunate position that you can arrange it and have it in place to start and so whatever you want them to do whenever you want them to do it.
Get a careline in for your elderly relative who keeps being admitted for tumbles
Fit a keysafe (£10 from b&q)
If you can do something yourself do it.

BumpowderSneezeonAndSnot Tue 02-Jan-18 22:03:03

The block is the discharge process. Instead of waiting on the letter ask for it to be posted to you if that's all that is keeping you on the ward

Support your relative - drive them home, set up an internet shop for them, visit them often, keep a notebook in the house for all visitors to write in when they visited what they did and what condition aunt mavis was in and whether anyone medical or social care was called. Get professionals to also write in it.

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