VERY big question. What is going wrong with the NHS. it seems to me that the NHS is dying from a thousand cuts and the current winter crisis has brought things to a head. SO, is really just a lack of funding? would throwing a billion quid at the NHS solve its problems? is it the lack of GP's and appointments causing more people to seek care in A+E? is it people turning up at A+E with trivial problems.? is it the overuse of bank staff costing many millions of pounds? is it poor planning and management of money locally by local CCG's? is it the cost of outsourcing basic services such as cleaning/catering? what about basic supplies that cost three, four or more times through official suppliers than to go to a local supplier? is it the lack of long term thinking that reduces the intake of student nurses, doctors, midwives etc? or do we expect far too much from our NHS? should the public be educated on how to use and not abuse the NHS? Has it got much too big to handle?
It's complex. Social care cannot cope with people who need to leave hospital so therefore people can't leave to go home, backing up the bed system and so on and so on. They are called DTOC's. Every hospital is overloaded with DTOC's. There are many home teams trying to keep people from going in to hospital at the same time. The NHS is underfunded but it's trying to cope with the fact that other services cannot cope. In my area for instance all the home care agencies are actually full up and have limited capacity for new clients. Then people live a lot longer. So we are obliged to keep people in a hospital until they do have care at home. At my hospital - where I work, outsourcing estates and catering has worked because that's their one function to focus on, whereas in the past managers were overloaded with all of the estates problems and it wasn't any cheaper anyway. In my area not only are people living longer it's a crazy sharp increase in people over 85 and this will continue to rise for some time. There are too many vulnerable people who need a top level of care and whilst the government continue to force trusts to slash their budgets each year by increasing %%'s this doesn't make sense. We all have to make cost savings in areas that are like bare barren waste land of staff anyway. Added to this -try employing a band 5 nurse. It's impossible. As vacancy rates soar, we have to fill them with agency staff who cost more and are less efficient than substantive staff