Has care in the NHS and in social care improved over the last year? The Department of Health wants your views: £50 to be won NOW CLOSED

[RowanMumsnet]

Hello

As some of you will know, following the public inquiry into the failings at the Mid Staffordshire NHS Trust, the government responded last year with a set of commitments for improvements.

A year later, the Department of Health would like to know what you think about whether there has been a real improvement in the care provided by the NHS and social care providers as a result.

They say:

"When we receive care, whether that is in the NHS, social care or in our own homes, we expect, and have the right, to be treated with dignity, respect and compassion."

"Two independent public inquiries reported appalling failures in the standards in patient care at Mid Staffordshire hospital, and in the system of healthcare regulation. As a result of these inquiries, the Government said that improvements had to be made. These include a new inspector for hospitals and a tougher, independent inspection system; more nurses on hospital wards; and plans in place for turning around failing hospitals. (To see the Government's response in detail, have a look here.)"

"We are looking now at what progress has been made in improving patient care."

"Have you noticed an improvement in care you or your family have received in the past year? Do you have examples of how it's improved or changed? Do you feel more confident that any changes introduced will improve NHS care? What do you think are the biggest challenges for making care even better?"

"Material from this thread (and from another thread we're running on Gransnet, and other activities including discussions with people working in the NHS and care providers) will help inform our assessment of progress. It may also be included in an annual progress report, the first of which will be published later this year."

Over to you. Everyone who posts on this thread will be entered into a prize draw where one MNer will win a £50 John Lewis voucher.

Thanks
MNHQ

[Got99problems]

No, of course it hasn't - nurses are care staff are more stretched than ever and morale is through the floor. I work in the NHS and also have been in hospital in the last month - things are not good because staff are too stretched and can't possibly stretch themselves any thinner. In this context how on earth is care supposed to improve?

[Got99problems]

grr "nurses and care staff"

[PausingFlatly]

No amount of inspection can make up for all the hours of care, in hospital, in respite centres and at home, which have disappeared in the "austerity" cuts.

Read the elderly parents threads, as people are pushed from pillar to post by each body trying not to take responsibility for elderly people discharged from hospital and unable to care for themselves.

Read the MH boards here: people being unable to get treatment even though very ill, and even though intervention to prevent deterioration saves money long term.

Read the threads by disabled people. Those with disabled children.

Pay for it, or it's just window-dressing.

[CMOTDibbler]

My parents are both very frail physically, have multiple health issues, and mum has dementia - dad is her carer. In the last 12 months they have each had 6 emergency hospital admissions, probably 10 ambulance call outs.

The social care aspect is so frustrating - every single bit of support is like waiting for a huge crisis to occur, then something might happen. For instance dad had a massive heart arrythmia in the night, had to call an ambulance. They wanted to take him in straightaway, but weren't happy to leave mum on her own. No problem, theres an emergency carer service. Who wouldn't come out. 2 hours delay in dad getting admitted, 2 hours of paramedics sitting around...

Theres no joined up thinking either between health and social care - I've had both of them discharged without any care in place which has resulted in readmissions. Ward staff without the time to look at people as whole and deal with their needs correctly. Dementia patients left on acute admissions, terribly distressed when theres a dedicated ward in that hospital which can help.

I could go on and on tbh, and would be happy to talk about it.

There are some great practices - the Geratology unit at the JR in Oxford are amazing, and treat my dad as the man he is, and with joined up thinking.

I'm hoping the new scheme for those at risk of being admitted may help, but yet to see any effects from this

[fluffydressinggown]

I am in hospital at the moment and all I have noticed is cuts. There used to be snacks and fresh juice and now we only have Asda value squash and a packet or so of Asda value biscuits. Doesn't sounds like much but a lot of people here can't get out to buy bits and bobs so they are stuck and hungry (lots of psychiatric drugs make you very very hungry). There is no fruit or veg to snack on either.

There are never enough staff on, the staff nurses don't have time to talk to you any more. I have not seen a consultant in over two weeks.

The staff try their best but it is not enough.

In the community I find the team to be lovely but over stretched and over worked.

[SnowyMouse]

I think that care has been reduced. The new clustering in mental health services has led to a lack of continuity of care - I lost my psychiatrist of some years due to this.

[PingPongBat]

Have you noticed an improvement in care you or your family have received in the past year? - No
Do you have examples of how it's improved or changed? - No
Do you feel more confident that any changes introduced will improve NHS care? - No
What do you think are the biggest challenges for making care even better?
An increasingly elderly population, and the under-staffing in hospitals which means doctors & nurses struggle to cope, and their compassion is compromised or disappears altogether. It sometimes beggars belief what happens (or rather, what doesn't happen) on a ward for elderly people.

The care my elderly DM recently received in an NHS hospital was patchy at best. It took up to half an hour for someone to answer a call bell (she could have been on the floor in pieces, for goodness sake), sometimes because the nurses were "in a handover meeting", but often completely unexplained.

There were constant broken promises to be "back in a few minutes" - she needed a TENS machine to relieve pain, was asked by a nurse "why haven't you got it on" - answer - "because there's no-one to help me, I asked but no-one came."

We felt like the only thing on their minds was to how to discharge her asap to free up a bed. On discharge day no-one turned up, no transport, no offers of help, no-one knew what was going on. Appalling.

[TheFairyCaravan]

No it hasn't.

I am a very regular user of the NHS. I always used to get seen within the 18 weeks for referrals or inpatient/day case operations. This last year, however, it has been an absolute shambles.

I had to cancel a day case procedure with one consultant in August 2013, due to illness. I had already waited 6 months. Unfortunately I never received another date so they saw me in outpatients in January 2014 where it was decided to do another procedure and I was put on the urgent waiting list (or so I thought) again.

Weeks went past, my other consultant wrote to the department, nothing happened. This happened 3 times. Once the 18 weeks were up I phoned, only to be told I had been put on the wrong waiting list and despite my other consultant writing it had not been flagged. I was put on the other waiting list, where I waited a further 9 weeks, so it was 27 weeks in total.

I did complain to the hospital, they told me they were down on an admin worker in that department, but couldn't afford to replace them and a consultant was off on long term sick and they didn't have a locum, so 2 consultants were doing 3 people's work.

I see another consultant who admits me to hospital 3 or 4 times a year. Usually when I see him, he gets me in within 6 or 8 weeks. Last time I saw him he told me the hospital have cut his clinic time and he has lost a theatre list as well, so waiting times have increased with him too.

I am waiting for an urgent physio appointment, atm I am at 6 weeks and still counting. I haven't even had notice of the appointment yet.

DS2 had a severe shoulder injury. It was over a year from the injury to the operation. He was on the waiting list for so long that all the tests they did went out of date and we had to re-visit the hospital for a 2nd pre-op assessment.

[Shakey1500]

No it hasn't. I've had to take a day's unpaid leave today to attend a hospital appointment. Unpaid

The appointment was for 14.40 and I received a call at 10.45 cancelling the appointment and rescheduling it for next Wed.

So not only have I lost a days money today, I will lose on next Wednesday as well.

I am severely bloody pissed off.

[KeemaNaanAndCurryOn]

I've been in hospital this year and I was two years ago. The cuts are obvious when you compare and contrast. Staff are more stretched as the number of posts have fallen and people are expected to do me with even less than they had before, which is saying something.

Setting targets is pointless if you keep selling the NHS off to the highest bidder.

Mental health is massively underfunded when you look at the number of people with MH problems against budget. In 2012, my area had a 60+ unit, a dementia and Alzheimer's unit, and a 18-60 ward. Now there is one acute ward for all of the above, meaning that only the 16 sickest get help and all mixed together, so the help isn't tailored to their needs.

People are being shipped miles away from their home. When I was last admitted, they were going to put me in a hospital over an hours drive away from my family and children. It's appalling.

Also, when I was admitted in 2012 with no possessions at the time, they gave me a toothbrush, toothpaste and soap. Now you have to get access to your own money - not easy on a section - and get one of the nursing assistants to go to the shop for you. A little dignity would go a long way.

Targets are useless and used as a stick to beat overworked staff. MH nurses used to be able to spend time with the patients, now they're snowed under in a form filling, text box ticking exercise that has little to do with patient care.

Bloody well fund the service and standards will improve for the patients. It's not rocket science.

[Madratlady]

I'm writing this as a nurse. I have worked in a hospital and a nursing home and I have to say I have seen no improvements. I have seen worsening staffing levels, increasing work load, less resources and a lack of time for the things that really matter, such as taking the time to sit and chat with an patient and get to know them a bit, of take a few minutes to hold the hand of someone very sick or dying. There is a constant pressure to discharge people to free up beds.

Do you feel more confident that any changes introduced will improve NHS care? No

What do you think are the biggest challenges for making care even better?
Recruit more front line staff, pay them fairly, this will free up time to spend with patients and improve the quality of care. Make it less of a paperworky, box ticking exercise and more about the bedside. Make it easier to nurse with a family e.g flexible working, allowing set days. These things will encourage good nurses into the profession and keep them there.

[rattlesnakes]

The very fact that the dept of health is getting its evidence from an internet forum is worrying. Why not do some real, academic research?

From my point of view, my brother, who is 15 and requires inpatient mental health care, has had to travel several hundred miles to get a bed. This means that he does not have ready access to friends and family, who are of course vital for his recovery.

Of course, this is just an anecdote. If you did a proper study perhaps you'd find that the quality of adolescent mental health care is dazzling. Unlikely though.

[wonkylegs]

Nope - long term outpatient here, most things at my hospital & GP seem to be ok a bit short staffed but ok but my specialist meds delivery & care which are outsourced to a private healthcare provider have become terrible. At first they were fab, now they unreliable, turn up at the wrong time (crucial as they can only hand over to me) & have failed to bring the supporting equipment. I'm now given the bare minimum of meds too and this means that I no longer have a cushion when they cock up. It's rubbish, getting through on the phone to them is awful too!

[Bonsoir]

My mother had orthopaedic trauma surgery in Tunbridge Wells hospital ten days ago (hip replacement) and was discharged into my at home care using the Therapy Assisted Discharge Service. She has had daily visits from OTs and/or Physios. The treatment and care she has received have been EXCELLENT and I was incredibly impressed with the way the hospital OT liaised with me by email (I was at home in Paris) to organise her discharge on the day I travelled over. I cannot fault the care she received and the hospital facilities were incredible.

[Fayrazzled]

I'm another with experience of the NHS this year and while elements are very good and many, many individual practitioners within the NHS are dedicated, caring professionals, there are real problems. I can't believe elderly care or social care has improved at all. Before she died in January, my Mum was in and out of hospital (she had chronic health problems). The gerentology ward she was in before Christmas couldn't wait to get her out and trying to get information from anyone when she was an inpatient was nigh on impossible. There was rarely a nurse or doctor around, most seemed to be healthcare assistants who were obviously reluctant to discuss patients (and for good reason). On leaving hospital (I believe she was inappropriately discharged) there was a total lack of co-ordination with the local authority social services/carers, which was immensely frustrating.

Huge amounts of resources that would be better spent on frontline care, was spent paper shuffling, carrying out assessments, requiring numerous visits from different people in different teams, none of which was clear to us. The GP ended up out on several house visits but he didn't seem to have the power to make things happen either. The carer and her agency refused to visit any more because they considered without the appropriate equipment it was unsafe for them (hospital style bed and mobility aids). It was OK for my dad with his heart condition to keep soldiering on though looking after Mum. The hospital promised physiotherapy at home, 4 weeks after discharge and several assessments no 'team' would accept responsibility for this.

My Mum was lucky in the sense she had two advocates for her care (my Dad and me) although we still couldn't make things happen. It made me so worried for people on there own or without adequate support who wouldn't have a chance in hell of negotiating the system. Mum acquired an infection and died of sepsis. Very difficult at the time, but to be brutally honest, I consider it a blessing too because I don't know how much longer she and my Dad could have continued as they were. Her care at home was totally inadequate and undignified and I wouldn't wish it on anyone. (Her care during her last admission to hospital when she ultimately died, was exceptional though. She and us, her family, were very well looked after by the medical staff).

I'd be happy to talk to anyone from the DoH about our experience.

[RowanMumsnet]

@rattlesnakes

The very fact that the dept of health is getting its evidence from an internet forum is worrying. Why not do some real, academic research?

From my point of view, my brother, who is 15 and requires inpatient mental health care, has had to travel several hundred miles to get a bed. This means that he does not have ready access to friends and family, who are of course vital for his recovery.

Of course, this is just an anecdote. If you did a proper study perhaps you'd find that the quality of adolescent mental health care is dazzling. Unlikely though.

Hi Rattlesnakes,

The DoH wanted us to pass on this reply:

'The Department of Health does research into healthcare and the NHS every year. As part of assessing progress since Francis and Hard Truths, this is just one way of many that we are finding out about care and compassion in the NHS. Thank you very much for your comments.'

[CMOTDibbler]

I think that asking Mumsnet/Gransnet is a great way to see overall patterns - formal research can look at one element, but those most likely to have complex care and health needs are the ones least likely to participate in research, and if they did may well not tell the truth. For instance if you asked my dad he'd say 'oh yes, all fine' as he is terrified that someone official will say he can't cope with mum and 'put her away'.

[TooMuchCantBreath]

There have been vast improvements over the past year, sadly these are totally eclipsed by the effects of the cuts. Staff work harder, longer and for less pay than ever but they aren't able to cover the shortfalls that the cuts (sorry freezes - cuts in real terms) have created so the users only see the worsening situation. This leads to understandable frustration being shown to staff who are doing their level best. In short the people who are trying to stop the cuts effecting the users are the ones on the receiving end of the fall out. Moral is at an all time low and no wonder when, yet again, the people on the front line are being painted as the bad guys for daring to consider industrial action over the latest debacle.

[Blondieminx]

What PausingFlatly said, with bells on.

Cuts mean care is very patchy and carers are stressed and often overwhelmed by the sheer bureaucracy of getting different NHS/social care departments to coordinate, whether that's for appointments/equipment or actual care.

The Govt needs to put some money in rather than pretending to consult us with things like this thread and attempting to bamboozle us all with spin

[TeWiSavesTheDay]

No.

I don't feel like it is appropriate to give examples because in some cases legal action is ongoing.

Let me be clear, I have had very good NHS care this year. But I have also seen and heard the reality of constraints on NHS budgets. NHS 111 is a farce, a dangerous one. A call handler going through a tick box cannot tell you what a medical professional can - they can't ask the right question to work out who is understating their symptoms and who is over. They can't do that because they don't have the breadth of medical knowledge that means they can link - say, a baby being fussy at the breast with breathing problems. So they don't, and an urgent call gets marked non-urgent.

There physically aren't enough staff and beds. Particularly in labour wards. There is chronic shortage of beds, in my area labour wards in hospitals regularly close because they are physically full. It's just not safe to be telling women in labour 'well, you can drive 40-60mins away to another hospital that might have space or call an ambulance'

[TeWiSavesTheDay]

To add: the NHS needs more money. Once you get to a certain point it's the only way to raise standards - the failings I've seen in the last year aren't because of individuals with a poor attitude, it's because of structural decisions that meant less staff were employed or certain protocols for screening were removed to save money.

[Bonsoir]

I think the NHS is amazing. Incredible. I live in Paris and the healthcare service there is abysmal in comparison.

[meglet]

No.

Our excellent 7 day a week walk in centre was shut. So the OOT gp's and A&E are over run at weekends.

Mental health care is so poor it's criminal. 3 years wait and 3 chase ups to end up with a hopeless trainee counsellor.

My sister turned her back on the NHS when cuts in her dept left the staff crumbling under the pressure. She felt awful leaving but wasn't prepared to see her own health go under.

The cuts are taking effect .

[AndHarry]

No. I had a major operation at a big London hospital and was discharged 5 days later despite still being very unwell and not having the facilities at home to cope. I ended up in A&E that night to get the care I needed.