How would you fix the NHS?

But what are you actually talking about

Well I care, I'm a tax payer. If you're proposing a multi-million pound (or more) expense id like to know how it works.

Who cares. -people die because GP want to have their little fiefdoms. Fuck em.

I know of a woman who worked for the NHS. She went off on the sick for one year, during which time she started up her own business, so was pulling in two incomes.
I'd crack down on this kind of thing, as they make it too easy.
Obviously that's only a tiny part of the problem though.

How would that work? Many GPs own the bricks and mortar and have sunk considerable sums into their businesses. What's the buy out cost?

GP surgeries owned and run by the NHS with GPs as salaried staff.

Disband, sure and as i asked earlier, replace with what?

& you can pass on the considerable costs of this to your clients, a GP practice cannot...

Area systems is where we go wrong, a GP practice IT system should be able to talk to any NHS system anywhere, otherwise its pointless, people move and can nominate ooa treatment.

Anyway, there is a program of IT works to integrate nhs into GP practice, funded by the NHS Digital, as it should be.

It should be the responsibility of the GP practice to procure software systems that integrate fully with the rest of the NHS in their area at least.

Here in accountancy, we are forced to use "compliant" software that integrates with HMRC's nationwide system for submitting tax returns, VAT returns and payroll, and which can read certain data from the HMRC. Likewise the software must integrate with Companies house for submitting company accounts and returns to Companies House. WE HAVE NO CHOICE. If we don't buy such software, we simply can't operate our businesses as we'd be unable to submit client tax returns as legally required to HMRC! Coming shortly is "MTD" for sole traders and self employed which will require quarterly returns to HMRC of accounting transactions, again by law required to be submitted by software which integrates fully with HMRC's system.

We can't just decide to write our own systems or choose a system that isn't compliant and fully integrated. We'd not be able to operate our business. Not sure why GP practices think they're so special that they can decide to choose their own software that isn't fully integrated. The GP contract that practices work under for providing services for the NHS should have been written to specify the exact tech specs of software they could use to provide a proper and full two way exchange of data between the GP surgery and other NHS systems.

No I don’t expect a small private business to integrate. They have been give the opportunity and they refused. The fact that they have systems that don’t comply with the NHS / GDS service standard is literally a crime that kills people.

I would entirely disband private GP practices full stop. They are an anachronism that holds back patient care. End them now.

😂

I ve worked in a roll out of IT within GP surgeries and our company provided IT services to several large district hospitals nationwide, some of the stuff they use is ancient, eg i ve seen (pre CV) XP used in Hospitals.

NHS IT is awful, back bone? what backbone? there isn't one but spending billions on improving this, wont, initially, get one extra patient an operation & by the time it was rolled out nationwide, it would be out of support!

You expect a small private business like a healthcentre to integrate IT with local trusts?? so my HC would need to integrate with 3 trusts... what about the rest of the country?
who pays for this?

You want GP surgeries to "drop dead" so what would you replace them with?

Clearly you’ve not worked in the NHS then. If you can tell me why GP surgeries aren’t mandated to provide services within the NHS/GDS service standard with systems and services that fully integrate with the backbone…

GP surgeries can drop dead. They are what hold
us back.

Yes, we have been here before. I was right then and I’m right now.

And yes, it will mean I have less money to spend on other consumables. I can cope with that.l

I know this is going to go down like a lead balloon,but at this stage of my life (edging 70) I am starting to think that I would prefer to buy any care I need or want privately, so that the provider answers to me, solely. Take a skid on NHS provision? I probably would not ..

We ve been here before.... the US Govt uses contractors, the NHS out sources services previously provided inhouse, now done by private companies, using previously employed NHS staff.

Thanks @Kendodd . It was the polar opposite of DMIL, whose departure took the path you describe. Dementia, on top of multiple chronic conditions, must be the cruellest way to go.

No, it uses many contractors.

My experience of GP surgeries and rolling out IT within them, is they are very much not holding anything back at all.

The NHS is full of privatised companies/services that scam their only customer, i'd start there before you turn on GPs.

I’ve worked in the NHS 5 times now. Working on a lot of the systems that need updating. GP surgeries are always the thing holding it back.

Ooh, prickly. No doubt ill-informed too, but I’ll leave it to GPs to argue.

You’re not “part of the nhs”. You’re a for profit Ltd. Company who’s only customer, is the NHS.
the sooner this insane wastage is ended the better. GPS hold back the health of the nation through your stupid Luddite attitudes.

I agree

I suppose the way to go is to talk about BMI in direct relation to standard height and weight measurements.

Rather than giving the impression you noticed they look fat.

I think the thing is tho that most people who are overweight know it and know it’s bad for their health. I think there’s a basic misunderstanding about the psychology at play and why people struggle to lose weight.

(Besides the fact – currently being demonstrated by Zoe and the data they’re amassing – that different people process different types of foods differently. I can and do eat cheese, butter and cream all day and it doesn’t impact my weight at all.)

From my own experience: I’m naturally on the skinny side (not a boast, just one of those things) and hated this at school as a teen, so never developed worries about weight gain and never really bothered about putting on a bit of weight or having a little pot belly (at a healthy BMI).

Then at one point in my early 20s I put on I don’t know – maybe half a stone or a stone (was living with a basketball player and sharing a junk food diet). So not a -massive- amount by any standard. The difference this time was that a family member kept on and on at me and made me feel really shitty about it. This weird thing then happened where I started eating compulsively. I’ve never felt the same before or since, but there was this few months where I felt bad for having put on weight (I was still a completely normal size, small even – maybe a size 12! FS…) yet would eat more than I ever had before while zoning out from these feelings of guilt. It was so odd and left a lasting impression. I’m just so sure that feeling ashamed, judged and fearful about your weight doesn’t help anyone lose it.

Maybe focusing on the health benefits of something like weight lifting would be a better approach? I think people respond better when they feel positive and virtuous about something than shamed and guilty.

Just my tuppence worth.