How would you fix the NHS?

@MoonPieHazySky it did drive me mad. It was the early nineties when I suggested it so over 30 years ago and it still annoys me to this day.

In our local newspaper many years ago (maybe 15 years??) there was an article about one particular ward at our local hospital where the staff procured their own non clinical supplies, i.e. sick bowls, loo rolls, soaps, paper towels, pens and paper, etc - so basically just consumables. It was some kind of trial.

The article said they'd saved tens of thousands of pounds in a single year.

For a start, it's unfathomable that they spent so much in a single ward on consumables to "save" tens of thousands, but that aside, it just showed the immense waste in procurement whereby the "official" procurement was grossly overpaying for such things when they should, by virtue of being huge buyers, have been able to command massive discounts far below what a random groups of ward staff could buy the things for!

Never heard of again of course. Can't have a single ward showing up the NHS like that can they?

Well, it's clear that fragmenting it into so many different trusts over the past 20-30 years hasn't worked, has it?

No other country has any form of "NHS" like hours! Fragmented via Trusts or not!

Absolute idiots! FS 🤦🏻

The incentive drives the cost savings 🤦🏻

This is driving me mad just thinking about it. Even a £10 incentive would be something. Fools, dickheads, twats. And it would surely reflect well on those implementing and signing off the scheme too. 🤦🏻

This sort of thing is standard in companies that follow six sigma and continuous improvement models, and it saves them millions of pounds a year – and results in a better experience for customers/suppliers/service users too, as well as employees and internal stakeholders.

This must have been such a frustrating, exasperating experience. Aaaghhhghhh!

Many years ago, we had a staff suggestion scheme.
I suggested a scheme whereby staff could put forward their suggestion, with estimated costings. In return, if it was implemented, the staff member would get a % of the savings from the first year as a reward. This would motivate staff to find ways to save money, to streamline processes, and to actively look for ways to improve.
They loved the idea but immediately threw it out as they didn't see why they should reward staff financially. The fact that they would make those savings year in year was of no concern.
Instead, they get badges printed with some trite saying like "I'm an NHS saver" on it. Like we are all 5 and love a badge.

Why has no other country adopted this? Why do you think this would work?

I’m not blind to the concerns, of course. But the better places to look for even tentative assessments of wrongdoing and unlawfulness are the court judgments in the many JR cases brought. Except in one very minor respect all the challenges to the contracts examined - which were selected as being the best cases to go for by GLP and EveryDoctor - failed comprehensively.

I won’t go through it all here: it’s too far off-topic.

I’m sure Nuffield or the BMJ (the secondary publisher) could give a full explanation.

I think they should focus on continuous process improvement and encourage staff to be feeding back inefficiencies, bottlenecks, wastage on a continual basis.

The resources wasted for absolutely no reason other than disorganisation and apathy are phenomenal.

amp.theguardian.com/politics/article/2024/sep/09/tory-covid-contracts-worth-15bn-had-corruption-red-flags-study-finds

@Rummly using which basis for inflation ? Because estimates vary defending on which you use. Depending on your original bias and agenda.

Make hospitals pay a charge if they cancel someone's operation. I am sure they could help people if they kept to original appointments. My DP has had 10 cancellations.

That's the problem. There is no National Health Service.

It's split between the various regional governments of the UK and, in England, among various "Trusts".

Stage 1. Nationalise it. One overall health service for the whole of the UK run by a UK wide Dept. of Health.

Never happen, of course, too many vested interests working against it.

The DoH estimates 1-4% of PPE contracts being compromised by fraud.

The graph is in real terms. It’s adjusted for inflation.

(Snark-free response.)

@Rummly oh and a lot of that extra 'funding' disappeared into the pockets of fake PPE providers. And private medicinal companies. Not into the NHS.

@Rummly do I need to explain how inflation works ?

The whole approach is crazy imo

Oh look, here’s a different graph (source is given). The dip after 2020 is obviously the drop in covid spend.

Another source

https://ifs.org.uk/news/past-15-years-have-been-worst-income-growth-generations

Not sure what you mean about measles, I had measles aged 1 in 1977, children still get measles now ( Andrew Wakefield, remember him?). AIDS- well pandemics happen (as we know) 1919, 'flu ? SARS , COVID not sure this was very unique to the post war generation.

Is this helpful to anyone ? NHS has been under funded for 14 years, both in capital spending and wages.

Which means if the average has been flat some people's income has been reducing.

The NHS operates on a commissioning model, it buys in services through the use of very rigid contracts.

Of course the one group whose living standards and income have continued to rise in real terms over this periods over the over 65s.

Real household incomes have been falling for everyone
Household incomes have been flat since the 2008 financial crisis, growing by less than 0.5% per year between 2007/08 and 2022/23.

From this:
https://commonslibrary.parliament.uk/how-have-living-standards-changed-since-2020/#:~:text=Real%20household%20incomes%20have%20been,%2F08%20and%202022%2F23.