How would you fix the NHS?

Stop thinking we’re special eg there are 60 people in s Scotland with ingrown toenails . There is a clinic in Lockerbie all day on X day. So you all sort yourselves out get there arrange lifts (you can phone the taxi/ relative etc on your phone or get someone to do it for you at home time .job done
Next day clinic invites any one with tinnitus in the region to come if they think it might help.

Etc

My last GP surgery the doctors only ever did mornings or afternoons. They even closed for lunch for 1.25 hours

Most of the time the GPs were only at work 1.5-2 days per week

14 hour days!! I don’t think a lot of GPs at large practices work even 8 hour days for more than 2 days in any one week

Lol, i'll stop replying to you, as your clearly living under a bridge now.... and i'm not going to try and walk over it anymore.....

I kind of think the cruelty of extending the lives of the very elderly in very poor health for as long as possible will solve itself in the next generation. The generation below have seen it and I've never heard anyone say they want every treatment going, so they can stay bedbound in pain and distress for years themselves. I don't think people will allow such treatment to happen to us with life extending medication.

@Alexandra2001 they're told, get back in the surgery and see patients or you lose your licence and your contribution to the partnership.

There are not millions unemployed at all, a GP receptionist is a stressful and skilled job, which requires training, there are approx 350k long term unemployed, most of these are unemployable, MH and substance issues, most people claiming unemployment benefits are churn, shorterm between jobs.

You want to forcibly stop GPs working PT or flexibly? how?

Practice GPs are not unemployed, the issue is locums cannot get work so easily now.

We need to move with technology, Video quality is now brilliant and ooh, there is nothing wrong with using it.

Perhaps we need to move away from a GP model of care? More and more surgeries are running very well with a whole host of different clinical staff meaning we all get seen quickly by people specialised in that type of care. I'm on multiple medications for a complex health issue, my medications are reviewed and managed by my practice pharmacist, and they have an in house physiotherapist. I can't remember the last time I saw or needed to see a doctor. Even when I've had an ear or chest infection I saw a very competent nurse who prescribed my antibiotics.

@Alexandra2001 we have millions out of work. There's your receptionists.

There are unemployed GPs. Employ them. Stop this part time, flexi working from home bollocks and get them doing the job they've been trained to do.

Where will you magic up GPs from and the associated staff they need to work efficiently?

GP locums don't want to work in practice... you cannot make them.

Stop sending appointment letters after the appointment has been

We have unemployed GPs. Employ them. Then easier to see a GP, less people in A&E, ambulances can turn around quicker.

@Alexandra2001 because GPs should be seeing face to face. Not over the phone from their bed.

They can do shifts. 2 x 7 hours. As they do in hospitals.

Can you explain please why you think its ridiculous?

You want GPs, receptionists, practice nurses to do 14 hour days? and if you don't, where are the staff coming from to cover these shifts?

You ve come out with some good ideas but you don't seem to recognise the lack of HCPs in this country.

@sharpclawedkitten they are legally not allowed to do the prescribing course. They should go to prison if they are prescribing.

ANPs can prescribe. They are highly trained. PAs can have a zoology degree and then do 18 months course. So not highly trained.

The NHS needs more staff. we have trained them but we don't employ them. Which is madness.

We do sent text reminders 48 hours before (or Fridays if a Monday appointment) and on our highest cost/highest demand clinics a member of the admin team calls everyone on the list the day before to confirm attendance to try to reduce DNA's, which is hugely time consuming. But even when people confirm attendance they either don't turn up, or turn up really late after clinic has finished and then shout at us when say we can't see them.

One of the clinics my DD attends sends text reminders, but they operate across 3 sites within a 15 mile radius and the text never tells us which clinic the appointment is for. I've also lost count of the number of times we've had appointments booked for the same team, in two different sites, at the same time. Trying to cancel is very hit or miss, and they can never just book another appointment when you call to cancel, they have to send another letter, and another text reminder. The amount of outdated needless admin and lack of joined up thinking is astounding.

So many people use a&e as an out of hours doctors. I have a family member who didn’t want to miss work, so she went to a&e for her medical issue so she could have access to help for her non urgent issue. What she done is ridiculous, but so many people do this with the cost of living and not affording to miss work. I think there needs to be more access to gps, both with calling as most people are in work when the phone lines open and if you phone outside of that - you cannot gain an appointment. And as gp open times are during work hours, there needs to be slots in the evening for every surgery so people can access the care they need.

I think a lot of it relies on gp surgeries, so many people go to a&e because they cannot access appointments. And if you phone 111, most of the time they tell you to go to out of hours or a&e. More funding needs to go into gp surgeries to decrease the load of people wasting time at a&e and preventing real emergencies from getting the care they need. I almost died when I had sepsis from a mastoid infection, but a&e was so overworked I was sitting there for hours unseen. When I finally got seen, I was so close to dying and if I would have been left any longer I would have. That’s the difference between critical people in a&e being seen and people using a&e as doctors care.

@Alexandra2001 that's another issue. GPs want to work from home. I've never heard anything more ridiculous.

GPs surgeries should be 7am - 9pm 7 days a week.

Just to add to that...

Some of the money saved from the over-zealous medical interventions for the very old could be used for regular home-visits by a doctor or nurse to check on them and make any necessary adjustments to their medical care. I bet most very old people would vote for regular home-visits from a professional than being dragged into hospital all the time.

Because a GP and the associated call handlers can work from home, a MIU needs a receptionist, 2 or more nurses, HCA's... radiologist.... a Doctor... security staff.....

sharpclawedkitten · Today 09:08

Probably not a popular opinion but we should stop treating people over 85. No more operations, no drugs, no more extending existence at the detriment of wider society

I agree - and I've lost many lovely elderly relatives and friends. Many hated the near-torture of constant hospital visits, scans, investigations, treatments etc etc and just wanted to be left in peace! Some said 'You've got to go some time!' and others 'I just want to be left in peace'.

Palliative care - of course. Alleviate symptoms and pain as far as possible. But putting aged people through gruelling chemo, endless hospital visits (incredibly stressful) or nagging them to stop smoking and drinking, change their diet etc when they've little else left to take pleasure from.

I'm not young myself, so I do understand the implications of what I'm saying here. It's not as if I'm 25 and just thinking 'old people don't matter'. Yes, they do - but keeping us all alive till we're 100 is ridiculous.

@Alexandra2001 how do they managed to run OOH GPs if the staff aren't there?

It's laziness. Plain and simple. They want a 9-5.

No they are not, we ve 7 MIUs in Cornwall, very often an MIU will have to close or offer restricted opening due to lack of staff.

Normal hours are 8 til 8 and one in WEst Cornwall is open from 8am to Midnight.

On-line GP services are offered by the NHS 24/7 & there is also a ooh GP service for emergencies, usually a phone call or a first responder may be called.

Very few people are net contributors.

Paying prescription charges would be a start. Fees for appointments that either go against the cost of a prescription or a refunded when you attend. More community based care.

Just read about taking out private medical insurance. so how will that work? After paying more than average tax for 40 years and having very little back in return I'm just about getting to the age when i will start needing more medical treatment. That means that insurance would be very expensive, we could probably just about afford it but most people probably couldnt at my age.

@Kendodd I've said multiple times that people who can't afford wouldn't have to pay.

But £4.50 is really not that much for a medicine.