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How would you fix the NHS?

969 replies

PinkFruitbat · 21/10/2024 07:37

The Government is asking for ideas on how to fix the NHS.

https://change.nhs.uk/en-GB/

What would you do to fix it?

https://change.nhs.uk/en-GB

OP posts:
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16
Pussycat22 · 21/10/2024 22:49

Allthecatseverywhereallatonce, correct. People need to take responsibility for their poor lifestyle choices instead of expecting the NHS to treat their myriad of preventable diseases and co morbidities. The NHS wasn't set up for self indulgent patients but to treat genuinely ill and disadvantaged people.

Itstime2023 · 21/10/2024 22:41

I hope you're all sharing this here, below. Because the government will not be reading this thread!

change.nhs.uk/en-GB

Sam0207 · 21/10/2024 22:09

Clearer pathways to treatment and joined up thinking.

I have Fibromyalgia and CFS. When I first went to the GP, she advised it sounded as if I had Fibro and referred me to Rheumatology on the off chance that the pains in my legs were arthritis and to the Chronic Pain Clinic to manage my (awful) pain levels. Pain Clinic wouldn't even accept me onto their list until Rheumatology signed me off. Waited 18 months just for a first apt, two years until they signed me off from their services (confirming Fibro and CFS). For six months every random GP I saw (didn't actually see them, it's all phone apts now) "kept forgetting" to re-refer me to the Pain Clinic. Finally got an apt through for Dec 2025!! Thats four and a half years after I first went to the GP with indescribable pains in my legs and worse fatigue than someone with newborn twins with colic!

I can't work, I can barely walk, my pain is not managed by Pregabalin, Gabapentin, Duloxetine or Amitriptyline which are the only medication GP's can prescribe without input from the Pain Clinic (none of the above are actual painkillers, two are anti-depressants and two are anti seizure meds prescribed off brand for Fibro).

My son was under CAMHS as a younger teen. Refused to work with Adult Services when he was transferred over because of his experiences with CAMHS. Was told that because of his diagnosis he would have access to the BPD pathway when he chose to engage. For the last YEAR he's been trying to access help. GP says there is nothing they can do and no other medication alternatives - these have to be prescribed by AMH Services. AMH Services won't see him (has multiple diagnosis and is therefore not an "easy fix") as he doesn't fit any of their narrow criteria pathways (despite still having BPD) and keep sending him back to the GP. GP shrugs shoulders and re-refers to AMH - who then send him back to the GP. He just wants help to manage his worsening OCD and Agoraphobia. OCD team won't see him because her has BPD, BPD Team won't see him because he has ASD, ASD Team won't see him because he has OCD and BPD. It's fucking ridiculous.

TheSnootiestFox · 21/10/2024 21:34

Bushmillsbabe · 21/10/2024 21:23

I disagree to an extent, I think you can learn how to be better with patients, I know I have definitely learnt over the years, and that becoming a mum has made me better at supporting families I work with as I understand better how hard it is to be a parent. But you have to be prepared to learn, admit what you dont know and seek training or support, and actually acknowledge when you haven't got things quite right, not for blame, but for learning and to try to make things better. I say sorry to a patient several times a day, as the nhs isn't perfect, and I'm not perfect, and we are all human and make mistakes, but I think just acknowledging that makes people feel heard.

Ah, now I will agree about being a mum helping you understand families, I found similar as a teacher. But I do think you've either got the personality to deal with scared stressed people or you haven't. And if you haven't, then the NHS may not be the place for you just like education isn't if you can't deal with children and young people. You'd be amazed at how many very clever people left teaching becauase they didn't like kids! You can't change your instinctive behaviour and personality in my opinion.

Bushmillsbabe · 21/10/2024 21:23

TheSnootiestFox · 21/10/2024 21:14

Can I apologise to @PinkFruitbat that some silly woman is derailing her really quite fascinating thread by her endless jibes at me? And this, @Bushmillsbabe exactly this. You can't teach this. I was called a 'people person' only last week by my boss, and you've either got it or you haven't. You need to be able to get what's actually going on with the people you're dealing with immediately and not just go by what's on a piece of paper in front of you. There's so much variation in the way human beings handle a situation and healthcare professionals need to a, be able to handle that and b, understand that sometimes what they offer falls short through circumstance and they literally have a duty of candour at all times. Many would be a lot better at what they do if they actually understood people.

I disagree to an extent, I think you can learn how to be better with patients, I know I have definitely learnt over the years, and that becoming a mum has made me better at supporting families I work with as I understand better how hard it is to be a parent. But you have to be prepared to learn, admit what you dont know and seek training or support, and actually acknowledge when you haven't got things quite right, not for blame, but for learning and to try to make things better. I say sorry to a patient several times a day, as the nhs isn't perfect, and I'm not perfect, and we are all human and make mistakes, but I think just acknowledging that makes people feel heard.

TheSnootiestFox · 21/10/2024 21:14

Bushmillsbabe · 21/10/2024 20:44

I think it should be compulsory for health professionals to work for a year in the nhs in a supporting role - porter, health care assistants, admin - anything with patient contact, to fully understand that this is really what they want to do, that they have the 'soft skills' to be good at their job.
Yes, it's important to have a certain level of intelligence, but what separates an OK health professional from a great one is their soul.

Can I apologise to @PinkFruitbat that some silly woman is derailing her really quite fascinating thread by her endless jibes at me? And this, @Bushmillsbabe exactly this. You can't teach this. I was called a 'people person' only last week by my boss, and you've either got it or you haven't. You need to be able to get what's actually going on with the people you're dealing with immediately and not just go by what's on a piece of paper in front of you. There's so much variation in the way human beings handle a situation and healthcare professionals need to a, be able to handle that and b, understand that sometimes what they offer falls short through circumstance and they literally have a duty of candour at all times. Many would be a lot better at what they do if they actually understood people.

TheSnootiestFox · 21/10/2024 20:59

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Cornercandy · 21/10/2024 20:52

lovemycbf · 21/10/2024 20:44

I agree we should be allowed to but more paracetamol as this is half the problem with it that we can buy but two boxes at a time

Think ourselves lucky! Most countries do not sell paracetamols in their supermarkets and other places. You have to visit a pharmacy and some question why you want them. A friend ran out of paracetamols whilst on holiday and was charged €2 for a box and that was in Italy,

I have family that live in France and when they visit here, they buy about 30 boxes of the 40p ones in supermarkets.

You cannot be stopped doing a "paracetamol crawl" - similar fashion to a pub crawl, you go to every shop in your area and buy 2 boxes. Done that many times when full of cold.

Thatsmyjob · 21/10/2024 20:45

lovemycbf · 21/10/2024 20:44

I agree we should be allowed to but more paracetamol as this is half the problem with it that we can buy but two boxes at a time

You can buy more if you ask the pharmacist and answer a few questions.

lovemycbf · 21/10/2024 20:44

itwasnevermine · 21/10/2024 19:58

@lovemycbf yeah the irony is that the elderly get the most prescriptions and don't pay for them! Yet have to pay a tenner on the rare occasion I get a prescription

I agree we should be allowed to but more paracetamol as this is half the problem with it that we can buy but two boxes at a time

Bushmillsbabe · 21/10/2024 20:44

I think it should be compulsory for health professionals to work for a year in the nhs in a supporting role - porter, health care assistants, admin - anything with patient contact, to fully understand that this is really what they want to do, that they have the 'soft skills' to be good at their job.
Yes, it's important to have a certain level of intelligence, but what separates an OK health professional from a great one is their soul.

Cornercandy · 21/10/2024 20:44

Kendodd · 21/10/2024 19:41

It's 5% of prescriptions that are paid for apparently.

Yet asthmatics in England not claiming any form of benefits to qualify for free prescriptions pay. Yet 3 people a day die of asthma attacks and related issues. Since covid, that has gone up to 3.5-4 people a day.

All asthmatics above should get a prepaid certificate as its around £11.30 a month for 10 months of the year . Know asthmatics who take 3-4 daily meds for their asthma. If they didn't have the prepaid certificate, they would be about £500 out of pocket. Based on 52 asthma medications plus a few more such as one off things like antibiotics and other meds they take regularly.

Alexandra2001 · 21/10/2024 20:43

Kendodd · 21/10/2024 19:50

Make an on the job apprenticeship route to nursing through care homes. So if you didn't get the grades for the uni course, but prove to have all the necessary characteristics through a couple of years working in a care home you still have a route to nurse training.

Bring back on site hospital accommodation for staff.

You ve got that now, my DD worked with many Carers/HCA's who have gone onto apprenticeships.

The problem is they don't stay, until retention is addressed and that often means how we, the public, interact with the staff, then nothing will change.

ie pp who cannot see how her being threatened with Police action by nhs staff, is in anyway wrong on her part.

Agree @Bushmillsbabe my DD did care work throughout her Uni degree, set herself up for working the NHS but she left anyway, mainly because of the way management treat NHS front line.

Bushmillsbabe · 21/10/2024 20:42

Kendodd · 21/10/2024 19:50

Make an on the job apprenticeship route to nursing through care homes. So if you didn't get the grades for the uni course, but prove to have all the necessary characteristics through a couple of years working in a care home you still have a route to nurse training.

Bring back on site hospital accommodation for staff.

There is an apprenticeship route to nursing, physio, OT and various other non medical health professions. These are usually health care assistants, physio assistants etc already employed through the nhs. They need a route where they get a varied learning experience across different specialities, age groups etc, so wouldn't work in a care home.
From my experience these candidates are often the best, their course funding doesn't get agreed until they have proved themself as compassionate, organised, a good communicator, team player etc, so they thoroughly earn their place.
I did my training straight out of uni, and I think with hindsight I didn't have enough life experience to really support my patients in a holistic way. I'm excellent at my job now, but looking back I was probably not always as compassionate as I should have been as I did the 'book learning' before the 'patient learning', and patients don't always fit the textbook.

mumsneedwine · 21/10/2024 20:35

For training posts though the recruitment is central. Not sure what your job was but must have been quite specialised.

And doctors from anywhere in the world can apply on equal footing for ALL jobs. Even for F1 posts out of Uni. That's why 1,000 5th years didn't have a job straight away this year - some only got one 2 weeks before starting, on the other side of the country.

Cornercandy · 21/10/2024 20:33

faffadoodledo · 21/10/2024 19:01

We need our eyes firmly on the fact that the population is aging. Sort social care. I'd make it better paid to attract staff and yes, we'd have to pay for that in taxes.
Someone upthread mentioned specialist hospitals for the elderly. At first I thought yes. Then I realised this is tricky. What is elderly? Do we class it by age (in which case what is the threadhold age?) or by types of illness? Tricky. But in theory perhaps a good thing to look at. I know geriatric medicine is a Cinderella speciality. Let's elevate it. It might benefit all of us.
I'd also invest in public health and public health messaging. I don't know the best way of delivering this but let's dig down. We've had huge success in cutting smoking so can we pull similar levers for obesity?

My parents are in their mid 70s and I know/knew people who are 15-20 years YOUNGER who have worse health than them. Combination of self infliction (excess smoking and alcohol), illness and accidents.

Then looking back at relatives that died, some of them were younger than my parents now. DM was talking about a great aunt and she realised that my GA was 4 years younger than my DM when she passed

Bushmillsbabe · 21/10/2024 20:32

mumsneedwine · 21/10/2024 19:54

@Bushmillsbabe that's not true anymore. Anyone from anywhere can apply for jobs in the NHS (only country in the world that doesn't prioritise its use trained staff).

This year 1,200 fully trained GPs couldn't get jobs, some now driving Ubers. To get a job after F2 now has a competition ratio of between 4:1 to 40:1 depending on speciality. Many resident doctor facing unemployment as there are not enough jobs.

Same with nurses. Many that qualified this year couldn't find work.

It's bonkers. We need these staff, but the NHS won't employ them for the jobs they have trained for. Be cheaper to employ them rather than use labour from red list countries.

We as an NHS department will always use a UK candidate (UK citizen or has leave to remain) over a candidate who needs a visa, as we have to pay for the visa out of our staffing budget. But in 4 rounds of interviews recently, the only candidate who had the required skills and experience was from abroad, so we had to go with them to fill a post which had been vacant for 8 months. On previous vacancies we had a similar experience. Recruiting from abroad is expensive and time-consuming, so it's never our first choice.

mumsneedwine · 21/10/2024 20:10

@Kendodd for junior fellow jobs (doctors not in training) there can be 400+ applicants. But only 3 are eligible as don't need a visa. But staff still have to go through all applicants which they don't have time for. So jobs close within 24 hours of opening.

Loonaandalf · 21/10/2024 20:09

Trying to sign up to complete the survey but they haven’t sent out the verification code to my email, tried a few different emails but nope! Anyone else had this problem?

mumsneedwine · 21/10/2024 20:07

@Kendodd yup. Madness isn't it.

Kendodd · 21/10/2024 20:06

mumsneedwine · 21/10/2024 19:54

@Bushmillsbabe that's not true anymore. Anyone from anywhere can apply for jobs in the NHS (only country in the world that doesn't prioritise its use trained staff).

This year 1,200 fully trained GPs couldn't get jobs, some now driving Ubers. To get a job after F2 now has a competition ratio of between 4:1 to 40:1 depending on speciality. Many resident doctor facing unemployment as there are not enough jobs.

Same with nurses. Many that qualified this year couldn't find work.

It's bonkers. We need these staff, but the NHS won't employ them for the jobs they have trained for. Be cheaper to employ them rather than use labour from red list countries.

So if I was a doctor applying for a job in a UK hospital, any doctor in the world could apply for that same job? Regardless of where they lived or if they needed a visa to come here or not?

itwasnevermine · 21/10/2024 20:05

@TigerRag easy way around that is to go to a couple of different shops.

Kendodd · 21/10/2024 20:02

TigerRag · 21/10/2024 20:00

Maybe we should allow people to buy more paracetamol at a time

I think the limit is to reduce suicides and has apparently been successful in doing so.

mumsneedwine · 21/10/2024 20:01

@TigerRag it's to stop people killing themselves with it, so maybe not.