How would you fix the NHS?

How will it be monitored? Targets and outcomes can be easily manipulated as we saw under Blair in the noughties where the NHS staff pulled trick after trick to "meet targets" on paper like changing a diagnosis, moving a patient between hospitals for no reason, fiddling ambulance response times by having single paramedics on motorbikes, fiddling A&E waiting times by creating separate holding areas between A&E and a ward, etc.

The problem with saying 'just make it visible across all sites' is that actually that would require a massive IT project - they tried, spent millions then abandoned it.

Pharmacy hours - we can't get pharmacists to cover current day shifts! There is a real shortage and trying to force people to work late wouldn't help.

Also - inconvenience to the patients is not a cost to the NHS. It's annoying and frustrating sure, but not an expense. Running clinics out of hours or on a weekend so you don't have to take time off work is financially idiotic- healthcare professional & receptionist overtime is a direct cost to the NHS. Your employer should provide paid time off for healthcare needs, it's their problem not the NHS's.

Personally I think we need to move to an EU style co-pay insurance model. We also need central government to take decisions on what the NHS provides to remove postcode variation.

Performance related pay. No happy medium with NHS staff (both clinical & clerical), they're either incredible or shocking, with the former needing to work even harder to carry the latter. So many employees doing the bare minimum, waiting to retire. It's why I left the NHS & will never go back. Properly rewarded, supported & motivated staff will automatically improve efficiency & outcomes.

This is a huge problem. I have regular blood monitoring because of meds I am on. I also have a yearly test ordered by a different consultant, same hospital, for something else. I have tried in vain to get both tests put on the same form so I can have just one appointment. It is such a waste of resources.

Performance related pay. No happy medium with NHS staff (both clinical & clerical), they're either incredible or shocking, with the former needing to work even harder to carry the latter. So many employees doing the bare minimum, waiting to retire. It's why I left the NHS & will never go back. Properly rewarded, supported & motivated staff will automatically improve efficiency & outcomes.

Performance related pay. No happy medium with NHS staff (both clinical & clerical), they're either incredible or shocking, with the former needing to work even harder to carry the latter. So many employees doing the bare minimum, waiting to retire. It's why I left the NHS & will never go back. Properly rewarded, supported & motivated staff will automatically improve efficiency & outcomes.

This is a huge problem. I have regular blood monitoring because of meds I am on. I also have a yearly test ordered by a different consultant, same hospital, for something else. I have tried in vain to get both tests put on the same form so I can have just one appointment. It is such a waste of resources.

I was not being critical of these families. Looking after someone who is frail is very very hard work, many of these people should not be discharged but we don't have the staff or Hospital beds for longer stays.

I was answering the PP who said that its all down to Pharmacy delays, the main problem is care packages, lack of care home beds and also funding decisions... these are keeping people in Hospital for weeks or on a separate short stay ward away from the main hospital but that is a huge cost, also needs staff.

I'm sorry about your Dad.

Well there is a reason for that. My dad died back in October after having an accident on the stairs because he was weak from prostate cancer
In my parents case they didnt want the adaptations but the reason that people refuse is because of accidents like this.
Maybe family members dont want to risk a life changing injury by helping someone with limited mobility up and down the stairs.

Will the NHS AND benefits system be there for them if they do Pffft

Another one - make the blood test, urine results to be seen by all doctors. I have heard of people having a routine blood test at their GPs then a couple of weeks later, at hospital, they want more blood tests and most of them are the same things that got tested on two weeks ago.

If just one or two more things need to be tested, just do a blood test on those. Especially if the other factors remain fairly constant. It would be cheaper and probably quicker to test one or two more things than the whole rigmarole each time.

Its about someone who has done this sort of thing for living & sees the problems day in day out vs your layman's opinion....

A pharmacy delay is 7hrs, maybe a day, compared to weeks to get a double care package.... or wait for a none existent Care Home bed.... or have a family refuse point blank to have their Mum/Dad back home until a ramp is in place or hand rails...

The same can happen in different hospitals within the same trust. When my OH finished his first course of chemotherapy at our local hospital, he was referred to a more specialist hospital in the next town, same NHS county trust. First thing the specialist consultant at the other hospital wanted was a full suite of all the tests again, i.e. MRI scan, skeletal x-ray and bone marrow sample - all had been done at the first hospital 3 months earlier but he said he had no access to the results/scans, etc. All he had in front of him was a two paragraph referral letter from the haematologist in hospital one and he said he couldn't access any test results, history of what drugs had been given, nor the monthly blood test readings showing the effect of the first course of drugs - he said the two hospitals used different systems - just 20 miles away, same county, same NHS trust. The cost of having to repeat those test was a ridiculous waste, not to mention me and OH having to make 4 more special journeys to the other hospital to have all the tests done (again). Why the hell aren't the computer systems linked within the same trust, and if they can't manage that, why the hell can't they just send the results in paper (or email) from one hospital to another. Paying a sodding taxi to courier the paper file would have been cheaper than doing all the tests again!

Its about someone who has done this sort of thing for living & sees the problems day in day out vs your layman's opinion....

A pharmacy delay is 7hrs, maybe a day, compared to weeks to get a double care package.... or wait for a none existent Care Home bed.... or have a family refuse point blank to have their Mum/Dad back home until a ramp is in place or hand rails...

Cut down on middle management, and have pharmacy with the same shifts as nurses. So patients seem on ward round at 8am don’t have to wait for the pharmacist to start at gone 9am. Or 10 at week ends. Freeing up beds quickly.

That the NHS is under one system. One example is that if we have a woman from another trust, or who has been booked by another trust, we have to repeat their blood tests even if they have had them done already by the different trust. So the woman had to be inconvenienced, there's the cost of the blood tests and the staff taking the tests, just to get information that is already there. We also can't access notes from other trusts including scans so it takes time to get these. It's so frustrating. These are small things but it baffles me that we don't have in place one system all trust use.

@ruethewhirl
I'm sorry I was a bit hard on you.

Its about someone who has done this sort of thing for living & sees the problems day in day out vs your layman's opinion....

A pharmacy delay is 7hrs, maybe a day, compared to weeks to get a double care package.... or wait for a none existent Care Home bed.... or have a family refuse point blank to have their Mum/Dad back home until a ramp is in place or hand rails...

But of course, if your DD says so, why are we even discussing things?

Why bother?

DD says no. End of.

No one ever has witnessed patients waiting for 7 hours to be discharged because the pharmacy can’t get their act together.

@TeenLifeMum I mean, the divisional nurses, deputy divisional nurses and all that type of management. The level above matrons. We seem to have loads of roles, that no one has any idea what they actually do.

Yes for charging but would the exemptions mean hardly any money is recovered?

Social Care needs funding but it also needs staff, where from? not everyone who is "apparently" scrounging on the dole, is suitable or even able to do SC, you need a clean DBS, be healthy and physically able, a car for most roles, empathy, a caring attitude and intelligence.

My DD has been involved in patient discharges across 3 trusts in the SW, the predominant block is Social Care and the roles around it.

Most patients are still ill, they need support, care packages, home adaptations, waiting for community services to assess need, mtce teams to facilitate this.

Bear in mind, time in hospital has been cut to bone, people are sent home that just a few years ago they would not have been, they need additional care... and families are often unable to do this.

For example, a friends mum was deemed fit to discharge, with a care package, none available, she cannot toilet her self without assistance, my friend didn't want to do this for her mum, Mum stays in hospital.

There are multiple reasons patients stay in district hospital when they should be either at home or in a community hospital.. or a Care home, something that is getting ever harder to get as more homes close of refuse none self funders....

On Pharmacies, if we have a shortage of dispensing chemists, what do we do?