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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
TeenLifeMum · 21/10/2024 11:12

Anjo2011 · 21/10/2024 11:03

Run it as a business. The amount of money wasted is astounding. Each department needs a thorough review by a team of people with a business outlook. There needs to be more care for the elderly, they can keep everyone alive longer but there is little to help with the things needed as one gets older. It is an astronomical task but it needs to be done.

They try and do this and spend millions finding out what the stay could have told them in the beginning! Deloitte has been in many times and I’m yet to see actual change and any value that matches what’s spent on them coming in!

rainfallpurevividcat · 21/10/2024 11:11

I've no idea but I am very glad they are asking for opinions and not just crashing ahead with a single politician's idea of reform.

Thommasina · 21/10/2024 11:11

Tax alcohol a lot more.

gladrefrain · 21/10/2024 11:10

Make GPs work weekends like they used to and go back to family Drs who knew their patients and would visit in the dead of night rather than having to trail a sick child to an out of hours centre miles away

Completely agree @TheSnootiestFox The pressure that has been put on A&E by GPs not working out of hours is ridiculous. Problem is there are not enough GPs either and the government is scared of losing even more of them by making them work OOH

Thommasina · 21/10/2024 11:10

Procurement is a massive scam anyway, across all public services.

TheSnootiestFox · 21/10/2024 11:09

Alexandra2001 · 21/10/2024 11:02

I was replying to your post where you so verbally abused staff that security were going to be called, you were so angry that they refused to treat your son.... that you show no empathy to over worked staff who are sick to the back teeth of people who think their sprained ankle is far more important than than someone with severe injury or disease.

I ve been forgotten in AE triage, a polite comment to the receptionist and it was sorted, no need for raised voices.

One reason my DD left the NHS was due to rude passive aggressive overbearing patients and family members.

I didn't verbally abuse anybody, tempting though it was, that was rather the point of my post.

Also, my son had a quiet word with the receptionist himself and was assured he had not been forgotten, even though in the end it was clear he was. He had, as it transpires, an actual broken foot, was in a huge amount of pain and of course could have suffered severe complications from his lack of treatment. As you were not there, I suggest that you keep your opinions to yourself. If your daughter has similar attitudes to you, then I'm sure that there will be a huge sigh of relief from the families of patients who are sick to the back teeth of incompetence, waste and staff who refuse to be accountable for their poor performance because they work for the NHS. If she can't hack the NHS then she'll have no hope in the private sector where people actually expect someone to do their job!

ThianWinter · 21/10/2024 11:09

As an NHS worker, I would get rid of the ridiculous need to order supplies through procurement and open up the ability to buy items (I'm talking about crockery, cutlery, bedding, tissues, wipes, pens, paper etc not medical supplies) from elsewhere. We needed some new lidded drinking beakers recently and the going price was more than £15 an item. The same beaker was 69p in Home Bargain. Someone, somewhere, is making an absolute fortune off the back of this.

TeenLifeMum · 21/10/2024 11:08

Better care for our elderly population would solve a lot. A&E only gets backed up because there’s no flow through the hospital. Most people in A&E do actually need to be there and are appropriately there (this has been a real shift in the last 10 years and the media message isn’t changing because it’s far more exciting than Mildred unable to be discharged do to lack of appropriate care).

Cornercandy · 21/10/2024 11:06

More policing in the number of people that attend appointments/A&E/visiting hours etc with the patient.

So why when I was allowed to see DM in a ward with DF - max 2 people per bed. was someone allowed to have 7 people round?

seagullstolemypie · 21/10/2024 11:05

Just for starters:

  • Re-nationalise the 'nolongernational' Health Service: NHS is now a misnomer! Get rid of Trusts, localised procurement and the post code lottery.
  • Get rid of the middle tier of clip-board carrying administrative management many of whom achieve little more than creating a bullying culture.
  • Those at the top should have had a minimum of 5 years clinical experience.
  • The only 'administrator' to run a ward or a clinic should be clinical (ie, a good old-fashioned Matron)
  • GPs: stop the generalised appointment system - clinics should be run on a-turn-up-and-sit-and-wait-your-turn-on-the-day, and appointments kept primarily for those needed follow-up treatment/consultations.
  • A complete overhaul of the nursing / health care assistant system and anyone wanting to enter into any aspect of healthcare to undergo psychometric testing to ensure an empathetic and caring nature. A return to the 'nursing auxiliary', 'state enrolled nurse' and 'state registered nurse' system and anyone wanting to enter immediately into registered nursing to spend a minimum of 6 months both in an auxiliary and enrolled capacity - ie, a minimum of a year's 'foundation training' in 'proper' holistic caring.
  • Geriatric wards/hospitals bed provision increased and nursing homes to be properly funded to stop 'bed blocking'.
  • Mental health provision/hospitals to be properly funded and in-bed improved to support the failing 'care in the community' and the pressure on emergency services
  • Hospice provision to be increased to stop bed blocking.
gladrefrain · 21/10/2024 11:05

Hatfullofwillow · 21/10/2024 09:13

I suspect this is a fishing exercise to see what the public will let private healthcare get away with.

We know why the NHS is struggling, we have an increasingly unequal and impoverished society and a we've cut funding to all our services. Combine that with Brexit and you've got a perfect storm.

Edited

Well no. There are other factors. Increased medical advantages mean that the cost of treatments and drugs keeps increasing Improved medical advances, including neo natal care, means more people are surviving with expensive conditions ( which has a huge impact on social care too). People are living longer which means they need medical treatment for longer.

We are also a very unfit and obese society, which is partly an individual responsibility, but also due to people living busy lives working full time and looking after kids with reduced support structures and increased workload ( kids don't run free range and entertain themselves anymore), as well factors to do with design of communities etc. Cancer rates are increasing for reasons no-one is quite sure of, with cancer rates now at a terrifying one in two instead of one in three. and many cancer rates increasing in younger age groups.

Kids are less fit and more overweight. I was genuinely shocked at the weekend when I was at an activity centre I sometimes go to, and there was a bunch of 10 year old boys there. Only one had the high level of physical capability and mastery over his body I would expect of kids that age and quite a few had poorer physical skills than me (and I am in my early 50s). All of those kids should have been able to kick my ass, no effort. These kids live in an affluent area surrounded by woods and nature and hills, but they aren't playing in that environment to acquire those skills or capability in the way kids were in my generation. Its actually quite concerning for what that means for future health of the country.

MirrorMirror1247 · 21/10/2024 11:05

TheSnootiestFox · 21/10/2024 10:03

The last time two times I have really lost my sense of humour have been been with so called 'health professionals' and I am also fed up with it. First was with my then 13 year old with a broken foot, sat in minor injuries for 7 hours watching others walk in and be treated, told I couldn't give him pain relief until he was was triaged but they forgot to triage him. Was told just to sit down and shut up. Then got to see the nurse and when I complained was asked why I hadn't just walked down to the garage (leaving him on his own to do so) to get paracetamol. I told her what had happened and demanded to see a manager to make a complaint. Was told there was no manager, nurse refused to treat my child who was in agony because I was 'aggressive' (no, but i bloody could have been!) and porter threatened to call the police on me as I was refusing to leave until I'd made a formal complaint. Second time was arriving to pick mum up after 4 hours during which time I'd assumed she'd had a colonoscopy. Clinic was running late and she'd not even been seen. This was 4pm a few weeks before Xmas. Was again told to sit and wait even though I had to collect kids, take mum home which was an hour away, get her settled (dementia), go home which was 30 mins from mum's, feed kids, get them off to cadets and me to work all before 7pm. Mum had taken piccolax and was refusing to leave until she'd had her procedure, I was refusing to wait any longer and a nurse stood with her hands on her hips and told me not to worry as if I was lucky I wouldn't lose a whole night's wages. No, I'd just have lost my job for not turning up 🙄. Single mum a few weeks before Christmas and they're telling me I can't go to work to earn money for presents.

I am sick to the back sodding teeth of hearing how stressed everyone in the NHS is. We're all stressed and busy. You're not special. In answer to the OP's question, my answer would be get rid of all the people like you who think the patients are the problem. Get rid of all the translators, eleventy billion managers that can't manage and the stupid amount of things treated. Luxuries such as IVF, smoking cessation treatments and weight loss treatments/gym memberships FOR THOSE WHO DO NOT HAVE diseases such as lipoedema or endocrine issues that make losing weight nigh on impossible. Make GPs work weekends like they used to and go back to family Drs who knew their patients and would visit in the dead of night rather than having to trail a sick child to an out of hours centre miles away. I refuse to believe it's cheaper to keep centres open and staffed. First and foremost start remembering that it's a SERVICE, the clue is in the name, and start treating the patients with more respect!

Why do you want to get rid of all the translators? They're necessary to make sure that patients understand procedures that they're being asked to consent to. I'm sure you'd agree it'd be unethical to carry out surgery on someone who hasn't had a full explanation of what needs to be done and why. Translators are very important.

Cornercandy · 21/10/2024 11:03

One thing when NHS first started in 1948, average life expectancy was 64 for men and 70 for women.

Now is 78 and 82,

NHS may have treatments and surgeries to reduce deaths in the first place but are suffering the consequences of people living longer and that has not helped them at all.

Also girls born between 2017-19 have a 1 in 3 chance of hitting 90.

Twenty years ago, you heard of very few people having grandparents living when they are in their 40s - unless they became parents at 19 and these children had children of their own when they were 19.

Anjo2011 · 21/10/2024 11:03

Run it as a business. The amount of money wasted is astounding. Each department needs a thorough review by a team of people with a business outlook. There needs to be more care for the elderly, they can keep everyone alive longer but there is little to help with the things needed as one gets older. It is an astronomical task but it needs to be done.

Alexandra2001 · 21/10/2024 11:02

TheSnootiestFox · 21/10/2024 10:47

Gosh, yes. Of course, you're right. Imagine paying for a service through non voluntary contributions and then asking asking for an explanation when it's not fit for purpose, how unreasonable!

I was replying to your post where you so verbally abused staff that security were going to be called, you were so angry that they refused to treat your son.... that you show no empathy to over worked staff who are sick to the back teeth of people who think their sprained ankle is far more important than than someone with severe injury or disease.

I ve been forgotten in AE triage, a polite comment to the receptionist and it was sorted, no need for raised voices.

One reason my DD left the NHS was due to rude passive aggressive overbearing patients and family members.

buffyfaithspike · 21/10/2024 10:59

More endometriosis centres
There are 3 local to me, all with wait lists of over a year. A friend told me wales has a 7 year wait
My consultant is off sick, the other is on mat leave so there is ONE consultant for the whole endo centre doing all the consults and operations
Meanwhile I'm clogging up a&e or a bed for pain management as they can't operate on me for months

Thommasina · 21/10/2024 10:58

Tristar15 · 21/10/2024 07:45

Focus on prevention, too many people are unwell due to lifestyle, this can be very complex at times so I would invest hugely in family support, education around health, access to early years services etc. It would take years to see any benefit from this but would make a significant difference in preventing people becoming unwell both physically and mentally. Much better joined up thinking between social services, health services, education etc

I also think that there should be hospitals just for the care of the elderly, sadly this group take up huge amounts of staff time, have long hospital stays etc if they had access to specialist services in dedicated hospitals it would make a significant difference to the way in which hospitals operate for other patients.

Agree totally with this.

Also invest more in social care so that hospitals don't become storage facilities for people who don't have healthy homes to return to.

Cornercandy · 21/10/2024 10:56

Snackpocket · 21/10/2024 09:58

I agree about social care being linked, it’s so important the two work hand in hand to keep the flow moving so people don’t stay in hospital any longer than necessary.

The NHS needs to move away from m
letters. If you are registered for the app then you should receive all correspondence through that with text/email notifications. Letters being printed and posted is a waste of time and resources. Most people get irregular post now so it’s not a reliable method of communication. But should still be an option for those exceptions who want it.

Procurement needs to be centralised so the NHS gets the best price for everything. It would have huge buying power. Currently I believe different trusts can pay wildly different prices for items like gloves etc. Costs should be consistent across the organisation.

Most appointment letters I get through the post are sent centrally from a place in Bath as has a BA postcode as returns address. Fine for anyone living around Bath, but not those who live further afield. Live about 140 miles away.

mumda · 21/10/2024 10:55

Superworm24 · 21/10/2024 10:54

Come on, we are putting a strain on the nhs and costing billions. I come from a family of "fatties". Pretty much everyone in my family is pre-diabetic or has type 2. Heart attacks and knee replacements are common. I don't think that suggesting preventitive measures regarding obesity is ridiculous at all.

But old people spend is higher than "fatties" and that's ignoring that Venn Diagram overlap.
Would you say the same about dealing with Old people? You can't cure old.

marmaladeandpeanutbutter · 21/10/2024 10:55

Definitely no privatisation.

I'd merge health and social care properly, though. If you've worked in either, the endless ping pong of blame between them, and the "us versus them" culture is awful.

Rummly · 21/10/2024 10:55

Clomid1 · 21/10/2024 10:50

Thank you for this. I am going to give this a watch. I really need to sort out my diet, I have two young kids and would like to be around for them.

It may not be a popular view, but other than in very, very rare cases being overweight is a personal matter and problem. We shouldn’t be spending hundreds of millions, possibly billions, on lifestyle change. The NHS cannot be expected to solve what we can solve ourselves.

Superworm24 · 21/10/2024 10:54

LadyGrinningSoul8517 · 21/10/2024 09:10

I wondered how long it would be before somebody blamed us fatties.

Look no further, folks. It's not sneaky underfunding to justify privatisation for the Tories rich mates, it's overweight people being too stupid to realise it's all those donuts they're eating apparently.

Come on, we are putting a strain on the nhs and costing billions. I come from a family of "fatties". Pretty much everyone in my family is pre-diabetic or has type 2. Heart attacks and knee replacements are common. I don't think that suggesting preventitive measures regarding obesity is ridiculous at all.

Alexandra2001 · 21/10/2024 10:53

Rummly · 21/10/2024 10:37

It hasn’t been fixable for decades. That’s why it’s never been fixed.

Of course its fixable, other countries manage, why can't we? Kent at one time, would send knee and hip op patients to France, to a public hospital, so quick was the turn around that patients would get an appointment time before they'd even booked a ferry....

The reason is has gone down hill in the last decade is down to less funding than it needed for population growth, an aging population & waste on privatisations.

BUT it wasn't great under Blair either, we ve paid less per pp, into healthcare than our european counterparts for decades.

Then there is turning adult social care into a NMW job, in fact even lower paid as most carers need a car, which they have to provide tax and ins themselves.

Clomid1 · 21/10/2024 10:50

Sajacas · 21/10/2024 08:18

  1. Have everyone in the UK read Ben Bikman's book, Why we get sick.
  2. In every NHS waiting room have The Public Health Collaboration's Real Food Lifestyle Course playing on an endless loop. (https://www.youtube.com/playlist?list=PL1J9GrLlUYVJQ9LUWZjp05ShyAeat5Aw- )
  3. We all start taking more responsibility for our own health, and the prevention of chronic disease.

To save the NHS and to put it bluntly, the entire western world from collapsing due to health costs, people need to learn or just remember that what we eat affects our health and lifestyle diseases are caused by our own actions.

People have learned that smoking has negative health outcomes, and we are working on accepting that drinking does too. I say working on because we all know that drinking is cultural phenomenon in the UK, and we can happily accept that drinking causes health problems, while chugging a pint or sipping a glass of something.

The next big thing is diet. We need to face the fact that the modern diet high in carbohydrates and processed foods causes ill health over the long term.

Check out the PHC for more information on steps you can take for your own health.
https://phcuk.org/

Thank you for this. I am going to give this a watch. I really need to sort out my diet, I have two young kids and would like to be around for them.

TheSnootiestFox · 21/10/2024 10:47

Alexandra2001 · 21/10/2024 10:10

So no mention of Dentistry what so ever....

@TheSnootiestFox

i'm afraid you embody all what is wrong with peoples attitudes and why staff are leaving and young people not going into health.

Edited

Gosh, yes. Of course, you're right. Imagine paying for a service through non voluntary contributions and then asking asking for an explanation when it's not fit for purpose, how unreasonable!