Addressing the elephant in the room; people abusing NHS, health and social care.

Are the expectations and routines clearly communicated with new patients?

So you're criticising both the patients and the staff?

A bit contradictory. The staff on one hand are running around them, allowing them to 'behave like VIP celebrities' but at the same time being lazy and not working 'gassing about the dogs and holidays'. Which is is?

When they enter your service do they get someone with authority coming around and explaining what the service is for? What I mean is do they get an introduction of this is what we provide but also this is what we expect from you? Do they get told the consequences for failure to engage and is this followed through? If the answer is no then that is where the first failing is. There will always be CF around and they will take advantage if they are allowed to. The only way the service can work is if it is running efficiently and rules are adhered to and there are active consequences if not.

As a pp has said there does need to be good communication between care and nursing staff as well as physios if they work there too. For instance a physio working there should have a list of patients and enough info on the patients and medication they are taking to be able to organise a 'ward round' to decide who to see at what point in the day.

I thought the NHS had negotiated good deals on drugs. Thought that was one of its strengths.

I’m disappointed if the Levo and Nortryptiline I’m on without an appointment in your average year is costing that much.

Annual blood test followed by a text here, too. And no interest as to whether I feel better at that dose.

This makes me laugh. I have hypothyroidism and take levo. I barely get a blood test once per year/. There are no check ups. I don’t have an endocrinologist. I have never had an X-ray etc. I think you are talking about the perfect service not the actual one people get.

I think the bottom line in this case isn’t that her partner couldn’t provide care (some people don’t have anyone - if you live a long way from relatives and have older children with special needs who can’t just go to a friend, for instance) it’s that it’s ludicrous that a hospital can’t provide so much as a slice of toast. Appropriate nutrition is a key part of nursing. Or should be.

The biggest issue is poor lifestyle choices, end of.

My husband was discharged to rehab last year.

He's a diabetic and blood sugar takes a while to rise in the morning.

Physio would arrive at 9am before he had eaten breakfast. Then, because he wasn't ready, she'd go off to see someone else and not come back.

It took me phoning the head of therapy to get him moved to a later slot on her timetable.

He had nurses attempting to manage his insulin. He's been managing his diabetes for 30+ years. He had to get his endocrinologist to tell the staff to leave him to it. Part of rehab is to be ready for discharge home rather being infantilised and stopped from doing your own routine care.

The food was also a nightmare. He doesn't eat dairy but the HCA claimed that he had "asked for ice cream" when what actually happened was that she just dumped it on his tray and walked off.

What should have been a opportunity for a 2 week intensive focus on his mobility ended up being 4 weeks of sitting in a room by himself.

I’ve worked in similar set ups. Obviously you want patients/clients to be happy and relaxed, but that’s completely different from taking the piss. You are in there for rehab, it’s not a rest home. Some people love it because it’s more sociable and supportive than home (understandable) but doesn’t have the negative connotations of being in a care home. They would happily live in that half way situation indefinitely given the choice. But there is a large queue of people who also need those facilities so you don’t want them to get too comfortable!

They did that to my father after a stroke - this heading on 10 years ago so nothing new). They packed him off home in a taxi, he barely got through the front door before collapsing and was promptly readmitted.

I still grind my teeth in rage when I think about it. All this shite about being grateful for the NHS winds me sky-high sometimes..

I know several people on levo, none feel better or have been allowed anywhere near an Endocrinology appointment or regular monitoring. Levo is dished out because it's cheap and makes your T4 /TSH look right whether you are converting T4 to T3 or not.

And on the flipside you have people like my MIL who has been in hospital with a broken hip since November and desperate to leave since the day she was wheeled in but they won't release her because her wound isn't healing properly. Her mental health is on the floor sat in a bed on a ward for months on end.

It would also penalise the parents of small children and potentially anyone with a serious long term illness. I can see what you're trying to achieve but I think there'd be too many unintended consequences.

Nurse here OP. I know exactly what you mean but plenty of people who haven't worked in healthcare will be along very soon to tell you how wrong/lacking in compassion etc you ...

I know a lady who has made it her life’s work to mug off the NHS. It’s disgusting and they should start blacklisting people like that.

I have said for a long time that we should all be allowed up to ten free GP appointments per year, then after that pay £30 or so. It would put off a lot of the malingerers.

The NHS needs massive reorganisation but no government will have the guts to do it. I had high hopes Wes Streeting might grasp the nettle but he's obviously hampered by Starmer. All that's been announced is minor tweaks and focus groups, kicking can down road. Labour has a huge majority, a real chance to do something, but I guarantee they'll do nothing. As Mrs T would say, they're too "frit".

Our parents are the same. They go the doctor weekly and insist on loads of tests. They refuse to buy any over the counter meds and ask the GP for it. All of our parents are in their 80’s and have never once had a major illness, or needed an operation. They have aches and pains, eat crap and do little exercise. They go to the doctor for any small niggle and demand tests and medicine.

If they call up and are told there are no appointments they’ll turn up to the surgery, write letters and start threatening to report people.

They just won’t accept that they are 80 - 90 and have had the luxury of a long, healthy life.

We no longer use our GP as we just can’t get appointments. We now pay for an online GP. No fuss, just get it done over the phone. I think it’s the way forward if you can afford it.

I also had twins by CS and similar happened to me, but my partner was there to bring me food - did you not have anyone with you? I'm not saying this is right but there are a lot of people whose families don't step up.

There is a group of people who are trapped at the point of needing more support but being afraid of losing independence. While also refusing the necessary lifestyle changes for improvement.

So they want the whole ‘I always use a tea cup’, while being unable to get their own tea.

They are used to organising things to suit themselves, and struggle with having tea at the time it’s made.

I had an unexpected spell in hospital and found the scheduled meals and drinks very pleasing, but DM would have only wanted one when they weren’t being offered 🤣

I currently have two elderly relatives refusing care or physio, one staying in bed watching tv all the time. My third elderly is looking on with horror and finally accepting she needs to allow some input from other people, rather than ending up like them.

Interesting, OP. My DM couldn’t wait to get out of her NHS physio care facility because the staff were uncaring and rude and the food was so bad the patients couldn’t eat it. She was left without basic toiletries and no working TV, so she sat there bored. When I went to visit, I couldn’t get her transferred out quick enough and also found the staff incredibly defensive when politely challenged about not providing enough care or food.
It was hellish.

I'm not exaggerating when I say my inlaws have visited A&E on a monthly basis for the 20 years I've been with my DH. Every minor slip, trip, twisted ankle, cut, bruise and cough gets seen to. Then it's back for check ups just in case. I think it's an enjoyment in being told by 'the system' that everything is OK. Then throw on top their various hip and knee operations (caused by obesity) - and they've bled the system dry.
Thankfully DH hasn't inherited their stupidity and has been twice in all the time I've known him.

Bloody hell, full of compassion you aren't you. Taken into hospital with heart failure, let me just get a card for the excess then we'll wheel you on through. I do agree though on the inefficiency though.

People should have to pay an excess for using NHS services.

The NHS is definitely run extremely inefficiently. The amount of paper forms, letters etc that they use is unbelievable in 2025. They really need to move into the modern day.

@Doggiedays you have my greatest sympathy. I’m so sorry you went through that.
After giving birth to my first son, I couldn’t move. I was thirsty, hungry; haemorrhaged after giving birth. Sick.
Food was left in the middle of the ward. Couldn’t physically get up to get anything. Care indeed. Hospitals are utter shit in the U.K.
OP…….I have healthcare qualifications. I understand a few of your gripes….eg tea in a china cup etc but blow me, there’s a distinct lack of bloody therapeutic care.

People with personality disorders are often very difficult to find placements for due to the disruption they can cause. Some of their behaviour can be extreme and they'd benefit from being in a psychiatric unit with suitably qualified staff, but these don't exist anymore.