Do non NHS people realise how bad it is at the moment?

[DoyouknowJo]

I had to justify to my managers manager why I needed to spend £7 on stationery. Stationery. Some biros, some staples and a box of envelopes.

One of my colleagues chairs broke and she was told to apply to charitable funds to get a new one.

Everything is held together with sticky tape and blu tac (literally and figuratively)

We have four members of admin staff bunched into a desk meant for two, because there is no money to pay IT to put a new port in on their desks.

Waste toner cartridges are on lockdown. If yours is full you should take a scalpel, cut the seal open, empty it and then stick it back together and put it back in the printer. Don't worry about all your printing then being covered in smudgy ink. We're broke ya know.

And some fucking idiot turned up to A&E today...because their arm has been hurting for two months and they are off on holiday tomorrow and could we sort it please.

I'm thinking of starting an anonymous instagram account to get all this crap out.

The amount of money wasted astounds me.

My son was sent an outpatient appointment three weeks ago for July 29th. Two days later another letter arrived as the clinic had been cancelled for the original appointment. He couldn't make the rescheduled date (31st) so I emailed to change it and had an almost immediate response with a new date, August 5th. A letter was still sent to confirm this although I had an email containing all details.

On Monday another letter arrived cancelling the appointment on the 5th and this time to rebook I had to call the consultant's secretary who informed me that it had been cancelled as the consultant is now going to be on leave that week. He now has an appointment for the 12th which has generated yet another confirmation letter.

We're just one family and this isn't the first time that this has happened. We now fully expect the first appointment that's received to be cancelled a few days later, I have two sons who each have attend outpatients every 3 months. How much is wasted in time, printer ink, stationary and postage for everyone in these cancelled clinics?

That’s only one type of chartered qualification though. It’s not true that you couldn’t qualify without a degree in the past.

Back in the 80s, the other bodies weren't "chartered". At the time, it was only ICAEW and they required degree entry. That's why there are a lot of ACCA and CIMA accountants in their 50's today - they were the non chartered bodies of accountants, at the time, that accepted A level entry, so became hugely popular to the detriment of ICAEW especially when ACCA and CIMA were granted chartered status.

I've just finished my nursing degree. None of my cohort are using their degree to access graduate schemes. We're all going into nursing (and we've all done more than 2300 hours in clinical practice, which I can assure you includes a cleaning lot of poovomit bloodpusall completely unpaid and without employment benefits like sick leave or pensions). However I have known quite a few nurses who've qualified, started working as nurses, and then left healthcare for an entry-level job because nursing is so grim right now.

The nursing role has shifted, and it requires a higher level of biomedical knowledge and autonomous clinical judgement than it did several decades ago. Patients are less likely to die if their nurses have a degree. I think we are going back to non-degree nurses, for what it's worth, with the introduction of nursing associates. But that's because it costs less, not because it will be better for patients.

(and all nurses provide their own pens, except those who steal them off students)

@Dungeondragon15 - you probably wait an hour because appointments are prioritized at good GP surgeries. That means if a real emergency walks or calls in everybody else will get delayed.

No, I go often and always have to wait a long time so I very much doubt that is because there always is an emergency. Even if it is then it demonstrates that that the no shows aren't causing them to sit around twiddling their thumbs.

If this is the case then why did I get TWO pieces of post for every one of my baby's vaccinations recently? A card to say I would get a letter, then a letter telling me to make an appointment. For the 8,12 and 16 week vaccines, so that's 6 pieces of post in total.

Yes Kazzy I know how the tax rate works but my point is that the public still suffer when Doctors leave or go part time. This Country isnt in a position to lose NHS staff willy nilly. The Government needs to look for ways to retain staff.

I think I have a clue.

Three years ago my consultant told me he was going to have to remove my right hip prosthesis because it had shifted and he couldn't replace it a third time because my bones were too thin. As a result of the shift the tail was grinding on the inside of my thigh bone and causing a lot of pain. Eight months went by and I heard nothing. It was only because I was with my surgery nurse who was looking on my records, she discovered a letter to my consultant saying they were refusing funding. Wrote to consultant who said oops, sorry you weren't informed but we have funding now.

Sends for pre op but can't be done at my local hospital, only one 15 miles away. I basically can't walk so get ambulance transport. The months go by, pre op is now out of date, still in a lot of pain, receive appt to see consultant who says sorry. Another pre-op 15 miles away, more ambulance transport, no sign of a date for op, that too runs out.

Last December see the Registrar at outpatients - we are definitely going to do op, 3rd pre-op, more ambulance transport. That was in February, now out of date, no word of date for surgery, still in a lot of pain. Just about to write to consultant to ask what the fuck is going on - politely of course.

So yes, I do realise, and if I hadn't had 3 pre-ops you could doubtless afford pens and a new chair.

Also the nursing course now has changed massively and I don’t think for the better, I qualified over 10 years ago, all my placements included a variety of settings including medical and surgical wards, theatres, various community placements, care homes, clinics, specialist units like renal. I have a diploma, I’m working towards my degree because there are modules I’d like to complete so I’ll use the points.

When I worked in theatre it wasn’t uncommon to have a third year student come to us in their final placement who had never carried out personal care, wouldn’t have a clue how to shave a patient or brush their teeth but they could write a good essay. The degree course costs more than my diploma course did as far as I know and yes there are fantastic students but it’s a common complaint from them that they’ve really had to fight for a care home or ward placement and I’ve seen a lot of newly qualified nurses leave the hospital and wards after six months to a year for things like PIP because the wards aren’t what they thought they’d be. I don’t know how that’s cost effective to put people through all that training for them to leave or not work in the areas which so badly need the staff because they haven’t been exposed to it at all through training.

The TPN crisis needs coverage too. Hundreds of people left with no nutrition as a private company paid by the nhs have screwed up again. People being admitted, hospitals having to make up a bag a day (not a quick process), patients physical and mental health taking a huge knock. I wonder how much the nhs paid the company

It seems like the nursing masters is very different @DefinatelyAWeeGobshite. The person I know who did it was used as an unpaid healthcare assistant on various wards and had six weeks of 13 hour shifts on one of them.

@Graphista that sounds a programme worth watching, I’ll take a look at it

YANBU. I do think it is hard for most people to know, whether it's the NHS or schools or local government or other badly affected areas, just how bad it is as, obviously, most staff are putting on a brave face and trying to be reassuring to the people relying on it. It also feels very complex and difficult to know what people individuals can do.

I’m very sorry for people who have had wrong diagnoses. Sometimes symptom progression helps give important clues - diagnosis is much more like trial and error rather than House.

While I don't doubt there are a few people who might expect it to be like TV, I agree this comes across as patronizing and ignores the mismanagement that is happening -- and the lack of any improvement or consequences when they're found out.

I had a wrong diagnosis for over 5 years because multiple professionals did not follow NICE Guidelines to use blood test results for someone my age rather than only symptoms. We can only guess that they diagnosed solely based on some of my symptoms, but as more than one said my results meant I had it, it has been very disorientating time to find out no, none of my results from the blood tests I've had over the years had ever come close to suggesting that diagnosis and their screens tell them when bringing my results the expected ranges for different situations so not really something that can be pinned on lack of knowledge in the area. There are now concerns that because there wasn't the trial and error to investigate my condition over those years, I likely have progressed farther down the losing the ability to reliably walk and other functions having gone untreated as everything was shoved under this condition I don't actually have (and maybe thankfully against NICE Guidelines, I was never treated for it either, I was just expected to manage it).

Part of the problem is, while fuck-ups happen because we're all humans, it is very difficult to see, to use the trite phrase 'lessons being learned' or much recognition at all even in cases of severe medical abuse and/or neglect with major consequences. Many, including myself, have tried to bring attention to HCP screw ups only to find there are gaps in our records that make it difficult to prove anything. I literally have a surgery no one can find any records for - it was a surgery I required after a HCP fucked up to the point I needed multiple transfusions and the surgery to fix, but my records stop just before the fuck up and continue after I'm in a high dependency ward. It feels that the staff that care and the patients are having to do a lot of extra work because we're at a point of just needing bodies in places and it's beyond ridiculously difficult to bring them to account and even when people should, many have concerns that doing so will only further damage the NHS.

In my medical imaging department, when x ray machines breakdown (weekly, often), the machines are so old the companies scavenge parts from decommissioned units in India. All four of our 'general' machines are over 22 years old.

Managers are trying to force more out of us by 'multi-skilling' us, which means Jack of All Trades and that your MRI is being done by someone with minimal training and maybe once every 3 to 4 weeks exposure to MRI, given that they're x raying hands and feet at 3 am the rest of the time.

So many staff have left due to Brexit, burn-out, better offers in other professions, anger with the ineptitude of the middle management who drive down to a budget, not up to a standard- that we have to recruit from the third world. Some are okay, some are evidently barely trained, x raying a right knee when a left foot was requested, and even doing that badly. No, he's not being 'thorough' with his fifth image- he's still trying to get his first projection (of two) correct.

I would conceded one point, though: I do think there's way too much absenteeism in the NHS. To a certain extent, this is because there are too few staff actually monitoring it, either in HR or an shop-floor management level. This has an unfortunate affect of dedicated, not piss-taking staff beginning to wonder why they're being so conscientious when they see no adverse consequences of working that enhanced rate Sunday then calling in on Monday, 'sick'.

Regarding nursing or HCP degrees, I think a looming problem is the political motivation behind introducing apprenticeships.

This will come to medical imaging, shortly. Several of our HCAs are preparing to leap in once they go live. By 'preparing', I mean trying to pass Maths and English GCSEs, and taking endless NVQ level 3 courses, amassing 'points'. Most are perfectly pleasant people but maybe, having worked alongside them, not the sharpest tool in the toolbox. They are either being lead up the garden path or we do need to fear for HCP standards in future.

I recognise there are many reasons why people didn't get qualified at school, but one which cannot be ignored is that 'they weren't clever enough'.

If the HCPC are, as seems apparent, turning a blind eye to Nigerian 'qualifications', I imagine the fall in standards we're already seeing will continue if the apprenticeship has lower entry requirements or masses of 'equivalency' entry.

It might transpire we're all 'okay' with this, that we do want lesser qualified, but cheaper HCP staff.....

How about we talk about the employers and the schools putting pressure on the NHS

The employers who always want their employee to make all their NHS appointment outside of work hours and put pressure on them to do so which isnt always possible

www.mumsnet.com/Talk/am_i_being_unreasonable/3629772-To-expect-this-employee-to-make-appointments-in-her-own-time

And the schools demanding that parents go to the GP to get a sick note for their child when they have been off school for a few days

There are so many people on this site complaining about individuals wasting NHS time that the law of averages tell me that its certainly possible they will have done the above as part of their job yet park it at the back of their minds on these threads.

I think @Graphista’s programme was “Can Gerry Robinson Fix The NHS?” which was done in the 1990s with the Open University. It would be really interesting to have him come back and do another one...

I work in community nursing and we have these issues too. We have patients who claim they cannot possibly come to the surgery but are them seen out and about at bingo or shopping or whatever. I haven’t got a full kit to enable me to do a full set of obs, really had to fight for a proper tympanic thermometer and am currently doing the same again to get a pulse oximeter.

I also applied earlier in the year to do my nursing through the open uni, got to interview but didn’t get a place, think it was something like only 3 places available for my board which is ridiculous when I am really keen to do my nursing and will continue in the board on completion but it’s all down to money. I can not afford to go to uni full time with young children so am not sure what my options are now, part of me wished they would bring the associates role to Scotland so I could go through that way and top up for full registration

To become a Chartered Accountant you didn't need a degree. At one point you didn't need A Levels you could start at 16.

I work for the NHS and don't recognise any of the scenarios you mention. I have to say, I do feel some trusts don't manage their budgets effectively. Sure, money is tight, but there's absolutely no reason people shouldn't have access to basic equipment they need to do their job.

In my area if you need an appointment with one area of expertise you get a letter saying your appointment is on 10th July
It states the appointment was booked on 16th June, the letter informing you of the appointment was dictated on 23rd June,

It was sent for typing on 3rd July

The letter was typed out on the 12th July

The letter was sent out on the 18th July

This department has 1000s of missed appointments. Surely some one typing these letters can see the complete lunacy of wasting everyone’s time and money

I think it's criminal that fees have been introduced for prospective students in NHS.

After all they do loads of free work on the wards for their training in the first place.

DD was so fortunate she did her degree before this was introduced

This makes me cross as public money is being spent so wrongly. A friend works for the MOD and I find it difficult to listen to her sometimes. She gets big bonuses that she recently used to fund a trip to SA. She routinely tells me about People who are sitting on big pay doing nothing, how x project went over by £millions, how inefficiency is overlooked. How the MOD used to have a flat based in the centre of the city and employees stayed their for free. They seem to always have the budget and resources to do this project and that project, it ends up going nowhere. How her new project is x billion as an experiment for xyz. I have to bite my tongue as she doesn't seem to care about the sheer waste of tax payers money, her own tax money.

It makes me cross there's money for this but not our healthcare.

I don't know anyone in a private company now who works less than a 50-60 hr week just to keep their job! In the public sector admin staff seem to work 36 hours and leave on the dot.

I'm currently working in private industry, and I work the hours I'm paid for - at £9 per hour gross I don't think that's unreasonable at all! Bear in mind that you are talking about admin staff who are barely above minimum wage, even some who had to have a pay rise this year as the minimum wage went up, and then ask yourself why they don't work 50-60 hour weeks. Minimum wage is £14, 422 a year by the way now it's gone up. Maybe you only know people on a slightly higher wage than that?

Those "gold plated" pensions? Similar to how many of the big industries used to do for employees, except of course it's based on a percentage of pay, and if your pay is crap so will your pension be. 50% of peanuts is still peanuts, whereas 30% of a decent salary will pay the bills.

Large amounts of annual leave? Those were negotiated in the 80's as a "sweetener" for Civil Service pay being increased by less than half the inflation rate at the time - we won't pay you any more, but give you more time off instead.

Yes to the late appt letters. I missed a consultant appt, a pre op assessment and the actual operation due to this on 3 successive occasions.

I also had an mri which was sent abroad to be reported on (saves money). Report came back saying badly torn tendon so consultant said it needs operating on. Also showed a cyst in the bone and consultant said he wanted a 2nd opinion on the cyst before operation and asked a colleague who thankfully looked at everything and said tendon was fine. If it hadn't been for the cyst I'd have had an unnecessary operation due to them fielding the MRIs out to god knows who.

I'd like to know where all these private sector organisations are that don't waste huge amounts of money, because I have no experience of them. It's a different type of wastage, of course (gratuitous self-indulgence from those at the top, ambitious individuals changing things unnecessarily in order to get noticed and then moving on before the long term effects of their toxic chamges are felt, in the hope the next poor mug gets the blame, etc). The problem with the public sector is that run down equipment and understaffing is 100% guaranteed to create inefficiency, because the organisation is too busy firefighting and looking for pathetic amounts of small change to be in a position to be able to make any improvements. It's like giving a workman a plastic spoon and telling him to use it to build the Channel Tunnel - then blaming him for inefficiency and poor working practices when the spoon breaks and he can only afford scellotape to fix it, rather than acknowledging that you've not actually provided him with the resources he needs to be able to do what you expect.