Is the NHS really underfunded?

[BobbyeinArkansas]

Curious to garner opinions on this.
Watching This Is Going To Hurt currently which has made me think.

I know staff are overworked. But is it really as “underfunded” as the media would have us believe or is it a combination of being inefficient, mismanaged and with too many “managers”.
I have no idea, by the way but I am curious as to what other think.

@HRTQueen

I would also like to see a cross party group dealing with the NHS

It’s far to often used as a political football and it doesn’t help the NHS to do this

You need the politicians to stop treating it as a political football first, which they'll never agree to do. Labour know that promising to throw money at the NHS is a vote winner, so anything that stops them standing on major policy differences between them and Tories isn't acceptable to them.

@Kylereese

Completely mismanaged and inefficient. Have t embraced and utilised technology. No accountability

👏🏻👏🏻👏🏻

As pp noted, transforming the nhs takes investment.

I work supporting transformation & improvement in clinical services.

Me: Hi, clinical team, I'm here to help you improve services. What do you need?
Service: Great, we've got loads of ideas. How many staff & how much funding do you have?
Me: None...

I tend to work in implementing digiital solutions, I have no budget to purchase anything, our in-house developers already have a worklist about 5 years long. When I do manage to find funding, it's usually fixed term.

We did pretty well with video consults (should always be clinically appropriate and patient choice) over the last few years (even pre-covid) but even now I get consultants who refuse to do them for no good reason. And they're allowed to just refuse because they can't be managed.

And that's before I get started on core under-staffing (not always money, also difficult to recruit).
There's a lot wrong with the NHS that money won't fix, but it also needs investment.

I struggle to understand why these things get defended. It doesn't require extra staffing to put water where people can reach it, put crutches within arms reach, to put bedpans next to the bed, to do blood tests once instead of twice, to take equipment that you need with you

Come back to me when you're doing the workload of 5 people on a 12 hour day and don't make any mistakes or drop any balls.

Completely mismanaged and inefficient. Have t embraced and utilised technology. No accountability

LOL you’ve not a clue.

@VerveClique

Probably not nepotism in operational areas s as such, but certainly favouritism, and appointing ‘people like us’.

Anyone without NHS experience is overlooked for non-clinical roles, and the few who do make it through often don’t last long.

A lot of NHS managers and clinicians alike think that they’re ‘special’ and misunderstood asa class of employees/organisation, and it creates a massive echo chamber devoid of critical thinking and constructive challenge.

This is definitely true.

And the PP who said "NHS England is run by a bunch of back stabbing bullies" is also spot on.

I have worked both in the private sector and the NHS (both provider sector and NHSE). I'm shortly leaving and I will never, ever go back. it's awful.

Non-clinical NHS staff (which is what I am) often seem to think they're something special, when in reality they're frequently just incompetent (in my professional field they are, anyway). They wouldn't last 5 minutes in a genuinely high performance environment. It's all about creating little fiefdoms and brown nosing the right person.

And the few good/competent staff end up being overworked to a ridiculous degree (while carrying their underperforming colleagues). It's demoralizing, and burns you out if you're good at your job and try to do it well.

@NeonK

As pp noted, transforming the nhs takes investment.

I work supporting transformation & improvement in clinical services.

Me: Hi, clinical team, I'm here to help you improve services. What do you need?
Service: Great, we've got loads of ideas. How many staff & how much funding do you have?
Me: None...

I tend to work in implementing digiital solutions, I have no budget to purchase anything, our in-house developers already have a worklist about 5 years long. When I do manage to find funding, it's usually fixed term.

We did pretty well with video consults (should always be clinically appropriate and patient choice) over the last few years (even pre-covid) but even now I get consultants who refuse to do them for no good reason. And they're allowed to just refuse because they can't be managed.

And that's before I get started on core under-staffing (not always money, also difficult to recruit).
There's a lot wrong with the NHS that money won't fix, but it also needs investment.

Digital transformation has shed loads of central funding, and has had for several years. The 21/22 budget for digital transformatiom was over a billion pounds. It's not spent particularly effectively though.

Sure they can rearrange management but I really do think people are utterly clueless. Prescriptions are offset by the NHS with millions getting them completely free. Medical equipment upgrades. Staffing costs. Medical supplies. IVF treatment. Increased Mental Health lists. Increased numbers of an aging population with multi co-morbidities. There are so many people complaining that they are waiting but so are millions of people. It all costs money. Money we don’t really have and no one wants to pay because they can’t afford it. The NHS is expected to wave a magic wand more often than not.

It’s inefficient because it’s underfunded. Not enough training spots for junior doctors to meet forecast demand and the withdrawal of nursing nurseries means that (slightly) older trainees with more realistic experiences of life no longer enter the system. Using foreign trained staff to prop up the system - now far harder post Brexit.

Not enough investment in digital transformation, poor procurement practices.

There’s an element of rising lifestyle disease, eg Type 2 diabetes and its complications takes 10% of the budget. For a minority Type 2 is unavoidable and not preventable, for many it is a disease of lifestyle. For those that claim IVF is a primary cause of NHS budget issues - that’s around 150x what’s spent annually on IVF.

Nursing bursaries, not nurseries.

@Merrymouse

Yes.

Just to talk about nursing and general patient well being, you need slack in the system to provide good care.

Just to cover the basics - making sure that patients are fed adequately and facilities are clean, you can’t always be functioning at or beyond capacity.

Absolutely, that’s the issue on the shop floor. It’s run at maximum capacity and sometimes I don’t think the public quite understand that the staff come into the job to try and make a positive difference and are absolutely running off their feet to try and provide the level of care they receive. Their appointment might be an hour late running but that’s because staff desperately trying to make sure everyone gets the care they need in a system which feels like working in a pit stop. Can guarantee if the clinic is running an hour late those doctors and nurses probably have worked through their lunch break and will be hours late off their shift. Those who could afford to pay more complain there is no 2 tier system where such inconveniences didn’t exist and would be lovely to work in a more relaxed system too. Although I suppose the beauty of the NHS is that everyone gets the same care and we’re not a super high tax economy but when people are waiting hours in pain for an ambulance perhaps that line needs to be considered. Yes definitely could be more efficiencies in admin systems etc but their are definitely a lot of staff who are working extremely ‘efficiently’ to do what the NHS does

Waste ,inefficiency ,fraud and people abusing the service are the major problem not funding .
TBH the service ill swallow any amount of money you give to it .

To be blunt anyone who thinks throwing money at it will fix it is stupid ask anyone who works for the NHS

It may well be underfunded, but why would anyone invest more in something so badly mismanaged? The answer to a leaking bucket it not just to put more water into it.