Chronic waste in the NHS

[Bestcatmum]

If the NHS cracked down hard on waste in the NHS we could all have the pay rise we are after.
Yesterday I did a clinic in the minor injuries unit, the thermometer read 27 degrees all day. There is no way to turn the radiators off there only estates can do it.
We sweltered, we all stank of sweat by the end of the day, the patients complained, we had to fling all the windows open.
I went home with a dehydration headache and a heat headache.
We've been asking for simple things to be fixed and they come and "fix" them, they fail almost immediately, two examples a fire door that has supposedly been fixed multiple times during the last 7 years which still doesn't work, a door handle that has been fixed multiple times over the last 7 years that fell off in my hand last week AGAIN locking me in my clinic, I was locked in for 2 hours until someone came by. there is no phone signal in there.
It costs £100 a time for them to come out and fix something.
I went out to the bins the other day and found hundreds of pounds worth of in date dressings and equipment that had been chucked. I couldn't work out why because they were all in date and intact.
This is just the tip of the iceberg.
it is a national disgrace.

OP the waste you describe must be annoying but it isn't a saving that can be converted into nurses ' saleries. For example fixing your heating system to have individual controls for different areas might involve tearing out and replacing the whole thing which would be v expensive and the savings wouldn't be realised for many years.

Increasing salaries is a long term commitment to paying out more every year, even when the nurses retire their pensions will be higher.

I absolutely support higher wages for nurses but I think it's wrong to think that can be achieved by recycling sone crutches and turning down the temperature in your hospital. We actually need to invest in long term improvements, not just higher salaries but also modern heating systems.

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It's not that they can't be cleaned. It cost more to pay the staff, cleaning products etc than to buy a new one

The blankets and sheets etc are probably 'leased' from one of the laundry companies. Most hospitals don't have their own laundry anymore.

The company will come and collect their blankets from you.
We have a high turnover of patients and when we have 25 hospital blankets we call the company and they come and get them.

Ambulance crews will take their own blankets back.

It's very upsetting, healthcare is a shambles because the government does not care at all about the people, we are just cash cows, we generate revenue that they waste with gay abandon, or syphon off to private accounts in the Cayman Islands.
They laugh at us from their heated swimming pools and multiple mansions, it makes me sick

Interesting this topic comes up now...government troll perhaps ???

Yes there is waste but our inept government are promoting and have overseen this state of affairs for years..actively encouraged it.

Buying cheap equipment isn't cost saving its wasteful. My own mother has gone through 3 shower chairs in 4 months because they rusted within weeks of arrival. Cheap tat. We are constrained by higher up directives and nonsense paperwork.
Finally we don't need more managers we need better managers.

Its an easy thing to say and would get some great cheers on Question Time, but the reality is that real terms spending on the NHS has been increasing year on year and represents a huge proportion of government spending.

Unfortunately, in order to continue to provide the care that it does, the government must either:

1. Reallocate other spending to the NHS - Sorry benefits, libraries, defense etc.
2. Significantly raise taxes - We are already incredibly highly taxed. Taxes on high earners are huge, with various pension 'taxes' tapers, top rate of 45%. Any higher and we'll be in serious danger of a brain drain and will inhibit entrepreneurial activity, ultimately reducing tax paid.
3. Borrow more - increase the national debt year on year, saddling our children, and at a rate of borrowing that is no longer cheap thanks to interest rates.
4. Look for savings and efficiencies within the service

Personally, 1, 2 and 3 are unpalatable without a serious attempt at 4.

Childish pot shots at the government don't help.

We have a process in our trust where if furniture is going spare it can be almost "freecycled" around to other offices and bases within the trust - which at least gets around some of this a little bit.

We've got the heating issue at the moment at the bases I'm in which are NHS owned. Thing is - we can't get INTO the fucking NHS bases this week as the local authority have closed their offices for the week to keep energy bills down - so the entire social services team have moved in and taken over our office instead and pretty much run us out!

It needs to be run by private companies that understand the bottom line but the contracts negotiated with these companies need to be rigorously enforced and negotiated by people who have half a clue, not managers who have worked their way up from the bottom but proper financial directors who actually care and can be fired if they fuck up.

We used to have a manager who would rock up at midday after feeding her horses and then do absolutely fuck all for the rest of the day, one who would come in late on Wednesdays as he sat and talked with his wife whilst she was having a bath as they had kids and apparently couldn't talk any other time without being interrupted, a psychiatrist who's Bradford scale (sickness rate measurement, I think this is what it's called) was the worst out of the whole trust. He had a dicky tummy one morning, had to leave and cancel a whole clinic which meant very sick children not being seen and one patient couldn't be discharged. We spotted him later on TV at the Chelsea Flower Show. Nothing at all happened, it was laughed about. It's an absolute shit show, no one caring or taking responsibility because it's just not run like a proper company because it's only the government who pays the wages.

Sickness levels were incredibly high but of course they were going to be. Being paid full pay for six months and then magically being well enough to come in for reduced hours as soon as your pay dropped was another common occurrence.

The same old "we will learn from this" is trotted out by the nhs after every costly investigation but they don't learn and it happens again and again.

Too many managers, paid over £100k. Pointless diversity consultants, paid £70k new insanity Director of lived experiences over £100k. Probably save several £100 million getting rid of these

It’s nice to see that the younger generation are joining and participating in MN, hopefully this means it’s has a sustainable future.

Yes OP, my neighbour was telling me how the local trust had spent goodness knows how much completely refurbishing a unit - just to sell it off the following year for next to nothing.

Other people’s money is easy to waste. My ex has a chronic life-shortening condition for which he’s on a fairly novel medication which costs the NHS about £100k a year. It’s delivered in monthly batches by a designated courier service from his NHS Trust as it must be kept at a particular consistent temperature. At least twice a year in the past couple of years the service has fucked up and they’ve had to send out a new batch - so the better part of £20k a year being routinely wasted just on his medication, and nobody seems surprised by this when it happens, so I can only assume it’s replicated on scores of patients and amounts into the hundreds of thousands or even millions Trust-wide. Whereas if my (private) large company was routinely fucking up to the tune of £20k, we’d pretty soon find ourselves over a barrel.

Absolutely this. I worked in the NHS and it's about the most diverse environment in which you can work, so no sure why we need managers to enforce this. There are too many low calibre managers, many from a nursing background without the necessary management skills, promoted from within.

Our offices are sweltering. We're based in accommodation which was judged to be unsuitable for patient care a few years ago. The heating is either on or off. We can't replace the heating system, place is full of asbestos so can't even used push pins in the walls. There's no money for replacement buildings and would take millions as well as years to replace. What's your solution????

Privatisation (and not PFI) which allows for the injection of cash which funds better infrastructure and services and ensures that wastage is always a consideration.

Privatisation isn’t a dirty word and it doesn’t mean “rich people get healthcare whilst poor people just die in the streets” or whatever rubbish people like to use to discuss the US healthcare model and why the NHS must never ever be changed. Scandinavian and Nordic healthcare models are always lauded on MN as being ideal, and all of them outsource to private contractors for a significant proportion of their infrastructure and services - apparently quite effectively economically and to the broad approval of service users.

Writing about appointments. Sometimes multiple letters. Let people opt in to email.

we are living longer and longer with ever more complex medical needs, it will always be a bottomless pit of need

According to the NHS website (drug cost page), my OH has tens of thousands of pounds of drugs sat in his cupboard which will get thrown away. One is a chemo tablet that costs over £1k per tablet. Then another chemo tablet that costs £300 per tablet. He gets prescribed them automatically by oncology dept every 4 weeks, but doesn't take them all (as agreed with haematologist). But it's "too hard" to change the prescription as it's pre-defined and pre-authorised so she apparently can't change it down to what he actually takes. It's the same with much cheaper drugs he never takes, such as anti-sickness, anti-diarrhoea which are a lot cheaper, but still impossible to remove from the prescrption. He gets 3 of the £1k tablets per month but only takes 2, he's on minimum dose of the £300 tablet of 21 per month, but only takes 11 (every other day instead of every day for 3 weeks per month). It's absolute madness. The haematologist doesn't care as she gets "funding" for the drugs she prescribes so there's no benefit to her by changing the prescription.

A neighbour works as an assistant practice manager at a local GP surgery. She's always bringing stuff home that's "out of date" such as boxes of plastic gloves, sticking plasters, anti biotic hand wash, large rolls of paper (that go over beds etc). She's always offering us things. She says they go out of date because the staff don't care about stock rotation, they never check use by dates when they take things out of the store room (and the ones putting stock in don't put new stuff at the back). She's been telling the partners/staff multiple times about it, but no one cares!

A few years ago, there was an article in a local paper about staff on a ward at our town's hospital who made big savings by procuring their own "consumables", not medical supplies, but non medical stuff like loo rolls, soap, tissues, paper towels etc. They saved over £50k in a single year by not using the official NHS procurement suppliers! If a single ward can do that on just the non medical consumables, just imagine how much the entire NHS could save on shopping around a bit more!

My favourite anecdote is that every time DM went into hospital, as requested, she took all her GP prescribed meds. They were all taken off her and disposed off, and she was given new, sometimes different, meds, when she was discharged, and being hospital had to wait for hours to get them. Each and every time she went back to her GP to get her preferred meds. Which the GP re-issued. Rinse and repeat.

This is a job I'd do for free, I'm so keen to sort it.

the problem we have now is how many non-essential people would lose their jobs if the efficiency savings are done.

This! I actually insisted on having mum's meds in my bag the last few times. They went through her bag but not mine (obviously).

When MIL died she had two walking frames, one wheeled, one not. BIL asked where he should take them back to. He was told that they had to be collected otherwise reception at the hospital filled up with returned equipment. Five times he rang up asking for collection and he was told he was on the list. Two years later they were still in his garage so he gave them to a colleague for his mother. At least they were useful to someone.

When I had an operation I got DH to stock up on Paracetamol and Ibruprofen for when I came out. Codeine made me sick and they stopped giving it to me while I was in. When I was released I had to wait 5 hours for the medication. They gave me Paracetamol, Obuprofen and Codeine. If I had know that was what I was waiting for I would have just come home, they could have had the bed back and made room for someone else a bit earlier. DH even offered to go to the pharmacy and collect the stuff himself but was not allowed to.

The worst I have heard was just this afternoon. My neighbours son is a consultant. He was asked to go to a hospital at the other end of the country to try and reduce their waiting list as they had a huge backlog. He was supposed to go for two days and they flew him there. Only three people turned up because the letters had only gone out three days before. He reckoned he could have done up to 20 minor ops in his own hospital in the time wasted. Unbelievable.

How many clinic coordinators does a clinic need? I had to change some appointments and spoke to three different ones, same clinic, a hospital that's not very busy.

All of then clueless.

Yes of course. Instead of front-line staff reporting an issue directly to the people in charge of fixing it, they should report the issue to an administrator instead, who will then report it to an administrator who works for the people in charge of fixing it. Brilliant.