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.

I have a relative who worked in a fairly new hospital and left because he said he was sick of ripping out nearly-new boilers and replacing them for "reasons".

It's the same at every level to be honest. Used to work in a pharmacy and we'd get disciplined if someone came in trying to buy a 22p packet of paracetamol and we failed to tell them they could get it free on the NHS minor ailments scheme. Of course the owner would have got a nice fee for every patient signed up so was basically a license to print money at the expense of us, the taxpayer.

Examples:

56 day prescribing for a drug Levothyroxine which dose hasn't changed since 1990. From 1990 to about 1999 I got 365 tablets a year. One prescription, one chemist trip for me. I am very very pleased that my GP has time to mess about with this. I don't.

Blood tests at my local hospital: two admin staff chatting at the desk outside but working for another clinic. 1 phlebotomist because it's liver clinic day on the wards. Notice outside that says current wait 45 minutes. After an hour a lady left because she'd been waiting for two hours. I went to the desk and asked the staff "nah, dunno, bloods are nothing to do with us". I asked if they could find out. They rang a manager who I spoke to on the phone. The manager came down and spoke to the phlebotomist. I was told the wait was three hours and she'd asked the phlebotomist to change the sign which he did (rather than deal with another patient). I asked why the situation was not being managed but that was due to another manager. Another manager came and explained about the liver clinic so I asked if the hospital knew there was always a phlebotomist required for the liver clinic, why they didn't have three on liver clinic days. I also asked why it was reasonable to waste people's time because the correct information wasn't being given to patients, ie, if I'd seen 3 hours, I wouldn't have had to wait an hour. That evidently was the remit of another manager.

The third manager phoned me that afternoon to explain about the liver clinic and the ticketing system. Evidently the two admins, who were chatting the entire hours, couldn't answer questions about the phlebotomy waits because they worked for a different clinic. She said she would make me an appointment for 9am the following morning because of the inconvenience. The following morning, she had forgotten to tell the phlebotomist.

So two administrators doing nothing but chat, three managers who are jobsworths and one poor phlebotomist run ragged whilst the scummy public with nothing better to do sit and wait for three hours. And the NHS is understaffed and under resourced.

You couldn't make up the sheer incompetence. And we are all supposed to be grateful because it's "free". The other one has bells on.

Has anyone heard the John Finnemore sketch with the two consultants who try to persuade the lady selling seashells at the seashore that she is sourcing and selling at the wrong place?

many organisations, including the NHS, take that advice. If you're trying to create state jobs, it's considered a success. Isn't that why the weird procurement etc was created initially?

When I was recovering from spinal injury, I had a lot of follow up.

One Friday, I had some tests. The following Saturday I got an unexpected call from a lady from the unit I'd been on.

We were still at the stage I had to watch for signs of paralysis.

My heart was in my mouth as she said "I'm calling to follow up".

I was absolutely panicked. Saturday follow up could only mean Very Bad Things seen on the scan.

Lady on phone - "oh please don't panic! I'm just calling because
the form you filled in yesterday, you didn't tick if you are a smoker or a non smoker."

I clarified later, they really were having admin staff going through forms on Saturdays, inputting them on to computer systems

. I had filled in several identical forms in the hospital, then at every follow up. My sister filled in some at the hospital when I was too ill. They were all the same.

What's that about?

and somehow till recently, they thought dad was mum's next of kin. He was long dead but it got told to us for ages after. I think it's been changed but tbh I wouldn't be surprised if it hasn't.

I feel that because such a lot of money is thrown at the NHS it attracts 'sharks' who want to rinse it for all they can get

absolutely we need to prevent waste.
I work in A&E. Several years ago I said to my (male) boss, why are we using blood giving sets (they have filters and are big) to give tiny 50ml bags of saline? Can't we have some small cheap giving sets for this? He said, no, we are A&E and that means we need these for all emergencies. So we continued using tubing costing nearly a £1 instead of 30p. We used thousands of these disposable sets.

A few years later I asked my new boss (female) if we could order the cheap ones and she said yes, sort it out.

Must have saved thousands.

Another example. DD wasn't well from 15 to 17.

A&E wanted to admit her, aged 17 after a tiny od, 48 hours later and she went to make sure she hadn't harmed herself. She was safety netted by a private adolescent consultant psychiatrist. They wanted her to have an emergency CAMHS review so booked a MH nurse to 1:1 her in paeds because paediatric staff don't have the capacity or skills.

They didn't call me for 4 hours so nearly 7bwhen I arrived. The paeds consultant, A&E sister and the person who's in charge to manage all the beds didn't know the local MH Trust, had on their premises a mental health liaison nurse from 8am to 2am who could assess 17 year old. All prepared to piss £900 up the wall. Despite:

A. CAMHS already having refused her care.

B. CAMHS when they assesses her 72 hours layer, then refused to do anything for three months the despite saying they would within 2/3 weeks.

Surrey and Borders Partnership/Epsom Hospital/Epsom CAMHS in case anyone doesn't believe the veracity.

Director of Lived Experience what fresh Hell is this?

@RosesAndHellebores I am on lifelong medication now, dose doesn't change - I can only get 28 days supply at a time. Why?! This just takes up more admin time.

Meanwhile, today, OH is picking up more expensive chemotherapy drugs that he doesn't need/use but which the consultant says "is too hard" to change the prescription. One of the drugs is over £1k per tablet and he already has a cupboard full of them! Last time he did a "stock take" of all the drugs he's been issued with that he can't control or cancel, it came to over £25K and that was a few months ago, so it's probably over £30K now.

If that wasn't bad enough, it's close to a full time job for him to actually get the stuff. He has to phone multiple people to initially get the blood test they need, then to chase up someone to look at the results and "press the button" to issue the prescription, then someone else to "approve" the prescription, and finally the hospital pharmacy to check they've actually done it and it's ready to collect, as he's had so many wasted trips when it's been there but someone along the chain hasn't approved it (controlled drugs). That's a lot of wasted time within the NHS for something which should be automatic - it happens every 4 weeks for the last 3 years, yet every time, he has to explain it to different people to get all the processes done, it's as if they've never done it before! If he doesn't chase them, no one does it!

You would still have the problem of paying someone to take them in, paying someone to clean them, paying someone to test them.

Then they need to be sorted and stored.

On top of that a system to take money off a patient and the ability to repay it.

Even if that was one person doing all of that on minimum wage it will cost more than the £20 for the wage and cleaning materials.

Then you have the problem with liability. A crutch still in the wrapping from the manufacturer will have a guarantee that it is fit for purpose. If the hospital is effectively recycling then the liability is with the hospital if the crutch fails.

A set of crutches cost about £10. Probably less if you buy in bulk.

Also would you want equipment that someone else has used?

it was so cold last week
now its raining and so much milder and nhs buildings are sweltering
we have had all windows open as much as we can.
awful.

The torys have been in power for 12 years...they've had their time to try and sort the nhs and just encouraged its demise. Sajid Javid talking about health insurance is all the tell you need.

Privatising healthcare is their main agenda....I wonder who could possibly financially benefit from such enterprises..the tories and their mates....see Michelle Mone for reference.

Blair/Brown didn't sort it out in their 12 years either. They just threw money at it, a huge amount of which ended up paying PFI providers for over-spec'd shiny new hospitals with atriums where they charge hundreds for changing a lightbulb. Lots of "private" PFI providers made millions/billions out of Brown/Blair too! Not to mention GP's being paid more money to do fewer hours which was supposedly to "solve" the GP crisis we had as far back as 20 years ago (NB it didn't "solve" it at all, as GPs worked fewer hours for the same pay so caused more of a shortage!).

I at no point said Labour had sorted the nhs out, I am merely pointing out the fact the tories are expediting its demise and have the blxxdy audacity to blame nurses and paramedics on people dying. Ffs.

The tories are currently lining up the argument that the horrible nasty nurses and paramedics are going to be responsible for the deaths of people lost during the strike....COMPLETELY IGNORING THE FACT THAT PEOPLE HAVE BEEN DYING FOR YEARS UNDER THEIR WATCH ....DUE TO POOR STAFFING/RESOURCES DUE TO LACK OF INVESTMENT IN THE STAFF. NOT TO MENTION PEOPLE DYING IN AMBULANCES BECAUSE THERE ARE NO BEDS AND LITTLE RESOURCES TO COPE WITH THE ONSLAUGHT OF PATIENTS THAT THEY ARE CONFRONTED WITH ON A DAILY BASIS.

It is their lies and deceit and ultimately their OWN PERSONAL GAIN that is behind this. They don't want to fix the nhs ...they want it to fail because it will be the michelle mones and their ilk who will benefit.

Under labour the wait times plummeted and the NHS were meeting their targets for wait times for the first time in years.

In Hampshire they use a company called Hampshire Equipment Services to do just this

Waiting times were fiddled. My DM and FIL both died from delayed cancer treatment in 2008 and 2010 respectively. In both cases, both their initial referrals and subsequent operations were WELL beyond the published waiting list timescales but they were fudged by being moved between consultants and then between hospitals. It was nearly 18 months before my FIL got his cancer operation which was far beyond the target which I think was 26 weeks at the time - they never offered a reason for being moved between hospitals and usually didn't even tell the next of kin it was happening. We once turned up and found an empty bed, thinking the worst, only to be told he was in a hospital an hour away, but they couldn't explain why.

Same in A&E, in those days, you'd be virtually ignored for the first 3 hours and then it'd be hell on roller skates as you were pushed through tests and/or x-rays/scans, etc with the doctor finally seeing you at around 3hrs 45mins to either send you home or fob you off to an observation ward. And that happened at quiet times, not busy Saturday evenings. We always used to joke to ask family to collect us at 3hrs 59mins after arrival, and that's usually exactly what happened.

I agree that equipment should be reused where possible but the problem is that when something is returned it is unknown how they have been used and stored.

We had someone recently who was using a refurbished mobility aid but it gave way and they fell. If you are non weight bearing using crutches, for example, they need to be able to safely take all of your weight so you need them to be safe.

Are you joking?! This is terrible

Our trust worked out that it cost far more to collect, disinfect, fix equipment. So that's why they're single use. Things like wheelchairs, hospital beds, specialist shower chairs are reused.

But there are ways for reusing to be made supportive and sustainable. An apprentice could help with the majority of the administration which would be cost neutral as the apprenticeship levy would be saved. Disinfecting could be done by those with LD's who have difficulty finding work. Help there for the young, the disabled, community overall and supports a green agenda. Isn't this something EDI directors could be involved with organising? EDI isn't all about rainbow crossings and chest feeding, it includes things like Disability Leadership awards too.

I'd have no difficulty reusing crutches. Not when I've had to ask for body fluids to be wiped off a mammogram machine before putting my breast between the two plates. And got the NHS eyeroll for doing so.

I think it depends on where you are. Some hospitals do take them back and clean and reuse them.

Ours has a service that reused them
there is an element of cost and not always cheaper to re use
but there service complemented new issue of stuff
like my dad had 1 Zimmer frame and u could get extra one from the service that reused them and they were always happy for cash donation