Catastrophic state of the ambulance service: what's behind it?

[tulips27]

Seeing the shocking and upsetting thread where the OP has been waiting for over 24 hours for an ambulance for her relative who has a broken hip I want to ask what has cause this state of affairs? How can this be possible in our country? Can anyone offer any insight?

(Link to the thread for those who have not seen it: www.mumsnet.com/talk/am_i_being_unreasonable/4701431-i-know-iabu-blatantly-using-this-for-traffic-emergency-situation-no-ambulance-still-and-need-advice )

Yes, Covid vaccines.

Germany and France could be role models

But be careful in that it will still cost us more be it taxes or other types of insurance

I suspect you are near me. I had my surgery cancelled this week. Just an awful situation and our location makes us so isolated.

If Labour were to run on French or German model they could probably do it. I don’t think the Tories have the same headroom in public perception

Not sure they would, and as pp said it’s more expensive

Would people be ok with higher fees?

There is an option to pay more atm anyway, ie private but it doesn’t cover all but could take strain off. In some countries it’s tax deductible I assume to shift burden

It is not post war Britain now ffs!

If you force people to pay 95% tax they will move to Dubai and we will see the biggest brain drain on the planet! Post war workers did exceptionally well investing in very cheap housing and were promised huge pensions! They had jobs FOR LIFE not for Christmas, and could live comfortably on just one salary. They had a quality of life most of us can only dream about!!

Many I know retired at 56!!! Factory workers.

Firstly, we all know they’d settle for less, and secondly, there is a magic money tree when it suits the government.

If public sector pay hadn’t been frozen or had below inflation rises for years we wouldn’t be in this mess right now. Austerity was a political choice, not an economic necessity.

People could move after WW2 you know

All I am saying is that they were prepared to pay for others

And now it seems that the next generation would rather euthanise the elderly than treat them with the respect and dignity and cash that the elderly treated their elders

Backed up hospital wards, affects A&E discharges to wards…..ambulances back up and have to wait.

Then there’s other community services having staff shortages and not enough funding - so like community mental health teams who don’t have emergency home teams etc and instead, ambulances get called when a crisis team would have been appropriate.

I think 12 hr shifts need reducing to 8 hr shifts.
8am-4pm
4pm - midnight
midnight-8am.
It would give a much healthier work/life balance for ambulance staff who are completely shattered.

What happens if they have young children or will lose their jobs if they have to stay at home with the elderly discharged patients because there aren’t carers?
I know from family experience that if people are discharged without proper care in place they end up back in hospital again. And it’s not always care that family can give. I’m talking physio, occupational therapy, etc.

It's not just adult social care that's broken, children's is too. One of the leading children's hospitals has at least 10 children ready to go home but with no care packages to support that due to lack of carers. Therefore they are bed blocking too. It's not a preserve of the elderly.

Some very good points raised.
The NHS does need an overhaul. I don’t think it’s feasible to keep providing the amount of services it does for free. I also think non emergency transport should be scrapped. People need to start paying for certain services.
Not sure if it’s been raised but there is also the fact that families are very different now. Take the family of an 80 year old. Their children (if they have them) will probably be having to work full time. They will not have the luxury of retiring at 55 or 60. They will loveyouu have a son and a dil who doesn’t work. So they are unable to care for their elderly parents the way the 80 year old cared for their parents.
Life is different now. We are expected to slog until we are 67. Not many women of previous generations did this.
Factor in higher divorce/separation rates and the elderly person doesn’t have a son in law or daughter in law to help shoulder the load.

Adding a layer like this would seem a really excellent idea for patients not needing active treatment but needing nursing observation, supervision and the kind of care community teams can offer while awaiting packages.

An elderly relative has been in and out of hospital in the past few months, and has had a catheter, central line and complex medication that could not be handled by anyone other than a medical team, so organising this highly time consuming and skilled care in the home has been time consuming to put it mildly. Staff and the organising has been brilliant for the most part, but it can't just be magicked up as fast as it's needed. And conditions change, and at every new twist in the story the meds and processes and tubes and infections all require a re jig. The reality of supporting complex health conditions in the older population is that this kind of nursing care is required, it's different to what support and care was available or needed forty years ago when many such patients wouldn't have made it this far, but systems haven't evolved to match the progress in care.

And yes, some decisions really need to be made regarding practicality and reasonability. It has been lovely that a relative's choice to be nursed at home has been possible- however we've been uncomfortably aware that the time and demand on resources has been much higher than it would have been in a nursing home providing 24 hour care, and there would have been less falls and less complications with that 24 hour care in a safer environment. It's a very difficult balance between people's wishes and right to choose and what can be afforded when it's a question of providing so much for so many.

How does that work? When DM had a stroke she bed blocked for over a week whilst they waited for a care package of 4x visits per day. I'm a lone parent, I have DS who was 8 at the time. We live close by but it's a drive. I have a very busy job. I was prepared to cover 2 of those visits each day (we were desperate to get her home) but thank goodness a company came through & offered to cover 4 visits per day & she was discharged.

Thank goodness for those carers. A year on & dm is doing really well. I am wrecked. Heaven only knows what state I would be in if I had had to cover teatime & bedtime 7 days a week. DS is pretty good too but it's taken A LOT to get him to that point.

It sounds like an easy answer. It absolutely isn't.

This isn't fair. Part of the reason the elderly are now living longer is because treatment is MORE advance since WW2. We do not have the inferstructure for this.

People are now having pacemakers at 94 years old. Staff are needed to look after people who have undergone surgery.

My DFIL was in a convalescent type of community hospital recently - it was perfect for what he needed and more of them would add so much to getting patients back on their feet. It meant when he did get home he didn't need any additional support.

The £65bn kwarteng jizzed up the wall in one day would have covered it for 5 years.

So would not going through with brexit.

Excellent points!!

I think the underfunding has made it worse in the last 12 years. There is a move to privatise by making the system collapse

I think the labour party are too far right - and not left enough - but the press crucified the first left policies (as it does not suit those in power). They started the underfunding - and carving up the systems for profit - Blair was right wing..

People keep voting for more of the same - there is no 'balance in politics' the 'left' vote is massively split but the system - puts left against right and really we need shades between

People are making profit from care - so the people doing the care are squashed by pointless paperwork for very little money - would you want to wipe sh*te for minimum wage and deal with adults who have no idea what is going on are aggressive and unpleasant to be around - as that is what a lot of old people in care area like

My comment's been misunderstood by people on here. I'm not saying don't treat people with self inflicted illnesses or the elderly!!!

I smoked for years and am picturing MYSELF old and not being able to die naturally when the time comes. My point is we have an unhealthy attitude to keeping very ill elderly people alive even when THEY want to die (I know several people who had this experience where for legal reasons they kept being given medicine and resusitated against their wishes etc despite it being in their best interests to pass away peacefully in their sleep).

Also we go all out spending millions trying to stop anyone getting ill with anti smoking campaigns as an example without much thought put into the fact if people are living decades longer the NHS is then stretched to help those elderly, young and all those inbetween who want to live. The argument smokers use up more NHS resources than non smokers when ill was discredited as it was proven it was outweighed by the anount of tax they'd paid over the years. My point being just let people smoke if they want to smoke and of course it's fine if they don't - we just need some sort of balance.

My post was actually coming from a place of sympathy for those like the Mumsnetter's aunty who needs an ambulance and should be able to get one immediatley as well as my gran who doesn't want to be in and out of hospital a million times a year feeling miserable suffering from paranoia and being completely immobile.

So you're contacted at work to come collect your elderly infirm relative who you don't get along with. They can't be discharged to their own home as unsafe to be left alone at all and they're being discharged into your care if you like it or not. Do you take them to their own home and leave them there to die? Let's say you have no conscience, they die, does that make you guilty of manslaughter? Prison? Lose your job, your own family evicted, now homeless, no social housing so what now? And how to put your life back together when you're released.

Or do you take the elderly infirm relative back to your home, which is now overcrowded because you didn't have a spare room, so relative is on the sofa. Kids have nowhere to play and have to stay quiet, you're stressed trying to make it work and keep everyone happy, run ragged.

But it doesn't work because you've lost you job now you're a full time carer earning £60/wk (ish) so your family is struggling to make ends meet, no luxuries and no fun, maybe no heating. You become depressed because your relative who you don't get along with isn't even grateful and is ever more demanding. No family life you've no time, no sex life you're too knackered, partner resentful of doing all housework and childcare when they're not at work. Your family breaks up, now you're facing eviction because you can't pay the bills or work and awaiting non-existent mental health care. You lose your kids who go live with your ex because you can't house them.

Your kids are messed up for life because they were emotionally neglected, have a strained relationship with their parents now, trauma from being homeless, anger issues from seeing the way elderly relative monopolised all the time and spoke to their parent/carer like shit, not doing well at school so won't get a good job, life of poverty. The cycle continues.

You can't force people to become carers, it's kicking the can down the road. There's lots of reasons why people can't do it the above is just an example and why the resulting mess would mean more lives being ruined and cost government more in the long run and the elderly people still ends up in a care home.

This isn't fair. Part of the reason the elderly are now living longer is because treatment is MORE advance since WW2. We do not have the inferstructure for this

The total number of years of ill-health that people experience has not changed; they are just experiencing them later in life (on average).

People living longer does make some difference to the costs of managing long-term conditions - if you have diabetes for 40 years, instead of 20, for example, you are clearly going to need more medication and have more check ups. But this is mainly outpatient and primary (GP) care, rather than hospital or care home beds.

I'm not blaming people for getting old. My comment's been misunderstood completely. In fact I'm in support of the elderly 100 per cent. I've replied to another Mumsnetter explaining what I meant in detail.

100% this. Cheers Tories.

You cant force someone to care. That would be coercive control which is illegal now. And if you do do the caring what happens after the person you are caring for dies. You are down at the Job Centre and being treated like you have been a lazy shirker for the last however many years Fuck that

agree

re your gran, doesn't someone have PoA to refuse antibiotics etc?