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 )

I think OP is asking these questions because she genuinely doesn't understand - tbh I am a bit weirded out at the lack of practical thinking. You need caring experience to realise that care of elderly can't just be handed to their relatives.

I have cared for my elderly relative, thank you.

I have a partial non-English cultural background where older family members are cared for by younger ones, that is where I am coming from.

Lack of funding and investment in the workforce. We do not have the right numbers of doctors and nurses. We have a broken social care system.

The fault for this lies at the feet of the government. They needed to take the tough decisions on social care and workforce. Instead they chose to focus on Brexit, immigration and austerity.

It wasn’t like this. Not at all. You could get an ambulance reasonable quickly even in 2019.

www.huffingtonpost.co.uk/entry/ambulance-strikes-risky-activities-will-quince_uk_63a1caffe4b0aeb2ace7af4d?utm_campaign=share_twitter&ncid=engmodushpmg00000004

BabyFour2023 · Today 17:40
Meant to say: it didn’t change when labour came into government. It has been like this for decades but people either didn’t care as much because they didn’t have Boris / Sunak to blame or because they were unaware or because it didn’t affect them

What a load of crap. It’s NEVER been like this before. Never. Your comment is just laughable.

My DH works for the ambulance service and most shifts they are waiting outside a&e for up to six hours before the patient gets in. There are usually 5-6 waiting outside too. So they can’t attend any other jobs. There are just no beds in the hospitals.

I worked as a nurse 20 years ago on a ward and even then trying to get some patients discharged with the things they needed in place could take weeks even though they no longer needed to be in hospital.

there really needs to be some sort of halfway care that people who no longer need actual hospital care but can’t go home should be able to go.

You’re right it’s not as prevalent in this society

I’m used to that but can see why other cultures view it differently

Really? Which trust do you work for? How long have you worked for them? Interested to see your response. My family; over 40 years collectively and various trusts including EMAS & YAS. Very much a true account.
It. Has. Been. This. Shit. For. Decades.

My friend works worked (is now leaving) said the 3 problems are….

1. Elderly staying longer than they should as nowhere to go/car package issues.

2. people misusing the ambulance service - not Ill /don’t have transport etc & non emergencies

3. huge amounts of MH issues

I’m a user of the nhs, l don’t work in it. I’m 59, l have never seen anything like it is now.

And l used to be a teacher. The difference between teaching under a Labour govt compared to this current lot were poles apart. It was properly funded and resourced. Why would another essential public service line the NHS be treated differently?

I have 25y experience of working in the NHS and it has NEVER been like this before. It's a perfect storm of Brexit related staff shortages (esp in care), funding cuts left right and centre, an ideological insistence on cutting hospital beds, and an ageing population with chronic diseases who are living to get frail and demented when 20y ago they would have died of a heart attack, stroke or cancer.

Add to that the massive backlog from covid- it now takes my patients at least a year to be seen in outpatients in most specialities, 10y ago it would be about 6 weeks - 12 at the most. That might mean another 6-12 GP appts over that year to try and improve symptoms and/or expedite things. It means we are working way out of our comfort zone, managing all sorts of things with email advice from consultants at best, which is massively time consuming too.

The pension tax as a pp mentions above is terrifying - imagine you are threatened every year with a possible tax of up to 50% of your take home pay just because your imaginary pension pot has grown - it's NOT related directly to how much we pay in, it's calculated on imaginary growth of money we don't have access to. I know many many senior consultants who have had to reduce their sessions to avoid this, or risk effectively paying to go to work- noboby in their right mind will do this.

I genuinely wouldn't advise my children to go into medicine in the UK and nor would many (most) of my colleagues. Which is a shame, because for the first 20 years of so, it was a brilliant career.

That’s sounds like a great scheme. One of my neighbours was very elderly and had frequent falls (1-2 per week on average) in his last few months. His wife had a list of neighbour volunteers and two would go and help him up when he fell.

Maybe you could have a chat to my dad who still has therapy, who still has PTSD from one particularly horrific week of shifts in 2007. Without giving too many details; several deaths due to having to wait too long for ambulances and then not being able to save them. It has not changed. Not at all. Paramedics, technicians and ECAs have been having to deal with this for decades. Say it’s shit all you want. He has lost 5 of his colleagues and friends to suicide because of things they’ve seen and had to do through no fault of their own. Deny it all you like but people have had to live through this.

Data for 2007

Data for 2022

for comparison purposes

Exactly that. Can't move people out of A&E to wards, because wards are full.

People say they want the German system but I am not convinced they are able/willing to pay for it.

Are you prepared to lose 14.6% of your household income every month? That’s how much it costs. We pay around 800 euros a month. Then lots of things need paying private. Contraceptives are not free. Want a coil fitting? That’s 380 euros. Extra dental cover. Another 50 a month. Etc.

I don’t begrudge that payment because I’ve experienced many times what that gets me. I’ve never waited more than an hour in A&E. Never struggled to get a GP appointment. Never waited 6 months to see a specialist. It’s worth it. But I think if you announced to the UK population that a new 15 percent tax was going on their salary there would be uproar.

I think this plays a big part, we don't tend to care for our family members when they need it because of a variety of reasons.
Taking my own family, one set of grandparents lived around the corner, the other at the other end of the country, both my parents needed to work full time, all my aunt's and uncles worked full time and are scattered across the country due to work/opportunity, there was no one to care for my grandparents should they have needed it (only one GM went to a home and it was for short palliative care that needed nursing input) without big changes to be made, loss of income.
And that's before you get to families breaking up, single parent families, illness and money worries.

I did bits and pieces for my nan as she got older, shopping, cleaning, caring for her after falls etc, but I also had a young child and a ft job, I couldn't have cared for her full time if she had developed dementia for example - I was the best placed to do so because I was actually a dementia care assistant, but practically it couldn't have worked and we'd have all had a miserable time and my nan and DD quite likely at risk.
Both sets of GPs cared for their parents until they died, firstly in their own homes because they lived around the corner and then latterly, moving them into converted dining rooms, but, neither of my GMs worked, both GFs did - one an ambulance driver (before paramedics) and one in a 'professional' job which he got on merit and working up rather than academic qualification. But they could support the family on that one wage, with my GMs looking after their own children, grandchildren and their parents, I can remember taking sandwiches and tea into my great GM and all the children filing in on Christmas morning to see her.

Redcisco €800 a month for how many people please?

@Redcisco do you pay the equivalent of NI?

Because 800 euros a month is much less than the ni that 2 of us pay between us.

Ah....so you know about all the problems of lifting, toileting, etc

It's exactly why I can't do it. Apart from the fact I don't want to - how would I earn? How would the physical aspect be covered (I have a previous spinal injury which I have to be careful with).

we need paid professionals. I am prepared to pay and to subsidise a system for those who can't pay. But the government has no interest in creating one.

The big issue is social care, and the lack of planning people make for their old age.

Almost all of my friend’s parents are edging into their seventies at least and still rattling round the large homes they had when their families lived at home. Often in locations with few amenities in small villages or towns. It only takes one patch of ill health or an injury for this to be untenable.

There is no possibility that my friends or I will be able to offer full time care for their parents, as we will all be paying our own mortgages into our late fifties at least (when our own children will only just be leaving home), and our pensions are abysmal compared to previous generations and cannot be drawn until we are in our late sixties. Family care is not a long term solution for most.

We should all be having conversations with our parents about their expectations and the practicalities of care.

What? Just your NI is more than that? (I'm going at 400 per person).

I think ( no payslip to hand) so probably wing, about 600 quid a month each?