Should NHS staff get prioritised treatment by the NHS

[mids2019]

Should NHS staff get prioritised treatment by the NHS.

The logic is that by facilitating recovery of NHS staff as a priority you actually make the whole system more efficient by reducing absence levels. To some extent this already happens with staff being allowed access to cancelled public appointments and there has been a hidden culture of serving or retired medical staff moving a little up the waiting list as a recognition of their service (but like a staff discount in retail I guess)

is this a good idea and should the NHS be more open about it?

Well it does work that way sometimes and we will get priority treatment if we let the students practice on us, I let the first year students remove my ingrowing toenails under local anaesthetic because none of the patients fancied it and they have to practice somehow. They did a good job 😁
Another time I let a junior doctor do a knee steroid injection on me because I'd been waiting for months and he needed the practice.
It wasn't the best but I got it done so I could function at work. What's a bit of pain?

Why is it a disgrace?

Most employers have some form of mental health support for employees - and what you quoted could be part of NHS’s staff wellbeing hubs. It’s not like the NHS can advertise/advocate private care instead for staff, it’s understandable that their employee assistance programme is provided through the NHS. Ultimately their staff can experience stressful situations including witnessing death and traumatic injuries etc as part of their jobs so they do need mental health support.

I sort of get what you’re saying OP but there’s many ways of thinking about it.

We have an economic productivity issue in the UK, for many reasons, but people being off sick/awaiting treatment/not healthy generally is one. That means less tax is generated. If those people were further pushed down the queue, there will be even less taxes raised - taxes that could be funding the NHS.

www.vitality.co.uk/media/38-working-days-lost-due-to-presenteeism/

The whole system has to work, you can’t just prioritise one as they are all interconnected.

How many people in the NHS go private I wonder? I guess they are silent about it but one could say it may be hypocritical of a chief exec or senior medical officer to have private treatment when they are responsible for an NHS trust. It could be argued that at a senior level to dissuade senior clinicians/management from going private some internal health care agreement might work.

I do think that if you believe any type of prioritization is wrong then you have to look carefully at private healthcare where prioritization is basically down to wealth. Is this ethical?. I think we can get to tied down in ethics with the NHS when we know if we look at society at large there are plenty of areas which are unfair to some and the ethics are debatable.

if we acknowledge society can never be truly fair I think the ethics of prioritising health care staff for treatment becomes less of a black and white issue.

it seems to happen at a number of levels but often in quite an ad hoc fashion with the personal ethos of staff members definitely being a factor.

But now you’re conflating 2 things. Going private is opting out of the ‘equitable’ system that is the NHS and you use that premise as further justification to make it less equitable.

@GuineaPorcus

yes the economy is a consideration but would your argument suggest we prioritise economically active patients over those that are inactive (interesting discussion!). If we start looking at healthcare in economic terms purely the whole thing would probably be a drain to the economy as a disproportionate amount of money is spent on the economically inactive e.g. the elderly.

I still like the idea that if you have healthy NHS workers you increase productivity and get the rest of the population back into work quickly.

No. People would take the piss and everyone and their dog would try to be classed as "NHS front line staff" similar to people claiming "key worker" status in the pandemic. Fund the NHS properly and improve working conditions to attract workers.

I didn’t suggest we prioritise economically active people. I believe in priority based on clinical need.

I’m saying the ‘short term pain’ argument of prioritising NHS workers so everyone else can be seen more quickly in the medium/longer term is flawed as you create less income in the economy. Also the issues in the NHS aren’t mainly sickness; it’s training, recruitment and retention, so my feeling is the impact would be small anyway.

@GuineaPorcus

I suppose the general point is that we accept inequality of healthcare by having private healthcare in society so society is 'happy' with this concept. What is the problem with having some inequality in the state system? For instance there is huge range of salaries within a typical NHS trust. It sounds like you have to be absolutely ethically supportive of equal access to health care no matter your role unless.you have the wealth to go private?

Would it be unethical for a private practice to prioritise one of its own staff for treatment over one of its clients?

@GuineaPorcus

wouldn't slightly preferential healthcare aid recruitment and retention in much the same way as a lot of companies (especially in the US) offer healthcare as part of the part of the salary package?

No it doesn’t make sense. Should the delivery drivers who deliver the clean linen for the beds in the hospital be given priority too? If there’s no linen then no operations. Where do you start and draw the line?

I agree recruitment and retention are major problems and we should have addressed this problem a decade ago. Yet some may argue increasing pay by something that even nears inflation is wrong. Are there ethics in that decision?

I personally don’t think private medical is a recruitment and retention tactic for NHS workers. You have to have (well need to have) private insurance in the US so it’s a necessity and not comparable in the same way.

That aside, private medical ‘perks’ don’t help pay off students loans, stop nurses needing to go to food banks or leaving altogether as they can get paid more doing less skilled work and in environments with far betters conditions.

You’re right there is already a 2-tier system for the wealthy. I’m personally a big believer in the philosophy of the NHS and it being free at the point of care for anyone in clinical need and ethically prioritisation within the NHS doesn’t sit well with me.

Interesting debate though.

I’ve shoved people on the end or (rarely as I am not a morning person) the beginning of a list or seen them while I’m eating. It removes them from the list without stealing an appointment from another patient. It’s essentially unpaid overtime and I’m happy to do it in certain circumstances but I’m not happy to work unpaid overtime for the 1.5m nhs workforce and it’s not ethical that they should be prioritised over other patients for normal appointments. Lots of people have non-healthcare jobs that allow society to function. I don’t want my kids teacher off for 6 months waiting for an appointment either etc etc.
We do get given names and numbers for staff waiting on the off chance that we get a cancellation that needs filling at short notice. They would have to be A - at work and B- contactable and C- be able to be released by their matron/manager so it hardly ever works out. I don’t think our bookings team are scanning patient info for clues as to profession so they can give favours to economically active people.

How many people in the NHS go private I wonder? I guess they are silent about it but one could say it may be hypocritical

My perception from NHS staff is that they are non-plussed about private healthcare. My dermatologist always recommends private treatments to me and tells me how much it helped her. My dentist offers teeth whitening, Filler and Botox and advertises this in their dental practice. My nurse friend hired a private dentist as her own NHS dentist wanted to remove her tooth, whereas she managed to retain it by going privately.

I think there’s a consensus that private care is faster, more expensive and more cosmetic in nature so you can get better results eg think surgery and the techniques used to prevent visibility of scarring. But ultimately private care can never compare to NHS emergency care - there’s no real private A&E options. Many senior clinical NHS staff work part time in the NHS and part time in a private position.

In my 15 years in the NHS I have never seen an NHS employee get any sort of priority in treatment.

The whole point is that NHS services have access criteria which are fairly applied to everyone.

That seems unlikely - given a lot of NHS consultants supplement their Income with private work, why would they have a problem with going private to sort out their own health?

This is a weird thread - given NHS staff don’t get bumped up the list other than on a minor/opportunistic/occasional level that doesn’t seem worth worrying about given the scale of other problems, and there is no prospect of any fast track system being formalised because it would be bonkers.. what’s the point of the thread?

@Lured

@Luredbyapomegranate

Should the majority of our nursing workforce do something similar and supplement their income by working in the private sector? That would solve the pay crisis enveloping the NHS currently. If nurses can be canny enough to negotiate good salaries they themselves could afford private healthcare? Problem solved?

@GuineaPorcus

I agree that the conditions for a lot of health care staff need dramatically improving especially from.a.salary perspective. Nurses using foodbanks is a disgrace.

As an NHS worker I have definitely benefited from being on the workforce and I am certain that anyone that works for a company ,regardless of whether private or public can benefit from the connection.

No, you’re right, OP. Definitely priority treatment. After all, it’s all in our interests to have them at work, working for us.

And the same for transport. They should have special NHS lanes on roads for NHS workers to drive on, so they aren’t caught up in any delays. After all, it’s in all our interests to have them at work, working for us.

But why stop at the NHS workers? Why don’t firefighters have a special number they can call if their house is on fire, which guarantees two extra fire engines and the fire engines drive 10 mph faster than on emergency calls for normal people. Police could be allowed to arrest one person that’s annoying them a month, so that they can focus on their police duties and not that their next door neighbour keeps putting their bins out on the wrong day.

Of course, politicians, as the ones ultimately in charge of the NHS, should get your priority treatment too, obviously,

There used to be (I’m talking mid 90’s) a scheme similar to Benenden Health which had slightly preferential rates for NHS staff. The benefits were also slightly lower than those for private company employees who were signed up to the same scheme but you would get things like £500pa towards dental care; the same for opticians and £1500 for private medical consultations.

It was great on paper but, the reality was, the availability of private providers who were on the authorised list for medical treatment was extremely limited and so it was rarer than hens teeth to get a private appointment unless you had the particular private provider locally. It was easier to get refunds for dental or opticians appointments or treatment because that just required a claim form and a receipt.

NC but I got a DC diagnosed with ASD in 3 months from referral to consultant paed appt and confirmation.

ED visit in 1 hour (booked in, reg identified to care for me, reviewed, scanned, reviewed again and on my way with meds) during a time when waits were 8 hours to even be seen.

Numerous OOH visits with my children were expedited once they clocked I was staff. Also outpatient clinic such as audiology when I had a funny ear, seen mid clinic no questions asked.
Same for a minor op which I was bumped for (was given the personal mobile of the theatre coordinator even) and also staff someone realised I was a colleague and treatment to me at this point was levelled up beyond belief.

Maybe it shouldn't happen but it does, the example in ED got me back to work (an on call shift) much faster. Got to be good reasoning there. It's also a well known perk of the job, when there aren't many others let's be honest!

Innocent try at discrediting NHS staff Op, in the guide of pretending to care. What shits you lot are.

@paintitallover

Not at all. I thought it a reasonable idea to improve productivity. It appears to happen on an as hoc basis so why not formalise it?

Isn't it caring to suggest that NHS are supported as fully as possible ?