Wtf is going on with the nhs, is this the new normal?

[letdownchristmas]

I was in A+E with a relative yesterday with a suspected pulmonary embolism (has a history of this ) although luckily turned out to be all clear. We got there by ambulance at 3pm yesterday and was on a trolley in the corridor until 9pm. There were 15 people in the corridor on trollies with ambulance crews waiting to be handed over. All I could think was how the fuck are there any ambulance crews left on the road when they are all waiting in here to hand patients over. I was told that that this is a fairly normal day now. On the electronic board I could see that there was a 42 hour wait for an inpatient bed and only 56% of people met the four hour target. A 7 hour wait to be seen for walk ins. It honestly frightened me as to how the nhs is going to survive another winter.

We’re saving so many babies that we wouldn’t have saved previously. People are so much sicker, our acuity has increased massively. We care for patients on the ward that previously would have been on high dependency units or intensive care.

We escalate staffing constantly. It’s met with a shrug from management and ‘there’s no help’. What can we do?

Our local surgery has two very part time GPs, who work 1.5 days/week between them.
On Wednesday there’s a paramedic based there who sends everyone to Ambulatory Care where you can sit and wait for hours and be sent home at closing time and told to come back tomorrow. There’s a practice nurse one morning and a different afternoon plus a very occasional locum.
There’s rumours that it’s closing; the next nearest is 6 miles away, no bus service and only opens two mornings a week. It has a long waiting list.
After that it’s a 10 mile journey, no buses, to the next town.
A considerable number of the residents in my village are very elderly and have no chance of getting to another surgery.
I have been waiting 16 months now for an urgent cardiac review, I have a telephone consultation mid May. My condition is deteriorating and irreversible but I guess being 70 I’m disposable now?
I bitterly resent successive governments wrecking the NHS after giving much of my working life to the NHS.
It’s sick, in every sense of the word.

My daughter is on a Teen Cancer Trust ward funded by charity.

We watch the air ambulance funded by charity.

She sees a social worker funded by charity.

All of the research grants into her rare cancer are funded by charity.

On the social media boards for her cancer type it is full of people from the USA asking for advice as their private health won't pay for access to the right specialist, won't pay for them to take part in a trial etc They are not able to spend time with their dying children because they will lose their jobs and their private healthcare package that is paying for their child's care.

We need to look to other European countries for a workable model not the USA.

Yes, it is normal. It doesn’t need more money - it needs root and branch reform. It’s pretty hopeless.☹️

Chest infection - my son almost died. We didn't think it was so serious. Thanks God NHS 111 sent us an ambulance. As he had serious issues with breathing in few minutes. You never know...

The figures are for publichealthcare services, regardless of private or state in origin.

No idea on the number of BUPA nurses etc in the UK but only a very few people have access, exactly the same as with a purely private hospital in Germany etc, so these are not counted.

The Kings fund has crunched the numbers.

Thanks @Alexandra2001 for knowing your stuff.

It makes me laugh that those saying NHS needs to change i.e. privatise it fully, are arguing that when the NHS was created healthcare was easier. We had lots of soldiers who had returned from the trenches injured and needing medical care. Rare diseases like polio were common then with people hospitalised in iron lungs. The challenges are different now, but the NHS then had lots of challenges.

Healthcare has always been challenging will always have to deal with new challenges but it was far less complex because there were less treatments, fewer medications, fewer operations, far less equipment used, fewer specialist divisions, and far less drugs used that doesn’t mean there wasn’t any complex issues

it’s become more complex overtime as medical science has so greatly advanced beyond what anyone would have thought possible and that increases costs not just for the treatment but for training, purchasing and maintaining equipment, specialist units, specialist teams and of course medication

some medications are extremely expensive, the continuous training HCP’s need, the changes in services that can be provided it’s all comes at huge costs

the money wasted, time wasting sat in yet another meeting, poor management which was really highlighted during covid, the slow decision making or lack of discussions with those that it will impact, the fragmented services not working together, the management often being out of touch there is so much that just seems so cultural to the NHS that needs to change

Quite. But why, in this day and age, does the NHS spend money on sending appointments out by letter as the default, rather than email or online portal? The last time I was referred to hospital by my GP I received four separate NHS letters about the same appointment. So wasteful.

Just a minor example of how investment is needed to modernise the admin/computer systems as well as the frontline healthcare.

@ScaredSceptic The vast majority of people who get hospital appointments are elderly people without an email address or inability to use an online portal. There have been trials using online portals and they have never been extended because too many people can not access them and end up using GP appointments to get access to their information.
I know it is popular to pretend on MN everyone can access things online. But lots of elderly people even if they could use online stuff, lose the ability as they get more ill and elderly. My father did. He cognitively could no longer navigate anything online he had not done before, no matter how many times you showed him how to do it. Lots of illnesses come with some cognitive issues.

That's why I said, why do they send letters "by default". Of course there will be many who prefer letter or can't access email/online systems for whatever reason. But there are many who can. It should be simple to record a patient's communication preferences/needs and use that method for that patient. But it's not, because the IT systems aren't joined up.

The IT systems are not joined up because so much of the NHS has been outsourced to private companies. It is not one system.
DH works for healthcare in an outsourced service. He has 3 different email addresses because of data protection he is not allowed to send confidential encrypted information from his companies email to the NHS, so has been given an NHS email address and is not allowed to send confidential information from his company to another company he works with so has been given an email address by them. It seems crazy, but the companies IT systems apparently are not good enough to do anything else.

You want everything to operate as one system? Then make it all NHS instead of lots of contracting out to the private sector.

Yep down here the private "Livewell" company provide services to the NHS: Physio MH community OT/Neuro - Why?

All they do is use NHS staff but with duplicated IT, HR and management, how on earth can it be more efficient?

We have a massive problem with flow. Cannot get in (not enough GPs), cannot get out (not enough paid carers and SWs).

We are not getting enough people training. The grants got taken away. Therefore fewer people are understandably not wanting to pay thousands to train for not great pay and massive stress.

It’s not just the NHS that’s struggling.

My friend has BUPA healthcare. They’ve been waiting for an urgent referral for CBT for over 3 months. Looks like the private sector is also not coping?

How long is it in the NHS?

For CBT? Years IME.

It's not just A & E, my mum had surgery for breast cancer reacted badly to the aesthetic had to stay in over night. Her consultant saw her before 7am and filled in the release form but it took until 5pm for the nurses to have the time to sort out the paperwork for her to leave.

I don't blame the nurses on the ward because like A & E the nurses are over worked.

The whole of the NHS needs to be reformed so we have more Front Line Staff and less office, middle and upper management.

It has been like this for years, even pre pandemic.

I spent 6 hideous weeks in hospital two years ago and in week two , 4 patients were fit to be discharged but couldn’t leave as follows;
3 elderly ladies who couldn’t go back home without support ( care package) either because their partner was too frail to care for them or there was nobody at home. I remember thinking that all they needed was a period of convalescence somewhere.
1 patient in her 30’s refused to go home as she was unable to use the stairs until she got better and did not want to sleep downstairs ???? She had a partner at home! She was spoken to several times but point blank refused. Most odd. Every day she got up and dressed and sat in the chair beside the bed.

They should stop spending so much money on expensive and mostly useless drugs rather than using out of patent cheaper medication. Why won't they do this? Lobbying from pharmaceutical companies?

They do, there is huge emphasis on cheaper, out of patent meds.

NICE decide which medications are made available, based on cost and effectiveness, even individual consultants cannot by pass this system.... but how would you feel if you or your child had a v serious illness and a new (very expensive) drug come on with a 35% success rate but the NHS said NO ?

I bet you'd soon change your tune.

...and this is why people die waiting for an ambulance.

I had to go to a and e in an ambulance 12 years ago...the ambulance staff were so relieved we didn't have to queue outside but they stayed with me whilst l was on the trolley as it was so chaotic the a and e staff kept asking me the same questions then gave me tablets to take but didn't give me any water etc..so grateful to them for staying when they could have left me there.as their job was done.

Is getting private medical insurance the answer?

Not always. Private hospitals don’t have A&E.