How would you improve the NHS/ - A&E, appointments, waiting times etc

[DistinguishedSocialCommentator]

Please dont bang on about throwing more money at it

If you are a NHS staff - what would you do.

I'm sure different hospitals, groups of hospitals work differently, so are there any good ideas about?

IWe are too old and many medicals to get medical insurance but our children and their children all pay into private care plans but we are all aware we need a good NHS

So, is there something that apworks at your place and not others, what is it

I've noted that the gov has over the last couple of years set up many new CT/MRI sites and recently heard from a friend that people from abroad were running mobile units and weekend ct/mri's units in hospitals etc and waiting times were going down - that is good.

I've noted and was pleasantly surprised I had an ultrasound and then a camera investigation same appointment. In the past it was go for an ultrasound, then a camera if required.

I've also experienced Sat and Sunday scan appointments, last 2 years - so there is good news

However, A& E is a shambles, and worst of all, I've read re seriously ill people going to A&E having to wait hours at times

Should we get rid of more management?
Should we proparely look/investigate procurement?
Should we revisit all nHS staff's contracts especially consultants' contracts so the NHS could be more effective?
Should we seek a mandatory working period for mandatory hours by newly qualified NHS where the majority of the money towards their learning is from taxpayers?

Could we adopt a great system from another country and if so, where from?

the link below - I don't blame the consultants but the gov for not changing rules re payments for contracts - not sure what difference it makes if the doc was working at the hospital or not?
https://www.theguardian.com/society/2023/feb/12/nhs-consultants-run-private-firms-charging-to-cut-waiting-lists-at-their-own-hospitals

Make doctors better and actually see people

Masivly increase scanners and machines and people to work them. Fast diagnoses no messing around.

Keep the NHS working at weekends it's absolutely disgusting that no one can operate scanners etc or things can't be done because it's the weekend!!

Oh, and increase mental health provision. So obvious that I forgot to include it.

@SunshinDay problem is that there aren’t enough radiographers and radiologists to use that equipment. The government tried to implement a 7 day NHS but there aren’t enough staff and junior docs went on strike because of it. Thing is no one wants to pay for it. They’d rather deny other people treatment to make paltry savings.

@IIdentifyAsInnocent

I've experienced that extreme laziness, I was in a hospital reception caught in some beurocratic nightmare about a form that could only be signed by a doc who was in a different hospital etc whilst I was waiting for bloods. The actual secretary was in mystery hospitals I didn't realise until the end when she said "I don't want to walk all the way down". Disgraceful because there had been panics as to why form wasn't being emailed to reception staff.
It didn't need to be all she had to do was done downstairs n

I think it needs improvement from bottom up. We need more pharmacies/GP/ walk in centre options. People shouldn’t be having to fight for appointments or go to A and E out of desperation.

if people can get the early diagnosis and referrals/treatment quickly then many issues could be stopped from escalating.

All of your suggestions require loads of money to buy and maintain equipment, buildings to put them in and staff to run them.

Staff deserve a break so if working weekends, they wont be working during some of the normal working week.

Once qualified with the 'basic' degree, the students / junior doctors need mentors and they are qualified doctors and consultants

By taking on more trainees, the senior doctors are less able to see patients

There are so few permanently employed consultants, that it isn't possible to treat all the patients and train up all the trainees and maintain their own CPD targets

But if you couldn’t /wouldn’t then it would be much more expensive to pay for your subsequent pregnancy/abortion.

Always ways around things, need creative thinking. Even if we all had to pay ten pounds flat fee when we accessed hospital would raise millionz however I wouldn't do that because one gov would say it will be low but open that door and the next gov ramps up costs.

Getting lore staff different shift patterns..someone has to be able to work machinery in a weekender

Invest billions and stop wasting money on certain things.

     • Higher tax on cigarettes, alcohol and            sugar

• Stop NHS cosmetic procedures
• Stop NHS IVF treatment
• Stop NHS gender reassignment surgery
• Stop tourist treatment
• Stop ridiculous NHS payouts
• Stop sending out ambulances when not an emergency/patient is able to get to A&E themselves
• Make it easier to cancel/rearrange appointments (having to queue on phone for doctors for 40 mins+ to cancel is ridiculous and no wonder there are so many DNAs)
• A means tested system whereby patients must pay to attend A&E
• Charge drunks and time wasters
• Build more hospitals and walk in centres
• Invest in more mental health support and social care
• More apprenticeship routes into NHS roles
• Reduce admin for clinical roles (having to wait ages to be discharged whilst paperwork is filled in is crazy)

And that’s just the tip of the iceberg…
I’m aware that that alone is nowhere near enough to save the NHS but just what came to my head when reading.

Many people in genuine need, especially older people are already reluctant to attend hospital because they don’t want to bother people. 20% of the country live in absolute poverty, that means they can’t adequate feed and heat themselves. These are the people who are more likely to be sick and injured and these are the people who would stop using the NHS. I don’t think this is the route to go down.

Agree that social care is the major issue here and needs to be funded. My side of this though for those that said about integrating health and social care, this has happened in my area and all it has done is that community nurses are now plugging the gaps and taking on care packages ‘short term’ they say but it never is. This on top of our already over stretched workload and it isn’t working, they need to be looking at the real issue of getting more people to be home carers, open the cottage hospitals back up and stop closing residential homes.

we also need to be more realistic about death and stop keeping people alive just because we can, I’m not talking about a sprightly 90 year old but those who have no quality of life stuck in a care home or at home and cannot move unless someone does it for them, antibiotics for every infection but the person has advanced dementia, cancer treatments that aren’t curative and will just make the last few months of a persons life completely miserable, 70/80/90 years old wanting resuscitated etc. we need to be having more open conversations with families and being honest about outcomes etc.

we also need people to be responsible for their health and this is in all age brackets, but for me in the community it’s the amount of people who do no follow our advice, don’t take meds that are meant to help, take bandaging off so leg ulcers take longer to heal or become worse.

Yeah i know, that’s obvious. That’s why i said it needs a review. Maybe still give free contraception to people who receive other benefits etc but the reality is there are so many who can afford one prescription every 6 months.

We shut the world down and spent billions to protect the vulnerable and infirm elderly. It's not likely that stopping treating them for anything and everything will ever happen.

Bring back convalescent homes. When I had my appendix out in the 80s I had an infection after the op as it had burst. I couldn't go home as it needed watching , so they sent me to a convalescent home for a few days to recover... with daily physio to make sure I kept moving. Much better than taking up a bed that was needed in hospital.

I don't work in NHS but spent a lot of time visiting hospitals recently

Agree with @BeyondMyWits. We should have convalescence care for people without sufficient support at home

Also, it seemed to me that people wait hours and sometimes more than a day for drugs from pharmacy before being discharged. Is there a way of improving that process ? Imagine if every bed became free 2 hours quicker then now . Surely that would help a lot. Waited 8 hours for meds for my dim

Charging for healthcare at the point of use would never work because the usual groups, children, those on benefits, the elderly (whose generation hold most of the wealth) would be exempt, penalising the poor sods (least likely to use it) in the middle yet again.

GPs open 7 days a week - this would help with a and e as so many people have to go there for things their own gp could deal with if they were open

Yes,

Hospital pharmacies have their own circle in hell.

I agree with this. Bed blocking is such a huge issue

Such as?

"Creative thinking?" are you in management?

Bottom line is that if staff are working sat/sun they wont be there on Monday/Tuesday and that means less treated during the week.... then you need the mtce teams available, porters, HCA's ....

So far more money required.

Fees, much like prescription charges won't be paid by the majority who use the health service.

I work for a gp practice.

First thing I'd do is increase the free prescription age to 67 in line with retirement.

Then change conditions for free prescriptions to limit to that condition only. For example you have a thyroid condition so get free scrips. You should pay for the script you need for tonsillitis.

I would then give gp surgeries lots more funding to allow them to afford to employ staff at weekends and evenings

Would it help to have a GP based at a&e for those gp related things? I know records are not easily available which would be problematic.

There is a very simple solution. They need more funding. They quite simply do not have the resources to function because of the lack of funding.

Why the government isn't prioritizing the NHS instead of other areas is beyond me.

I think there just isn’t enough GP’s to do that.