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

No free prescriptions for rich old people.

ah, so you mean those old people who have paid taxes all their working lives, those people.

Paying taxes isn't a savings scheme!

Those who are financially able should be paying taxes and supporting themselves.

Those who aren't financially able should be the only ones claiming benefits, and that includes free prescriptions, bus passes, winter fuel allowance, etc.

We really need to expand means testings for ALL benefits.

When the country in trillions in debt and has an annual deficit of hundreds of billions, we can't be pandering to certain elements of society.

A pensioner with a decent income can and should pay for prescriptions, bus fares, etc., and I'd go further and say those with the highest incomes shouldn't even be getting a state pension. It's insane that a pensioner with, say, an income of £50,000 who already gets away with not paying NIC, also benefits from freebies like prescriptions and bus passes, etc. Why should a pensioner with income of £50,000 be better off than a worker with an income of say £40-£45k!

It's insane, unjustifiable and unsustainable.

When money is tight, which it is, state support should be restricted and concentrated on those who actually need it, and not as some kind of perverted reward for people who've previously paid tax (most of whom will have already taken out more than they have put in, in terms of usage of ALL public services).

Sixty isn't old!!!

i don't particularly want to pay for prescriptions but as a country we cannot afford this for the 60 plus age group.

Why not tie free prescriptions to the retirement age of 66/67 & direct that money in to GP practices? ring fencing it solely for patient care.

This little subthread is madness.

We need more children! The population is aging and theres a smaller ratio of economically active people to pay for them.

We could euthanize pensioners as well, that would have an even bigger financial benefit for the country.

Plus their half empty 4 bedroom house they paid 2-3x their annual salary for that's now worth 10x the average salary of someone trying to buy their first home.

@DistinguishedSocialCommentator

Therefore, cancel the 111 service and put the money towards, A&E or more 'Minor Injuries units. I don't have a idea what it costs to rum the 111 service but I guess it could be a few million.

"A few million" doesn't even touch the sides. It's cost is around 3 BILLION per year.

We could adopt the Danish system of actually valuing and adequately funding services which benefit society such as healthcare, social care, education and welfare.

You can say don’t bang on about funding but it matters. We have less admin, less beds, less clinicians and so worse outcomes: https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries.

Why not
As almost always, those working, and paying taxes get hit the hardest.

So free prescriptions it is unless you want everyone to pay
Untill I reached 60 recently, we bought the yearly pass.

People that are well don't need prescriptions so free prescriptions from 60 it is unless you want all to pay.

I’m in Scotland where prescriptions are free for all, but I wonder about a voluntary / optional payment, with that money being ring fenced for improvements to the local NHS?
Also agree with the above poster about appointment letters.. why are they still paying postage (and large letters usually as well, especially when they’re enclosing all sorts of info leaflets etc) when they could just send an email? They’d save so much on printing costs too. Plus less missed appointments where the letter didn’t arrive or arrived too late.

Haven't rtft but a few small changes I would make are;

Improve the communication between different departments of the hospital.
When my DC was rushed to hospital via ambulance, we were asked numerous questions, as expected on the journey. Once at the hospital, the information the paramedics had was not automatically uploaded to the triage nurses computer, so we were asked the same questions all over again.

On another occasion, my DC was brought into A&E via ambulance and taken straight to resus.
Whilst in resus, no fewer than 7 doctors and nurses asked me exactly the same questions. I thought then it would have been helpful for all concerned to have a designated whiteboard where information was written up to save time, instead of having so many staff ask the same questions when as a parent, I'm probably not at my sharpest, since my concern is with my child at this time.

Another suggestion I would make is for the hospital to provide a designated break area for their staff.
When people go to A&E, they feel a sense of urgency, and the wait in the queue can feel interminable, so to see staff sitting behind the screen, not registering any patients, but chatting about their plans for a BBQ that weekend creates frustration and tension amongst patients.
I assumed those receptionists were on a break, but with no designated break area, they sat at their desks at reception while the queue grew and grew, and creates confusion and frustration amongst people waiting in the queue.

Lol!

You want others to pay, like pregnant women but when it comes to losing your free prescriptions.... its "Oh my God! Dont you dare!!!"

Yes, we should, wherever possible, pay for our prescriptions, same as everything else.

Pretty much why the country is in such a mess, too many people wanting it all for themselves.

I have read the thread carefully, and my take outs are that free prescriptions should be limited to those over state retirement age (eliminating seven years entitlement) children in full time education and the medically exempt (for example Type 1 diabetes or cancer; I don't have to pay parking for the hospital locally if I am attending a treatment for my cancer (which is treated and hopefully sorted out already).

However, at nearly 68 and with pension and savings behind me, I can afford to pay for prescriptions etc. If I need that many, I could buy the frequent flyer season ticket.

But my DM89 who was financially raped by divorce 50 years ago gets by on her old state pension (£156 pw) plus pension credit that brings her up to standard SP rate. She worked shifts, latterly PT, in mental health nursing care until she was 77 years old. We step in to meet unexpected expenses and she draws down the equity in her two-up, two-down terrace for new hearing aids and glasses, both of which can cost £'000. She has a council tax discount but does her budgeted shopping at M&S and manages okay, with support (free allotment veg) from the family who ensure she sees some of her children, grandchildren and great grandchildren most weeks. It helps enormously that DM is NOT living with dementia or immobile, although she now needs a walking frame for support for any distance beond a few hundred metres. This should be a model for a dignified old age. DM is not decrepit or failing but she is aged, and actually, her whole small street offer little bits of help to her, and she takes in parcels and deliveries when they are at work, small services but the kindnesses come and go around.

free prescriptions should be limited to those over state retirement age (eliminating seven years entitlement)
This is known to increase costs to the state as people cut back on medication, meaning their conditions worsen and they need surgery/other interventions, plus then they take more time off work (reducing tax paid and/or claiming benefits).

Free prescriptions save money.

@calligraphee . it rather depends on what the Rx are for. For routine pain relief, OTC meds are cheap and work. For cancer therapy, rather less cut and dried.

You have picked the two far extremes there - cancer or OTC medication! What matters is actually the middle ground - blood pressure meds, for example.

There is extensive research to show that free prescriptions save more than they cost - prevention is always cheaper than cure.

Doctors do not give prescriptions for basic OTC cheap painkillers.

Deliberately chosen extremes. Between them, and across age groups, and working/non-working people, there's always the option of the annual pass for £108. Before he hit 60, DH had the subscription because he needed five drugs daily for heart issues for maintenance (nothing expensive or rare), so his bill would have been over £55 monthly. Using the subscription plan, it was effectively a prescribing charge for the drugs that have enabled him to stay alive, and working, running a business employing 10 people (employer's NICs) and supporting a community of 30 while paying corporation tax of £30k pa and VAT on top. How many ways would you like to pay tax? Obviously we also pay income tax and council tax too.

They shouldn’t but they do. I overheard an older lady in boots ask the assistant if she could put paracetamol through the self service she’s never bought it before because her doctor normally prescribes it and she needs it for tonight as she always takes one a day at bedtime.

more legitimately if someone struggles to get to shops and takes lots of regular paracetamol you can get a prescription for 100 rather than the 2 packets you would be limited to in shop.

To a point, but I always re-check things like allergies, smoking status, medications, previous operations.

In the heat of the moment, peripheral information is often not-known, which then the empty box frequently gets re-interpreted as 'none' when the next person reads the notes.

Make people pay for their own childcare and put more money into sorting the nhs at its roots.

Making the whole system more joined up- so much money is wasted.

I was under a consultant ( waited 6 months on a waiting list) and having treatmentWhen this suddenly became unavailable. I was told to go back the GP and ask to be referred again to another hospital in the SAME trust. This involved a further 9 months on a new waiting list and, regardless of the fact I had all the scans and treatment plan in place , had to have a further two appts before treatment could continue. What a bloody waste of time and money !

If you did that, you would have a very rapid number of doctor/nurse/pharmacist/care worker/everything else vacancies and the whole system would just fall to bits.

Well yes if someone really needs it every day they will get a prescription, but that costs bugger all for the NHS anyway as the packet is about 5p

What I mean is a 20yo with a hangover isn;t going to go to the GP for a prescription for paracetamol, they will pay the 15p (retail) themselves.

Free prescriptions save the NHS money, the research has been known for ages.

My dad takes maximum paracetamol each day (on top of prescribed pain killers morphine etc, with drs knowledge) but still can’t get it on prescription. The paying isn’t an issue - the restrictions on amount are though!

You've picked apart your own argument there - if a cert only costs £108 then giving free prescriptions can only cost £108, which is not very much.

Charging for prescriptions actually costs more than it saves. So by giving free prescriptions we can save taxpayer money for something more useful instead of wasting it on administering the certificates, the checking, the exemptions and also on picking up the pieces when people don;t take medicine they need because they don;t have the funds at the point they need the meds.

It is only mad England that persists with this bollocks policy.

In terms of 'how many wasy do I want to pay tax' - I pay income tax, council tax, VAT and any other taxes as required. I want free prescriptions as a step forward in cutting tax wastage.