to hope that the report on mid Staffs hospital will shake up the NHS?

[grovel]

It was just awful and everyone from the then government through management to clinicians and nurses come out of it badly.

I don't for one moment think it reflects all (or even much) of the NHS but it does suggest a direction of travel which needs to be reversed - from caring service to self-obsessed bureaucracy.

[Sunflowergirl2011]

Lots of very interestingoints raised on here. as usual more insight than on the tv/ radio news :) As there seems to be a lot of medical people on here, a genuine question... If my loved one was in hospital and I was worried about their care, getting fed /taken to the toilet etc, would I be allowed to stay in with them? .i assume not, visiting hours seem quite strict? Could I insist do you think? Does this happen?

[logitech56]

something I came accross on fb.

[Picturesinthefirelight]

Can I just give a huge cheer for Julue whatshername the cage owner without who none of this would have come to light.

In over the border in north staffs. Things arnt perfect there but it's far far better than this.

[Picturesinthefirelight]

I remember listening to this radio interview at the time.

[claig]

Put Julie Bailey and Heather Woods in charge of the NHS.
What a waste of space that Sir Gerry Robinson - the businessman with enthusiastic platitudes - was on Newsnight. This is way above that idiot's head.

Julie Bailey was right - hold them to account and stop those who were involved working in public office again. Heather Woods and Julie Bailey showed the RCN up with their arguments. The platitudes of the RCN representative about "all working together" belong with Sir Gerry's platitudes - in the dustbin. These people are not capable of solving this crisis.

[GeorginaWorsley]

Sunflower I would be eternally gratefu for your help,but paeds nurses used to family input obviously!
Have a feeling it very different on adult wards,unfortunately.
Ridiculous,families could be such a help and support imo.

[Picturesinthefirelight]

When my nanna was in north staffs a patient in the bed opposite regularly had food or drinks put in front of her which she couldn't eat without assistance so it was taken away again untouched. My dad used to go and give her a drink.

[plus3]

I am a nurse and work on a ward with a 1:1 ratio with good reason. I refuse to work in an environment in which I can not deliver the care I wish to. My hospital is a centre of excellence & I am incredibly proud to call myself a nurse, and to be part of that team.

My SIL works in NHS management in another trust. She believes that a 32 bed ward should operate completely well with 2-3 qualified nurses per shift, with HCAs working along side them. It is cheaper. All the nurses have to do is administer drugs - the HCAs will do the caring. She states that nursing care is 'dire' but cannot recognise increasing the ration and that paying experienced, clinically savvy nurses would be beneficial to the patients....

I sincerely hope this report changes things.

[AtoZandbackagain]

I can't remember hearing anything from the NHS Chief Exec today?

Why might that be?

[claig]

I wonder why Sir Gerry was invited on. I hope that they don't implement a solution of letting loose enthusiastic business leaders on hospitals who think the solution is to 'enthuse' the workforce and provide 'fantastic leadership'. Julie rightly wanted statutory regulations about candour, but predictably Sir Gerry was worried about statutory controls - enthusing the workforce and fantastic leadership was what was necessary.

[AtoZandbackagain]

Sir Gerry did a series for BBC2 a few years back where he examined some hospital up north and made recommendations to improve eficiency - such as making better use of the operating theatres etc.

It was actually a very revealing series that spoke volumes about the NHS mind-set.

I've been spending a lot of time in hospital recently. Have seen some good practice and some very very poor stuff - like the HCA who aimed the thermometer near my ear but not effectively in it!

Have also seen the elderly left to sleep through mealtimes - visitors are banned at mealtimes.

One robotic European nurse response to any question was 'We are giving you the treatment' - like a worn out record. My heart used to sink when she cam on shift.

It's the weasly stuff that annoys me. I was ready for discharge but had been prescribed a drug but it wasn't available. I said I would rather be discharged without it, as the alternative was to spend another day in hospital while they sourced the drug. Someone then said I should ask for the hospital doctor to get my GP to issue me a prescription for the drug that I could collect when I got home - which would not delay my discharge. When I asked for this option I was told quite bluntly by the nurse that it wouldn't be possible as I had refused the drug!

That made me angry.

[meddie]

Well I watched newsnight. I so hope the recommendations are taken on board and actually put into some useful changes,
Sir Gerry was like an enthusiastic puppy. I agree that culture comes from the leaders, but no amount of enthusiasm will enable a nurse to grow a second pair of arms or to be in 4 places at once.


But I fear that what will happen is someone in an office somewhere will develop a set of forms and tick boxes to 'measure' good care, this will then become the responsibility of the ward nurses to fill in,
they will then employ a data collection person to collect this data and bully the nursing staff into making this their priority OR ELSE!!
They will then have to employ a few people to audit the figures then someone else to report and monitor the results.

poor results, because wards are understaffed and you are heaping more work on the nurses and leaving them less time to carry out patient care will be met with, nice new chairs in the patient waiting areas and emails about 'striving for excellence' from someone who has been employed as 'the patient experience co ordinator'.

They will then go on to produce their own set of forms to fill out to guarantee patient experience which will involve ticking a box to say you greeted every patient on arrival and offered them a cup of tea (because it will look good on their CV that they were trying to do something)
meanwhile staff will be sent on improving your customer experience courses and made to fill out 20 page reflective diaries on 'good customer care'
Am I cynical .... yes. I,ve worked too long in the NHS to expect reasonable common sense solutions.

[Want2bSupermum]

Finally we have proof of what we have all experienced at some point in time when dealing with the NHS. Now the real question is how to change the culture.

Living in the US we pay a lot for our medical care but the standards have been very high compared to what I received in the UK. The major differences I have noted are:

1 - They really embrace technology here. Doctors are dictating notes and the speech recognition software and saving everything down onto the centralized server. The PCP's (GP's) are able to access this information as well as any other specialist within the hospital. Scripts are sent electronically to the pharmacy. No paper.... My obn walks around with her tablet. When I needed a CS after being in labour for 24hrs my obn was able to see what timeslots were available while still in the room with me. Two clicks later and I was booked into a timeslot and I signed the consent forms on her tablet. Paperwork was complete with minimal fuss.

2 - Everyone is on 12 hours shifts (7-7) and there were nurses who only did nights (mostly nurses with small children). Each block is run over two weeks and full time is 6 shifts over the two week period. Nurses only working nights received their training during their shift (7pm to 11pm). They also offer job sharing for non doctors so nurses can work 6 hr shifts if this is better for them.

3 - The doctors and nurses seem to get along well with each other. In the UK there seems to be an us and them attitude. How you change this goodness only knows.

The other difference is that patients see what hospitals bill their insurance companies. The birth of our daughter (I had a CS) was $10K. In the UK so many people say the NHS is free. It isn't free. It is very expensive and I think that employees of the NHS and patients should be more aware of what a treatment costs. It might make both sides value the healthcare more.

[drizzlecake]

The other good thing about the US is that it is actually the consultant/surgeon that deals with you. Not some underling that you've never seen before. And they have a more efficient and professional attitude, I feel the local hosp staff here are there to chat to their mates first and deal with patients second.
They see this as 'being friendly', imv being unprofessional. They have this 'there, there dear' attitude to patients which might have been ok in the 1950s when patients were beholden and in awe of doctors and nurses (think stern matron) but is an excuse for sloppy care nowadays.
There is also rivalry between departments which leads to patients waiting around to be discharged due to their prescription not being ready or blood test results not through yet.

Banging a few heads together might help. But sadly no one is in charge and no one takes respsonsiblity.

[LurkingBeagle]

Drizzlecake - you are so right.
The platitudes surrounding the NHS really get my goat too. The first thing Cameron said on PMQ's was "I love the NHS".....well that would be a ridiculous thing to say about the manufacturer of a plane that had just crashed killing hundreds of people. Why is the NHS any different??

No progress is made to improve healthcare in the UK because of illogical sentimentality about the NHS.

[Eliza22]

I'm an ex nursing sister of 24 years' overall experience in NHS, Community Nursing and Private care. I gave up 6 years ago as my son, who is disabled, was ill. I was a single parent then and could not commit to the unsocial hours. It is a total myth, in my experience, that working as a nurse can be family friendly and flexible.

When I trained, in the 80's I was shocked by the attitude of some qualified staff who I personally found to be bone idle and happier in the office, shuffling paper and poring over targets. This worsened in the 90's and I became a community sister, so hacked off was I with staff shortages, the attitude of management toward members of staff who insisted on taking their days off or even holiday leave . By the time I left I had so much "time owing" (overtime, unpaid) that I could have taken a months' leave. Would you expect a solicitor to work overtime, unpaid? No, but then nursing is "the caring profession" made up, in the majority of women and we were always expected to go the extra mile for nothing. there were ridiculously low staffing levels. Nurses from abroad whose English was practically non-existent. Low pay for the auxiliary nurses (as they were then) meant huge turnover and lack of continuity). Agency staff were often placed in impossible situations, at a moment's notice. The wards were filthy. I remember cleaning (with a bucket of antiseptic and soapy water) the toilet doors and handles, in the cubicles, in the patient's toilet because they were worse than a public loo. The same with bedside commodes.... Often human faces on the seats/handles. Bloody awful. No wonder our hospitals are full of C Diff, MRSA and E Coli epidemics. In short, I wouldn't have wanted my CAT in there, never mind a relative.

I remember, as a junior staff nurse just feeling constantly that I was doing half a job ALL THE TIME because staffing levels were crap and so, patients ended up with the absolute basics being done. I'm not proud of this and in fact, when I "whistle blew" relating to care standards just a few years before I left, I went through 18 months of purgatory and witch hunt attitudes toward ME for having the audacity to complain. In the end, the nursing union (RCN) upheld my case. Apologies were made and they were going to "learn from their mistakes". That was ten years ago. Nothing's changed.

Nothing.... And I do mean nothing, would induce me to return to nursing.

[Eliza22]

Does David Cameron USE the NHS? I think not. It's fine to wax lyrical about the institution when YOU don't have to suffer it. Would Mr Cameron like to know that his mother, sister, wife or friend were lying in a soiled bed, drinking vase water, slowly starving to death because of neglect? Nah, didn't think so.

It made me smile (ironically) over Xmas when the Duke of Edinburgh was rushed into a private hospital and we were given frequent updates on his care and progress. No waiting list for him, then? No lying on a trolley in a corridor without so much as a drink of water, for 8 hours? I'm so glad the poor man didn't have to get himself to the diabolically filthy lavatory only to have a fall and be lying on the floor for twenty minutes, before he was manhandled back onto his trolley and spoken to like a five year old.... "What were you doing Phillip? You KNOW you shouldn't have gone alone!"

It's a disgrace.

[XBenedict]

"It is a total myth, in my experience, that working as a nurse can be family friendly and flexible."

Oh you are not wrong there Eliza I am also a nurse with a lot of experience (but not as much as you) and i would love to work on the wards but I can't due to the inflexible working.

I have returned to nursing after a career break and can't believe how much it has changed. During my 4 month course the most experienced nurse on the ward didn't do a single clinical shift due to management demands, most of the time she wasn't even on the ward. I felt really sorry for her, it was like she was being pulled in two directions, one from her ward staff and the greater pull from trust management. Apart from 3 staff nurses the rest of the qualified ward team had been qualified for less than a year.

[LurkingBeagle]

Would you expect a solicitor to work overtime, unpaid?

Eliza, I take issue with this bit of your post. I am a solicitor and I work overtime without pay every single day. I also have not had an uninterrupted holiday for about 5 years. My ExOH who is a registrar in the NHS? Not so much. Home by 6 every day without fail. Spent a lot of time grumbling about being paid less than me though!

I agree 100% about everything else though

[LurkingBeagle]

That's good if it means that nobody else suffers as they did in Staffs. I am a little surprised it's only 5 - it could have happened in all 3 of the hospitals local to me. They are all appalling.

[Eliza22]

Apologies Lurking. I only know that, on the few occasions in my life, when I've had need of a solicitor, I've been billed and had to pay even for a 15 minute telephone consult. When I received the itemised invoice, I was flabbergasted by the minutiae for which I was "billed". I'm sure it's not like that everywhere. But, consistently in the NHS, baring in mind you are on the ward, ready to work by 0710 and can still be there at 2100, there's a lot, a LOT of unpaid work goes on.

Again, didn't mean to offend.

Oh, and one hospital in the report, where I worked as an agency nurse ONCE has had an appalling reputation for care and clinical/surgical mistakes since I first was there, in 1988. It is truly a scary place and I categorically refused to go back. I was putting myself unprofessional jeopardy.

[Eliza22]

In professional jeopardy.... In terms of accountability.

[LurkingBeagle]

Eliza - I know that kind of ridiculous billing goes on. (That's why I complain about every bill from a solicitor I recieve! ) But I promose that it's the partners - not the salaried lawyers like me! - who benefit. Anyway, off-topic.

Incidentally, my OH's former hospital has a "Protocol" for VIP's, i.e. if a politician or sleb came into A&E, they were given rather better service than the average Joe. So even when they do use the NHS, they don't, IYSWIM.

I just cannot believe that the people supposedly running the show did not walk up and down the wards and see this going on. I remember the hospital where I used to live celebrated getting Foundation Trust status by building a bloody great fountain out of local stone on one of the car parks at a cost of 1 million quid! Meanwhile the (mixed) ward I was on had 2 toilets for 12 people (one of which was also the only shower) and was so cramped I didn't even have room for the table thing next to my bed. Nobody should remain in management after making decisions like that, and yet presumably they are still there!!

[XBenedict]

"Incidentally, my OH's former hospital has a "Protocol" for VIP's, i.e. if a politician or sleb came into A&E, they were given rather better service than the average Joe. So even when they do use the NHS, they don't, IYSWIM. "

Arrghhhhh! This is so annoying isn't it? I remember an MP visiting our hospital (a few years ago now) and the faff that went on was unbelievable. Fresh flowers on all the tables in the canteen, we weren't even allowed to use the canteen that day only "invited staff" He was shown around selected wards wtf????? I think he should have been shown it how it is, how can we make these people understand if we dress up up visits like this?