NHS in a state

[Feellikescrooge]

My DF is in his mid 80's and my DM died in April and my DB died suddenly ( road traffic accident) in October. Two weeks ago he went to his GP feeling very unwell. She called an ambulance and sent him to hospital they sent him home late that night, the first I knew was a call from my DF in a taxi because he didn't have enough cash, I had only left him an hour before.

Next morning he attends his regular dialysis appointment and the staff there are so concerned they call for medical backup and he is transferred to A and E at the end of the session. Again he is sent home in the middle of the night without my sister or I being contacted.

The following day I call in at about 10 am and find him on the floor unable to get up, a man who a week before was walking 4 miles plus a day with his dog. Again he was admitted and this time he was kept in. Last Thursday he had a heart attack and was transferred to the CCU. Yesterday he was sent home, when I got there I said to the nurse he did not seem well enough and she shrugged and said that beds were being cleared for Christmas.

I insisted Dad stayed with me and heard him calling at 3am terribly poorly. He was blue lighted to hospital and is now in Intensive Care having been given the Last Rites. I know they are under pressure, my DH was a GP, but surely there is something dreadfully wrong if people as sick as my Dad are being continually sent home.

I may be wrong but I was under the impression that in order to be sent home from hospital, a patient has to have an official assessment as to whether they are fit enough, able to care for themselves etc? (My friend works as a volunteer for AgeUK and she's told me this often, as they get cases where elderly ill people are dumped in taxis and ferried home far too early in their recovery)
It all seems a dreadfully incompetent and dangerously sloppy approach to his health care.
I'm very sorry he is so ill.

It is getting worse. My dh had a major motorbike accident a few weeks ago, he was bluelighted to A&E, broke one wrist, dislocated the other shoulder, broke one toe and tore all the ligaments in his other knee. So literally not a limb worked - they sent him home at 3 in the morning, admittedly I was there but he couldn't even use a door handle let alone go to the loo and not one person asked how we would cope at home.

Blue lighted again the week after because of a chest infection and asthma and was sent home in a taxi at 2am again.

When we were in resuc there was a conversation about the chap in the next bed, he needed an MRI but an edict had gone round saying that no scans could be agreed out of hours without an on call hospital manager giving permission - turns out the manager wasn't even a clinician.

Its awful but its not the fault of the staff, its the fault of the government who insist on making these changes without having any sort of an idea about working in a hospital.

Don't even get me started on the balls up they made with the return to work programmes - getting people in to run it cheaper and they have royally fucked it up!

Sorry to hear you are having a rough time of it OP by the way - let my rant get in the way.

Hatespiders, they should but its expensive to pay people to do this, although it works out cheaper in the long term it's easier to think short term and play russian roulette with people's lives.

Bloody tories

Our A&E is shockingly incompetent. My dh rushed me there one evening at 7pm with bad chest pains. I could hardly breathe and felt as if I was blacking out. (I'm 70) I was kept waiting, clutching my chest and doubled over, grey-faced, standing in front of a reception window, totally ignored. Then after about twenty questions, which I answered in short gasps, I was sent to a waiting area to wait for triage. Half an hour later a nurse saw me and drew a face showing mouth open (trouble breathing) and frown lines (pain) on a form. My BP was 186 over 96. Then I was moved to yet another area for FOUR HOURS waiting to be seen by a doctor. My sis is a doc up in Scotland. She reckons I could have been having a heart attack and could have died in that time. By 2am I'd only had an ECG and an Xray, which showed my heart was enlarged. My dh and I decided to bail out, as nobody came and no-one showed the least concern. We got home at 3am. The pains subsided in 24hrs, but I still don't know what it was, or if my heart is still 'enlarged'. Tbh we'd have been better staying at home for all the interest they showed.
Disgraceful.

The. NHS now consumes more than the total amount of NI in the country every year and has never spent less in a year than its budget. Wit is an absolute monopoly. It would be like marrying a guy who spend more very month than he earns. There in no way for this to end well. Until staff are willing to work for reasonable pay, and give good value for money, the system mathematically cannot avoid failure. The only unknown is when. No-one can justify spending £900 to change a lightbulb, and yet would you ever see a member of staff bring a lightbulb in and swap it to save the NHS £900? No, because pissing money up the wall is what the staff are trained to do. They have whole sets of rules and regulations to make sure the money is wasted as quickly as possible, and they will discipline any nurse who dares to save money.

What the nurses don't realise though, is it is their pensions, their future pay packets and their very job security they are pissing away each day. They see their staff numbers dropping and they do nothing to stem the tide of waste. They fear losing their jobs, so they continue to help the system fail, to squeeze an extra year of twos pay from the system. All the while neglecting more and more patients and turning their backs on the moral values they had when they started their careers.

There is no magic pot of endless money you can continue to spend as you please. If you're under 40, it is very unlikely thee is even a pension for you in your old age. A promise of one, yes, but there is no money behind that promise, and the likelihood that two generations from now, when we hand them the bill, they'll say, Sure we'll pay that, no problem; I suspect is remarkably slim. I certainly wouldn't hang my old age and care on the promise of a system you can see failing and wasting money by the bucket load every day.

OP, So sorry that your DF has been treated like this - I obviously have no idea re the circumstances of your DF admission or discharge,but in my experience an elderly patients condition can deteriorate very rapidly and unfortunately it is common for patients to go from well to quite poorly very quickly,but the pressure to discharge patients is such that as soon as a patient is 'medically fit for discharge' they are sent home - there just isn't the bed capacity to hang on for a couple of days.

I work in NHS bed management and discharge planning.

The pressure this week to discharge patients prior to xmas and free up much needed beds has been horrendous.

I work in 'health care of older people' The minute patients are deemed 'medically fit for discharge" we are under pressure to free up an acute hospital bed regardless of individual social circumstances or choice ,unfortunately I regularly have to transfer confused patients with Dementia to short term care home placements because they are awaiting care packages and its going to take another 24 hours or so to be put in place - its completely unsettling and obviously not in a patients best interests but I don't really have much of a choice when I have elderly very sick patients who have spent 18 hours on a trolly in ED waiting for a bed.

The last few days have been spent transferring patients to care homes or residential rehab community beds - this is often done at very short notice and it really is a race against the clock to arrange medication,transport etc I'm literally running on adrenalin for 10 hours a day trying to ensure everything goes according to plan (and safely).

Today I had a (understandably) annoyed wife and son of an 89 year old gentleman turn up to visit,only to find out he had been transferred (at the last minute) to a nursing home placement but in the rush to get everything sorted nobody had double checked that the NOK had been informed and that's an unacceptable level of service BUT when hospital managers are demanding to know why this patient is still occupying a bed all of 30 minutes after being declared medically fit and you've got admission wards racing to book the aforementioned bed,you really don't have the time to double check arrangements - I've lost count of the number of times medication has had to be taxied over to patients because of the rush to discharge a patient.

Two patients have since been blue lighted back in after "falls" at home and are now being readmitted. DH suspects the families are just trying to palm them off for Xmas

Nice to see what your DH thinks about the families.... Nothing to do with the fact that their house might not be adapted to accommodate someone who is serioulsy ill/has issues moving etc (eg with some stair lift or whatever is needed). Or whether themselves are actually able to do so (eg to be with that person all the time in case of falls when they go to the loo). Or whether they have any idea of how to care for someone who is so ill...

And all that because ... oh yes he is short of staff so people HAVE to vacate the beds because the NHS cannot actually provide the service it's supposed to do (ie if it wasn't Christmas, these people would be staying in hospital to receive the care they need). Oh the irony... :(

What I would like to know is, when are they going to give people the option to 'bail out' if they can't provide the care/treatment that's needed? Most of us won't be treated at all by the time we're much older, so how are they going to deal with us and when are we going to be given a choice?

In my experience, most nurses prefer to sit at a computer all day. God forbid they should get their hands dirty.

I'm a nurse and I don't prefer to 'sit at a computer all day' I'm quite happy 'getting my hands dirty' thank you very much.

Mind you, I don't work in the NHS and neither would I want to, judging by the recent reports and peoples personal experiences.

Hidden, you are so right. I'm a GP and I've spent the last two days largely telling fit healthy adults that they have a cold, that no, I don't have a magic cure because it's Christmas and no, I'm not going to see them just because then they'll get paracetamol free and not have to pay for it. The NHS is on its knees and it is the selfish abusing public that mean it isn't available for those who really need it, like your dad. There is a saying among doctors that the NHS is FATPOA - free at the point of abuse.

Until staff are willing to work for reasonable pay, and give good value for money, the system mathematically cannot avoid failure. The only unknown is when. No-one can justify spending £900 to change a lightbulb, and yet would you ever see a member of staff bring a lightbulb in and swap it to save the NHS £900? No, because pissing money up the wall is what the staff are trained to do. They have whole sets of rules and regulations to make sure the money is wasted as quickly as possible, and they will discipline any nurse who dares to save money.

Your implication that NHS staff are the root of the problem is unfounded and inaccurate. The staff who work clinically with patients work extra hours without pay, bring in things from home to ensure that patients get what they need, go without toilet or drink breaks in order to make sure people don't go without because they have so many unreasonable and inappropriate demands placed on them by pen pushers who have no idea of the practicalities of working with real people. You are right about the light bulbs but this can't be blamed on clinicians who as you say would be disciplined for using initiative and saving money.

Windchime, what experience is that?

Elephantspoo, I spend my time changing medications around to save a few quid at the behest of our local prescribing team, while the recent reorganisations cost billions , including redundancies for staff who went straight back into the same job under a different name.

Money is being waste but it isn't front line staff who are wasting it. You could cut several layers of management and not notice a difference.

Green fizzy completely agree. A nurse consultant on about £50k a year who tits about offering his opinion on everything when staff on wards are working 14 hour shifts without a break for less than half that.
Band 7 managers being made redundant and coming back having received huge packages and then doing fuck all.

Those wittering on about "sense of entitlement", you do know the social care which was keeping people out of hospital has been cut to the bone and beyond in the last 4 years?

The knock-on to the NHS was completely predictable, sadly.

Oh, and by the way both myself and my husband (NHS consultant) take home less for the same job now than we did a few years ago, due to pension changes and no pay rise. With respect elephantspoo, your opinions bear a striking similarity to your username.

I work in the nhs as an auxiliary nurse. I very very rarely get to use the computer.

As an example, on a typical Monday myself and three others will -

Wake up up to twenty five adults
Make twenty five beds
Serve breakfast (two of us do this)
Do a drugs round (two do this, often takes an hour, done four times daily)
Set up IVs, blood products, check drains, etc.
Tidy away breakfast dishes for cleaning
Wash or assist all twenty five
Tidy bedrooms and wards
Check all toilets and showers
Support patients who need full care including turns and treatment of pressure sores
Check observations
Check blood sugars
Take patients to x ray, mri, ct
Work with physio, occupational therapy, etc
Take patients to theatre
Receive patients from theatre, itu, HDU
Try to discharge patients
Put people in the day room as no beds available when they arrive
Run to pharmacy and ask for meds before people are discharged, so they can get home faster
Serve lunch
Change all pads, empty catheters, check fluid levels
Check that patients are being checked on four hourly
Serve lunch
Clean and refill water jugs
Offfer snacks and juice regularly
Meet relatives, answer telephones
Maintain ward and keep clean.
Tidy all toilets, check toilets and showers, tidy sluice room as domestics won't wash bodily fluids
Clean and wash beds fully
Clean and tidy all equipment
Prepare twenty five menus for the next day
Serve tea
Again, catheters, etc, tidy up..

Often I have post operative patients, patients with severe cognitive impairment, life threatening illness, all sorts. Most need a LOT of care that often we struggle to give fully. I often have at least one patient that's dying or will die within weeks. I often see sad and frustrating situations with no easy answer.

I've been bitten, been groped, had poo on my fingers, been vomited on, been weed on, been fallen onto, held all sorts of bodily fluids, dealt with gangrene, faaecal vomit, gi bleeds, c diff, rectal catheters, all sorts..

But I also - paint nails, tidy hair, change clothes, get a better dinner, put ice in the water, get an extra cuppa, fix the telly, meet countless grandchildren and sons and daughters, cuddle, celebrate, laugh.. I go home in tears of laughter often.

Love my job.

But it's certainly not easy - I get my hands dirty every single day!

Pausing - yes, yet more short sighted 'planning' everyone trying to reduce their own budgets without seeing the bigger picture

I should add that I get just about a pound over minimum wage. I don't go home rich. If nhs staff worked for the money very, very few people would be there at all.

And all that because ... oh yes he is short of staff so people HAVE to vacate the beds because the NHS cannot actually provide the service it's supposed to do (ie if it wasn't Christmas, these people would be staying in hospital to receive the care they need). Oh the irony...

Well actually that's not strictly true,its simply that the demand for beds will be a lot higher - Believe me,the beds will be occupied just as normal.

Lack of social care in the community is the biggest bed blocker in our Trust. Its the responsibility of social services to assess patients and provide care packages or residential placement ,unfortunately this takes time,but in the mean time a Medically fit patient is occupying a bed @ £500 + per day and poorly patients are waiting on trolleys in corridors.

Its also quite common for families to insist on finding their own care home - fair enough,except this can take weeks with relatives stating that they have been too busy or on holiday so haven't yet started looking and then complaining when you set the wheels in motion for a temporary placement for the interim.

Its also very common for patients to refuse any sort of care or equipment (sometimes because they are reluctant to pay for it) its frustrating to know that 'mrs smith' will be readmitted in a matter of days due to not being able to cope once home or because of their falls risk.

Society as a whole needs to take care of our most vulnerable citizens instead of leaving it to a single organization.

Your implication that NHS staff are the root of the problem is unfounded and inaccurate. The staff who work clinically with patients work extra hours without pay, bring in things from home to ensure that patients get what they need, go without toilet or drink breaks in order to make sure people don't go without because they have so many unreasonable and inappropriate demands placed on them by pen pushers who have no idea of the practicalities of working with real people. You are right about the light bulbs but this can't be blamed on clinicians who as you say would be disciplined for using initiative and saving money.

What you're effectively saying is, "It's not me, I'm just watching it happen." The 'I was ordered to do it' defence, a common defence of the lower ranks. But the entire NHS budget is controlled and spent by NHS staff. Do any of them give a fuck how it is spent or whether they get good value for money? Do they hell.

'Those wittering on about "sense of entitlement", you do know the social care which was keeping people out of hospital has been cut to the bone and beyond in the last 4 years?

The knock-on to the NHS was completely predictable, sadly.'

People don't need social care for their viral infections

I actually have relatives browbeating me to get the doctor in to check out things which are so simple a fool could deal with them. Entitled isn't the word. It's far worse than that. Arrogant perhaps.

Sadly, the population are now so dumbed down that they struggle to apply a plaster to a finger. God only knows how Homo sapiens have actually succeeded as a species if we're this pathetic