AIBU to wonder what the heck is going on in hospitals right now??

[Rinoachicken]

Before I start, I want to make it clear I am NOT blaming the hospital staff in any way.

13 hospitals have declared state of emergencies or whatever it is.

Why is everyone suddenly descending on A&E all over the country all in the same week? Has there been an outbreak of something I don't know about?

I don't get it. A&E is always stretched to the limit, but Why this sudden crisis all over the country?

Am I missing something??

Also, here in the US they have a lot more specialists so, for example, when in labor the L&D ward had someone able to attend theatre and one running around giving epidurals. Once given an epidural I was monitored remotely by one nurse watching everything from a screen. My friend had an epidural in the UK and the midwife was then 1-1 with her with constant checks. It was a very inefficient use of midwifes time.

Interesting example. If I was going to pick an example of how much better theUS healthcare system was than the NHS, I'm not sure maternal healthcare/childbirth would be the one I'd go for. In fact I'd be steering well clear of it.

'If families could try constructively engaging with hospital staff, putting themselves out to take responsibility for their relatives and accepting that their relative is their responsibility too, things would be considerably better. Lots of families do do this. Lots of mumsnetters will be doing this but not all and 'dump a granny' season which is mentioned in the Telegraph article below is a real problem. It's not that common but it happens and it never should.'

Never? Even if the family member were abusive and toxic, if you have to move hundreds of miles away to make a living and have no room to house the relative and no spare money to pay for it and no time due to work commitments? Even if the family member has complex health needs (advanced dementia requires 24 hour/7 day a week care?

There are loads of reasons why it is not possible for 'family' to take responsibility for another adult family member.

I have spent 20 years of my life caring for various elderly relatives.
Eventually one has had to go into a dementia unit due to double incontinence, violence, aggression, and complex medical problems.

It still takes hours and hours of time just to deal with the GP, the care home, social services etc, never mind the constant missing teeth, glasses, clothes, shoes etc.

I have a job, 3DC and another elderly relative to care for - it is hard.

Last week the one in the dementia unit had a bad fall and was sent (probably unnecessarily) to A&E by care home staff. DH was summoned at 3 a.m. to go and collect and transport back to the care home. He still had to get up and go to work for 14 hours the following day.

Some carers/family just reach breaking point.
In fact, for many people the only thing that triggers any support or help at all is "carer breakdown".

And it's just been announced that the govt are now looking at stripping nhs workers of unsocial hours pay for working weekends and nights.

They just don't get that a huge part of the current problem is due to the inability to recruit frontline staff. Reducing pay further is only going to make this worse.

1. not enough beds-people wait for hours in A&E cos there is not a bed to admit them to. When there is a bed available and people are admitted the pressure is on to free up that bed again.People are discharged too quickly and have to be re-admitted.
2. priorities and bed numbers in the health service decided by accountants and managers-they may be clever people who produce wonderful reports about "inappropriate admissions " but they arent the ones not sleeping at night because they are trying to manage someone in the community who really needs a hospital admission but there are no beds to admit to.

3.Social care does its best but is focussed on number of interventions rather than quality of interventions

1. the number of elderly patients with complex health needs is escalating and is a demographic time bomb but there are no resources to deal with this and there is sometimes also a focus on keeping people alive at all costs even when quality of life for the person is poor.
2. you get what you pay for !

DH was summoned at 3 a.m. to go and collect and transport back to the care home. He still had to get up and go to work for 14 hours the following day.

EXACTLY A lot of carers have the caring AND a full time job!

We got fantastic service from our local A&E last night, despite it being at breaking point according to the local paper. My son dislocated his knee. I took him to hospital and he was triaged within 10 minutes, examined by nurse practitioner, x rayed, had a splint applied and we were on our way home within an hour.

The waiting room appeared quiet, but when we went round to radiology there was another inner waiting room that was packed, and numerous people on trolleys lined up in the corridor. I'm guessing their experience probably wasn't as positive as ours sadly.

However, I can only say good things about what we experienced, and I was very grateful for the service we received.

'And it's just been announced that the govt are now looking at stripping nhs workers of unsocial hours pay for working weekends and nights.'

WTAF? My only guess is that they want the entire system to collapse, in order to privatise it along the lines of the US.

That's a clusterfuck, and I was born there and lived there the first 31 years of my nearly 44.

So the poor can die, as they deserve, for not being better than they are, mostly working.

Fuck this lot.

My sister had never cared about politics. She was an A&E doctor (training) until 6 months ago. She is re-training as a pathologist as A&E was such a nightmare. She has gone from being apolitical and never voting to despising the Selfservatives and the Fib Dems (as she calls them).

She blames the government's "unnecessary" top down reorganisation of the NHS that has wasted billions.

Theres been talk on here about how families should be more reponsible for care of elderly relatives and some of us have explained why thats not always possible.

Well what about the responsibility of organisations Ive just seen this article. The elderly ppl in this complex could so easily have ended up having to stay in hospital due to the neglect to fix this problem.

www.ely-news.co.uk/Sanctuary-Housing-bosses-apologise-elderly/story-25812815-detail/story.html

Haven't read it all but loads of reasons.
We had 166 Did not attend in our surgery last month that is 4 days of GP appointments wasted yet over a 3 day period when we were ' shut according to the media and mumsnet' Christmas New Year we had 60 unused appointments yet the local hospitals were teaming colleagues say their practices were the same.
People who have been sick once or twice, cough started last night, child with a temp for 1 hr etc etc but well all needing to be seen now leaving no appointments for those who really need them.
Flu and norovirus are going round
Etc etc etc

Expat in Scotland- that's the truth, they've been trying to prove the nhs doesn't work for years, to justify privatisation.

I went to a seminar years ago where they were trying to convince staff to form social enterprises, so basically private non profit companies, and re-hire themselves back to the nhs. The plan was to have no salaried staff at all.

I spoke to a very senior person there and he said the government (and this would be labour at the time), were throwing money at a badly managed nhs, knowing it would be mis-spent, so they could prove the problem wasn't lack of funding. And indeed, instead of sorting basic structure and prioritising ground floor services, we got that God awful, now scrapped, it'll solve all the nhs problems, computer system.

If they remove out of hours supplements the nhs will collapse. why would anyone work the hell that is nights for no extra?

Actually there are some families out there that are dumping relatives. In fact just before Christmas we had a patient who was ready for discharge so we phoned the family to let them know only to be told that they couldn't possibly take them as they had party plans over Christmas! Now not all family is like this but there are obviously some ??

And I sincerely hope they don't cut the weekend/night enhancements otherwise they are going to lose a lot of staff

Are they really thinking of stripping pay? I had heard that they were thinking about getting rid of it for bank holidays but for nights? That's the whole reason a lot of people work nights, is for the extra pay. Who's going to want to work nights now?! I know there are some people out there who like doing it but the extra pay is an added incentive. I guess the day and night shifts will be spread out more equally amongst people in that case but wow that is crap.

In regards to labour, I'm not sure what is meant about there being less specialists as we have obstetric anaesthetists available and a theatre team. Admittedly, the anaesthetist might be somewhere else in the hospital at the weekend or at night so will have to make a trip to maternity but it's not like the US where practically every woman has an epidural so they're not needed on the ward all the time. I don't like the idea of watching someone remotely, having an epidural puts your labour into a higher risk category which is why midwives have to give one to one care. If anything happened (for example a woman's blood pressure can drop drastically, women with epidurals are often on the syntocinon hormone drip as well which you have to monitor closely to make sure the baby's not distressed by it and that the woman's uterus isn't hyperstimulated) and you said oh well I was out of the room and watching a screen that wouldn't stand up in court. Not in the UK anyway. I personally wouldn't be happy just to watch a screen, I would want to be in the room.

My local A&E has been rated one of the best in the country by the CQC but I'm not sure what makes it so different. I've heard very good things about it but the general assessment wards are hell. They look incredibly disorganised and the nurses have said no-one is based there all the time, it's mostly agency nurses or nurses who are taken off other wards to help out so no-one has a clue what's going on and patients hardly ever see the same nurse. I do think hospitals that recruit a lot of agency staff tend to perform worse because the nurses aren't affiliated to that trust so they don't have the same commitment, they don't know the paperwork so well which takes up a huge amount of time and errors are made a lot.

There's also the fact that a centralised national patient database is a necessary artefact for the fragmented, privatised NHS Labour and the Tories both planned.

Because you can't move people around 8 different providers for each itty bit of their treatment without it.

There are numerous problems, both with the NHS and also people using it appropriately.

PFI is a big issue but trust need to look at why their finance directors agreed to a contract that cost 25% of their income! That is total madness, esp as all PFIs increase by at RPI each year and sometimes more. They assumed their budgets would always rise by more than RPI but have obviously found out that's not a given.

MISS thats one patient. In my link above there could have been an influx of elderly patients due to an HAs reluctance to pay bank holiday rates so that the residential home wasnt forced to go without heating and hot water for two weeks.

Stripping workers of their extra night wage. Christ how low are they going to stoop

As low as they think they can get away with. Haven't they already reduced the weekend rates in the past few years? I'm almost certain we used to get different rates for Saturdays and Sundays and now it seems to be a flat lower rate for both days.

I'd heard about the possibility of stopping unsocial hours payments. If this goes ahead, think there'll be a real crisis with many people just quitting.

I work in elderly care and morale is so low, the workload so heavy that staff turnover is very high. Every shift we have agency staff ...
Can't give the care we want to, rushing about with no respite.
depressing place to work and high levels of sickness as people are exhausted and demoralised.

• gp's not availabe when you need them (ours wasn't open between christmas and new year at all!)
• gp's not able to deal with everyday urgent but not life threatening stuff (like cuts that need stitches, x-rays)
• difficulty to even get a gp appointment for minor ailments.

If they stop our unsocial hours payments then people will leave.

Being an ex-A&E nurse, I think this has been bubbling under for years & often internal major incidents should've been called but weren't, now, attendances have rocketed (20k a week more than last year even)

yes.

This is result of multiple factors:

Huge reduction in hospital beds over last 10-15 years

Older patients with multi factorial problems needing increaed levels of care , longer time in hospital to recover.

Reduced availability of GP appointments

System struggling in the summer time will flounder jan - February.

Social care system struggling to find staff ( largely due to poor pay and conditions)

I work in a small market town with over 800 (!) people over 80 on the caseload of the local gp's but no nursing home beds ( only residential care )

Whilst the fact this is an election year may hav an impact on the reporting the problem was and will still be there.

I agree with the poster who said it will be an excuse for the cons in particular to say "oh the nhs isn't coping we need to pritivise quicker."