A question for NHS staff

[Glowinginthedark]

AIBU to think that no amount of money throw at the NHS in it current state will fix the issues? What is the real problem? Lack of funds or people completely abusing and misusing A&E or both?

PS How to save some dosh. STOP SENDING TAPES TO BE TYPED OUT TO INDIA WHERE ERRORS ARE F R E Q U E N T and a staff member here has to check them - yep that is kept quiet.....My own Hosptal letters were addressed to the WRONG Dr and my address was wrong after the first line - yet nowhere from MY records was this address obtained - so someone in India made it up!

Gerty your post shows that you know less about it than you think. Many non residents ARE entitled to emergency gp & a&e treatment. The charges are "later" because its not until youre having further/in patient treatnent that you actually start running up a bill...not when you walk through the door in a&e!

I agree with those that say the real problem is underfunding and lack of staff.

The reason I believe that is because I can remember the underfunding, closed wards and patients dying in corridors in the 80 and early 90s. The long waiting lists for treatment was another common problem.

The Conservatives have always hated the NHS and wanted to privatise it. They do that by underfunding it. Blaming longevity and health tourism is merely deflecting the blame from where it firmly belongs.

Sorry I am not talking about anyone constantly shouting and screaming in pain - what I am saying is, we all look at some folk and "know" they are taking the hiss and find it amusing to do the selfie-ing - ie taking pics ooh look at me in A&E. If they are sitting there smiling away, chatting, laughing is this an A&E emergency? NO! Sorry but NO. Its a GP surgery jobbie.

If they are sitting there smiling away, chatting, laughing is this an A&E emergency? NO! Sorry but NO.

Bollock.
Im not going to post the details of our laughing/chatting lady, but Ill tell her this much, EVERYONE who saw her scans looked like this:

Theres a lot of thinly veiled propoganda on "real life" tv at the moment. It is NOT the service users who are killing the OP

GertyTheGert Or maybe they're relatives trying to lighten the mood? I know I probably acted like that a few times when I was taking in and sitting with my lovely mum during the several admissions before she died. She was scared and afraid. Sometimes I'd even have a close friend with me as I was 20 and not sure what I was supposed to be doing caring for her. You want everyone to sit around in hushed reverence? Come on.

Gingerbread I am taking about those NOT entitled not those entitled! As per what I said! In Spain, you pay the 100 Euros as soon as. Then you pay as you go along. Here in the UK? Nah. You are billed. Its not just one pal I had in the NHS, I only mentioned my best pal as she dealt specifically with the non-entitled (the non coughers-up). I also had other pals in similar environs in the NHS who told other stories of time-wasters etc etc. I'm not guessing, I am speaking from these folks stories of waste of NHS money - including some Mgmnt "meetings" discussing shite - blue sky thinking etc etc.....

The more shocked/scared people are the more likely they are to laugh it off!

I'm so confused, do you mean those who are legally entitled and not entitled to use the service or some weird idea of people who are demanding a service that they believe they're entitled to when they... are or aren't?

Oh gerty listen, we all have stories about time wasters, whether we work in hospitality, retail or healthcare. And they are the stories we tell over a bottle of wine after a long hard week. Im not saying your friends stories arent true. Im saying that they are not the biggest problem eating away at the core of the nhs right now!

Errrrrr my whole point is being missed here! I am talking about these A&E alleged very sick folk (very sick meaning Emergency as per A&E -
and that isn't sarcasm honestly). I'm not talking about their carers laughing, shouting, taking photos! Hushed reverence, thats one extreme to another? We can all talk a bit less shouty can't we? (I am 75% deaf in one ear but my OH doesnt shout at me!) Sorry anyway, do we need loud folk when maybe 20 feet away is a genuinely ill person behind some flimsy curtain.....

So first it's "A&E. If they are sitting there smiling away, chatting, laughing is this an A&E emergency? NO! Sorry but NO. Its a GP surgery jobbie." and now it's the volume people speak at. Seems like you're just trying to find any evidence to fit your belief that most a&e patients don't need to be there, and you're magically able to tell that from their behaviour with no medical training and without examining them. Alright then.

Its basically the same as shop lifters. A % of the populatiom do do is, and it IS an issue that retail staff have to deal with, but shop lifters are NOT the reason for ghost streets of shut down businesses in towns that have been plunged into recession due to central policies, unfair business charges/rates, take-over by large chains etc.

Now replace shoplifters with timewasters, and ghost precincts with crumbling nhs services, and then you might understand.

GingerbreadMa So ban people who DO exercise and ban people who dont? No, charge people for the cost of their treatment, if caused by voluntarily taking part in very risky extreme sports which they should get insurance for. Also people who choose to voluntarily drink, eat & smoke to unhealthy dangerous excesses.

We should never be immune to scrutiny Agreed but financial penalties does not make the NHS better, it just harms patients.

People dont bed block for fun Hopefully not, but if they are able to be discharged and cant be, then a charge should be made against their estate for the full cost of their stay in the NHS hotel.

A lot of your ideas aim punishment at the people who are already being punished No they are aimed at reforming the system so that everyone who genuinely needs health care (through no fault of their own) will be able to get it.

Really? My friends you seem to think are just very slightly exaggerating what goes on? Nah not at all. In fact you are missing the point. This IS the cause of money being wasted - folk aren't entitled to NHS but they use it - our money is being used, be it via our taxes or be it we have to pay for staff to chase up millions of pounds in unpaid debts to the NHS. Folk who attend A&E but aren't an emergency - that Dr could be seeing a genuinely ill (emergency) person - so it IS relevant to the money! Lemonshark - folk who ARENT entitled to use the NHS but do so - they get it FREE cos they do not pay their bills. Or they pay £50 and sod off back to wherever.......

I am giving up with Lemonshark - you are making lists now - does common sense not tell you if the sick person sitting in A&E is having a rite ole laugh joke, pic-taking etc - that they are not an emergency? I assume you think its free to sit in A&E and get treatment for a cut your GP could sort out. Not a great big cut to the bone etc etc .....You are being a bit sarcastic with "my medical knowledge" and it sounds a bit childish tbh. Folk dont walk into a shop for a steak and say I will pay you later but tomorrow I am flying back to Thingyland so I may or may not pay you, so why does anyone think the NHS should be different - pay as you go if you are not a British taxpayer (a non contribuitor to the NHS).....

Most of the non tax payers who do use the NHS are from.........Britain! Not "Thingyland"

Live abroad and if you need to access healthcare services the first thing they ask for is your health insurance card.

If you don't have it, you need to get one. You don't have one, you don't get treated, unless you are literally dying.

I haven’t read the whole thread but this is my take on it. I am a GP, my old boss near retirement age was telling one day about how the treatment for an MI (heart attack) used to be aspirin and bed rest for a week. It is now admission for PCI (opening the blocked artery with a balloon). There is a target door to balloon time so my DH a consultant cardiologist needs to be available to do this when he is on call at any time of the day or night. Now this much more effective treatment is obviously good for patients but as a GP if all those years back I failed to treat a patient with an aspirin and bed rest it wouldn’t really be the end of the world. If I miss the chance for urgent intervention now it is a much bigger deal (plus complaints/compensation culture). I could go on but thought that was a good example.

It is largely poor people who eat, drink too much and don't exercise enough.That is due to oppression.

I have sat in A&E with relative with cancer who was admitted for a few weeks, laughing and joking. It is a way to deal with fear. She died a few months later.

The nhs can not for many, many reasons be maintained.

I for one, am fed up of the work, its a thankless task & people have very little respect for the services offered, it's a shame as we had a great service to be proud of.

We have ourselves to blame unfortunately.. not the government or politicians.

we need to sadly , adopt the other countries medical services..

To my list previously, I suppose we should add waste. Waste in many forms. Some down to NHS itself- poor contracts with private sector, problems with outdated IT- for example where systems don't "talk to each other" so lots of admin and clinical time spent on transferring/finding information and so on. Waste in terms of medications given which aren't used and thrown away.

A big issue in our trust was related to missed appointments. Approaching 21% of all primary care appointments (so GP, practice nurse, phlebotomist), 19% of hospital appointments and 33% of community mental health appointments were missed. That is a colossal waste. The striking thing about the breakdown is that the appointments most likely to be missed in primary care were those booked on the day or the day before- I had thought it would be more likely to be those made in advance. Also found that text reminders didn't make a significant difference to attendance. Only one trust but suspect it won't be so very different across the country.

The number of NHS beds has reduced from nearly 300,000 in 1987 to almost 150,000 in 2015 whilst the number of patients treated has increased significantly

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Supply has decreased at the same time demand has increased. We are constantly being fed the mantra that the NHS is falling apart and mounting pressure etc. but successive governments and in particular the current lot are responsible for massively underfunding the NHS. Why are they doing this I wonder

Gerty do you understand the meaning of the word Triage ? And how it is used in every A&E department in the UK ? No Doctor is going to be looking at a swollen ankle if there is someone else with a life threatening emergency , people are triaged according to their need . There is also usually a separate entrance for real emergency admissions via an ambulance , which is why people often don't understand the wait times as they don't see the critically ill arrive through the self referral entrance .

The cost of A&E attendance is probably a tiny dent in the NHS budget though , most people attending are seen and sent home , it is those who require further inpatient treatment , whether due to social or medical issues , that are the real cost .

But blaming those in need of treatment again plays into the hands of those who wish to dismantle the NHS , it isn't as a result of dire mismanagement and underfunding and bed closures , oh no , its those pesky forriners ( British folk who prefer a warmer climate in their old age ) or pensioners ( all of whom are apparently sitting in ££££ homes with final salary pensions ) or basically anyone who has the audacity to live and breathe without a private health care policy