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?

It’s controversial but we need to discuss end of life more openly and make more living wills and discuss peoples right to end their life

I agree. My mum has a living will. But her older brother, who is 90 next week, does not. He has advanced dementia, fortunately he has never been violent etc but has no idea who he is or where he is, and has no quality of life especially as he has had a fall and a bad chest infection. He's in a care home, but has been taken to hospital to patch him up and sent home again - and he is getting the full NHS funding for the care home as his needs are so great now. But what is the point? He's not living, he's existing. At least he's not in any pain.

Alexa as people have pointed out , the NHS does actually provide very good value for money in comparison to other types of health care system . Do you have any figures to back up your comments ?

I am also intrigued why you have such an ardent dislike of something you are not contributing to or using , Alexa ? How will it benefit your life if the NHS is dismantled ?

I still use the NHS occasionally and of course family members and friends use it. I think most uk residents simply don't have any comparison for it. I do have experience of another system and can't for the life of me think why anyone would want to continue with the uk system as it is.

But why on earth would you feel the need to use the 'stupid' NHS when you have a far superior healthcare system where you currently live ? makes no sense

*Money alone is not the solution. We need to accept that certain elements of what we expect from a “free” service will inevitably be subject to additional cost to the individual sooner or later. This might be paying £10 to see your GP

If I was paying £10 to see my GP would that mean after I had explained my symptoms I could expect more than a "What do you want me to do about it"

Whilst I think that privertising the NHS is the way things are going I think that it is going to be an awful shock to some that when someone complains the "Oh we have lost your notes" Isn't going to cut it anymore to stop any court case.

Of course it makes sense if you are in the uk when you become ill. I was in the uk over Christmas and had a UTI. So a trip to the walk in centre, who wouldn't help, then to another clinic, who misdiagnosed, then back to another surgery two days later where I finally got some antibiotics. Then a text from the second clinic a week later to say oh yes you've got a UTI. Just useless. In my home system I can be seen and treated by 9am by dropping into my local surgery.

And that is simply a very small and the most recent example.

Anyway I admit the thread asked NHS staff for their opinions and I'm not NHS staff so I'll shut up now.

we have much higher expectations of a cure.

They are not the only hcpc registered profs in the hospital setting. Who require the amount of education that "they do"

Unrelated but the whole poor nurses things gets right on my tits.
I agree poor nurses.
Also poor physios, poor odps, poor radiographers!

Yes poor radiographer and physics who get paid a higher band than me and are not threatened with shanks on a daily basis.

I do believe everyone in the nhs needs a pay rise in line with inflation but asking why the focus is on nurses when they are paid a lower band than most AHP is a bit stupid really.

Do you pay tax here, Alexa?

Alexa , does the country you reside in sell antibiotics over the counter with pharmacy approval ? I am under the impression that that is the case in some countries , especially in the EU , which of course would negate the need to see a GP in an awful lot of cases . Won't get into the whole antibiotic resistance debate

Because otherwise no, I am not at all sure that it "makes sense" for those of us who do for you to use the NHS. Why didn't you pay to go privately?

I'm a second year nursing student and worked in NHS for several years. I currently do my extra shifts in the community nursing evening service.
One thing I have noticed that causes a lot of problems is the development of new services/teams being really poorly implemented. Nothing seems joined up, we have a new community service that is meant to be taking over some of our workload but no one knows what exactly they do, except that it's never what we need them for. So we're running parallel services with little communication.
Systems don't talk to each other, so we can do a visit and patient isn't there as they've been admitted to hospital and we aren't aware.
I had my last placement on an elderly care ward, majority of patients were medically fit for discharge but no care package in place for them to leave. The service the NHS provides to deal with this (community care short term) has long waiting lists so isn't much help. Lack of adult social care workers means we can wait weeks for assessments. Relatives refusing to allow the patient to return home once admitted. Huge wastage on drugs and tests that aren't needed.
Nursing training places are restricted by the availability of mentors to train us (as mentioned by PP) so despite the gov wanting more nurses for less money (bursary gone) we just can't fit more in. Nurses are already overworked and have little enough time to teach on the job. Although filling the training spaces isn't hard, there is up to 25% drop out rate for nursing students.

Wider issues of poverty and poor housing impact on the NHS is many ways. We've had patients admitted and unable to return home due to being in unsuitable accommodation. Mental and physical health massively worsened by poor living conditions and lack of community support.

The NHS was never designed to do what it is expected to do now and I feel it will have to change, I just don't know how. Governments being on short terms mean that the party of the day will only make short term decisions/changes when we really need to play the long game with healthcare...

Also what does your home system cover you for ? do you have to pay for anything or is it all covered by the insurance , are there limits , so if you develop a long term condition or if your children require a lot of health care in their early years , are you penalised financially for this or do you still pay the same regardless ?

No I don't pay tax in the uk and yes before you ask I was perfectly entitled to use the NHS as I did. A UK tax payer would be entitled to reciprocal care in my home country too.

No in my country I would have seen the GP by 9am without an appointment and received a prescription for antibiotics. I would have returned to the GP a week later to check the infection was clear. Because it's a well run and properly financed system.

I can also call my GP directly between 12 and 2pm if I have any further questions.

So a non tax payer turns up, happily takes up 3 spaces in clinics/walk-ins, when lots of local residents can't get appointments, pays fuckall for it, then gets antibiotics (did you pay for those?) - then does nothing but whine about how crap the system is and how better it is back home.

And you think that "makes sense"??

You need a whole packet of s.

Rebecca. It is a reciprocal agreement.

For every Alexa getting an emergency appointment here theres a brit getting one abroad...its not unfair. It balances out. Unless you think brits abroad dont make use of things they are entitled to in other countries

Well then as I suspected there are a lot of blinkered people out there who don't understand what a functioning health system can look like.

You are also not understanding how the EU wide system operates.

Fine. Not my problem

But if Alexa was diagnosed correctly in the first place she wouldn't have had to take up a place in the other 2 clinics

Which gets back to my point that you are rarely diagnosed and get the proper treatment without going back several times

I would love to do the mentorship course I enjoy second-mentoring but you have to stay on the same ward for years to get up the queue for the funding.

What pisses me off is that they push people into the mentor course who DONT want to do it just because theyve been there longest. You can be a good nurse and a bad mentor, its not for everyone! But its not offered out as in "we can fund two mentorship courses in 2019, give your name to sister if youre interested". No, instead the longest serving band 5s are pushed into it even if they hate it, and the fail rate is quite high which is a waste!

Ive seen nearing-retirement nurses who didnt do the degree route and hate academic stuff forced to do mentorship while those of us who are keen and academic and have been through a more similar system to our students so understand them a bit better are sat there like "will I be 55 before it's offered to me?"

(And I have asked to be put on it, Im "in line" for it )

Ah, but she whinged and complained but still went back 3 times instead of putting her hand in her pocket and paying for it. plus her single isolated experience in one area qualifies her to judge the entire UK system?!

That's why she deserves a big box of biscuits.

Gingerbread definitely. I've had mentors who hadn't done the course who were much better than ones who had but didn't want to. Also, should be paid more for doing it as it's extra work, or given extra time to do it. Unfortunately, progression is often dependent on having done mentorship which is unfair as it isn't suited to everyone so you end up with mentors who don't want to be doing it.
We don't have the peer mentorship mentioned by a PP but I have come across it on nursing groups and it just seems like cost cutting at the detriment to our education.

"*Money alone is not the solution. We need to accept that certain elements of what we expect from a “free” service will inevitably be subject to additional cost to the individual sooner or later. This might be paying £10 to see your Gp"

I'd be interested to see what sort of economic ramifications there are to this kind of system where you pay £10 to see the GP. I'm guessing that it might cost the NHS more in the long run as people who could be seen sooner for a mild complaint that is treated might put it off or be unable to afford it, so it develops until they are in need of more intensive or hospital treatment? For example the person with mild clinical depression who may be seen by the GP and prescribed anti depressants. If they can't afford to attend and it gets worse then eventually they may end up needing a long course of 15 sessions of hour long psychotherapy at a much much greater cost.

I also think a lot of people are naive in thinking everyone can afford £10 to see the GP, and those who can't must be on benefits and would therefore be exempt from the charge anyway. I've never been on benefits but working insecure NMW zero hour contracts for many years left me in a position where I couldn't even afford the £7 for a prescription, no way would I have been able to also afford a £10 fee to see the GP. Lots of working people are cut so fine with their income and outgoings that a spare tenner is impossible to find. Imagine the single parent with three kids who has to pay £10 each time they or their children need to be seen. Or illnesses that require regular appointments, having to return twice to see if an infection has gone, etc.

In my old surgery they insisted I attend every month to be given my medications as 'we wouldn't put those on a repeat unless you're dying of cancer or something' (they're strong painkillers) which was an almighty waste of time just to show up get a script and leave. Luckily my new surgery is a lot more realistic and has happily put them on repeat so I'm not wasting an appointment every month!

There has to be some penalties for non attending and last min cancellations however, id support charging for those as an incentive not to waste resources like that. And you can't have another appt until you've paid. After three or more DNAs (so as not to penalise the very occasional mistake that might make someone try harder next time. Only for repeat offenders who clearly don't care).

Quite honestly I would be happy to be a sign off mentor for no extra pay, I would enjoy it and it would add to my job satisfaction. However I DO want the academic / university credits. Theres talk of changing it to in-house competencies to save money on uni fees and that's BS. IMO. I dont mind not getting extra pay but I DO want the RECOGNITION you get from the uni credits! Also uni credits contribute to career progression if you do it at masters level... this is the kind of thing that improves retainment, seeing yourself being built up within the organisation.