To support the NHS but...

[AudTheDeepMinded]

Think that sometimes people's time and money is wasted due to needless stupidity?
Two recent cases in point. Few months back received a letter regarding son's flu vac. Great, I'll book an appointment. Rang local surgery's overloaded telephone system, as requested, spent flipping ages in a queueing system. Eventually reached a real person to be told flu vac apps not yet available for booking. What a pointless waste of my time and their resources! Why not either send the letters out later and/or include when the bookings can be made? It's not rocket science is it?
Last week I received a letter to make app for son's jabs. Went into the surgery the next day. Queued up, spent a good few minutes sorting out a suitable app with receptionist. Went to app today to be told that son had to be two weeks older in order to get the jabs. Great, this info was not on the letter and the receptionist had not been trained to check. So I wasted their time, my time and the nurses time we were attending.
When you hear how overstretched the NHS is it is so frustrating to feel that I have unwittingly contributed to wasting much needed resources. So AIBU?

I agree. a lot of time wasted in waiting rooms, on the road (to the specialist unit 3hours drive away), waiting for treatment...

the idea of the NHS is great, most of it's staff fabulous. but it's woefully underfunded and in some instances downright dangerous.

As a process improvement guru, I would love to get stuck in.

And you'd probably make a huge difference and save a lot of money. Bit can you imagine the headlines if it was discovered that the "cash-strapped" NHS was hiring process improvement consultants?

A lot of the problems are the lack of infrastructure, computer systems not linked up - letters which appear to come from the GP about your smear/flu jab but which are generated centrally and the two computer systems don't talk to each other. When that ransomware attack hit the NHS was so badly affected as their computer systems are so behind the times - running Windows XP or something.

But no government is going to say "we're spending a billion or more on a shit hot NHS IT system" because they'd be asked why they're not spending it on nurses or MRI scanners.

I have one, too. Similarly love the NHS, long may we protect it and all that, but booking my smear is actively impossible:

"Need to book my smear appointment."
"Tuesday at 1pm?"
"I'm afraid not, I'm a teacher, and can't book time off work during term time. Is there a time after 3pm?"
"Sorry, the nurse has young children and only works school hours."
"Fair enough, can I get one during half term week?"
"Sorry, the nurse has every holiday off with her children."
"So....... when am I supposed to have my smear?"
"Tuesday at 1pm?"

Aaaaargh! I get that it's a lovely, rural surgery and more power to the nurse for being able to plan her work to optimise time with her kids, but surely I can't be the only female teacher on their books who needs a smear test some time?!

I think a massive part of the issue is that where most businesses would utilise technology to do a job well, a recurring theme I see in the NHS is relying largely on poorly paid administrative staff whose roles get harder as patient demand goes up and more complex as patchy 'solutions' are implemented. Investment is desparate needed in order to implement solutions that improve services and reduce spending in the long term.

@PiperPublickOccurrences

I tend to agree, especially when the only real justification would be to lose the amount of people they employ, because obviously if the NHS system was more intelligent, automated and any where near technically advanced as private businesses, they simply wouldn’t need to employ so many admin staff...

It’s like the working tax benefits system, there is no reason why this couldn’t be factored in at source, e.g let’s stop taxing people rediculous amounts every month, to only have to claim it back by an over engineered pointless process... but ironically that would mean less jobs and would never be popular opinion!

Everything is the country that is publicly owned is just a shambles of wastefulness and pointless bureaucracy!!!

I see both sides of this, both as a practice nurse and a regular user of the NHS for me and my children.

I work in a medium size GP surgery. We have approximately 3000 flu vaccines to give between September and December, on top of our normal work. Letters and texts are sent out to eligible patients early in September. Saturday clinics are filled within hours, and weekday clinics fill fast.

We have dedicated clinics to do children’s nasal flu vaccines, and this year are splitting clinics into under 65s and over 65s as they now receive different vaccines and we want to reduce the risk of errors.

We order our vaccine in May/June - we have to stagger deliveries as we don’t have the fridge space for all of them at once. The adult vaccines are delivered as expected. The children’s vaccines are due on the Monday and our first kids clinic is to be the Wednesday.

The vaccines arent delivered. They are provided centrally so we have no influence over them and can’t source them elsewhere. Our receptionists have to phone approximately 100 children’s families to postpone their vaccine to the week after - the week in which we have another 100 kids already booked in. We want to do extra clinics but have no room availability in the surgery despite nurses being willing to come in on their day off.

These are just some of the issues we face daily and may go some way to explaining why things can’t always go to plan. The NHS is massive and unwieldy. It generally is managed fairly well but is hampered by a lack of cohesion and communication. Sometimes patients don’t help themselves - we have a number of patients who don’t consent to information sharing, who then query why hospital X hasn’t liaised with us, who need to talk to clinic Y.

Patients move house, change mobile numbers, won’t accept calls from unknown numbers, don’t open post that looks vaguely official, DNA appointments repeatedly.

Don’t get me wrong, I know the system fails many of us regularly. It’s as frustrating for those of us that work in it, as well as use it. But it’s vast, does way more than it was every designed to do, and relies heavily on the goodwill and dedication of those that work for it.

Your local GP is run by a CCG and not the NHS.

@Freezingbum I think the problem with the NHS is that it doesn't employ people like you to problem solve. The senior people tend to be clinicians who have worked their way up but not people who have training in business or systems etc which is think they actually really need!

Also casing point I have regularly been put forward for roles in the NHS to work on “improvement” projects.

As a self employed contractor, using an LTD as a tax vehicle.. paying between £350 to £500 PER DAY.

Locum doctors are double this amount..

Sadly YANBU. And unsurprisingly, some of our health outcomes are worse than other developed countries which don't have our system. I imagine when someone's going to get a bill (whether it's the individual or the insurance company) that that does rather focus the mind on e.g. being able to contact people, even if then means everyone pays more £££ ultimately.

I completely agree with the previous poster though - the UK system works despite itself only because a huge number of people (often unsung poorly paid admin people) somehow make it work. I haven't forgotten my 30 mins hanging on the phone while an incredibly patient secretary went through what sounded like an old-fashioned family Bible-sized paper ledger to find DD an appointment that I could make without taking a whole day off my teaching job.

Yes, plenty of money so poorly used

NHS admin generally seems a bit of a mess. I assume it's underfunded and undervalued. So I'm never convinced when people say they need to ditch the managers.

I was referring to sidge's post.

Please don't come and improve us. It takes four years to see the long term benefits following significant reorganisation. We're just getting into the second year when we have a new contractor come in to lead a "performance optimisation" project . It happened constantly. We never saw the benefits.

There are lots of improvements that could be made that are not though. That's one of the reasons I left.

I find there's an unacceptable level of variation too. My GP practice (which I chose after asking from advice from NHS colleagues about which they received fewest complaints about!) is unbelievably better compared to the one I used to go to. When my DPIL were getting a terrible service from their GP (it was very serious as DMIL had a cardiac condition and couldn't even get an appointment despite being retired and available at any time) then they didn't even realise they could change practice or that practices varied.

@sourpatchkid I have first hand testimony to this, I did some consultation work in a private company that matched locums to jobs. Also working in law firms, senior partners etc are just not up to date with technology, and only when something becomes a burning concern they decide to through (a rediculous) amount of money at the problem.

It’s kind of why I sometimes lean towards privatisation of certain publicly owned services, The risks are huge but the benefits are also not something to be sniffed at. There needs to be a massive cultural shift in this country towards technology and productivity.

I would love to see some sort of progressive government committed to this, whikst supporting the “admin staff” who would traditionally be employed as paper shufflers, in having paid opportunities to retrain in these areas...

I believe in the NHS principle that health care should be free at the point of need and available to all. Sadly though, I believe our NHS is dying a slow death. Not because of a lack of money, but because it is irreparably inefficient.

Friends and relatives in the NHS have such a low morale at the moment. They are massively underpaid, their working conditions are unacceptable and the level of stress is unsustainable.

I work for the NHS - sadly it’s on its way out. However I’m not immune to the difficulties. For example last Friday I had bloods done at hospital A- my local district general. Tuesday I had an apt 10 miles down the road at hospital B. Unfortunately the clinical databases do not communicate therefore 4 days later I had to have another blood test for the same things I had the blood test for on Friday. Hugely inconvenient, time consuming and a waste of money

May I make one plea though as a health care practitioner? Please turn up for booked appointments. Some days no patients turn up. They still get offered a further 2 opportunities to attend. It’s so wasteful and just can’t continue.

@Wheretheresawill1 it must be a massive annoyance when people don’t turn up, but is there any investigation when no body turns up. Twice I’ve had an appointment changed and I’ve been informed by letter. Except the letter has arrived the day of the original appointment or after the new appointment has passed. Then it’s back to the bottom of the queue.

@PiperPublickOccurrences
The reason you keep getting invited for cervical screening even though you don't have a cervix is because the person who deals with this at your registered practice hasn't notified the central system not all call you anymore (aka cease).
Ask your practice who does the Prior Notification List, state that you are still getting invited for screening, and that as you no longer have a cervix they should mark you as ceased due to no cervix on it. That should stop the letters.
If it doesn't then google "screening and immunisation team" for your local area, and email them to complain. They will want to know that the practice is not carrying out the adminstration of screening correctly. They can also use this form.

Also a guide to the Open Exeter (central screening database) here for anyone interested.

@SachaStark might be worth looking for a Well Woman or GU clinic, as they often have different hours. Some GPs do them, so ask if they could do it as the nurse isn't available when you are?

I work in a GP surgery and it frustrates and annoys me when letters are sent out to people to book a double afternoon appt with the GP of their choice for an annual health review, eg learning disabilities or dementia only there are no appointments available.

I was admitted to hospital in June with chest pain. Was in and out for 5 days having all sorts of investigations. Saw GP on discharge who asked if I'd had a 24 hr trace done. Nope. So I had to wait 6 weeks to get one done, and only saw my GP yesterday to get the results as I had to wait another 6 weeks to get an appointment with him. It was advised on the results that I see a cardiologist urgently. Since then I've been in A & E twice with further chest pain, resulting in further admission. As I got so fed up with the lack of progress and sleep, I discharged myself and apparently that now means that all the referrals I'd been told were actioned were all cancelled and I've only just found out from my GP. So I've been waiting for an appointment that was never going to come. He's said he will refer me, but they rang me today to say that they won't accept the referral without a recent ECG (i've only had about 50 since June) so am now having to wait another 10 days for an appointment at my surgery for this to be done before the referral can be sent off.

I only hope that I haven't got anything majorly wrong as to be honest, I just don't have any faith in the system .

NHS staff would love to have joined up IT systems but it doesn’t fly with the general public.

Totally agree with you OP.
This year my (adult) dd broke a bone.
I won't bore you with thedetails, but the sheer, total, inefficiency and waste of resources, over and over and over again around her follow up appointments is absolutely astounding.
I see it as well with my job - the wastage in terms of missed appointments isn't all down to people choosing not to attend.

The fact that nobody seems able to say 'hold on a minute, this doesn't make sense' and make alterations to systems is the odd thing.

For example - hospital Dr says they want to see her in 3 weeks. dd queues up at Reception (with diary in hand) to make the appt, but no, that person can't make an appt then. They have to send her one. Cue costs of printing letter, envelope, postage and person to physically put this together. dd can't make that appt, tries phoning - just continually on hold. It suggests e-mail. She e-mails. They e-mail back to acknowledge it is received and tell her they will put another appt in the post. WHY ?? Why not suggest another appt BY E-mail - it is free, and it is instant.

This ^ is only one tiny, tiny bit of the whole inefficiency saga, but if it is repeated every single appt., imagine how much the NHS could save by someone using a bit of common sense.
Before anyone say "Everyone doesn't have e-mail". I know that. But they were having an e-mail conversation with her, so clearly she did, and, of course, she was right in front of them and their computer when in hospital in the first place

I have so many reasons to be incredibly grateful to the NHS, as I suspect most families do, but I want the resources spent on healthcare, not faffing about with inefficient wastage such as all the examples on this thread and so many others I know of personally.