To ask what YOU would do to help save the NHS?

[TamiTayorismyparentingguru]

I don’t care if you’re an HCP or not, I don’t care who you vote for, I don’t care what you think about Brexit - all opinions welcome.

Opinions on practical suggestions on how to save the NHS only though.

Our local hospital is getting worse and worse with regards to staff shortages and waiting lists getting longer and longer. I will say that our GP is really great and we’ve never really had a problem with getting appointments etc, but as soon as you are referred to the hospital things go massively downhill. (We did have a GP misdiagnose/miss DH’s cancer which was pretty shit - but I wouldn’t say that was a particular problem with the system - more just one of those unfortunate things that happens, that really shouldn’t happen, but that are just a matter of course.)

The hospital is a different story though - wait lists for some departments are insane (current wait time for an initial cataracts appointment is 42 weeks and then up to 18m for treatment, paediatric dermatology is a min of 30weeks, paediatric podiatry is approx 30weeks also. I have been on a wait list for max fax for 14mths so far. I also had an 8week wait for an appointment at the breast clinic after seeing the GP with a noticeable lump.)

DH has also had to fight for every single appointment since his cancer treatment last year - instead of the 4-weekly appointments he’s meant to have had, most of his appointments have been 7-8 weeks apart and have been cancelled at the last minute (sometimes just an hour before) at least 4 times in the last year.

It’s awful and yet I do trust that the doctors, nurses, receptionists etc etc are all doing everything they possibly can.

What’s the solution?

I also know if a young girl who became blind because if NHS errors and misdiagnosis. When she went blind she had to be admitted urgently to the same hospital that had said it couldn’t treat her as there were no beds.

It looks like you are not used to dealing with a chronic condition:

Both myself and OH have chronic conditions, as did my mother and father in law. In all cases, we've learned to take responsibility for ourselves as you just can't trust the NHS when you're seeing different staff in different places. We've saved countless appointments that would otherwise have been wasted by checking things out ourselves beforehand, and we've also ensured treatments have gone ahead quicker (or at all) by being proactive. Far too many consultants/depts don't talk to each other, far too many different systems that aren't integrated or where staff don't have access to a system they should have.

Most recent case. OH needs a monthly blood test for a particular identifier which is apparently very expensive. Had one done in hospital A two weeks ago. Went to a different consultant in hospital B last week who wanted another one done - we told him one had been done the week before, but he said it would be easier to do another rather than phone and ask hospital B for the result. Just shows how glib they are with money! Why couldn't he get a receptionist/HCA to phone up and ask for it, and more importantly, why wasn't it on the system when OH is being cared for jointly by these two consultants? There should be automatic access to all data - it's crazy that each consultant/hospital are doing independent tests etc.

I spent time in hospital last week and was astonished at the waste of silly little things that I hadn't even thought of before like medicine dispensing cups being binned after each use, wash basins binned after each patient discharged, water cups replaced and binned 4 times a day.

I asked about this at work recently (I'm a nurse). Apparently is significantly cheaper to buy throw away cups and dispensing pots than buying reusable, plus dedicated dishwasher to clean them plus the time man power to clean them (can't be cleaned by hand for infection control reasons).

I ended up in A and E with Norovirus unbeknownst to me I also had sepsis -

"Don't go to A and E with Norovirus" policy would've killed me, just saying.

I'd like to opt out of the NHS.

Work already pay for private care, which I am taxed 40% on, and I'd happily pay an insurance on top that would cover A&E or 'other' care.

My experiences of the NHS echo many here: uninterested admin, too many paperwork problems, antiquated booking systems. We've had some top notch emergency care in ICU, but once you're 'fixed' there seems to be a drastic lowering of standards in nursing care as well.

Private health care won't be of any use if you're involved in a horrific accident. There is no A&E provision in private health care. Are you going to have that job for the rest of your life? What happens when "work" doesn't make that provision any more? What are you going to do when you retire and the premiums for private healthcare insurance are like telephone numbers?

Put a walk-in centre/minor injuries unit next door to every A&E, so that all those people who can't get a GP appointment can go and wait 6hrs in the minor injuries unit instead of in A&E.

I had to ring fil's GP surgery the other day. To my amusement, the receptionists are now "Care Navigators" . The automated message said I was about to reach one of these Care Navigators who would "navigate" my call. After five minutes same old cross and bolshy receptionist as before picked up. What sort of crap initiative is this and how much did it cost? Small amount of money maybe, but still money completely wasted.

I awaiting procedure at private hospital paid via nhs my issue is I get 5/7 days notice I need 2-4 minimum being self employed need to sort finances out! And finally they given me a date for 4 weeks time perfect now they changed I cannot do! Made it clear I would rather go to a normal hospital than all this aggravation and cost nhs less?

There needs to be much more sharing (and forced implementation) of best practice within administrative processes.
And I don’t mean high level stuff - I mean departments/specialties within the same trust actually looking at each other’s processes and implementing the most efficient/cost effective.
The most likely reason is that no one can actually agree what best practice is and that there is a huge objection to change when it’s not your idea.

Just needs someone with some commonsense to go into a dept and look at a few things to start with and ask a few awkward questions

starter for ten ....

" why have you come to a n e with your stubbed toe when you need to be at minor injuries ?

" why are there 10 people in the nurses station filing in forms ,talking,and on the computer, phone and only one nurse actually with patients ?

"why has this person come in for this appt when we could have spoken on the phone/skype/email ?

"why tf have we got a fax machine ?

Each NHS trust negotiates its own contracts, which impact prices. Better to do NHS-wide consolidated negotiations, with multiple competing suppliers.
All NHS trusts should follow the same policies around what treatment they fund, or criteria etc.

Very inefficient to have localised medical records. I had blood tests recently and it was a logistical shit-show.

I’d go private for treatment, I have private healthcare as do my husband and children. Still doesn’t tackle the issue of needing A and E or emergency care.

Maybe private hospitals with a and e departments would be a good way to go. I’d quite happily opt out of the nhs system to save it money.

I would require proof of medical insurance to be shown at passport control, so no health tourism.

I would happily pay a fee to see out G P : we pay for our dentist and prescriptions so I would see it as an extension of this.

It's not a solution to a big problem and would be awful for so many people but I feel it will come in eventually : or a fee if you miss an appointment and you don't cancel it within a certain time scale.

Personally, I think the whole GP system is outdated. We're decades past the days when your local GP did everything, i.e. minor injuries, minor operations, attending accidents, and even ward rounds in local hospitals. There just weren't the same number of specialisms and departments. In those days it made sense that your GP did virtually everything for you, so they were the "hub" for your healthcare. Now the GP seems to be a gatekeeper role for most patients - just someone to refer you to a consultant or tests etc.

I think we'd be better moving to a local clinic system where you have clinics on street corners you can drop into, where there are nurses etc to do tests and treat minor injuries, and also a doctor for more serious things.

Along with more facilities for "self referral", where you take yourself along to reception for appropriate departments (i.e. audiology, physiotherapy, podiarty, x-ray, etc) and where the receptionist or triage listens to your concerns and decides what to do. It works well in opticians, dentists and pharmacies - the receptionists in those works within guidelines to make appointments or give advice or suggestions to go elsewhere. My son had a toe nail removed last year - he had another foot problem this year and rather than the merry go round with the GP, we just phoned podiatry direct on the off chance they'd see him without referral, and they did, no problem at all - got a podiatry appointment long before we'd have got a GP appt for a referral.

Having to go via the GP just for referrals is exactly why you can't get appointments - far too many people needing appointments just for referrals who don't actually need any "treatment" from the GP.

The idea that the GP is responsible for all their patients' healthcare is also a bad joke. Once you've been either admitted or under treatment by a consultant or a specialist department, they "discharge" you back to your GP, who usually hasn't the foggiest idea about why you're suddenly sat in front of them. Just happened with my OH. After months of chemo (and a bag full of other medication every month), it's back to the GP, but the GP couldn't issue prescriptions for the ongoing meds needed as he hadn't the foggiest about what was going on - nothing on his computer system, no "discharge" letter from the consultant, so it was down to OH to take in his bag of drugs so the GP could prescribe them on repeat for the future - no only is that inefficient, it's also dangerous as the GP had no idea what meds were needed going forward - something could have been missed, something could be dangerous to continue. Just what is the point of them?

I would happily pay a fee to see out G P

I wouldn't, if it's just needed for his gatekeeping role. I went last week to get a physiotherapy referral. A few years ago, I went for a referral to audiology for a hearing aid. No way I'd be happy to pay the GP to do that as it's something I think I should be able to arrange directly myself, just like I arrange direct appointments for eye tests and dental check ups.

Make better use of pharmacists. It's a symptom of health care systems where seeing a GP costs money, but in both the US and where I am now, pharmacists have an impressive array of drugs that they can sell over the counter for minor ailments. This frees up GPs (and A&E) for the people that really need to access them

Cut down more on who can access treatment. My sister moved to the UK and had been in paid work for 1 month (paid 1 lot of NI) before being struck with a horrible illness which saw her in hospital for 2 months, she had rounds of very expensive treatment, tests, consults, and then months of weekly physio once she was well enough to be released. I'm so so glad she had the treatment she did, but she still had top tier cover travel insurance. She was only there on a 2 year visa and ended up moving back to our home country after treatment as she still wasn't well enough to work.
As I said, I'm so glad she had the treatment she did (it saved her life) but it was hundreds of thousands of pounds worth of treatment which could have been covered by insurance, and even though she absolutely was technically entitled, I think the issue is more nuanced. But then where do you draw the line?

I will continue to vote for parties committed to the NHS, continue signing petitions against privatisation by Virgin "Care" etc, continue fighting Brexit and the creeping Americanisation of the debate

Make better use of pharmacists. It's a symptom of health care systems where seeing a GP costs money, but in both the US and where I am now, pharmacists have an impressive array of drugs that they can sell over the counter for minor ailments. This frees up GPs (and A&E) for the people that really need to access them

The same could be said of street corner "clinics".

Procurement - I understand why it needs to be used but we pay over the odds for EVERYTHING, stationary, courses, equipment, labour. For example a £16 train ticket for a course, can't be just bought and paid for by person doing it, it has to be bought by the training dept, who have to use an approved provider, actual cost of ticket eventually £114!!! Just one example and This goes on all day everyday in every public sector, the money wasted is eye watering!!!!!

I think A & E as the "gateway" to hospital isn't working. We need mental health A & Es, where people can go directly for emergency help. This help would include the sobering up period - mental health practitioners will not assess someone under the influence of drink or drugs, so they have to sit in A & E to sober up.
I would allow ambo crews to refuse to convey patients to hospital for minor injuries (obviously i exclude people with mobility issues here). They are not taxis. They are not allowed to clear from hospital until their patient is handed over. Due to triage system, ambo patients with minor injuries are at the bottom of the queue so this means the crew are hanging around at the hospital even longer before they clear. I would also consider a separate method of ambo patient admissions in order to allow them to leave their patients sooner. I would bill would for inappropriate use of ambo service (if you don't require the kit on the ambulance and family/friends can get you there, do not go by ambo. They are not there to save you paying to park).
I would allow on duty hospital staff to jump the queues as much as possible (think maternity appointments etc).
Just a couple off the top of my head. Great thread!

Centralise admin tasks such as payroll, hr and occy health. I have no idea why I ever needed 5 payroll numbers at once, but I certainly did. Suspect that would cut the backroom costs hugely as well as tax liabilities and economies of scale.

Charge for anti natal and maternity services. Having children is a choice not an illness.