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?

Bariatric surgery actually saves NHS money. Worth it imo.

Jesus didn’t take long for this to get to a my illness is worse than yours thread.
Just a few.... plastic surgery...what about burn victims, children etc. Breast reductions where there is severe back pain etc
Paracetamol...I think they did do this but there are people with chronic pain that need to a if it.
Charging for a n e...stupidest idea of the lot.

The issue is the miss management and middle managers. The simple solution is to ask the doctors and nurses they will tell you how to save money, but they won’t.

Most important thing is to get rid of the Tories.

I really strongly believe that there should be a reasonable charge for GP appointments. It should apply to anyone over 16, and under pensionable age, and be affordable; between 5-10quid.
Payable before you actually go in to see the dr.
Perhaps if the first appointment triggers an episode of care that requires further appointments, only the first one of that episode is chargeable (similarly to dentists).

Might just make people think twice before seeing the dr, and would create a huge amount of revenue.

Totally agree with all of your points @Thatssomebadhatharry

Petra: I agree but it's all things politicians will not address. Euthanasia is also a no no. ( whole other thread though)

I would both: increase tax to pay for more NHS clinical staff, and once those staff were in place then I would go through it reforming. Staff numbers need to be forecast around normal decent working conditions - staff need to be able to have pee breaks and lunch and not work 12 hour shifts. I’d pay for it by reducing agency costs, reduction in sick leave and reduction in compensation claims when knackered staff make mistakes.

And I would commission a massive IT overhaul to get all the systems talking to each other, and every single part of the NHS would be made to use the integrated system. No opting for one hospital to use a different system and GPs to have a hundred different ones and district nurses are on another. And it would include the facility for people to book their own appointments and people with pre-existing conditions could go straight back to their consultant without needing to see the GP again.

Pacer

We have been told repeatedly by DD's consultants that if we are not satisfied with the care she is getting (in A & E mainly); we are her best advocates and we are to stand and argue with doctors, that they must seek advice from consultants at a tertiary centre - we are the best people in the world to ensure at 3 am, she gets the care she needs!

Having trouble posting so please be patient.

Oliversmumsarmy - there will always be a few exceptions (and REALLY crap GP's who are crap to everyone) but several studies bear this out statistically.

Helena - yep! Yet more nightmare situations due to bloody UC being brought in too fast and without proper organisation and support!

All those talking about convalescent homes, cottage hospitals and similar - did you know the last of these that had somehow survived were mostly got rid of by the last Tory govt (thatcher and major) in the late 80's/early 90's? I worked on placement in one during my training, it was due to close 8 months later. The sisters working there were saying to me and other trainees even then that it was a false economy as it would increase bed blocking! Govts NEVER listen to the frontline staff!

Paddyf0dder - agree - I live far closer than I'd like to, to a certain controversial nuclear weapons area. Weapons which are outdated and highly unlikely to ever be used. Also a republican. And yes as a benefits recipient it pisses me off how we are CONSTANTLY bashed yet unpaid taxes FAR FAR FAR outweigh the cost to the country in benefits payments.

Pacer142 - absolutely! Anyone that's run a budget from a household to a large company KNOWS that pennies wasted in many areas = huge wastage overall.

I strongly suspect the issue re items being cheaper outside the normal procurement channels is corruption! Backhanders from those providing the supplies to those who decide on who the suppliers are! Or those deciding on suppliers have shares in the companies they're choosing from - huge conflict of interest!

Roominmyhouse - a central procurement system would also surely improve the economy of scale/provide opportunities for getting better prices? IF it was run fairly without conflicts of interest/corruption.

Among them WILL be smokers/ex-smokers, overweight people, people who eat more than the recommended red meat/processed foods/fats/sugars, drink more than the recommended alcohol themselves, drive unsafely, live in high pollution areas, participate in injury high sports... But of course they'd NEVER expect the same moral attitude applied to THEIR healthcare!

Re admin staff - most are good hardworking people - but there IS a significant minority who are clearly surplus to requirements, if there are staff who have the TIME to be chatting for long periods of time about non work related stuff, putting up birthday banners etc (and I've certainly witnessed similar issues plenty of times, including one time a receptionist was too busy describing her bloody weekends socialising than to book me in as present for my appointment which THEN resulted in me being marked 'late' - I was there 20 minutes before the appointment time! - and got a bollocking off the dr! I corrected the dr and complained to practice manager BUT this same member of staff is still there years later and still as useless!)

Also personally I think birthday banners etc are inappropriate for a clinical setting AND a flaming infection/safety hazard! I HATE seeing that kind of thing.

Iamallastonishment and ALL the others saying charge for X y Z - you ever been on meds that increase weight while ALSO having a condition that severely reduces your activity? Ever been depressed? Too busy or poor to eat well? I rather suspect not! Is your health and lifestyle absolutely perfect? How old are you? Are you NEVER drunk yourself? Do you ALWAYS practice safe sex and verify that your partner has been thoroughly screened? Do you only wear cotton pants and never wear tights or tight trousers? Do you ALWAYS lift/move correctly? I HIGHLY doubt it! If you drive so you NEVER speed, or drive when ill or tired? NEVER had an accident caused by your own inattention? What job do you do? Where do you live?

Want2besupermum - are you American or Brit living in states? I suspect American. Here in Scotland we have similar laws on not drinking outside etc. The stereotype is of Scots and Irish being heavier drinkers but several studies show that all uk countries are roughly the same but since Scotland introduced certain measures - most recently minimum pricing on alcoholic drinks - scots are apparently drinking less. English and Welsh politicians and lobbyists etc interested in this issue have been watching with interest and suggesting the same should happen in England and Wales. Personal observation Scotland was where England and Wales are now about 10-15 years ago, so we hit the binge drinking earlier but we have hopefully learned how to reduce the problems and England and Wales now need to catch up. I'm not familiar with how it is in Northern Ireland. Also our drink drive "limit" is essentially zero here and the police here do not mess about!

As someone who moved around a lot (army brat) and FREQUENTLY had issues with notes being sent to new GP being messed up - including having to argue with one GP that I was ALLERGIC to the medication he was trying to get me to take! But the page with that info was missing! - personally I think everyone should be able to possess a copy of their own medical notes. There is absolutely NO GOOD REASON why this can't happen. There are shit reasons because some of the comments some hcps put on notes - particularly regarding MH issues are appalling! And for those of us that are ok with tech they could be held on our electronic devices. The argument will be "security" but let's face it the nhs have fucked up on that more than once!

Re nursing recruitment - personally and I say this even as someone who was one of the first wave of this (but I'd applied before it came in), I think making it a graduate job was the worst idea. It's a practical/vocational role and many of those who would be BEST at it, ie hard working practical types are being excluded because they're not academic enough, PLUS the removal of the bursary means it's now only really accessible to mc up. Not saying some of those people aren't suited to it but it's excluding poorer, less academically gifted people who would make EXCELLENT nurses.

A friend I did my training with is now responsible for mentoring trainees. For the most part they're OK (though ill prepared she says) but she also says around 20-25% of them come through with an attitude that because they're graduates certain "menial" tasks are "beneath them" which drives her demented! They no longer see the value in feeding a patient, or dealing with bedpans, or washing patients. She admits part of the issue is the training - it's not being explained to them that doing these "menial" tasks actually allows them to make certain clinical obs and to get to know the patient - invaluable in gaining info, in developing a bond of trust.

BrazzleDazzle - some of that will be due to infection control measures. Sadly it's cheaper to use disposable items than to use reusables that are then sterilised.

The lack of integration and cross-specialism communication is dreadful! I've a relative with 3 chronic life-threatening conditions. The 3 consultants basically act in to my mind adversarial ways, thinking "their" specialism is more important than that of the 2 others, completely ignoring the poor patient trying to manage all 3! WHY ON EARTH they can't just bloody talk to each other properly and agree a course of action I don't know!

"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." Surely making GP services better would be preferable?

The lack of COMMON SENSE is astounding!

"Now the GP seems to be a gatekeeper role for most patients - just someone to refer you to a consultant or tests etc." Except as per my first post THEY ARE NOT BLOODY DOING THIS!

Also - false economies - our local sexual health clinic cover has been MASSIVELY reduced. We had 3 full time clinics. We now have 1 part time - for the same number of people! That doesn't save money! Not least because embarrassed youngsters don't want to go to GP for such things for fear of bumping into someone they know (VERY small town everyone knows everyone HELL most of them are related!) so they go to a&e where it's a bit less likely or out of area.

Re some posters who've referred to residential care if the elderly as "bum wiping" I hope you have a LOT more respect for those doing this ESSENTIAL and demanding job when YOU are elderly and needing such care! It's an incredibly undervalued and under respected role. I worked in geriatric nursing for several years. When bodies are old and breaking down (natural aging process) there are a LOT of co-morbid conditions going on. It takes people with real skill, compassion and knowledge to care for these patients. There's a lot more to it than "bum wiping"! There's balancing treatments including often loads of different medications, it's getting nutrition into people who have no appetite or even fear food, it's keeping them hydrated when they don't think they're thirsty or again even fear taking a drink, it's providing personal care for people who are in pain, or think you mean them harm, it's taking the time to try and analyse what they're saying because their speech is affected by various conditions physical and mental, it's trying to find ANYTHING That gives them pleasure when many of the things that used to are no longer available to them, it's trying to maintain a professional distance so that when they die and you're supporting their loved ones in the aftermath YOU don't fall apart (something I really struggled with). So PLEASE don't dismiss it as "bum wiping" that anyone could do!

Sorry gone on a bit there

Haha! Graphista That is a very impressive reply to everyone.

I'm a Brit in the US. Quite a sight to hear people coming in to try and fight the fine. 'I can't afford it' Well you clearly had at least $100 of drinks so you can pay $100 a week for 12 weeks or $1000 now. You pick.

They take visa!

I admire the NHS. I think people are more likely to visit a gp if it is foc. I definitely had more health checks in the UK. It is 60 euro a visit in Ireland and 100 for an A&E visit, the problem with the charges is people neglect their health, they definitely have a wait and see approach, even with children. Sometimes it is to late, A huge percentage of cancers are diagnosed in A&E.

Whatever it takes to save the NHS it is worth it. You can see it on those 999 emergency shows there is little or no social care, it is not any better here we have the privilege of paying for bad treatment. Not from the medical staff but the constant cuts to services.

I’d train pharmacists up to give out basic antibiotics for simple things like skin infections. And I’d give them the ability to call up and get an appointment for more serious things like tonsillitis or ear infections.

I’d charge people for inappropriate use of ambulances, and insist on prosecutions for hoax calls if the person who made the call is caught and the punishment would be a fine and community service rather than jail.

I’d reopen a local a+es which all shut completely a few years ago and puts pressure on the larger hospital which cannot cope with the patients who would have gone to one of the 3 smaller a+es.

I would set up a ration-card type system where each person gets a certain amount of gp appointments a year, 5 visits to A&E a year (with charges for more), 1 prescription a month (you can have more but then you get charged). Missed appointments count.

If you have a potentially fatal condition such as cancer or something non-fatal like diabetes you either get an unlimited ration card or a different set amount of free appointments

Thanks want2besupermum

But as a Brit I'd have thought you'd know the law across the uk countries varies on certain issues? How long you been in USA?

"I’d train pharmacists up to give out basic antibiotics for simple things like skin infections" as I and others have said already they can! But they don't always because over use of antibiotics is a serious issue. There's also the issue that pharmacists don't have access to your full medical history, so they have to be careful as they can't risk giving people medications that contraindicate with conditions they're unaware of. And ultimately they are not Drs.

"5 visits to A&E a year (with charges for more)"

So when i was back and forth back and forth to A and E in 2002/03 while waiting for an operation i would have had to pay for more or remain rolling around screaming in pain.

Hang on a min and i will find the post that shows how i was treated when i did the right thing and lost loads of weight and YOU would have made it even worse.

Jillian - sorry but that's an AWFUL idea! The people most in need of medical appointments would be the ones most disadvantaged.

Myself and others have already told of our experiences of REPEATED visits to GP for the same condition that has gone undx for YEARS because they simply don't accept what the patient is telling them! And don't refer to specialists as soon as they should!

I lost 10 stone 16 years ago.. I got gallstones and it got so bad i couldnt eat SOLID food. i went through months and months of excrutiating pain and A + E admission. In and out of A + E for TEN MONTHS. then doctors coming to my home to give me morphine injections whenever i had an attack . Finally a doctor prescribed me morphine pills which melted under the tongue that i took every time i had an attack. First attack was 3 July 2002 Scan was on 19 Dec 2002 after months of A + E admissions . Early Feb 2003 i got a letter telling me id have to wait for ANOTHER YEAR. I cried my eyes out and actually considered suicide. It was only after a private consultation with a surgeon and then another admission to hospital and an NHS appointment with the same surgeon that my op was promised within 6 weeks It was done 5 weeks later on 28 April 2003.id lost 8 stone by the time i had my op. The surgeon and two doctors told me it was caused by losing weight too fast. (slimming world) The pain was excrutiating and the first attack appeared after id lost nearly 4 stone. Back then i had no idea fast weight loss could cause gallstones I was losing a stone a month and whenever i did try to slow it down i either stayed the same or gained.

I actually did seriously consider suicide especially after i got the letter telling me id have to wait ANOTHER YEAR. I thought it was beyond cruel especially when id lost the weight by myself with willpower.

i believe due to mixing tramadol with as many over the counter drugs as i could in the early months to stop the pain i have been left with long term issues and its also left a bitter taste in the mouth TBH. Im grateful for the NHS but i was in so much pain i was thinking of overdosing (which i was bloody close to anyway) i also think the fact i won Class Slimmer of the Year and started to appear in our local papers may have been a factor in me getting the op sooner than that awful letter said but i shall never know.

I remember an Mner posting on one of the fat shaming threads how her NHS consultant told her off for weight gain while writing out yet another prescription for steroids The Mner did her pieces over it and next time she went in she was granted the £12"000 a year injections instead.

They arent above moving the goalposts to suit their wallet.

And they know that because of the attitudes to overweight people that they can get away with it.