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?

Graphista Yes there are people who for a number of reasons cannot get a GP appointment. However, it still remains that there are time wasters. A majority of patients do not need to see anyone about a cold. Pharmacy at best.
You'd be amazed at the amount of otherwise healthy people turn up to a&e with one and i don't mean the ones who have a long term health problem etc where a cold could be potentially dangerous.
I mean people who have literally no reason to be there.

Yes there a homeless people, victims of DV but at my trust at least, they're an exception to the rule not the norm.
The NHS choose better campaign tried yo educate and it's failed.

On any given shift I work. I guarantee there are people there who really don't need to be there.

The NHS is a mess in general but I'm a personal level this is something I encounter every day.
That and the queues outside resus because a&e is so horrendously busy.

cherrypavlova I’m not sure where you magical hospital with music and gardens is but it is a very long way from any of the experiences I’ve had at hospitals in the SW. There is absolutely no denying that is on its knees - you can’t get a GP appointment, there are no MIU’s as they’ve all been shut, they’re seriously considering shutting the maternity ward as there simply aren’t any staff. In summer that would mean a journey of 2 hours to get to the nearest maternity ward. It’s complete chaos, my dsis is a junior doctor in our local hospital and says patients are at such risk.

Reinstate the nursing bursary, increase the numbers of training places for all medical staff, write off student loan debt for nurses and doctors after 15 years service in NHS. When staff numbers have increased, move to a 3-shift system to reduce risk of burn-out and improve staff retention.

Simplify targets, so that they don't need to gather so much data. More minor injuries units/walk-in centres to reduce burden on A&E.

Can you tell us wherr you live cherrypavlova where I live it's a four week wait for a blood test at the GP and if you need one via outpatients as I do every year one can wait for up to three hours in an environment whete receptionists shout at people and there is often one phlebotomist only on duty. But yes, they have a grand piano in reception. Priorities misaligned I'd say.

I didn't say I couldn't get my purse out oldsu but when a free prescription is all I get from the NHS and when essential NHS care MH was denied mh daughter and when our family pays a six figure tax bill, actually it's a tiny something back in return for a huge wadge for fa.

I've seen multiple people say get rid of the 12 hour shifts and I disagree so much with that. I currently work in a trust with 8 hour early/late/mid shifts and am counting down till we transition to 12 hours later in the year. At the moment it Is not unusal to work long runs of shifts (currently on day 4 of 9) getting split days off. Nights and days in the same week. Only 1 day off after nights. It's shit. My work life balance is non existent. I can go over a week without putting my son to bed because I'm on all late shifts. Working only 3 shifts a week has got to be better than what we have now. Even if those 3 shifts are long and tiring.

I do think there’s a middle ground between the UK and the US systems.

There are loads of options between, currently used in many countries. The UK and US systems are at each extreme end of the spectrum of options. Yet always those who support the NHS always trot out the US system as being the alternative. Why not talk about the Australian system, or the various European systems?

Oh, and more use of nurse-practitioners. That would free up a lot of doctor's time.

More minor injuries units/walk-in centres to reduce burden on A&E.

And better opening hours for them, and GP surgeries etc. Evening and weekend and bank holiday opening should be the norm. People don't just get ill and have minor accidents Mon-Fri 9-5! It's no surprise people turn up at A&E when everywhere else is closed.

To whoever it was saying that the NHS in England was worse than in the rest of the UK (or however you worded - sorry: not a direct quote) - I live in Scotland and my family live in NI and I can assure you that there are plenty of problems in both those places.

Waiting lists where I am are horrendous, massive staff shortages, and every HCP I know is on their knees with how things are just now. I will admit that part of it may be where we live - we also have a particular problem with getting and retaining good teachers and as a result there is a massive shortage there too - so maybe our city has been hit particularly badly, I don’t know - but I do know that treatment is not what it should be and patients are needlessly suffering and dying because if it, and HCPs are desperate to leave as a result of their working conditions.

NI has its own set of problems and I can guarantee that things are not all roses there either. The unique situation the country is in without a functioning government is largely to blame there, but there were myriad problems even when Stormont was sitting.

I think a lot of the problem is that the NHS really is a postcode lottery - not just for availability of medications but for procedures, availability of different treatment centres, wait lists etc etc etc. I think a whole overhaul needs to be done, but as I said upthread we could at least start with small areas of saving money - keep making small dents. Budgetary issues are huge and there is untold wastage which, if resolved, could pay for additional staff which would, in turn, provide more front line staff which is ultimately what we need. Training and recruiting staff needs to be looked at too - but yes: we need a complete overhaul.

I love the NHS but it’s disingenuous at best to call it the NATIONAL health service - there is nothing national about it with so many differences across the 4 nations of the UK and more differences even across different trusts. In a time when people are more connected to one another and the world is a much smaller place - I think many people genuinely don’t know what is normal anymore, don’t know what they can expect because people 50miles down the road have an entirely different experience

I am a HCP working in the NHS.

I see the amazing work and dedication of the staff who want the best for their patients.

I see the frustration that we can't always do the best job because of the massive understanding, lack of resources, policies, lack of support staff like admin etc.

The bottom line is it is hugely and deliberately underfunded by the government.

It was designed over 70 years ago for a smaller and much simpler medical world. People are living longer, patients have more complex medical problem and medical technological and drugs are getting better (and more expensive)

If this was a business founded 70 years ago, nationwide, had over a million customers every 24hours it would be booming. NHS finding is diminshing every year- you cannot expect excellent treatment with less and less resources

More funding is needed and for god sake drag us into the 21st century with some joined up IT systems fit for purpose!

Maybe the NHS is being run down so that privatisation which has been discussed will be introduced. It seems that a many issues could be resolved but are not, for whatever reason.

I totally agree that Doctors surgery’s and Medical centres should be open early evening until say 8.00 pm and all day Saturday and Sunday until 4.00 pm. They are after all a service industry. My doctors are nearly all women GP’s who work part time.

NHS finding is diminshing every year- you cannot expect excellent treatment with less and less resources. More funding is needed

You mean like when Labour trebled it's funding? That's three times as much in just a decade. If it was all about money, that trebling of funds should have made it a perfect system for the next generation. Yet, in reality, it was just water poured into the leaky bucket that is the NHS and the NHS was crying out for more within a year or two! Until the NHS is managed properly and the waste/inefficiency is tackled, pouring more money in will not save it.

I am sorry your husband has cancer.
I am very very lucky. I have seen my GP once in 12 years and have not even had a cold ofr 2 years. May we should start with me. I don't drink or smoke or eat junk food and I'm not fat. If we could move the nation on to drinking tap water even something as simple as that we might do a lot of good and reduce demand.

Secondly I would strip out non essential health things from the NHS coverage.

We have a massive local problem of people not being eligible and not being able to recover charges once they return abroad. Our A&E has large signs up about who gets free treatment and who does not - in some parts of the country more could be done about that but I don't think that's a major issue in most areas.

I like to see a smaller NHS and much lower taxes (writing as someone who pays a small fortune in tax works full time and just about doesn't get ill so far touch wood and due in part to my life choices)...

This will be popular - no IVF.

The NHS needs a total and utter overhaul. There are brilliant people in it and some rubbish people in it, some good trusts and some bad trusts. But it is being asked to do all manner of things which it was not set up to do.

But it's a sacred cow and every single Government is too afraid to do what needs to be done.

The NHS is the FIFTH LARGEST EMPLOYER IN THE WORLD. There are 1.7 million people working in it, which is 300,000 more than in 2010. So it really isn't about the staffing levels and nor is it about pouring more and more money into it.

That's not to say it shouldn't get more money but doing it necessarily by general taxation/NI is probably not the way.

May we should start with me. I don't drink or smoke or eat junk food and I'm not fat. If we could move the nation on to drinking tap water even something as simple as that we might do a lot of good and reduce demand.

Well done you but everyone being saintly wouldn't actually help that much.

The patients that need the most are, the elderly, the young and those with long term conditions usually born that way or no fault of their own. Alot of cancers are also just fate/genetics.

Smokers actually pay for their own care through tax, drinkers die young saving lots of money to the NHS. All the fat people will also die young again saving money on care homes etc.

Glove punch for fellow gallstone sufferers. By the time I was diagnosed I was eating about a spoonful of porridge with water for a meal and black coffee. I can honestly say the attacks were worse than childbirth (and I nearly died having ds). The GP kept on saying I had indigestion. Indigestion! Finally I had a scan and I was declared an emergency.

Anyway, I was reading that what will bankrupt Western nations is the elderly population and its future health needs. I am not advocating Logan's Run (!) but I think the hippocratic oath is no longer relevant in the light of medical advances. When fil was in hospital - on the orthopaedic ward - there was no one under the age of 80. And they all had dementia - some severely. Yet they were all having procedures , and then bed-blocking. Fil himself was a bed blocker, as he was 90, with dementia, and it was difficult to find an appropriate home (even with paying) for him. Agree that cottage hospitals should make a comeback (although the War Memorial in Gosport has been in trouble for helping patients to, er, move on...).

Graphista I'm sorry you are ill. There is a very good reason for needing a permanent address to receive NHS care. As an expat it's astounding that even now I have to be the one telling everyone I'm not a resident and please bill me. When I get the bill it's very low and it's because they only charge 1.5x their internal cost of care. It's actually placing a huge burden on the system for the NHS to treat me as a foreigner.

In my fathers case the wait lists have been horrendous. My father first went to the GP in 2002 with prostate problems. It was late 2015 when he was diagnosed. It's stage 4. The ineffectiveness and inefficiency I've seen is mind blowing. Yes spending needs to increase and you need an insurance card system to help bring in universal IT systems.

An awful lot of what we have experienced here in the US in terms of care for our DC is brilliant. The way it's funded isn't. Mh services for DC is heavily coordinated through school. Opening hours for going to see the doctor are 7am-8pm. Appointments are available on both Saturday and Sunday. My DC with autism have case managers who coordinate care making sure it's joined up and that everything is made as easy for us as parents. We don't need it but there is help to cover respite care up to 60 hours a month, help with completing the process to apply and qualify for Medicaid on an exception basis. The issue is the UK takes all the worst from the US and none of the good bits. Changes in tertiary education is an example of this.

@Irma Speaking about dementia. There is an increasing large number of the population suffering with a B12 deficiency. It can often make you feel very lethargic and generally under the weather but it also causes nerve damage and longer term potentially dementia. I was regularly ill and had memory issues so they did the test. I had dangerously low levels when the body is supposed to retain several years worth. I have always unknowingly had a diet high in B12 but for whatever reason years ago my body ceased absorbing it.

A monthly injection costing 50 p would ensure my B12 levels would remain constant, make me feel well, and stave off increasing nerve damage and dementia. That's £6 per year. I'm 44 now. They won't do it. They will let me have it every three months if I really kick off, which simply isn't enough. Some places will do it monthly. If I lived abroad, it would be no issue.

So I buy high doses of B12 tablets which don't have quite as good an effect. It costs me around £60 per year. I can afford it but it's not the same effect. If I get dementia and nerve damage, I'll end up costing the NHS shed loads. All for the sake of £6 per year. And it is a condition that impacts me on a daily basis.

They won't pay for that. Yet look at what they DO fund. Go figure.

Unfortunately the system is simply not designed to cope with the current level of usage which ends up with dysfunctional behaviour. My elderly DM encourages neighbours to exaggerate symptoms and call an ambulance because it's impossible to get a doctors appointment for the same week.

DM also pursued a long interaction with the managers of local hospital as they falsified their records to say that DF was seen more quickly than he actually was. It's highly likely that staff did this through having to meet time targets and using unofficial prioritisation for the patients. Grim for my DF in pain, but his condition was not life threatening so perhaps A&E need more realistic targets.

Again on the targets. DM has had treatment for breast cancer. NHS has been absolutely marvellous- sorted out in record time. When I went to collect her from surgery she was on an empty ward with about 4 nurses staffing it - again I wonder if target treatment times are forcing inefficiency.

Doctors should not be allowed to leave the NHS or go private until they've worked for a number of years- even then should have to do certain amount of NHS work.

Doctors surgeries could be open for longer hours including weekends - if you want an evening appointment you pay for it.

System is already two tier. The generic replacement for cerazette that I got caused my endometriosis to flare up. I can't afford not to work so rather than trying to get a doctors appointment ( practically impossible) and argue my case I pay for it myself through Lloyds. I also have private medical cover for family through work.

Stop anything that isn't related to treating an illness either physical or mental.

There definitely needs to be a rethink about recruitment and deployment of staff. Over 50% of trainee doctors are women. Good. But the majority aim to be GPs. Not good. At my health centre all the older GPs have now retired and every GP is a part-time woman. It now seems to be the convenient "second" job in a marriage/partnership.

Regarding nursing, yes, it should be a vocation, and nursing degrees was a ridiculous idea. Does anyone know why the old RGN/SEN system was dropped?

They defiantly need a 24 hour service that is an alternative to A&E.

We were in the kids A&E for ds over Easter weekend, it was full of kids with tummy aches, head aches and hurty arm/leg/toe.

When my ds was taken to A&E via ambulance we were in the emergency/crash type room. They had a load of these rooms full of top of the art equipment and loads of very good highly trained staff. My ds was the only one having lifesaving treatment. The other rooms just had confused looking old people sat in them.

If those old people had somewhere else to go they wouldn't need as many staff or as much equipment - saving money.

Parents also need to take responsibility, taking a kid to A&E caz they have tummy ache is a joke.

Pacer142

Labour were last in power 8 years ago. Since this conservative government every year there have had to be cuts. I'm speaking from experience working as a frontline HCP. maternity leave not covered, jobs not replace when people leave, downgrading of jobs so you get paid less than you did for essentially doing the same job, redundancies, cutting services to the bare minimum, only doing your role (Not being able to go the extra mile) ..... I could go on.....

There seems to be a disconnect between the actual medical staff, who are always saying (and we can see ourselves) they are overstretched, and the admin staff who routinely seem to expand a task to fill the time.

If it is not the case that admin staff are too numerous and underemployed, what is giving this impression because I should think every one of us has witnessed it.

Shatner, if you feel you need B12 every month injected to stave off dementia you could pay for it - perhaps take a Saturday job. It seems to cost £50 a shot per month - www.vitamininjections.co.uk/vitamin-injection-treatments-2/energy/vitamin-b12-energy-shot/