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 agree that we should charge more for overseas patients. I was recently in hospital with pneumonia (which, as a fit and healthy 34 yo, I contracted by inhaling contaminated water at a water park - lifestyle choice?) and there was an American woman in the bed opposite who had developed pneumonia on a cruise and had to be rushed to hospital. She had been severely ill and spent a week in the ICU before being moved to a respiratory ward, and she had further complications because one of her vertebrae had crumbled during her illness and she was in a lot of pain. Her son said that the amount she had been charged was peanuts compared with the same sort of hospital stay in the US - he said one night in the ICU here was £1000 all in, whereas in the US it would have been more like $10,000 not including the cost of drugs, X-rays, blood tests etc. So we could probably up our charges a fair bit without foreign insurance companies refusing to pay out.

Things that could help - I was in during August and we were encouraged to drink a lot of water. In the 4 bed ward I was in, 2 of us were mobile. But if you wanted a refill of water, you had to ring for a nurse to get it. The nurses couldn't tell whether you were buzzing because of something minor like wanting more water, or for something more serious - an old lady fell out of her chair one night and I rang but no one came, so I ended up going into the next bay to find a nurse. Couldn't each ward have a drinking water tap to reduce call on nurses?

Back when the funding did increase under Labour it all certainly ran better. We had time to properly train staff up. We took lunch breaks, we left on time. I felt valued as a staff member. The strain now on staff is obvious to see. There are posters up about staff wellbeing and stress everywhere in staff areas. Managers trying to suggest if we all took 5 minutes to breathe it would solve the problem of the fact that 1 person is now doing the job of 2 or 3 people. We are human and dealing with people lives here. The responsibility is huge! You do not want a tired/stressed clinician, or someone effeciency rushing you thrpugh a bad news appointment because they have 10 people to see.

The NHS is not perfect, but it needs investment. All those problems with appointments eff are not the fault of the admin staff (who I think do a damn good and thankless job) it's the systems they are using. Invest in better IT and it would all run smoother. However it's not easy with such a huge fragmented organisation as the NHS.

But I believe the NHS spent £££££millions on a new IT system a few years ago. I don't think the best IT system in the world personally installed and maintained by Bill Gates would solve the NHS's core problems.

Ohtheroses - yes we COULD end up with a European system - which would still be prejudiced against the poor - but the tories some of whom have either shares themselves or family members who go in various American healthcare providers have been 'consulting' with those providers getting 'advice' from them.

Xenia - biggest cause of ill health - aging! You're young and hardly using it now (do you have DC?) but as you get older you'll need it more and more. And suggesting lower taxes is ridiculous!

Shatners the NUMBER of staff says nothing about who those staff are. As myself and others have said there's FAR too many administrators and not enough clinical staff. I agree the short sightedness on preventive treatment - like your b12 situation - is a ridiculous long term waste of money for short term minimal savings. See it time and again, don't know if that's poor GP decision making or poor policy - I suspect both!

Want2besupermum I am guessing you are employed in USA? Have fairly decent health cover?

Rookiemere - I agree the whole target nonsense is MAKING problems. The current situation where many of us have the craziness of having to phone (repeatedly) first thing to make "emergency on the day" GP appointments has come about due to a blairite policy that was intended to push GP's NOT to keep patients waiting more than X amount of time for an appointment - meaning you can VERY RARELY make an appointment in advance! Because in order to meet that target they block out X amount of appointments to be available on the day. But note the tories haven't remedied this - suits their agenda.
It also adds to the admin burden recording info they wouldn't need o if targets weren't an issue.

"Does anyone know why the old RGN/SEN system was dropped?" Supposedly to 'improve' things, personally I believe (look at the timing) it was because at the time immediately preceding there was a huge scandal regarding the overworking of junior doctors (it was true they were being made very ill and there were even a few deaths of Drs! God knows how it affected patient care), the (Tory again) govt thought that they'd move many junior dr tasks/responsibilities onto senior nurses, which meant THEIR tasks had to be moved to junior nurses - nurses being cheaper! But in order to do that nurses needed training slightly more akin to dr training. But Drs and nurses are different animals to be honest and it was never going to work.

Fluffymullett - agree it wasn't perfect under Blairites, but certainly better than now and better than the Tory government preceding new labour. But from what I'm hearing from friends still in and on here it's worse now than it even was under thatcher/major!

But I believe the NHS spent £££££millions on a new IT system a few years ago. I don't think the best IT system in the world personally installed and maintained by Bill Gates would solve the NHS's core problems.

They did, but then shelved it because it was too complicated and didn't work. Classic Governmental IT failure. They tried to computerise disjointed/illogical systems which is impossible - classic "garbage in, garbage out"! The existing systems and working practices, both paper and computer, should have been evaluated and standardised first into something logical - once you've done that, you can computerised/integrate it. From what I've read and heard, there were far too many "vested interests" who weren't willing to change the way they did things - the old "we've always done it this way" attitude - so the computer programmers were never going to achieve anything if they had to program for illogical working practices and different systems in different places for the same information flow.

Xenia re B12 injections they cost about £3.50 on the internet and many people are qualified to administer an injection.

The problem is, and I’m going to get flamed for this, is because the support staff often leave at 4.00 pm even Phlebotomy departments close on the dot and if you are seeing a consultant who requests blood tests it means coming back another day. The NHS is totally inefficient and run for the benefit of its staff in many cases.

Then we'll be flamed together because I agree.

Xenia I too never drink I don’t like it, I have never even had one cigarette so never smoke, I have never taken a drug or had a puff of anything I eat healthily and always have. I’m a stone or two overweight.

I was however diagnosed with Asthma when I was eight months old. I now have suffocating (brittle) asthma and see a consultant once a year. Believe me when I say that in 60 years there has hardly been any improvement in new drugs. There is immunotherapy but I don’t know who you have to sleep with to get that, and I’m probably too old. I tell a lie, as a child I was treated with adrenaline but although still used in the US it has not been a treatment in the NHS for several decades.

Health is mostly a luck draw. But if the NHS wants to save money why I wonder the constant healthy living mantra. If I smoke 10 a day and down 1/2 bottle of wine a day, I'm likely to topple off the coil 5/10 years earlier than otherwise. That would be a significant saving for the NHS.

The problem is, and I’m going to get flamed for this, is because the support staff often leave at 4.00 pm even Phlebotomy departments close on the dot and if you are seeing a consultant who requests blood tests it means coming back another day. The NHS is totally inefficient and run for the benefit of its staff in many cases.

that's hilarious. My trust is going through its worst recruitment crisis ever. And that isn't just clinical staff, it's at all levels. Do you honestly think this would be the case if it was run for the benefit of the staff?

Graphista I purposely live in a blue state, New Jersey. The taxes are high but that means there is much more support in terms of healthcare coverage and social care. I wouldn't live in most other states.

We know the system we are in depends on us having a job or lots of money. To qualify for higher levels of welfare you need a job. We have been living on much less than we make so we have savings. Most people here are either end of the spectrum with either lots of savings or none. There is a lot of help where we live for parents in our situation of having disabled DC. There is even help to help parents get help. Funnily enough because people pay for their healthcare most are generally much more diligent about preventative care and leading a healthy lifestyle compared to the UK.

DH is an employer. His business offers the best healthcare coverage in the local area and it's what attracts the best employees. It's zero cost for employees with all copayments reimbursed. Yeah we could make more money but truthfully 40% of the extra will go to the government anyway in taxes. It's just easier to do the right thing and treat people how you would want to be treated.

The NHS is totally inefficient and run for the benefit of its staff in many cases.

I don't agree with this statement, but I do think some NHS staff need to get more in line with modern working hours. Yes people working on A&E and wards ect are there 24/7 365 but when it comes to consultants, community hcp, day clinics etc, they do clock off early and they pretty much close down for the school holidays.

Ds neurologist took 8 weeks off over the summer. I can never get audiology appointments in school holidays, if you do happen to have an appointment in school holidays the hospitals are quiter, easy parking. Physio, ot, portage and salt all stop in holidays too. Maybe if the staff worked all year round like those of us in the private sector with 4-6 weeks holiday, the waiting times wouldn't be so long.

You put it so much better than me. I have only observed the early closing and long holidays but you have experienced how inconvenient it is for a sick patient.

Funnily enough because people pay for their healthcare most are generally much more diligent about preventative care and leading a healthy lifestyle compared to the UK.

Is this really true though? Like is there some figures to back this up? Becasue I've seen this touted so often but from where I'm sitting the US has just as much of an obesity crisis as we do, average life expectancy is lower... I know there's multitudes of factors behind these but I don't see that people are making better lifestyle choices. Prepared to be proven wrong though.

onlyhappy The staffing levels are a huge issue because there has been a push to get women working without thought to childcare. It doesn't pay for most NHS employees to work during the school holidays. You either need to pay more or offer subsidized childcare. Where I had my babies is a teaching hospital. They had a 24/7 childcare facility on site. They took DC of employees and patients. Fantastic idea that enables employees to work and social workers have a much easier time managing DC who can't be cared for by a sick relative admitted. The savings for social work must be massive.

I said in my earlier post that I'd work with staff to better manage schedules. A working parent not working during the school holidays might be open to working outside of their OHs schedule. Clinics are often run only during business hours so childcare is needed. Reality is more can be done at weekends and outside of business hours. It would make it so much easier for DC supporting their parents too.

Lots of Trusts are on the verge of bankruptcy and are being run by emergency measures. Doesn’t exactly inspire confidence if you are looking for a job. There is also a culture of agency staff doing more than their share of the work. I met a sister once who boasted she did the night shift because she was able to sleep and look after her two children the following day. Woe betide anyone who woke her. This was a long time ago and probably couldn’t happen now.

Who gets 8 weeks holiday off consecutively in any other working environment.

Physio, ot, portage and salt all stop in holidays too. Maybe if the staff worked all year round...

We have had physio, or and SALT appointment in the holidays. I don't think postage is an mgs service.

The following no longer free on NHS:
treatment due to excess alcohol
treatment due to injury caused when doing risky sports or activities

@hazeyjane

I'm sure they still run, but for my ds who has these services regularly in the community he doesn't see anyone in the holidays as they run on a sceleton staff. Mainly because they are pretty much all women with children.

I know childcare is an issue but the private sector manage. Maybe we need to also look at when the schools are open.

user1457017537 Wed 17-Oct-18 07:03:23

"Re the cancelling of a kidney transplant due to and hour and a half journey and no transport being available I still think a cab fare us a small contribution to pay towards getting a transplant."

People who are ill are being sanctioned. A diabetic woman died recently because of a sanction. It might be a small contribution to you but a small contribution of nothing is still nothing. You sound like some of those dicks from UK Power Networks circa winter 2013. Moaning that the householders who had been left without power for days hadnt made them a cup of tea while they were dragging their heels working on restoring power Yep some of them expected householders to make them a cup of tea WITH THE POWER THEY DIDNT HAVE!

DH was attending a rehabilitation course to help his heart in the winter of 2006. He couldnt finish it because we could no longer afford to attend. WHY? because i had been put on a "work placement" (i had to sign on back then) if i didnt attend i would be sanctioned. How would no money or food have helped DHs health. I also needed to pay the fares UPFRONT so we had no choice but to take the money we were using to go to the hospital and use it so i could attend the work placement instead.

You have NO FUCKING IDEA why people cant afford to go to a medical appointment or operation And coming on here with a patronizing attitude and wanging about small contributions really fucks me off I hope you dont work in the NHS but going by the attitudes ive seen on this thread it wouldnt surprise me. There is a really shitty attitude towards patients and their carers. I wish family carers WOULD go on strike. Because some NHS workers obviously need to learn the hard way.

Formally There is a very strong correlation between obesity and lower socioeconomic status, so when most Europeans interact with an American who is similar income level wise, the American tends to be from a lower socioeconomic group compared to the European and therefore fatter than they are.

The equality trust has done some good research in this area. If you look at unequal income in different countries the top countries all have huge issues with obesity. Top countries are Mexico, US, Israel, Estonia, Spain, Greece, UK, Australia, Italy, Canada.....

The distribution of socioeconomic classes is interesting too. Top 20% of income earned is 40% of the population in the U.K. In the US the top 20% of income is a mean household income of $257k which at an exchange rate of 1.5 (yes it's lower right now but I'm trying to be fair) is £171k. The top 20% of income in the U.K. Is £81k for the top 20%.

It is probably different in different areas then as d's regularly sees these services in holiday times.

HelenaDove but it was a life-saving kidney transplant. I do understand about sanctions and how desperate the financial situation is for some people. However, I still think responsibility should lie with the person having the op to actually turn up at the hospital. Obviously not if they are completely immobile then obviously transport should be sent for them.

I don’t, and never have, worked in the NHS or healthcare. I am in business and have a corporate background. Perhaps why I look at things from a different perspective.