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?

The NHS should be taken out of party politics completely, so that it can benefit from long-term strategy and planning. It could be answerable to an all-party committee in Parliament, but the overall running of it should be removed from politicians. I would have it run along the lines of Transport for London, with a ring-fenced budget from central government, guaranteed for a decade, minimum. It could use its assets (buildings, services etc.) to generate additional income.
Procurement should be centralised, and kept in-house.

There desperately needs to be a roots and branch, belt and braces, new and comprehensive IT system. Instead of just digitalising the old and inefficient processes people have always done, everything gets reviewed and improved. It happens constantly in corporates where efficiency is valued. It would involve a huge massive initial investment, but that's what it needs. And some no-nonsense, get it done, project managers.

GPs need to get into the 21st century and offer FaceTime / video-call consultations. It's ridiculous that GP At Hand are the only NHS GP service offering this. It seems a no-brainer, more use of the technology we all use every day - sometimes it feels like you go back in time when you have any dealings with the NHS.
Libraries know when you take a book out, how long you've had it, when it's due back etc. The technology exists, so why are crutches etc all on a one-way road out? Check them out and check they're returned, I bet most people would be happy to return them.

The way medicine and treatments have changed over the years is enormous, and generally people need to move on from the local hospital model. Regional specialist hubs are more efficient and concentrate expertise and resources. There is always huge resistance to changing the way the NHS is structured, but treatments have changed so the way we are treated needs to change too.

I really like the idea of telling people how much their treatment costs, especially for ambulance call-outs and A&E visits. We need to quantify it to appreciate it.

Social care should be taken out of local authority responsibility and brought into the NHS - maybe rename it the NHCS (National Health and Care Service)? It needs joining up and it needs to be fair and consistent.

It's just such a massive job, people are resistant to change and there are a lot of vested interests - particularly now there's so much private sector involvement. That's what makes any kind of meaningful reform so difficult.

Yes, and as I said, a less extreme version of this is the hospital parking. It really gets my goat when wealthy pensioners complain about this. You are getting free treatment. You are running a car fgs - you can afford it . Healthcare may have been offered from the Cradle to the Grave, but the right to park your car outside for free was not .

I agree a 24/7 service with allied health professionals, social services etc on hand would be the way forward. The 3vidence says it requires I think 40% more staff to do this as you can't just stretch 5 days staffing resources over 7 days. Again funding is the issue! We don't even have the staff to cover 5 days well.

Where I have worked have always had holiday cover for physio/salt etc - even school based therapists visit the kids at home and sort equipment there. Saturday mornings and evening clinics also offered. Not many people use them.

The other thing with staffing taking the phlebotimist example finishing at 4pm. If we extend the hours you have to pay the staff more. This is the problem, the money to make the changes isn't there!

I love the NHS and give it my all working there, doing unpaid overtime, courses training in my own time, funded by myself etc. I hate this public v private sector divide. Different pressures in each!

@missSueFlay agree completely with all your points

I really like the idea of telling people how much their treatment costs, especially for ambulance call-outs and A&E visits. We need to quantify it to appreciate it.

I really hate this idea!

Yes handing people a piece of paper telling them how much it has cost to tell them they have cancer or their baby has died is the way to go.

Want2besupermum - and you think that's acceptable? As I said, I've seen reports and discussed with friends and family (one of whom has a debilitating, painful condition which makes her even more fearful of losing her job - which she's at risk of BECAUSE she's often not well enough to work - because the very basics would mean her getting less effective treatment and being in more pain). My perception is that USA citizens who don't work in a reasonably well paid job are seen as UNDESERVING of decent healthcare - that's NOT a situation I want to see happen in the uk. Though I fear it's starting! Just as we're already too far down the road of seeing being on benefits (welfare in USA) as shameful!

In short I really don't feel how the USA treats anyone who isn't in a position of privilege is something I want to see becoming uk culture. Americans/people who think the American way of doing things is right, seem unaware of how much of how well a person is doing is LUCK!

"They are taken care of." THAT is a loaded sentence and could well be seen as social cleansing by some given the way the poor are treated!

Do you actually know very well, are close friends or related to anyone in America that is poor?

Shatner etc re shatners example - yes I took that as an example of false economies occurring within the nhs, just as I gave the example of untreated chest infections and others have given similar examples.

It's short sighted and doesn't save money LONG TERM.

Triwarrior - if that's true that you'd help patients in that position I'm sure you can find some to help nearby. Unfortunately I suspect that is just empty virtue signalling.

My reluctance to agree that social care should come under nhs remit is 2 big issues:

1 I think this govt in particularly but actually all, would see this as a way to MASSIVELY reduce funding of social care for those who can't afford it.

2 there are large numbers of boomers, not sure about following generations who can easily afford to pay for their own social care. I'd rather they did so than those who can't afford miss out. The nhs was never intended to cover this.

Irma - I've a few VERY wealthy relatives who've moaned to me about parking costs. VERY irritating when they're getting free treatment and they can DEFINITELY afford it.

Yes of course more staff is required fluffy, generally speaking but there are also CURRENT nhs staff on very high salaries working part time hours - that's not acceptable either.

@hazeyjane

Maybe thats the difference. All ds community care/therapy is NHS run out of the special needs centre. I can't fault the hcp's or the work they do for him, but everything does grind to a halt when the schools go on holiday.

I've no experience of virgin care but I don't hear good things.

I agree with miss Suflay too. But I don't agree with the comment about parking. Am happy to pay parking for a reasonable period. The last time I went to outpatients my apt was at 9am, kept waiting until 9.15, three nurses, 2 patients. All three tried to insert a cannula with the third being successful. . I left at 11.30 for an apt that should have taken an hour. At the car park machines broken and only accepting cash, hospital ATM's out of order, trail to security to be met with abject rudeness. Arrived at 8.50 inefficiency took me into the 4th hour. In those circs, yes I very much object to parking fees.

St George's Hospital, Tooting 2018. Shambolic. Not quite the glossy article shown on 24 hours in A&E!

Onlyhappywhenitrains1 - to be honest, his holiday appointments were back in the days of the nhs or services still run by them.....getting an appointment at all with virgincare is a feat, if you can actually manage to not get discharged!!!

Sorry sock and hazey - I agree it should be handled sensitively - eg I suggested a public campaign and website people can look up which they could do at a time they could handle it.

I've had mc's, relatives have had cancer and other very serious conditions.

I'd actually like to know how much it cost to WRONGLY treat me for 14 years with endless ineffective prescriptions for both the gynae symptoms and the ones that were WRONGLY thought due to other causes, without referring me ONCE to a gynae, how much those 2 mc cost, how much the surgery I had after them once the endo was FINALLY dx cost, which I know had to be more extensive as a result (surgeon and gynae said)

Vs

How much it WOULD have cost to refer me to a gynae, give me an ACCURATE dx, CORRECT treatment early on, possibly not even needing surgery - certainly not as extensive, in all likelihood (again according to gynae & 2 surgeons) prevented the mc's.

Because I'm pretty sure it would have been A LOT cheaper to dx and treat me earlier!

And that's WITHOUT considering the emotional impact, or even days off work!!

Ohtheroses - as a bit of an aside I too get when frequently coming across staff that seem incapable of basic tasks. I don't mean unwilling I mean incapable - to the point that's another discussion I've had with mentor friend re "what the hell are they training them to do these days?"

I've come across nurses who can't insert cannula, don't question a CLEARLY inaccurate bp, pulse or pulse ox result - just blindly accepting what the auto machines tell them! Don't deal with stomas, or catheters properly - inc doing stuff that's just ASKING for an infection or causing serious pain to the patient, in one incident almost resulting in a huge meds overdose!

Machines are great but they're not always right - they break, go wrong etc - so you should know at least ROUGHLY what a result should be.

There was another incident I've just remembered the autosphyg wasn't working in my practice nurses office but I could see she had an old set up, but when I asked "oh I don't trust them, don't feel confident using it"
It was a necessary thing for me to get my bp taken and it had already been murder to get the appointment so I asked if she was sure, in the end she went and asked another (older) nurse to do it. Imo that really shouldn't have been necessary. That's a basic skill!

I would guess alot of the people that, don't mind paying for gp appointments, parking, prescriptions etc are not people with long term health conditions.

I mind paying for parking alot. I'm a full time carer to a child with complex health needs, we can be in hospital sometimes three times a week, fiver a pop for parking. That has to be paid from either his dla or my carers allowance and goes straight in the pocket of a private parking firm. I also have a blue badge but I still have to pay to park in a hospital. Its taking advantage and making money of the worst off in society.

Impose a hefty fine on patients in A and E who have had accidents if their blood alcohol count is high or who have given themselves alcohol poisoning.

Tackle the awful drinking culture in Britain.

Employ more hospital pharmacists. My mum was a bed blocker several times, sometimes for a whole weekend as her meds weren't ready in time for her to catch the long distance transport she needed to get home.

Have the WHO buy out the mega pharmaceutical companies. Pay pharma researchers handsomely so that the reward for developing effective drugs is a bonus to the team working on it rather than to the company shareholders who hold the NHS to ransom with their extortionately priced drugs.

Invest more in preventative medicine.

Rogue - to be honest my experience was it was usually due to someone not sending the prescription TO the hospital pharmacy promptly for the pharmacist to complete the order.

Though there are busy periods - particularly mid Dec- March - where certainly employing extra temp pharmacists or even pharmacy assistants (who can do more than people realise) would make sense.

There are locum pharmacists.

Impose a hefty fine on patients in A and E who have had accidents if their blood alcohol count is high or who have given themselves alcohol poisoning

Ok...what about...

People who've taken an overdose?

People who have driven dangerously and crashed their car?

People who have injured themselves doing extreme sports?

People who have started fights and been punched in the nose?

People who have been drinking but whose illness or injury is unrelated to their drinking? Ie... someone has had a night out and is standing on a pavement whilst a car runs out of control, mounts pavement and hits them? Or they are drunk but have an entirely unrelated heart attack?

Please stop adding your own spin to my comments. Low income earners are taken care of. It's fact not some derogatory comment. We pay 29% in taxes which doesn't include significant costs such as healthcare or college. That 29% of our income goes to pay for those who don't have. Same system applies in the U.K.

Want2bSupermum
I belong to a facebook group for people having a specific medical procedure. Many members are in the US and report having to pay thousands of dollars in co pay to their insurance companies.

Many are deciding not to have the treatment because they can't afford to pay this. Is that common?

How is it "spin"?!

I've asked fairly simple questions and made comments based on what I've seen in news reports and discussed with people I know in real life.

Seems to be there are certain questions you don't want to answer.

Because the reason Brits fear a USA style system is usually precisely because we've seen/been told horror stories either by visitors to USA or citizens of.

It's stories like these : that put us off

thehill.com/blogs/pundits-blog/healthcare/346652-too-many-americans-with-insurance-are-being-denied-coverage

nypost.com/2017/06/07/1-in-4-americans-refuse-medical-care-because-they-cant-afford-it/

eu.usatoday.com/story/opinion/2018/07/12/cover-pre-existing-conditions-reduce-health-costs-other-ways-column/763590002/

www.cnbc.com/id/39646830

And when I come across stories like these I don't take them at face value either. I ask my friends and family in USA if the claim in the story is likely accurate, go and find more info etc. But it's not hard to find such reports far from it!

So how is that spin?

weetavix It happens in the middle-lower income groups who have extended themselves . For our DC their healthcare costs out of pocket max out at $25k. We aren't looking to do treatments which are experimental. The insurance company have been challenging in the past but our state has an insurance ombudsman who had a fit with the insurance company, fined them and made them pay the DC compensation for delay of services. This is why we live in NJ. Go to Tennessee and I doubt the state ombudsman would be quite as helpful.

Americans have much higher incomes but they fritter it away on rubbish half the time. People are shocked we live in 2200 sqft. We don't need more space. Apparently we are crazy for not living in a home triple the size with all en-suite bedrooms. I don't think it's crazy. We have what we need and save the rest.

Lots of Americans will have a fit with eye drops for pink eye that cost $90. I really don't think it's a crazy amount to pay given that taxes are lower and people make more. The doctors office has samples to give out if you need it.

Sorry let me correct the size of our home. We want to live in 2200sqft. We currently live in 1500sqft. We do need two extra bedrooms for the DC and a study for me so it's easier to work from home.

So that would be £68 for eye drops. - again that's well over my weekly food costs.

You've also now admitted your own family has had difficulties getting the coverage you're not only entitled to but have paid for!

$25k is £19k that's out of pocket - does that mean costs the insurer won't cover? That's more than my annual income from benefits by several thousand. It's even a few thousand more than the max a nmw worker can regularly earn gross.,

Plus the thing that really bothers me is paying upfront and then having to try to recover the cost. Poor people don't HAVE the cash for the upfront payment!

Yes but a family making £150k or less wouldn't pay for the care of our sick DC which is pretty much all of the $25k. They would qualify for income exempt Medicaid. That would mean my disabled DC are fully covered and our family would pay for 1DC who isn't disabled and ourselves.

Someone earning MW here is nearly always on Medicaid. If they aren't they are on a state subsidized program. They pay $0 for the eyedrops I pay so much for.

Given our household income is so high it's fair we pay.

Graphista Suspect all you like; you know nothing about me. Or my regular tithing to my church's social justice fund, or my direct debit to a local homeless shelter, or my regular contributions to our crisis nursery, or, or, or. You may choose to believe whatever you like about me; that doesn't make it so.