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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

999 replies

TamiTayorismyparentingguru · 15/10/2018 18:40

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?

OP posts:
Thread gallery
5
DieAntword · 18/10/2018 16:10

Constantly updating is not a big issue if handled right.

I get that the other things are worth considering though. I still think there’s a case for handing off some of the routine prescribing work to computers though, I don’t think it could ever take over all of it. I think pharmacists are in many ways better placed to do the drug interactions bit than doctors. Maybe some (would never work for all) prescriptions could be for a class of drugs and pharmacists could have broad authority to select the one that would be most appropriate for the individual - BUT of course the have a conflict of interest that might not make that a good idea.

Graphista · 18/10/2018 16:16

Ewits - d'oh on my part - that is of course the most obvious difficulty with an app! It won't see or feel symptoms patient is neglecting to mention. And yes, they certainly won't notice nor be able to help with the mh side of things.

Then there's the "doorknob question" the real problem that the patient is reluctant to verbalise.

Onlyhappywhenitrains1 · 18/10/2018 16:18

Maybe living wills needs to he compulsory for all and the NHS should be able to legally follow them. Even if that means upping pain meds until you overdose or refusing antibiotics and iv when you get a chest infection.

Graphista · 18/10/2018 16:18

POSSIBLY an automated or semi automated system perhaps supported by pharmacists for repeat prescriptions could be an idea. Would need good checks and balances though.,

Pharmacists can and do prescribe and recommend many medications. I think people are very unaware of just how much they can do and how good their knowledge is.

gemsparkle84 · 18/10/2018 16:21

£10 charge to EVERYONE who access' A&E. If you're on benefits it comes out of your benefits if you're not it comes out of wages so there is NO OPTION not to pay. Of course homeless ppl can still access. Might make ppl think twice about attending. Prob far too much underlying paperwork but just a thought.

weneedtotalkabouttheNHS · 18/10/2018 16:29

That people who chose to go into healthcare which by definition is mainly a 24/7 role shouldn't expect mon-fri 9-5 hours?

Because what you think you want to do when making these life choices in your late teens or early twenties and are footloose and fancy free and what you actually want to do when you are in your late 30s+ with a partner and children (or even without a partner and children) are 2 very different things. The nhs had my all of my 20s and most of my 30s on 24/7 rotas. Now I work 2 days a week, no on call and no weekends in a hugely understaffed speciality. If they tried to make me work more I’d leave completely. And I don’t feel guilty.

Fontofnoknowledge · 18/10/2018 16:33

A biometric NHS access card that allows free at the point of need care , (in line with its original ethos) to ALL people in the UK with citizenship or indefinite right to remain.

NHS fraud is an epidemic of its own. I prosecuted one identity fraudster who obtained anti retro virals in numerous identities and sold them at huge profit back in her home country. We need to know that those using the NHS are entitled to do so.

NHS cards can be issued with National Insurance numbers for those resident at birth or before 16 or via the National Insurance interview when they supply genuine documentation for a number. It already happens. Just another card at the same interview . WITH A FINGER PRINT ON IT !

EwItsAHooman · 18/10/2018 16:52

£10 charge to EVERYONE who access' A&E. If you're on benefits it comes out of your benefits if you're not it comes out of wages so there is NO OPTION not to pay.

Brilliant. Then all the people living in poverty or just about managing financially can choose between "live or eat" instead of "heat or eat". The variety will do them some good, I'm sure.

TinselKitten · 18/10/2018 16:55

Roll out GP appointments via an app right across the country immediately- Babylon Health are offering this.

Double number of medical students trained on a very rapid timescale.

Move to something like French system where payment is socialised/subsidised/regulated but provision isn’t, so it’s not one huge behemoth, bureaucratic organisation.

Justanotherlurker · 18/10/2018 17:00

NHS fraud is an epidemic of its own.

Its not an epidemic, and an ID card to bring us into the rest of Europe wouldn't be a bad idea but I wouldn't trust either strip of our Government to impliment it without some further encroach on civil liberty.

As others have said, the NHS is now being asked to do far more now than what it was intended for, as people got healthier demand hasn't shrank but instead grew creating an infinite paradox that the "pay more tax" shouts is more just a feel good quote rather than actually offering anything realistic.

We need to depolitice it and have adult conversations about long term funding, and what is/isn't part of the NHS remit.

Most of the EU offer part private funding, but in the UK some like to jump on the political football and start shouting about the US

AndhowcouldIeverrefuse · 18/10/2018 17:09

NHS fraud is an epidemic of its own.

Personally I think that what is breaking the NHS is obesity, diabetes and especially an ageing population. The first 2 seem very stubborn to deal with. The 3rd one requires difficult political decisions that nobody wants to make (more immigration? Less immigration but significantly higher taxation of the dwindling pool of workers? Relying on women families to provide unpaid care, further reducing the workers pool? A massive economic correction leading to an impoverished society, "natural wastage" of the weak, elderly and poor and a lost generation?).

I haven't heard any politician grabbing this particular bull by the horns.

hazeyjane · 18/10/2018 17:13

£10 charge to EVERYONE who access' A&E.

Genius.

Unless you or a family member have chronic health conditions....or have fuck all money.

rose69 · 18/10/2018 17:33

Apologies if it's already been mentioned. In our area, if you have a free prescription card you are able to have meds for routine ailments proscribed by the pharmacy. This stops people seeing the go for minor ailments because they need a free prescription.
Cut down bureaucracy! If you have a test the doc or nurse will ring if they need
To discuss the results. At dm's surgery they send you a letter asking you to call them!

Yoksha · 18/10/2018 17:36

Here's my suggestions. Sorry if they've been covered ^^

Charge for missed appointments. Really infuriating when you can't get an appt for 4wks, then when you go to Gp's, there's a notice saying 37 appts missed last week!

Last I heard there were around 3,000 Doctors in these refugee centres awaiting their cases being heard. Could we not bring them up to speed to work in the NHS?

formerbabe · 18/10/2018 17:38

£10 charge to EVERYONE who access' A&E

What on earth could go wrong hey?!

PetraDelphiki · 18/10/2018 18:35

We need to depolitice it and have adult conversations about long term funding, and what is/isn't part of the NHS remit.

Not sure depolitice is a word but you are absolutely right. The issue is having the adult conversation when everyone has been brought up to think that the NHS should fund everything.

Graphista · 18/10/2018 18:49

"£10 charge to EVERYONE who access' A&E. If you're on benefits it comes out of your benefits if you're not it comes out of wages so there is NO OPTION not to pay" bloody hell no!

Guessing yet again this is a poster who's not been on benefits recently if ever?

£10 is a lot of money if you're living on just over £300 a month! And it's money you just don't have AT ALL if you're waiting weeks/months for UC To come through or are dealing with appealing for disability payments!!

Weneedtotalkaboutthenhs - wow! True colours coming through now! Yes it's unacceptable to go into medicine without recognising that it's a 24/7 industry!! And expecting it to accommodate your changing circumstances. Do you think people in other 24/7 industries don't face the same challenges? Do you think police officers, or fire fighters, or soldiers should also get AFTER having millions invested in them in training should also get to decide to work 2 days a week on more money than many many full time professionals could hope to earn working full time?! I think that's a hugely shocking and damaging attitude to the nhs as an employer! Bloody hell!

"Double number of medical students trained on a very rapid timescale." In light of weneedtotalks post at 1629 (and I'm struggling how to word this) can I say I think maybe we need to carefully consider HOW medical students are being recruited, are they actually suited to not just being Drs, but working in the nhs with all that REQUIRES rather than risking keeping ending up paying full time salaries to people who are only giving part time service?

Rose69 I'm sure someone will correct me if I'm wrong but I don't think the minor ailments service is anything to do with a "free prescription card" - although admit I'm not sure what that is.

Those that haven't read the thread need to read some comments at least I think.

Eg "can't get a Drs appointment so make people pay for them" at this point I'm thinking lack of appointments is far from just due to missed appointments. I'm beginning to think a BIG reason is not enough Drs, not due purely to lack of recruitment/retention but because nhs paying for full time role but only getting part time service! Am i the only one thinking that's been kept bloody quiet?!

Yoksha · 18/10/2018 19:00

PetraDelphiki I agree, adult conversations are needed.

The govt need to start listening to those of us in my generation. I'm 62 soon. I'd welcome the law allowing us to choose assisted suicide. Let's look at the Dutch or Swiss system.

I've gone in for quite serious operations when up to 25yrs younger. I had a living will lodged in case I didn't come out with capacity. I don't know if it had any clout?

I've forced my 2 Dd's to begin to address this problem with dialogue. They're starting to have a healthier mindset.

My mum had early onset Alzheimer's at 64. She trundled on for 10 yrs. My mum-in-law had a very aggressive cancer. 11 wks from final diagnosis to death. My lasting memories at the hospice were her screaming in pain when staff changed her dressings. I mentioned to them that we wouldn't allow an animal to suffer! They agreed, but they had protocol to adhere to. Neither of my loved ones had a good ending. I don't want this for me should it occur. Also, massive amount of resources used with mum. She lived in the twilight zone being drip fed. Not acceptable. Soul destroying too.

My cat on the other hand had liver cancer. I had the vet put her to sleep. Not comparable to some, but infinitely more compassionate.

RB68 · 18/10/2018 19:46

I think some of the issues are more fundamental than just process - I think often the processes whilst sometimes overlong are fundamentally sound.

I think there is an issue with subbing out work e.g. cleaners there is often a long string of companies involved in the provision of cleaning each taking a cut until the person actually doing the job is untrained, unqualified, and under paid. Contractors should not be allowed to sub out work more than once. They should provide staff with demonstrable competence in the extreme levels of cleanliness needed in hospitals, cleaners should be held in higher esteem (this is a cultural issue for the main part) but it is also about the level of professionalism shown - there needs to be better management of cleaning teams and recognition for excellence, they need to be fully staffed and better quality checks held.

Rules need to be abided by everyone so if toilets only for patients then enforce it, for visitors make sure they have facilities too - work with families to help provide care for e.g. when someone in long term and family can provide a level of care work together.

Food should be patient paid - don't want to pay should get your own brought in etc. Not sure how this could work in practice but consideration should be given to it.

Staff resourcing is an issue - fundamentally there are plenty of trained people, but they are no longer working for NHS - in a predominately female workforce whose stupid idea was 10 to 12 hr shifts? There needs to be better all round support for staff to ensure they can continue to work around families and other life commitments be it kids, other dependents, elderly parents, their own health issues etc.

We have an oversupply of "in" ie patients coming in, we need to manage that process better ("Disnefy it if you have to ie set expectations, keep people informed of progress and over deliver in terms of promised wait times). They need to be better screened e.g. using triage system better and having different grades of service for differing injuries and being a bit harder about some of the ways things could be dealt with.

Better health education within school environment or through other sources e.g. bumping up kids in St Johns for e.g. so their understanding of what is pharmacist/GP/A&E is better from a younger age, that people know the right things to do for common ailments. A decent NHS guide to family illnesses published and available in a useable format that could be "gifted" to e.g. new parents - bit like readers digest DIY manuals - lol

Improve the availability of recovery wards or hospitals or homes for people who are not in urgent medical need but are effectively in rehab or recovery or waiting to go home (so assessments etc needing to happen), put a better system for home assessments in place before people actually need hospital - so in the same way that we can childproof homes can we elderly proof them and make available grants for this to prevent falls, knocks, accidents that commonly afflict people (there was an interesting "slipper" project for people with poor sight at one point - providing proper surround slippers to people to prevent falls - they say an elderly person going into hospital for a fall ages more than 10 yrs in a 10 day stay)

There needs to be something around cross working between different medical specialisms - so patient centred care not condition - so where a patient has a range of conditions that they are managed as a whole not in part.

Some bloody IT systems that link together and deliver what they say on the tin

We should have a system that allows us to identify those NOT entitled to free care and a credit card should be taken before treatment or insurance details - we need to be smarter in the NHS environment on what insurance companies will pay for.

We should insist on payback for those trained by the NHS - ie so many years service in terms of hrs served rather than time elapsed unless a genuine reason exists to not do that. (But in the same breath better work arounds for those with ill health or other commitments)

De-politicisation of the decision making, and making statistics based decisions (around allocation of funding) based on proper information not on out of date or known to be skewed information.

Remember you get what you measure and people will find work arounds and ways to screw the system to get outcomes that are measured and adjust process and measures accordingly

Its also little stuff like when you get to A&E and are waiting in an ambulance - that ambulance has to be on for the machinery to work. instal caravan type hook ups - saves diesel, reduces pollution and is healthier. Install green energy production to reduce cost of running and feed into local area.

Relook at delivery to hospital system - the hospital transport system is making peoples lives a misery and is screwing up appt times and causing frustration with other patients as those coming in don't arrive for appointed times, are given priority and queue jump but are still int he hospital for ridiculous lengths of times and these are often the most vulnerable.

Stop people being accompanied by more than one person in waiting areas.

Aquilla · 18/10/2018 19:56

Small charge for prescriptions for all. Small charge for GP visits for all. New arrivals to the UK to take out health insurance until at least 2 years national insurance has been put into system. No health tourism. Every little helps!

FormerlyFrikadela01 · 18/10/2018 20:05

Staff resourcing is an issue - fundamentally there are plenty of trained people, but they are no longer working for NHS - in a predominately female workforce whose stupid idea was 10 to 12 hr shifts?

I'll repeat what I said earlier in the thread. I can't wait to move back to 12 hour shifts. I do 8 hours now and haven't put my son to bed In 2 days and won't for the next 3. I have a shitty work life balance. And childcare is no easier to arrange for a 8 hour early than a 12 hour long day. At least with 12 hours I only have go find care for 3 days rather than 9 in a row as often happens now.

weneedtotalkabouttheNHS · 18/10/2018 20:09

Graophista
Weneedtotalkaboutthenhs - wow! True colours coming through now! Yes it's unacceptable to go into medicine without recognising that it's a 24/7 industry!! And expecting it to accommodate your changing circumstances. Do you think people in other 24/7 industries don't face the same challenges? Do you think police officers, or fire fighters, or soldiers should also get AFTER having millions invested in them in training should also get to decide to work 2 days a week on more money than many many full time professionals could hope to earn working full time?!

Really unfair and a bit naive. Of course I knew it was a 24/7 industry, I'd be shocked if anyone going into medicine didn't realise that. But what you seem to be saying is that anyone who commits to a vocational job with on-call commitment commits to it for life. I know several part time police officers and fire-fighters. People's life circumstances change and if they don't have a job that can accommodate that they will leave and find something else. I have a colleague who works part time to long after a parent with a long term debilitating condition- do you think she is also being unreasonable? .

As I said previously I gave all of my 20s and most of my 30's to the NHS. As a junior i stopped counting the hours of overtime. my mum says the worst week she remembers was when I did 120 hours in one week. I got paid for 40 of them. Pre children I don't think I ever left a shift on time. More than once when someone didn't show for a night shift I just stayed on. Started at 2pm, finished at 9am the next day.

Mental health, often stress-of-the-job induced, is also a huge problem in healthcare workers. Many work part time just so they can cope.

So I'm really sorry you think I'm unreasonable and "showing my true colours", but I think I've done more than my fair share of unpaid work for the NHS over the years.

AlmaGeddon · 18/10/2018 20:10

I can't see any of these last suggestions making a bLind bit of difference-especially as the 'poor people can't afford to pay for anything' is touted as soon as anyone suggests paying for anything.
It'll grind on for a few more years with the private options expanding to fill the growing gaps.

MereDintofPandiculation · 18/10/2018 20:12

The govt need to start listening to those of us in my generation. I'm 62 soon. I'd welcome the law allowing us to choose assisted suicide. Let's look at the Dutch or Swiss system. This, absolutely. While life expectancy has been increasing, "healthy life expectancy" has not been increasing at the same rate, so we're spending more of our life in ill-health. During her last illness, my mother said to me at Christmas "well, what have I got to live for?" - and she was right - everything she enjoyed was denied to her, she was in constant pain, and every day was a torment to her. But she lingered on until April.

Twogirlsandme · 18/10/2018 20:14

I will be forever grateful to the NHS after they saved my daughters life this summer.
One thing I did notice is that there is so much waste. For example pre surgery wash in big bottles once are opened for one patient need to be discarded and one day they needed sudocreme type stuff for her and again once open needed to be discarded, it was a massive tub, they said I could keep the rest as they needed to throw it away and couldn't use it for another patient.