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?

"when you go to Gp's, there's a notice saying 37 appts missed last week"

i will ask to see a statistical breakdown if i see that in my surgery

"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"

I want to see exactly the same change happen in social housing. This crap has seeped in everywhere.

"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."

So what happens after a DLA recipient has their DLA stopped after 28 days in hospital. What do they pay for it with after that.

As Carers Alllowance is linked this would stop too. If you keep on with these kinds of attitudes towards patients and their carers i can see "granny dumping" becoming a regular occurance The only way to stop these attitudes is for carers to go on some kind of national strike.

The reason for DLA being stopped................BECAUSE THE HOSPITAL IS DEEMED TO BE CARING FOR THEM.

Perhaps carers should point this out before walking away on day 29

HelenaDove come to my small surgery. I'll show you how many people did not attend each GP, phlebotomy, nurse, antenatal, mental health counselling, asthma, diabetic, heart, warfarin appointments each month despite having a text message reminder system.

RB68 - I'd go further and ban contracting out it doesn't really save money and is ripe for corruption. Go back to the nhs directly employing their own cleaners, porters etc

The sub-contracting nonsense seems to me to enable companies to essentially set up almost bloody Ponzi schemes!

Enforcing of rules requires better staffing levels.

Food patient paid - again nutrition is a VITAL part of healing so generally I'm against this. But IF it were brought in quality and nutrition would need to be much better. I have a vague recollection of a tv chef ATTEMPTING To tackle hospital food a la Jamie Oliver and school dinners but giving up cos met lots of (some of it due to 'can't cope with change' mentality of staff) obstacles

"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" there's the nhs site which provides a good format BUT sometimes the info is very out of date.

Eg page for format only

www.nhs.uk/conditions/chickenpox/

"put a better system for home assessments in place before people actually need hospital" that would come under social care which has faced SEVERE cuts under Tory austerity policy. Which is shocking considering most in need are elderly/pensioners yet this demographic is also more likely to vote Tory.

"Stop people being accompanied by more than one person in waiting areas." OMG yes! I live in an area where it seems to be a trip to a&e is a flipping family day trip! Why?!

"I know several part time police officers and fire-fighters." But they're not in the majority and rarely in front line roles.

"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?" Honestly? If still drawing a high full time level salary for the paid job - yes.

I agree unpaid overtime due to poor staffing levels is unacceptable but if senior (now) Drs continue to be paid high full time salaries while working part time AND apparently - according to a pp getting up to millions in pension then we potentially don't have the funds to employ enough junior staff and the cycle simply perpetuates. Although I must admit I believe the money IS there if the govt were honest - we certainly seem to find the money when it's required for bailing out failing businesses (not just banks), wars, outdated military programmes, the whole brexit palava (which no I don't believe will ultimately save us money even JRM has admitted it could be 2 generations till we see any benefit), and buying political parties to keep marginal govts in power!

I don't on principle object to part time workers, I object to part time workers on full time salaries and pretty high ones too! I'd be perfectly happy to have an nhs staffed predominantly by part time staff, enjoying a better work/life balance and not getting burnt out and quitting, it would also be beneficial to have a greater variety of staff - but not on too high salaries and crazy pensions.

HelenaDove what for? Because you don’t believe it?

My practice has an online booking system, as well as being able to do it over the phone or in person of course. Patients get a confirmation by text (if a mobile number is provided and 94% of our patients do) at the time of booking the appointment. They get another reminder 24 hours before. We also have a reminder service for vulnerable patients who do not have a mobile number recorded - the receptionists will call them.

Appointments can be cancelled on the phone, in person, on the app or the website.

We still have a number of DNAs weekly. Last Friday I had 3 in my clinic alone, despite all these measures. Not one of them had a good reason (admission to hospital, death, dementia etc). One of them had only made the appointment that morning yet DNA’d the same afternoon.

For many people they just don’t care. It has no value or cost to them so it doesn’t affect them. I don’t agree with charging for appointments or DNAs by the way but until people give a shit it won’t change.

Collected all the hoarded medicines from my mum and stop giving her repeat prescriptions. That should halve the NHS drugs bill.

And of course clinical care is 24/7 - no one goes into medicine or nursing not expecting to work all sorts of shifts.

But I’ve done those, for years - I moved into primary care mostly so I DON’T have to work nights, weekends and shifts. As a single parent with 3 children, one who is disabled with complex needs, I don’t want to and can’t work day and night. Luckily my bosses know I can’t do late nights or early starts, they value what I can do, and I do it very well.

We need flexible working, not this rigid mindset that we must all do shifts, or long days, or rotational working.

Fair enough but that shouldnt stop someone asking for a statistical breakdown.

People just not turning up for no good reason is taking the piss

Hmmm, I got taken in as an emergency with sepsis - didn't have any cash on me as I'd literally just come back from a weekend away. The NHS even had to pay for my taxi to A&E (nhs direct arranged it).

What do you expect people in that situation to do if they had to pay for food? I'd packed an overnight bag in a hurry waiting for the taxi, but they kept me in for a week on IV antibiotics...

Also, food is part of the treatment process. Patients need to eat. At first the only thing on the menu I could face eating was ice-cream, so they gave me extra helpings to make sure I was eating enough. What do you do if a patient who hasn't paid, isn't eating enough? Serve them a meal and charge them anyway?

Troysmammy - but what percentage were flakes and what percentage had a good reason for not attending? Eg admitted to hospital, memory issues etc? Died?

I've personally had difficulties with my own GP surgery sending text reminders where the day of the week didn't match the date, or wrong time (that's actually where the texts were useful cos I could prove I was there at the right time according to what THEY text me) or even on one occasion absolutely not even my appointment - I hadn't made one! If I'd have ignored that as "just a mistake ignore" they'd have assumed the correct person got it and just didn't bother attending. I'm pathologically punctual so I've then immediately phoned to double check and even THEN been given wrong info!

Both dd and I have had letters re hospital appointments sometimes the letters themselves (wtf kind of secretary writes a letter dated several days after the appointment time to tell the patient the appointment time? Or is it automated IT systems?), or the letter has a possibly ok date but the postmark on the envelope is several days after the appointmeny date - I now know to keep the envelopes.

Also once for dd had 3 different letters for 3 different appointment times for the same appointment. Sorting that was fun!

Graphista, Drs continue to be paid high full time salaries while working part time Who? Drs/ nurses/ managers working part time get paid on a pro rata basis, across the NHS. I work 2 days, I get paid for 2 days work. My colleague caring for her parents works 3 days plus weekend on calls and gets paid for 3 days plus her on call. Drs aren't being paid full time to work a part time job, but for many a standard shift is 10 hours and full time is 40 hours/week. So on a week where they aren't doing a weekend or an on call full time is 4 week-day days. If they do a weekend and an on call they might only work 1 week-day shift, but they are working full time, they just aren't doing a 5 day 8 hours/day week plus weekends and on call. that was outlawed in the early noughties.

Sorry to be posting here, it’s been a very long time since I was here. I’m looking for parents experiences with their kids teeth. I’ve done a ‘teeth’ search and nothing comes up 😕. What do I do?

People need to be responsible for themselves.

We have many missed outpatients appointments a day, which is frustrating. If appoinments were cancelled they could be reallocated to other patients and avoid breaches and fines!

We hear excuses like “I didn’t get the letter because I have moved house” and these patients don’t think to inform their GP or hospital. Other people DNA and when they get rebooked they get mad because we don’t provide a taxi service as they don’t like getting the bus and don’t think they should have to pay for a taxi.

Your best bet is to start a thread.

Go back to the main page

www.mumsnet.com/Talk/am_i_being_unreasonable

And click the + sign button in the middle of the toolbar at the bottom of the screen, write your opening post, click post.

Thank you! I’ll give it a go now.

I'm referring to the level of pay being so high. I will be clearer in future.

No deaths, the hospital admission rang us from hospital to cancel. One with memory problems. The rest couldn't be arsed to advise us. Booking a morning appointment and not turning up that morning is not acceptable and not attending a phlebotomy appointment, rebooking and not turn up and then rebooking and not turning up and living a street away is no excuse. I'd say 99% of people have a phone to cancel a valuable appointment.

HelenaDove but why? Do you not think we’ve got enough to do?!

What purpose would it serve? How would it benefit you to know that information?

With regard to food - it would need working out, those in lowest income bracket could get free and emergency - say first few days could also be provided. But fundamentally if it were paid for it would improve dramatically and the "health" argument disappears as people would pay for good food - perhaps it should be an upgrade pyt or something - all of it needs thought. DLA - no longer needing care is wrong because it is clear hospitals don't run errands, chat to people provide one on one care that carers or relatives frequently do - but because the system is wrong in one place doeesn't mean you shouldn't strive to get it right in another

Over the years, I've missed several GP appointments because receptionists have accidentally booked me in for one time and told me another.

They were really brutal about it being all my fault as well. Even when I had an appointment card at home with the wrong time on it. Apparently not being a mind reader is unacceptable.

The way this thread is going is reminding me of exactly how I feel when that happens.

I'd go further and ban contracting out it doesn't really save money and is ripe for corruption. Go back to the nhs directly employing their own cleaners, porters etc

This is where adult conversations are needed and to try and take it out the political sphere, all of Europe work on a private/public funding model with a mixture of contractors/public servants etc.

It is more cost effective to have the cleaning contracted hence why every health care service does it, it might need better regulation but to suggest bringing everything back in house is not going to help.

We cannot just keep expecting to increase funding year on year in a can kicking exercise (and lets be honest, that's what the "pay more tax" are essentially purporting) , and still expect to treat everything and anything under the sun, the problem is that trying to state what the NHS remit should and shouldn't be is that some will always come along and use an appeal to emotion of the lowest common detonator.

The problem is that the NHS is in downfall because the general public are not ready to accept the tough decisions needed that means its there for our grandchildren, as a part of globalisation we may have to adopt some European model that some services will require insurance or not available (whatever they may be)

detonator ???

denominator

*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."

How would that work for people, who live in residential care homes and social services takes all their income (benefits/pensions) except for £26 per week, which has to cover their clothes, toiletries, gifts, a new TV for their room or God forbid a holiday?

Only one person with the patient in the waiting room

So, how that does that work, when the patient needs to be under constant supervision - the parent/carer can't go to the toilet or get a drink or something to eat in maybe 8 - 12 hours, because the patient can't be left on their own? Or, people who need 2:1 or 3:1 or even 4:1 care, out in the community because of challenging behaviour?

There is nothing DH and I like better than hanging about in A & E from say 7.30 pm, then having to explain DD's complex medical history at 3 am (after a stressful day and being woken up 4 x the night before) and if we are lucky getting to bed at 5 am, only to have to get up at 8 am to give DD her regular medication!

Poster after poster talks about charging the most vulnerable people; the patients with chronic, life threatening conditions, who are likely to be the ones, who need:

1. hospital car parking for multiple appointments every week
2. regular trips to A & E (like every week)
3. prescriptions, on top of their regular medication because they are in a fragile state physically and any new infection/illness needs addressing pronto
4. GP visits as per 3.
5. Family/carers to accompany them to look after them in A & E
6. Regular meals with adequate nutrition

Due to their chronic condition, they are less likely to be able to work and end up living on benefits, while their carer has to also give up work and live off carers' allowance - but with increased living costs, like food, heating, clothes, equipment, etc. One of the groups most likely to be in poverty, are families with a disabled parent or child - and yet some many of you want to charge them the most for using the NHS?

It beggars belief, that some people have so little imagination about the reality of life for people worse off than themselves!