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 also agree with the prescription thing. I have been offered so many prescriptions for creams for DD (she has eczema and psoriasis) which are available over the counter. I always say no unless it’s actually one that needs to be prescribed, but I am annoyed that they even offer it.

I have had chronic psoriasis all of my 57 yrs. the creams may well have been available over the counter but there is not a chance my parents could have afforded to buy them so I would have gone without. There have also been times in my adult life where I wouldn't have been able to afford them. U less you know for sure the patients financial situation they absolutely should be offered.

There are a few problems with telling everyone to buy drugs over the counter rather than get a prescription:

1. One drug I'm on I get 3 times the amount on prescription than what I can buy over the counter for the same price.
2. I am also not using the drug for it's over the counter use so if a pharmacist challenged me I wouldn't be able to buy it. You had to ask the pharmacist for the drug until about 2 years ago.
3. Another drug I was prescribed the pharmacist actually checked on me during my first two months of taking it. If I just brought it over the counter that wouldn't happen.

I agree with this, but they should provide a card or something that allows you to buy in bigger amounts. That's the usual reason as to why people get them on prescription.

You can buy up to 96 at a time in a chemist. It's only supermarkets and small shops where they are restricted.

Sack tbe hige number of admin staff, sack the management staff. Stop working with commissions and what have you.

Eh? Stop working with the commissions? You mean the ones that go in and inspect safety and care quality? That doesn’t sound like a good idea to me. Or do you mean the commissioners? They are the people who plan and order healthcare for each area so not a good idea there either.

Sack the admin staff: I know a hospital that tried that and it fell apart the next week when they realised making appointments and sending out results and reports to GPs, and making sure files are in the right place and waiting lists are managed are kind of important and if you fuck them up people, well, they sort of die.

Because it’s all very well being diagnosed with cancer, but if your notes don’t get typed up and the referral doesn’t get put in you don’t get treated do you? And doctors and consultants don’t do that themselves- they pass it on to admin staff for them.

The management thing is a bit of a red herring as the over management thing is a bit of a myth. They need to get rid of poor managers rather than managers per se. But then there is the question of who do you replace them with?

I think the answer lies in ‘good’ nhs management disseminating knowledge on how to run a good trust to those who aren’t making a great job of it currently.

@latebreakfast myself, my family and my friends' who doctors couldn't be bothered to diagnose until it was nearly too late/an emergency wouldn't mind if doctors actually believed young and/or BAME patients in the first place instead of telling us our health problems are nothing or made up.

www.braintreeandwithamtimes.co.uk/news/16971246.church-lane-placed-in-special-measures-after-inspectors-visit/?ref=fbshr

Church Lane Surgery, in Braintree, was labelled as 'inadequate' across the board by inspectors who found huge range of problems during a visit in August according to a CQC report published on Monday.

It was found that safety systems are not good enough to make sure patients and staff are kept from harm and systems to make sure medicines were stored safely were not always effective

There were also not enough staff and inspectors found a backlog of correspondence, pathology results and patient notes as a result.

It comes just weeks after fed-up patients set-up Action to Change Church Lane, a group demanding improvements at the Virgin Care-run surgery.

The CQC report states: "Services placed in special measures will be inspected again within six months.

"If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service.

"This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve

James Cleverly, Braintree MP, said in a post online: "This is both disappointing and distressing.

"I speak with the management team at Church Lane regularly and recently had a very frank meeting with the Chief Executive of Virgin Care.

"The difficulties with this practice predate the current leadership and Virgin Care have made it clear that they are committed to improving the rating of the practice.

"I don’t think that yet another change in contract holder would be beneficial to the surgery after years without continuity of senior leadership.

"While problems with the telephone system and prescriptions are frustrating, the problem that constituents raise with me most is the lack of permanent GPs

Virgin tell me that they have recently recruited a practice manager and are seeking to recruit permanent GPs too.

"The poor CQC rating makes this process harder.

"I will continue to liaise with the management team at the surgery and at Virgin Care to ensure that the service and rating improve.

Virgin Care says it will not walk away from the surgery and says it has made efforts to improve by recruiting more permanent GPs and improving the telephone system.

Christian Ellwood, practice manager, said: "The report’s rating is disappointing to our team who have worked so hard to improve the service.

"We have a comprehensive action plan in place and we welcome the CQC’s report which confirms that we are focused on the right areas to improve the services we deliver to our patients.

"We will work with the CQC as we strive towards a ‘good’ or, in time, ‘outstanding’ rating for Church Lane Surgery.

Triumphdaytona 10th October 3:20 pm
1 Trouble with prescriptions frusrating??? It's right appalling! Regulaly going without medication and never getting through to reception it's down right dangerous!

Last Updated: 10th October 5:14 pm
Emma Louise 11th October 4:57 pm
0 Dissapointing and distressing??!!! Really, it's not only dissapointing for patients, it's frustrating, and for some, life threatening, when they can't get their prescriptions on time, when they can't see a doctor for three to four weeks. Dissapointing and distressing, doesn't really cover it. And these problems do not only pre-date Virgin with Provide the previous supplier, but Virgin have made it even worse, there are no improvements in any way shape or form! The promise to recruit permanent GP's has been promised for the last two years, believe it when I see it. Virgin have promised not to walk away, I can't see Branson wanting to keep hold of a "problem" personally. Roll on the next provider to it up further. If that is actually possible.

I believe English prescriptions some patients are charged
I believe that Scottish and Welsh are free, unsure about Ireland. Why the difference ?

Mostly, people need to take responsibility for their own health. I work in the NHS, and the number of wasted appointments is ridiculous. GP appts for things they could deal with themselves. Oh, and don’t get me started on missed appointments. Ambulances called for no real reason and repeat offenders.... that’s not even starting on hospital care. Self care should be more prevalent and that includes ensuring we eat/drink the appropriate amounts. Not waiting until our body is breaking under the strain of our lifestyles and hoping that a Doctor can fix it for us.

I would charge £50 for anyone attending a&e and/or using an ambulance because of alcohol or drugs. This would be a 'fine' just like a parking fine, and could be paid in arears. There could be a alcohol test for this. I am not talking about people with liver problems for long term drinking, but people who get pissed and have to call an ambulance because they have passed out on the pavement. If they can afford alcohol, they an afford a fine.

I would charge for all visits to GPs, a flat fee of £5. This is enough for people to not 'forget' to cancel their appointment, but not too much to stop people from actually making appointments.

I would raise taxes, and actually put money into the NHS to get the qualified staff.

I would have better training support for nurses.

Start charging people who dont attend appointments and they recieve no further appts until the fine is paid.

No more prescriptions for things like plasters or suncream.

If someone attends A&E for something trivial e.g back pain then refuse them treatment and kick them out.

The first time someone abuses staff they are blacklisted and never given treatment by anyone again.

The main problem is customer expectation.

People don't want to wait for healthcare. They want to be seen today, now, this moment. So off they trot to OOH and A & E, for something that can perfectly well wait a few days to see a GP.

Tackle that, and the NHS stands a prayer.

Put in preventative measures for heath to stop the preventable diseases.

Spending money on getting people to change their lifestyles and this will save money, increase quality of life.

Look at countries that don’t have obesity crisis, diabetes epidemic and see how and what they do - then emulate it

I believe as a country they train the highest number of doctors. I believe the training is free. The doctors work locally or abroad, although I believe that there is some controversy about wages for those who work abroad due to their home country politics. My point is that if Cuba can train lots of doctors, why can't NHS

Because until this year they were banned from training more than 6,000 a year.

I would fully support charges for alcohol causes.
You got smashed on a night out and needed an ambulance? Your problem. £50 would be adequate.
I do wonder how much this costs NHS.

People need to take better care of their health. Smoking, alcohol, lack of exercise and poor diets (all of which are mostly up to individuals to regulate) are the root cause of an awful lot of NHS expenditure.

What I would do is get rid of individual trusts and make the budget a national budget again. That makes the whole nhs a level playing field.

1). Lot less management needed as not required on an individual trust level

2. supply chain could be centralised again driving costs down as bulk buying means that you can get prices down from suppliers and there isn’t all this stupid competition from companies ‘oh so and so trust does this’ and ‘surgeon a is used to using this’. Well they wouldn’t cause they would al be using the same stuff based on the latest evidence based practice.

Also means you can drive drug costs down and maybe afford to give some of this cutting edge drugs that we can’t at the moment.

3. I would increase the amount of in work training places for nurses and midwives and other allied health professions. They are going to be rolling out apprenticeships very shortly but I think that it would be a much more utilised resource. Although I am currently at uni training for a degree, I am a much more practical learner and would benefit personally from a less academic way of training but hey ho.

I think the supply chain would be the biggest cost saver though as working in different places and seeing the differences in the costs spent in consumables (I work in theatres so it’s a high cost there) it really makes you think how much could be saved from that alone.

@Gingerrogered yes, yes. Glad to hear a voice of reason.

Let's just sack all the admin and managers... yeah let's try that...

Absolutely systems and processes need to be improved and made more efficient, but the nhs would collapse without admin and management.

I agree with you that what we need is BETTER management not necessarily less management.

And charging for missed appointments would be unworkable and make no difference to 'fixing' the NHS.

Lifecouldbeadeeam - overbook clinics in the same way hotels and airlines do. Then those not showing up won’t be wasting time, if everyone turns up you may have over runs but as so many don’t turn up it won’t be a regular occurance

I think they need to get harsher with "patients". I've seen them say they have to send an ambulance if its requested!

They should be able to turn you away from A&E if you don't need to be there. They should be able to say no you can't have an ambulance if you don't need it.

Ivf should be means tested. Elective c-sections should only be approved by a pschyatrist. Plastic surgery only for those with disfigurement. The gp needs to be a minor illness and injury service. The system to get a specialist referal is ridiculous and lengthy and should not start at the gp. You should be able to go straight to the doctor you think you need. If your a time waster then they can fine you.

Trial prescriptions should be given in smaller amounts. They give you 3 months worth, after a week you say it doesn't work and then move on to somthing else. If your issue can be fixed by diet and lifestyle, then you should have to pay for medical treatment.

Legalise assisted suicide.

Change how private insurances work in this country: to be reimbursed of my private specialist consultation I have to be refered by my GP. One waisted pointless appointment every time.
I do a yearly mole check, why is a referral needed? My choice if I want to waste my money.
Obviously referals needed for NHS specialists as not to waste resources, but why do they care about private ones?
It is not the same in other countries, the Gov should be able to change it here.

but the nhs would collapse without admin and management

Not in the hospital I work at, honestly, the admin staff were shite, workshy and there to rinse the NHS for as much sick pay, carers leave and flexi-time they could drain out of it.

I wouldn't so much charge people for going to A and E as fine people who go in for bollocks reasons like "Sore Throat" or for being drunk, ditto people who ring 999 over rows about the PlayStation or Facebook and that sort of garbage.

I also don't think the NHS should fund anything that is vanity elective and not a threat to life.

"People need to take better care of their health. Smoking, alcohol, lack of exercise and poor diets (all of which are mostly up to individuals to regulate) are the root cause of an awful lot of NHS expenditure"

While attending Slimming World a fellow member found it hard to follow the plan because she didnt/couldnt get to eat the right things when she needed to For several shifts she didnt get a break to do this at all....................she was an NHS theatre nurse!

Many nurses end up with kidney problems through not having time to drink enough or restricting their liquid intake so they dont have to take toilet breaks.

NHS need to sort out their own problems in this area.

Many many employers do not allow their employees to take proper breaks to do whats needed.

Having worked in an NHS hospital for several years, I’m convinced that we should use what money we have more efficiently. Penny-pinching should be the order of the day. No matter how much money you throw at it, management will find a way to squander it.

As an aside, when my father was terminally ill at home, we had two separate deliveries of medicines that we didn’t request or need - it was tens of thousands of pounds worth of stuff! Where did it come from? Who ordered it? God knows! I tried to point out that we didn’t want or need it, but we never managed to find out who’d sent it. Total incompetence and such a waste

I agree with the people saying that the NHS should be partially contributory. It's simply unrealistic to think that taxes can fully sustain it.

Most European countries have a health system which is partly contributory, and most of them are associated with better outcomes (in terms of waiting times etc) than the NHS.

Also, social care in old age must be paid for out of savings (unless the person has none). Again, it's simply too expensive otherwise.