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?

Get them to bother with collecting back things like crutches etc. They lend things to people and then make zero attempt to get them back...

"If your a time waster then they can fine you"

Like i said earlier...........................as long as it goes both ways.

Charge a set fee for missed appointments.
Stop prescibing paracetamol and othet over counter medication- paracetamol costs 22p a packet if you buy the generic stuff in asda/tesco etc.

Best way to save money in the NHS is to give it more money, at least in the short term.

1. properly fund social care, including appropriately resourcing transitional teams to expedite discharge. Continue the integration between health and social care which has started but much more to be done.

Remove elderly ‘bed blockers’ from the system and you free up an enormous amount of capacity.

1. properly fund and invest in public health, and use legislation where necessary to drive individual and corporate behaviour. The smoking ban has been enormously successful with smoking cessation. We need to examine root causes of obesity; this includes advertising and targeting manufacturers, not just taxing individuals. We need to properly fund and promote services to approve our utterly abysmal breastfeeding rates, as well as other sources of infant ill health and mortality (news today demonstrating that infant mortality is strongly correlated with poverty, this is utterly shameful for Britain in 2018).

1. Properly fund secondary care in hospitals so they have enough resources to do their jobs. As an example; I ended up as an inpatient for 3 nights, all of which were completely unnecessary, as they were too busy to review a test. More urgent cases came in before me and they were Not confident to send me home without results. But if they had sufficient resources to review that test, I would have freed up 3 bed days on an acute ward and saved the system hundreds, plus left the capacity open for someone who needed it. This kind of thing is happening everywhere. 10 years of cuts have begun to reduce efficiency in some areas, not improve it.

The NHS is feeling the strain now because we are picking up everyone else’s mess, so to speak. Social care has been decimated, so more and more people are relying on the NHS for support instead. Everyone benefits from properly funded services. And the whole thing is more efficient and cheaper overall as a result. We just need to accept that the government fronts up this cash and we should be looking to recoup it from business and tax, rather than the poorest in society.

Oh and I totally agree with hierarchical waste.

Without being specific money is spent on things like hiring hotel rooms for Board meetings and the accordant hospitality involved including free catered lunches

Also bollocks awareness raising initiatives and the requisite displays and paper and associated teaching your grandma to suck eggs type seminars

I agree with TheOneWith & “18changeasgoodas”. The NHS needs huge reform, throwing money at it won’t help.

Procurement needs to be sorted.

Stop plugging the social care gap with hospitals, perhaps for that a wealth tax. We can’t keep laying the burden on a ever shrinking tax paying population.

Massive cuts to bureaucracy. The NHS is obsessed with writing letters. GP to consultant. GP to patient. Hospital to patient. Consultant to patient. Etc etc. It’s all a completely unnecessary waste of vast amounts of time and money. It must be possible to save millions by ending this nonsense and using modern communication methods.

Government (not NHS) subsidised tuition for HCPs to encourage more people to train.

Annual wage increase in line with inflation to retain workforce, but cap on upper management salaries above a set threshold

Charge for missed appts.

No free IVF (sorry), or cosmetic surgery unless in exceptional cases like burns victims etc.

Focus on recruitment instead of chucking money at locum staff.

Opt-in PAYE NHS subsidy to salaries- I’d happily lose an extra £10 a month if it went straight to the NHS. But must be voluntary.

No outsourcing healthcare to private companies like Virgin.

Means test prescriptions for children & elderly.

And never, ever vote Tory (I’m already doing that one).

In Scotland I'd like to see the option to pay for certain things like private rooms and to pay for your prescriptions (they're currently free for everyone). I'd happily pay for certain treatments etc if it meant a better service and in turn more money pumped into the system so those that can't afford to pay benefit also.

There has to be a change in the training/hiring process.
I can name a handful of people (which I appreciate is a small number in the grand scheme of things) that would make amazing nurses, people that are already caring for someone sick in some capacity, but 6 years training means they're unlikely to do it despite wanting too.

Lol at getting surgeons to all use the same standardised equipment... that'll never happen!

I think the biggest problem by far is staff morale and retention. A unappreciated work force is not going to work to the best of its ability.

Stop using and pushing the staff to the very edge of their ability and integrity with chronic understaffing and lack of facilities/ equipment.

Reduce the working day from 12-13 hrs back down to 8.5 as it used to be. Then I bet sickness would reduce dramatically. Offer more flexible working, become more family friendly.

Increase pay, make it worth being employed rather than working on the agency. Why should others get paid significantly more for doing the same job for less responsibility?

Look after the staff and they will reap the rewards.

@user139328237 while I agree certain things shouldn't be on prescription some people do need a paracetamol prescription if they have a chronic condition as you can only buy a small amount yourself.

Not sure why Scottish people should pay double for prescriptions but I would happily pay for my prescriptions.

I would review all systems (but using common sense) and cut out as much waste as I could. So

No multiple letters sent arranging, the cancelling, then re booking the same appointment. Letters generated and then posted on the same day.

Stream line clinics as far as possible. So if it's known that certain tests will be needed eg bloods or x rays consider giving patients these before the clinic so that all results are there at the consultation, rather than making a follow up appointment to review tests ordered at first appointment.

When starting a new drug arrange for pharmacist to only dispense one week's worth of medication at a time until they know that patient will continue. I've had so much dispensed only for it to be discontinued and then the surplus was destroyed because it had left the pharmacy.

Inform patients by letter and phone call of appointments made in their absence. On occasion I've had a letter arrive after the appointment date.

Talk to patients about where efficiencies can be made. We are the "mystery shoppers". We get the true experience. The vast majority of staff are just working so hard but the systems are letting them down.

kaytee87

Could the GP not issue a permission slip to let a patient buy a larger quantity of paracetamol? My prescription is sent electronically to the pharmacy so I don't see why a request for paracetamol couldn't be sent via this system but that I then buy as normal?

First aid to be compulsory in schools
Basics - water on burns, how to stop bleeding, what to do in an emergency, how to ring 999 and when appropriate, how to do CPR, what to do if someone has drunk too much

I did a decade as a 999 dispatcher and in all those years not one, yes you read that right, not one person had thought to put ANY child that had burns near water
People with blood spurting out, just letting it carry on rather than clamping a hand or towel on it

In addition:
End term time working for the vast majority of staff.
Ban agency staff working in NHS hospitals to stop the absurd situation that people leave to make more money in less hours.
Free nursing courses on the condition of 20 years full time work in the NHS.
Charge airlines for any non UK resident that ends up in hospital within a week of arriving in the country.

End IVF, Bariatric surgery.

Why? Evidence shows there’s less than a 3 year payback period for type 2 diabetics, for example.

I had a letter sent to me saying I’d missed the appointment - next day I got the letter telling me I had an appointment posted after the 1st letter saying I’d missed it I’d not be happy to be charged for that!

Surely in this day and age a better way of communication should be found??

I have worked in the nhs for the last 11 years. The only solution I can see is if we get rid all together and make people pay privately.
This seems to be the only way to stop

•people missing appointments when waiting lists are long
•drug addicts being admitted to hospital for abuse of resources and medication and often then abusing staff
•people booking GP appointments (valuable resources for coughs/colds/urinary tract infections/ minor ailments when they can visit pharmacies.
•people wasting nhs prescriptions demanding nit lotions, and over the counter medication that charges the nhs £8 but can be bought in home and bargains for 19p
•people inappropriately clogging up A&E
•people attending walk in centres for coughs and colds that can be treated in pharmacies

I also think of it went private people would start to be more responsible about their health.
It's funny how people always make sure they have money set aside for fags. Priorities would have to change a little bit if that £20 a week had to go towards private health insurance and if it was more expensive if you were irresponsible with your health.

I disagree with charging people as where do you draw the line? Perhaps better education or a 3 strikes rule for repeat offenders.

people wasting nhs prescriptions demanding nit lotions, and over the counter medication that charges the nhs £8 but can be bought in home and bargains for 19p

The issue is though how come Sainsbury’s can source & sell it for 19p but the NHS can’t?

If you have a medical exemption card for prescriptions you should only be able to use it for the condition it is prescribed for and any associated conditions. When being triaged at A&E if you really don’t need to be there you should be told so and redirected to the more appropriate service.

Surely in this day and age a better way of communication should be found??

I live in a different EU country and I book my own appointments by phone, at a pharmacy or online and I can check them online. Sending letters seems a rather inefficient way to operate.