To think sometimes we need to question NHS efficiency more?

[DayCareCase]

I support the NHS, I’m up for funding it properly even if this affects taxation. I get lots of contracts etc create issues and the NHS has a tough job.

But...

Sometimes it seems there’s a culture of ‘it’s not us, it’s the cut’ that behaviour can be inefficient, service is no just wrong, but simple things could be easily done to make things better. Either at no cost, or even reducing waste. For example our local hospital only sees children for blood tests in the busiest day when all the clinics run. They could change the time, sometimes you wait 2.5 hours with a 3 yr old, when at 3:30 you can be seen in ten min. Or they could run a kids queue, most no cost options.

Today I’m having surgery. The same. Everyone turns up at 7. Even if you’re due in at 4pm. The first load are allocated a cubicle but about half the people sit in the discharge lounge all morning. I cannot see how this is efficient or benefits anyone. Why not give appt times? (Knowing people may still have to wait) or even just the lot you’ve already got marked down as those without a bed until the first case are seen to come in later. No water 6am-4pm is hard!! Surely it makes later finding vines hard, more anxious patients to deal with and a generally more stressful environment?

I’m also sitting next to where the consultant sees male patients. I’m 6 foot from a guy having to discuss his testicles. Makes the whole male/ female division pointless. Moving the desk a bit, closing the door would be cost free.

Small examples, but every time I go there seems to be no real effort to improve. Some individuals work hard. The lower levels of staff are obviously working hard in a crap environment and ready for abuse. So I guess management? Consultants? There needs to be some focus.

Sometimes I think the culture of don’t question the NHS goes too far...

Agree with most things said.

Our A&E staff here are paid by an Agency. At a higher hourly rate cost. Seems silly.

It's not the clerical staff that need cutting, but the higher executive staff that run the NHS trusts, there are over 600 executive staff earning over £100k a year, the highest paid earning nearly £200k, these are the roles that need slimming down, it's scandalous that nurses & junior doctors who in the main are the ones who work on the front line are paid a tiny fraction of this. It's time that trusts are encouraged to buy supplies & equipment from the cheapest source, not tied to only using contracted suppliers, a patient isn't going to complain about medical staff using latex glovesthat cost £3 a box instead of £8 through a contracted supplier but the savings throughout a hospital by small savings will soon mount up. Bed blocking can only be prevented by housing providers working with hospitals to sort out housing problems as soon as possible, my ex husband was in hospital for 10 months, 8 of which he was fit to leave but due to his home not being suitable for him, it took the council being threatened by a solicitor that if they didn't start doing their job instead of arguing against giving him priority to get a home they would be taken to court for the council to award priority & adapt a property to make it suitable for him. On the rehabilitation unit he was in, nearly half of the patients were fit to leave hospital but had no suitable home to go to, they were stuck in hospital catching infections that spread round the unit like wildfire because there weren't enough single rooms to isolate anyone starting with an infection.

If you cut the Exec staff, who would do the work they do? Or do you just mean pay less? In which case, given the responsibility and crap they take on a daily basis, I doubt trusts would be able to recruit. The ones I've come into contact with are working 7 days a week, including evenings, and often during annual leave. They are run off their feet making important decisions. Just because they arent clinical, they still have an important function, and the salaries reflect the agreed NHS pay scales and the level of responsibility.

Doctors and nurses arent the only ones on the front line, what about radiographers, physios, ODPs, porters, receptionists, ward clerks etc ad infinitum? Each aspect of patient care is just as important as any other, whether that member of staff is visible to the public or not.

As for saving a fiver on a packet of gloves, they are procured nationally to save money, as are other commonly used items. I do however agree that bed blocking is a major issue, which is causing immense problems for the NHS.

Yes, stranded patients are an issue. That’s sometimes a lack of adult social care provision but equally is often vulture relatives refusing to accept a care home because they know there is a cost and it will affect their inheritance.
There should be an automatic move to care home, when agreed that it is necessary, and relatives can argue about which one after discharge.

Returning to paying student nurses and a more hospital based degree would increase workforce and improve the lot of student nurses thus increasing recruitment.

There are now associate physicians, nurse associates and matrons assistants to ease burden on clinical staff. Increasingly HCAs are taking on more responsibility and moving to grade 4 posts across many disciplines. There is a balance to be had to ensure the right people with the right qualifications are making the decisions about clinical care though.

It was in our local paper a couple of years ago that nursing staff in a ward of our local hospital had saved a whopping £50k p.a. by sourcing their own consumables for their ward - that was just things like gloves, paper towels, sick bowls, wipes, etc., not dressings or other medical items.