To think the NHS is in meltdown?

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Just had a horrendous experience. Had an accident at home in the evening - lots of blood (head wound). Went to my local A&E as there are no alternatives (no minor injuries walk in clinic or similar). Was told it would be 5 hour wait. Waited for nearly 6 hours only to be told it would be another few hours wait. About 30 people waiting and only two doctors on duty. Central London so very busy. The people doing the triage were referred to as nurses but I don’t think they were - the woman who saw me said she wasn’t qualified to provide an opinion on the severity of it or to put a dressing on. I had to leave without being attended to as I was close to fainting and the environment was terrible - not enough seats, drunk people lying on the floor, etc.

Plainspeaking

No, my personal experience has been similar to yours. The quality of acute and critical care has been, from my observation, exemplary.

However

• routine care is not timely. DH frequently has his hospital appointments and procedures etc. delayed and cancelled. (The quality of care is always great, when he gets there)

• the oveall picture is worsening. Or am I hallucinating the bed state emails most acute Trust staff see most days?

Our A&E in Liverpool is fine OP. You're treated in order of priority. The drunks and similar get left waiting because they are not priorities. So you have to sit with them. That is not the NHS, that is idiots going out and getting drunk and going to a&e for a twisted ankle. You weren't dying, you didn't have concussion and you had a cut to your scalp - the scalp bleeds profusely, but not for long. First aid 101, right there.

There were probably people with stab injuries and heart attacks being brought in by ambulance. Unless your scalp was hanging off you were, imo BU to expect anything more.

Maybe complain to PALS about the lack of local urgent care or out of hours... Did you even call 101 before going?

starzig I completely agree, but you can’t have a ‘proper’ 24/7 A&E without a ‘proper’ full hospital backing it up, and this is where the stalemate is. A proper A&E needs ITU, Paeds, O&G, acute medicine, surgery, T&O behind otherwise where do you send the patients on to? There are a few private A&Es in central London, but really they aren’t much more than a Minor injuries unit with drs and a CT scanner, and often they won’t see children. The private system in the UK isn’t set up for people who are acutely I’ll, it’s set up for well patients who need elective surgery. A step in the right direction would be to have private A&Es sitting beside NHS ones selectively located in affluent areas of the country so you have a choice to wait 5 hours or pay and wait 15 minutes, the same with scans- they private option available at your convenience should be offered as standard. But all the liberals go up in arms at that suggestion because it creates a 2 tier system, yes it does, but in the 2 tier system those who pay get seen super fast and those who can’t afford to pay get to wait, but their wait time is 10% shorter because a % of the waiters have chosen to pay, so everyone overall gets a better deal. But the NHS and private system are so separate that getting anything linked up in between is impossible.

Totally agree re the private hospitals in UK - the majority don't have an A&E department so any emergencies you have you still have to attend an NHS hospital in the first instance. Then when you are there you can ask to be referred to a private hospital - but in my experience the staff then get very sniffy as if you are suggesting their care isn't good enough rather than realising that a referral to a private hospital frees up a bed for someone else.

Overseas, where we lived for many years, the private hospitals have 24 hour A&E departments with a full hospital to back them up. So much more sensible and if private hospitals in UK worked in a similar fashion it could to a small part help alleviate some of the issues with the NHS.

A&E is often clogged up with people who should not be there - lots if posts on here asking if should go there with non-energency conditions and nearly always told to go. This means that people like you who are an A&E patient have to wait so long.

It would be a lot worse had we had a bad winter.

I'm a strong supporter of the NHS and think the staff do an amazing job in difficult circumstances. But I agree it's in meltdown and it's gone too far now to know what to do.

I was at A&E myself 4 Saturdays ago. I'd slipped down the top two stairs at home, rolled over on my ankle and heard a crack. Walk in centre closes at 8pm. Called 111 and was told a doctor would call me back in an hour. More than an hour later I'm still lying there in agony. Luckily dh had some crutches, I was fairly sure it was broken, and I managed to get a taxi to the hospital (there was no way I was going to call 999 for an ambulance). Dh couldn't take me as we have two young children and nobody was free to come and look after them.

Waited 5 hours at A&E and it was an eye opener. Drunks, people who had been in fights, another couple of people with clear mental health issues becoming aggressive - an endless stream of people accompanied by police officers. I'd broken my fibula above the ankle and the care, when I received it, was first rate and the staff were amazing.

Returned to the fracture clinic more than week later and was promptly sent to the ambulatory care unit for a suspected DVT (later confirmed) a couple of days later.

I think they do a marvellous job of treating everyone, regardless of background, in increasingly difficult circumstances. But I've found that if you're treated by different departments, they're over-reliant on patients keeping each department updated as the systems don't seem to speak to one another.

So far I've written off two whole days at the Ambulatory Care Unit, waited for hours and hours for xrays, ultrasounds, blood tests and results. The care, when it happens, is first rate. The communication is horrendous. I've been left wondering how an elderly person with no family support or other vulnerable people such as those with alzheimer's manage when the communication regarding care plans is non existent between different units and patients are left chasing appointments, care plans and medication. But I can't lose sight of the specialist care I received from the people who potentially saved my life by diagnosing the DVT and responded with compassion and sympathy when I broke down in tears with worry and frustration.

Underfunded. Understaffed.

EU staff leaving - 2 polish consultants I know left last year, for instance.

Nurses no longer get bursaries for training - so less applicants etc.

Pretty awful now.

Last time I was in A&E I was triaged and on a trolley in Majors within half an hour of arriving. Yes I waited about 6 hours for the surgeons to come down but they’d have been busy in theatre and on the wards. I was admitted, CT scan requested the next morning and done that afternoon, and emergency surgery done the following day.

Yes I’ve had some not so good experiences in A&E, waiting six hours in January to be told I was constipated, which is clinically not possible (it was a sub acute small bowel obstruction) but that’s because I have a complex surgical history and sometimes you get a Dr that just doesn’t want to accept that the patient knows more than they do about their condition.

I’ve got lots of surgical trainee/consultant friends and I couldn’t do their job at all. One of them is currently doing a six month rotation in a hospital that’s a good 2 hours drive from home, it’s not overly far miles wise but the motorway traffic is just horrendous. It’s fine if you chose a job that’s two hours from home, but when one minute you’re a few stops on the train, and then the next you are told you’re going two hours away it’s a completely different thing. Or getting stuck in theatre on a case that over runs and getting home 3 hours late.

Hi - I have just come back to this thread (OP here).

Obviously none of this is the fault of the NHS staff. And I know that if I had been heaving a hart attack, etc I would have been seen straight away. But that’s not the point - the point is that I did have an injury that should be looked at be a doctor or nurse. And here we are, living in a first world country, where it’s not possible to do that. I am ok - slept for a few hours with a towel on my pillow and the bleeding has stopped.

Glad you seem to be recovering, OP.
I agree that the NHS is on its knees.

I dont think it's in meltdown, I just dont think it's that good. Underfunded and poorly managed.

The NHS went into red when the Tories came into power. Yet people keep voting them in.

This.

I pointed this out to my Tory-voting SIL when she was complaining about having to wait 90 mins in A&E with her 10yo DS (who only had a sprained ankle anyway). She was adamant that this was NOT what she voted for. She also didn't vote for welfare reform, aka benefit cuts, or slashing local government spending, apparently.

She's 50, ffs, she was voting when Thatcher was last elected, and she still doesn't get it. She's not thick, either.

We can have free-at-the-point-of-use healthcare and put up with it being creaky and overstretched.

Or we can have insurance-based healthcare and (I hope) mitigate the damage for the poorest.

I choose the first. But I recognise that the NHS has always been like that and no amount of promises and slogans will change things. As pps have said, it will only get worse because the range and cost of what’s expected will rise and rise.

By 2020.. that’s one year away there will be a shortfall in nurses by 70,000 across the uk.
This is going to get even worse.

I had grave doubts when they did away with the old training model for nurses and made it a degree-only profession. Then tuition fees and loans and the abolition of bursaries was the last straw. They struggle to take on p/t work because of their shift patterns, so end up worse off than someone doing media studies.

Why would anyone go massively into debt to end up doing such a shitty, stressful job?

My friend's daughter is doing midwifery. They are in the fortunate position of being able to help her financially, and reckon that it will cost them £64k. They even had to get her through her driving test and get her a car, because she's in a geographically large trust with several maternity units, and she wouldn't be able to get to many of them otherwise.

I wonder just how many future health professionals are being funded by family in this way? And I'm delighted that some families are able to do this, or things would be even worse.

That's what you get when you vote for a Tory government but for some reason people just keep voting them in.

I had grave doubts when they did away with the old training model for nurses and made it a degree-only profession

Research shows that wards with good staffing of degree educated nurses favours patient outcomes and decreases mortality. Is this really a problem for you?! Why would you not want highly educated professionals looking after you if you have the misfortune to be ill and in hospital?? Absolutely mind boggling. Please do share your ‘grave doubts’, I would love to hear them 😊😊

Nursing is a much more technical profession - think itu. That's why they need degrees.

Nursing can be technical but it's also about basic care. The unglamorous stuff that involves cleaning up puke, and dealing with bodily waste and keeping people fed and hydrated and comfortable. And it does seem that that basic willingness to nurse is often lacking in many nurses today.

Students are also now like paying customers I’ve had students tell me that as they are paying tuition fees they will not be cleaning up an incontinent patient, touching vomit or doing scheduled shifts they want to choose.
It’s in a sorry state

All other HCP such as physios, OTs, speech therapists, radiographers have had degrees for years. Nobody bats an eyelid.

Most countries have university education and degrees for nurses these days.

Students are also now like paying customers I’ve had students tell me that as they are paying tuition fees they will not be cleaning up an incontinent patient, touching vomit or doing scheduled shifts they want to choose.
It’s in a sorry state

This is very true. Basic nursing care seems to have escaped some students, they see it as beneath them, and some of them need to leave the attitude at home. Anyway all that will be left to the NAs now that training is changing. The new students will be able to cannulate but will they be able to make a bed?

It's not about not having a degree - or at least I dont think it is - but you need a course that encompasses and includes the routine yet vital caring stuff. Saying "I dont do vomit/incontinence/helping elderly ladies eat their dinner and still qualifying as a nurse shouldn't be an option.

Saying "I dont do vomit/incontinence/helping elderly ladies eat their dinner and still qualifying as a nurse shouldn't be an option.

As a mentor I just wouldn’t tolerate that. You either do that and realise that nursing is about all patient care, or you can go home.

Very true about students. I asked oneto make a trolley up for me (while I went to get the patient from the waiting room). She said to me “the linen cupboard is over there”. This isn’t about pulling rank (I’m a consultant), it’s about working as a team. I make up trolleys every single shift (no I don’t think it’s a good use of my time or expertise but if I was to wait until the trolleys were made up I’d probably never see any patients). This particular student clearly thought making up a trolley was beneath her.........but it was ok to make the consultant do it .