To be really worried about the NHS this winter

[AtlasPine]

Just that really. Lots of issues around GP access, backlogs of people waiting for treatments and overstretched A&E departments. Flu season coming, Covid cases rising, staffing problems linked to Brexit and the rise of private practices offering better terms and conditions to doctors.

What can we do to support the NHS?

Vaccinations (flu and Covid) and look after ourselves as much as possible I suppose. I can’t afford private health care like most here I suspect.

@justasking111 I didnt realise that.

We dont want a Canadian or American system - who would - but that’s what we’ll get if the only alternative put forward by Labour is the current failure. The current CAMHS waiting list here is 2 years! 2 years!!!! I am so angry about the ridiculous omnishambles that we are presented with and told that we are ‘lucky’!. Won’t someone please - please - put the NHS down and suggest something more sustainable!

@Nat6999 Im so sorry That is horrendous.

@goldenlilliesdaffodillies @Cheerychirpy im sure @katesbushh will be along soon to point out that you both hate the NHS

Because im damn sure she isnt just picking on me. Right?????

Sorry not sure what you mean MercyBooth. I don't hate the NHS (otherwise wouldn't be training to do the job I am doing). I just think it needs better management and more joined up thinking.

I hate the NHS. I hate the way we are supposed to be grateful for something that we pay a lot for and just does not work.

@goldenlilliesdaffodillies Im not saying that you do. But there are a lot of people who will assume that as a default setting if you dare to point out its shortcomings.

I hate the NHS. I hate the way we are supposed to be grateful for something that we pay a lot for and just does not work

So what do you suggest instead ? How much will it cost and who will bear the cost ? the individual, the state or the employer ? or a combination of the three ? How will the private sector manage if they suddenly have to take on a lot more patients ? Most private hospitals do not have ICU capability, so where will high risk patients have surgery ? How will the sector cope with bed blocking ?

Honestly you might hate it and there are certainly parts of it that don't work well for the myriad of reasons that have been mentioned on this thread, including lack of beds and staff and the lack of social care funding, would it not just be cheaper to improve it rather than completely dismantle it ?

I suspect some hospitals like schools will become academies the USA is interested in this they've employed time and motion companies to study some hospitals seeing where they can improve the system. Reduce waste, administration. And other overheads

Time and motion studies may have their use in areas of planned care, where you can predict the bed occupancy, so you know who is going to be using a bed and when and how long for, which is why private hospitals manage to appear more efficient. Ultimately they choose who they treat and when they treat them. The when is important because surgeons may also have NHS list's.
A large part of the NHS is unplanned care, and whilst you can look at previous trends to try and plan for what is going to happen, there are limited resources ( beds ) and so unplanned care can negatively impact planned care. Patients may need to be 'boarded' into planned care beds when there is too much pressure on the unplanned beds, the knock on effect being operations are cancelled/delayed.
The lack of availabe resources in the community mean that some patients in unplanned care beds and those boarded into planned care beds become stuck there because there is no-where safe to discharge them to.

chpi.org.uk/blog/private-hospitals-have-no-doctors/

This is an interesting and quick read.

We are fucked basically. Winter pressures started in august. 50 hour wait on beds in a&e for a ward. Unable to discharge due to no care in the community.
Maternity at our trust isn't coming back as risk assessment showed it's unsafe.
We are running on less staff and getting more grief and abuse off the public.
I had a man shout at me because I wouldn't let him into a&e through the staff door to by pass the wait!
Due to me not opening the door , if the man he was with died it would be my fault.

We are tired, moral has never been so low but people still arrive at a&e with a splinter and then shout they have to wait 6 hours plus to be seen.
No you don't get seen quicker because you have had a lift in a ambulance, that heart attack beats your cut finger believe it or not.
From reading some threads on Mumsnet recently about should I go to a&e for this no wonder the nhs is on its knees.
There is 111, there is your practice nurse, GP associate, chemist .
Please utilise these services before you come to a&e.
Yes the nhs is run badly. Please don't say to many managers .
It was the managers who implemented so many over night changes in hospital trusts nation wide that kept hospitals safe and running during the pandemic
It was managers who with hours notice set up COVID wards, reallocated staff, they actually kept the hospitals working , sourced ppe, implemented changes that many didn't agree with but in the long run worked, many my not agree with me on this.

What is this obsession with putting forward the US system as the only alternative to the (completely unfit for purpose) NHS?

There are other models with proven better outcomes to look at it the world….look at the co-pay system in France, or the means tested system in Australia.

And 😂😂😂😂 to everyone bleating on about what a great system the NHS is…. Have you ever experienced health care in other countries? The U.K. has not ranked best in the world for healthcare, on any measure, for years (and that was pre covid). Norway, The Netherlands and Australia all provide far greater outcomes than the U.K, while spending a similar % of their GDP on healthcare.

www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly#rank

Just a personal anecdote. Recently waits of over 40 hours reported in NI A&E departments partly due to lack of hospital beds to move people to. My brother was admitted via A&E a few weeks ago. On the night he was admitted he was told he was scheduled for surgery next day. Next day he was told that they were going to "watch and wait" instead. Now, a sensible approach would have been to discharge him, and if his condition worsened to tell him to come back in. What they did was keep him in a hospital bed for 4 days, watching and waiting and eventually discharging him with no surgery. Seemed to be the norm in that hospital- keep people in hospital while we see how they get on. What waste of resources at time when people are waiting hours in the back of ambulances to be seen.

The other thing that niggles me about doing away with the NHS, is losing the NHS's buying power when it comes to medication.

lowdownnhs.info/drugs/billions-are-spent-by-the-nhs-on-drugs-every-year-but-how-does-it-work/

On the night he was admitted he was told he was scheduled for surgery next day. Next day he was told that they were going to "watch and wait" instead. Now, a sensible approach would have been to discharge him, and if his condition worsened to tell him to come back in.

A similar thing happened with DH, who also fortunately didn't need surgery, the surgery would have almost certainly required a stoma formation so he was mightly relieved. Part of that watching and waiting included regular observations and IV antibiotics. So he was getting treatment during that time, just no surgery.

[quote Shizen]What is this obsession with putting forward the US system as the only alternative to the (completely unfit for purpose) NHS?

There are other models with proven better outcomes to look at it the world….look at the co-pay system in France, or the means tested system in Australia.

And 😂😂😂😂 to everyone bleating on about what a great system the NHS is…. Have you ever experienced health care in other countries? The U.K. has not ranked best in the world for healthcare, on any measure, for years (and that was pre covid). Norway, The Netherlands and Australia all provide far greater outcomes than the U.K, while spending a similar % of their GDP on healthcare.

www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly#rank[/quote]
We pay way less per person for healthcare. From a quarter to half as less. That our outcomes are so good on so less money is testament to the efficiency. Instead people want another layer of bureaucracy to sell and manage insurance policies and co pays which makes healthcare more expensive. And it will still be rationed, it will just be your insurance company refusing to accept your claim now or setting enormous co pays because of your age pr pre existing conditions.

[quote frumpety]The other thing that niggles me about doing away with the NHS, is losing the NHS's buying power when it comes to medication.

lowdownnhs.info/drugs/billions-are-spent-by-the-nhs-on-drugs-every-year-but-how-does-it-work/[/quote]
Yes everything will cost more. Singapore who have been quoted here set wage levels for staff and bulk buy medicines and supplies, just like the NHS.

@julieca We pay way less per person for healthcare. From a quarter to half as less

What data are you using to support those claims? And we pay less per person for healthcare, as compared to who?

I thought the NHS was amazing until I went to Singapore, my DD was around 2 at the time and became sick with severe D&V and was very dehydrated. MIL who is a Singaporean citizen took her to a children's hospital, a pediatrician was waiting for DD and she was seen instantly no queues, was given tests and meds. It cost us 30 Singapore dollars which is £15. It would take hours and hours here !

People are living a lot longer with long term conditions, The NHS wasn't designed for this we need to have a conversation about its future. I haven't been able to get a GP appointment after I had surgery for blood tests or refill of medication I have had to pay privately.

Whatever figures are quoted they need to take into account Covid, health expenditure went up for most countries during this time in response to the pandemic, so will skew the figures for 'normal' health expenditure.

[quote Shizen]**@julieca* We pay way less per person for healthcare. From a quarter to half as less*

What data are you using to support those claims? And we pay less per person for healthcare, as compared to who?[/quote]
We pay a quarter compared to Canada and about half compared to a lot of EU countries. Yet people compare the NHS to countries that pay way more for their healthcare. Someone has already posted links to these costs.

@julieca did you look at the link I posted? When compared to % of GDP, the difference in spend isn’t very big at all between the U.K. and other counties. It’s the same % as Norway & The Netherlands, who far out perform us on outcomes.

Don't become ill. If you do, don't expect any help.

This really. My DH had a serious head injury and we waited 6 1/2 hours in the street for an ambulance. It's made me realise that we cannot rely on the NHS anymore.

@Shizen it depends what healthcare spending you include. A lot of analysis leaves out co pays.