To think the NHS is just not working?

[Caketeaandwine]

My toddler has an ear infection. Repeatedly rang the doctor and couldn’t get through. Eventually got through and couldn’t get an appointment, rang 111, had to listen to a lot of messages about covid, eventually through to someone - who rang my GP and sorted a (telephone) appointment.

Isn’t it time we admitted it’s not working at all as a system?

@TwoPenguins
Are you an ED reg?

@Kanfuzed123z
I am not disputing your list of shortcomings, I have experienced some myself because of Covid. My life was changed by postponing what could have been a simple operation.
The involvement of these private subcontractors is part of an answer. They are better managed to make better use of the resources. My son nursed in one for a time. They saw more patients. The NHS bureaucracy is stifling, so many rules to do with admin.
This is not deliberate by any political party, only by internal forces that just want a quiet life.
Tony Blair put huge amounts of money in and they used it for clerical staff not front line.

My clinics are rammed, full for the next six weeks with smears, vaccinations, asthma reviews etc etc as they have been for months. So are the GP's. All seeing patients all the way through the pandemic, including COVID suspect patients in a hot hub. Still running that too. In fact, stats show more people are seen countrywide f2f in primary care than before the pandemic.
However we've had three members of staff with over 100 years experience between them leave over the last few months. So we're pushed, struggling to recruit.
The wait to be seen is weeks. Not helped by several patients every single day booking appointments and not turning up.
Some areas are better than others. Frustrating all round.

@bitchesgonnabitch

The obvious solution is to re-nationalise primary care and bring GPs back into the proper NHS under the same terms and conditions as every other NHS department and service, who don't get to pick and choose who they see, when they open, what they are paid, their specific working hours. That doesn't mean I think GPs are overpaid or don't work enough, just that operating under their own individual terms and conditions differently to the rest of the NHS is not working out for the patient, for A&E, or for the rest of the NHS.

This is pretty much what is being planned in the next 10 years. However, there is a flaw in this plan, and it’s similar to what happened with out-of-hours care.

When I started as a GP, we all did our own out-of-hours care, so we worked days, nights and weekends. The government thought we were being paid too much for it, and reckoned they could get it cheaper with paramedics, nurses etc, so GPs were given the option of opting out of out-of-hours care (for a fee), which they all did. It’s been chaos ever since. When I started, if you got unwell on a Saturday night, one of your regular doctors would come and visit you - imagine that! But no, the government weren’t happy.

Anyway, I think this will be similar. GPs will become NHS employees like hospital doctors, doing shifts with a defined start and end time. And when we start clocking off (we’ll not me, I’ll be retired by then) at the end of our shift, they’re going to realise just how much extra work GPs have done all along. They’re going to get the shock of their lives.

[quote goodforyounoonecares]@TwoPenguins
Are you an ED reg?[/quote]
Close. Paeds ED.

It’s absolutely terrible. There is no quick fix solution. Training more staff yes but they have to work alongside someone to learn. We don’t have the time to teach them everything they need to know. The knowledge required by a new trainee is immense. Far more expectations is placed on them and the workload enormous with huge responsibility. People also need to take responsibility for their health and their choices where able. Most of us do actually want to do better. Today for example I saw a patient, they don’t like taking their medication but without it end up unwell. So unwell sometimes that they need to be seen first and as a priority. A referral then needs to be made to several different services, tests requested and then reviewed. This can take up hours and it’s one patient. One patient taking up multiple members of staff. I don’t blame them or judge them. I empathise as being unwell and being in hospital stops them being lonely.
Carers are amazing, they should be recognised as a profession and also be vocational course. They work so so hard. Please don’t bash the NHS anymore. One kind word may stop someone who loves their job from resigning.

You can’t get an appointment for love nor money at my surgery. Call at 8am for a same day appointment but they don’t have a queuing system you just gave to redial until the phone is answered, nor do they do e-consult.

When I first registered at the practice there were 4 full time GPs and 2 part time. Now there are only 2 full time and there’s been around 300 new homes built in the area adding goodness knows how many extra patients.

It's been like it for a long time. There are lots of things that don't work, it's not just the GP system (and it's not the fault of the individual practioners)
My elderly uncle missed a heart appointment because the letter arrived the day of the appointment, and he didn't have time to arrange transport to get there. I know this is not uncommon that a letter arrives the same day or after the appointment.

My dad was very unwell in 2015 and needed a lot of hospital care and after care. The communication between NHS and social care, and between different branches of the NHS is awful or sometimes non existent. Several times we were told he was going to be discharged only for someone else to intervene and say he couldn't be discharged yet.

My GP surgery has been very good and much easier than normal to get an appointment since covid though.

I picked up my DH yesterday from a short stay in hospital. 5.30pm on a Monday. There must have been 20 ambulances waiting outside each with a patient.
My husband was admitted on Friday at 6pm following a stroke. He was blue lighted down there. From the start of the stroke to receiving treatment that means he has a very good chance of full recovery was under 4 hours. Blood tests, two CT scans and commencing treatment just 4hours.
A true emergency is prioritised.
Going forward we need far more screening and prevention.
DH should have had screening over the pandemic but all clinics were cancelled. GPs were unable to weed out those whose strokes and heart attacks could have been prevented. DH has essential hypertension which was asymptomatic. He did have some episodes over the last few weeks that suggested TIAs but we’re so short lived they would only have merited a phone consultation.
The NHS is not failing people when they have a true emergency. Or if they need treatment for cancer. It’s failing the people who are still outwardly healthy who could receive treatment in time to give a different outcome.
A number of my close family have had diagnosis of a serious health problem over Covid, myself included. Treatment has been fantastic, quick and for most of us a good outcome.

@FangsForTheMemory

Are you shilling for Boris Johnson, op? IT sounds like it. The NHS is fit for purpose, but it has suffered from long-term underfunding. Blame the government, not the NHS.

Totally agree with this. I know there can be some issues with management sometimes, but you get that in all large organisations. There is not enough staff or funding for new staff. People don't want to work in healthcare because staff are underpaid and the conditions are stressful, like a lot of other public services.

Gold plated pensions though. Much better than elsewhere and early retirement. Huge benefits others don’t get.

We've just had to pay 10k for DH to have surgery privately as his injury is so serious unable to work and it was going to be around a year wait on the NHS.

just have access to the same IT systems so that brief notes can be added and viewed by all

This has been tried several times. It has failed several times, wasting billions of pouinds in the process. And if, miraculously, someone managed to find a way to standardise IT provision across all hospital trusts, all community trusts, all integrated care systems, all primary care practices, all pharmacies, etc., people would find out their medical details were being sold to private health insurance companies and half would ask for all their data to be removed, so it still wouldn't work. It doesn't matter how much money is put up to support IT developments, soemone, somewhere (usually Michael Gove) will demand that private investors are allowed to make money out of it, preferably without actually having to invest anything.

People are also forgetting that Brexit isn't complete yet. There is no possibility whatsoever - absolutely zero - that the UK will be able to negotiate a trade agreement with the USA unless American healthcare corporations are allowed unrestricted access to the market (i.e. NHS providers would have to bid against massive American corporations to be allowed to provide services, which would entail spending hundreds of millions of pounds on preparing and promoting bids to try to compete with corporations with much more experience and financial muscle). Under clause 4 of the Trade Act 2021, parliamentary approval is not required for international trade agreements. These can be negotiated completely in secret by the government, placed before parliament for 21 days and then become law: there is nothing your MP or you can do to stop it. (Well, the country could stop voting for liars and crooks, but it won't.)

@BattenbergdowntheHatches

True *@TizerorFizz* and yet we constantly hear how underpaid they are. DH is a consultant so he’s on the old (better) pension but it’s still astonishingly generous. I’d love to know what better-paid jobs all these useless GP’s think they could stroll into. Law is often the one they refer to, seemingly not realizing that most warn about £50k, get a poor pension and the tiny number coining it it definitely are not working 3 days a week under any circumstances.

It’s tiresome to hear, especially as a patient who receives utterly shite NHS service.

I find it interesting how you refer to GPs as one entity. All useless, all underpaid, all greedy, often wanting to go into law (?!), lazy part-timers (inferred). Let’s hope the NHS burns to the ground and then we’ll see what the daily mail has to say.

I don’t read the Dally Mail but there’s a lot of hidden info about the NHS. As DM is currently on a ward I’m left wondering who needs a degree as well. It’s hardly intellectually demanding work.

@BattenbergdowntheHatches

True *@TizerorFizz* and yet we constantly hear how underpaid they are. DH is a consultant so he’s on the old (better) pension but it’s still astonishingly generous. I’d love to know what better-paid jobs all these useless GP’s think they could stroll into. Law is often the one they refer to, seemingly not realizing that most warn about £50k, get a poor pension and the tiny number coining it it definitely are not working 3 days a week under any circumstances.

It’s tiresome to hear, especially as a patient who receives utterly shite NHS service.

Per hour worked, you’d be surprised at what the salary is. It’s a lot less than you think. I’m part time - 3 days a week - which works out at about 45-50 hours per week if you include all the work I do on my days off. And I earn about £50-60k in a relatively high earning practice. I have over 30 years experience as a doctor, so I’m not just starting out.

@TizerorFizz

I don’t read the Dally Mail but there’s a lot of hidden info about the NHS. As DM is currently on a ward I’m left wondering who needs a degree as well. It’s hardly intellectually demanding work.

Why don’t you train as a doctor then, if it’s “hardly intellectually demanding”?

Who sees a doctor? I meant the nurses attached to the computers.

Until 2 months ago I would have been one of those saying my GP surgery is the exception.

However a few things have changed my mind and today has convinced me that the system is broken.

My child came home yesterday saying he was hearing voices in his head. Rang the GP this morning and was given a telephone appointment. GP rang back and said he was printing off forms for blood tests which I had to pick up and take to the hospital. He also said referral to CAHMS was 18 weeks and that to get a more urgent referral hich was needed I should go to a and e.

So I collected the forms (just to forms for tests, no covering letter, where to go etc) and got my son from school.

I drove to the hospital to be told there is no walk in system for children's blood tests anymore!! There hasn't been for 2 years. It's appointment only. The next available appointment was 2 weeks away. They suggested as we were going to a and e anyway to ask them to do the blood tests.

4 hours waiting in a and e to be told they couldn't do the blood tests and that they couldn't do an urgent CAHMS referral as the voices in his head had stopped.

He now has blood tests in 2 weeks and an 18 week wait for CAHMS.

I am beyond furious.

Just to confirm I am not angry with anyone at the hospital. They were all wonderful but their hands were tied by stupid red tape. I am really fucked off with the GP who had either forgotten that there's no walk in service for blood tests or just didn't communicate to me how the process worked. If you're told to pick up forms for blood tests and take them to the hospital would you question it?

@TizerorFizz

Who sees a doctor? I meant the nurses attached to the computers.

Right...What do you think all the nurses are doing on the computers?

@Sarahcoggles
So pro rata it’s £100,000 a year. Lots of people would be working really long hours for that too. If you are self employed it’s easy to rack up hours. So are you saying full time GPs work 90-100 hours a week.

30 years working doesn’t make you 65 does it. Maybe work full time? Might help patients and reduce waiting times. My DH is self employed and a business owner he has now worked for 47 years. I don’t think medics realise how long and hard other people work.