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?

GP surgery’s are nhs but privately run.

Some are better than others.
If it was all linked together it would be a lot smoother.

It depends on the area. When I call the GP I’m usually in a queue for an hour no matter what time I call. I can access Livi for free and haven’t tried that but next time I need to see a GP I will.

I had a sleep test for sleep apnea and have been waiting now six months for the results.

I appreciate that they are understaffed with a huge backlog so I haven’t called yet to ask when I might know the results.

Same with an investigation I have going on with cardiology / endocrinology.

I can only assume that I am not urgent or I’m sure I would’ve heard something by now.

With all the pressure and backlog they do have to priorities emergencies.

I did work for the NHS for seven years. I left about half a year before the pandemic because I was being asked to work longer hours and the strain was incredible. It was sad to see it get worse.

Don’t get me started on supply chain… what a rip off. The NHS is ripped off left right and centre for basic supplies. It wouldn’t been cheaper to have had a credit card and gone to b&m.

@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?

It's working a lot better than the alternative of privatisation. Stop agitating.

Underfunding and staff retention is a huge problem. This needs to be addressed. The government can't provide "sticking plaster" temporary funding and make promises to train more doctors/nurses, they need to look at longer term.
I have been treated for cancer in the last year. Filled out econsult one weekend, had a call from GP on the Monday morning, face to face on the Tuesday then seen at the hospital breast clinic the following Wednesday.
Like any big organisations there are things which could be improved to make things run more smoothly. I'm currently on blood thinners and am being changed over to tablets, my oncologist said she hoped there wouldn't be an issue with the GP prescribing them as there are issues around who should be funding them. This sort of thing is crazy. I have more examples.
Overall, I think it is fit for purpose but it needs adequate funding, staff who want to stay so improved working conditions and a thorough look at processes and systems-obviously this would be a lengthy and costly job! There are some excellent people working within the NHS and it is good but we need a government to take it seriously along with social care.

Sadly it's not been fit for purpose for a while..... I do think covid has made things worse and I have to say (shoot me, I'm ready for the back lash) that public expectations and not being prepared to help themselves has quite an impact on current issues. I'm a nurse that suffers health problems so I do understand how frustrating it is being on the other side..... but as a nurse please be assured we are doing the absolute best we can but we are not indispensable - we suffer health problems, financial problems, we leave our children to care for others, we pay to be registered to do our job......
I agree something has to change.... ever since I qualified as a nurse 13years ago and in my previous roles as hca and student nurse I have given so many hours to the nhs free of charge to help keep it going.... ultimately I do believe in it we will be worse off if we have to pay for care which with rising living costs we simply can't afford

I think there is a misconception about where all these vanishing doctors and nurses are going. Most of them are retiring, or leaving the profession early because they're not suited to the job. DH works for a private healthcare company that are really struggling to recruit because they can't compete with the NHS salaries or pension schemes and still keep treatment affordable. The government pension scheme completely blows all comparison out of the water.

What we actually need is better provision at university level - funded courses so we get the best suited candidates into medicine, rather than the ones whose parents can pay 6 years of fees and living costs. Better routes for medicine students to work clinical placements in other English speaking countries. I know plenty of people who were full A* students but ended up in other professions because they were turned down out of snobbery (not in the right after-school activities because of working part time), or their face didn't fit and there was too much competition for places.

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

This is what happens in the public hospital I work at in Australia. It’s a state wide system and if you log into a patient’s file you can see notations from all of their interactions with services across the same state. This incorporates allied health, community health including public psychiatry and medical services across a number of different hospitals. Any investigations done publicly are accessible and there’s access to pathology and radiology from the major private companies.

It has its annoying quirks but it’s efficient and helps to ensure investigations aren’t repeated and communication is clear.

It’s also good for alerts for patients with complicated medical conditions

It's very variable. My GP surgery is not without fault but I can always get through to someone and have been able to get same day appointments for DD on the few occasions she's needed them. On the whole they're very good. I also have nothing but good things to say about the neonatal and paediatric services at our main local hospital.

Unfortunately the other local hospital, which handles routine antenatal care, has been woeful in providing it. Really negligent.

@nolongersurprised

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

This is what happens in the public hospital I work at in Australia. It’s a state wide system and if you log into a patient’s file you can see notations from all of their interactions with services across the same state. This incorporates allied health, community health including public psychiatry and medical services across a number of different hospitals. Any investigations done publicly are accessible and there’s access to pathology and radiology from the major private companies.

It has its annoying quirks but it’s efficient and helps to ensure investigations aren’t repeated and communication is clear.

It’s also good for alerts for patients with complicated medical conditions

We mostly have this with system one… trouble in our area is that isn’t the platform the hospital use. It’s the platform the GP services and other NHS community service use though.

We mostly have this with system one… trouble in our area is that isn’t the platform the hospital use

Similarly, here it’s not the system the GPs use, so they’re reliant on good communication. Another issue is that complicated patients here often choose to use a hybrid public/private system (this is quite normal and not discouraged) so, for eg, someone may choose to see an endocrinologist privately because they want to see the same person every come and to choose their doctor. They may also see cardiology publicly but Dr x (private) and Dr y (public) won’t have automatic access to each other’s notes. Usually they’ll copy each other in to all correspondence and it’s usually not a problem.

@EatSleepRantRepeat
I don’t agree that it’s necessarily the wrong people going into medicine it’s that after a very long and expensive training there’s no requirement to work for the NHS for a few years. It’s a free global market.

The NHS staff always cite low pay. Nurses are better off than quite a few grads when you look at salaries after 5 years. Plus they ALL get grad jobs. They are doing what they trained to do. They are not waiting tables or making coffee. They still have the best pensions. We, tax payers, pay for generous sick leave and some pension contributions. We also make it easy to return to work and be part time. We even allow employees to have second jobs: as highly paid private consultants.

We, as a nation, have an over blown NHS. We dongle evaluate outcomes but keep praising it. It’s not necessarily under funded but probably need to look at priorities and how it spends money. It cannot do everything.

Having seen the elderly on wards my DM has been in, no one in their right mind would want to be kept alive with dementia. I would happily agree to being bumped off if I got it.

@Jansobieski No, they think that if a cost is involved in going to see the GP then people, other people obviously not they themselves, won't go so much and so they will find it easier to get in. Which is true - poorer people will avoid going and so their illnesses will be diagnosed later. Best case scenario this means some people will be incapacitated or in pain for longer, worst case they will die of things they could have survived if diagnosed earlier. Of course the people who are happy to pay for healthcare believe they will never be in this position because they are better people, more responsible, hard working, all the usual shit, so other people's lives is a price they are willing to pay.

Why iz survival at 90 plus necessary or even desirable?

It's working a lot better than the alternative of privatisation. Stop agitating.

Privatisation is not the only alternative to what we currently have but trying to shut down any conversation about how to improve things is what is going to end with privatisation as the only option because bu that point it will have been run so far into the ground it isn't salvageable.

The NHS as an organisation is great, but that doesn't mean there are not ways it can be improved and processes simplified to be more efficient and cost effective. Refusing to have these conversations about ways to improve the NHS doesn't mean that the NHS is suddenly going to become fit for purpose, its just going to allow it to become less and less fit for purpose.

A simple example - I was found to be dangerously anaemic and was immediately sent to hospital for multiple iron infusions. Once I had my last infusion the hospital said I needed to go back to the GP for ongoing treatment. When I phoned the GP I knew that I would need a blood test (so we knew what my new baseline level was and what the ongoing treatment needed to be) but the receptionist refused to book one without the GPs authorisation because the hospital hadn't asked for it on my discharge paperwork. There was no way for them to speak to the GP and book it in, I had to have an appointment but it wasn't "urgent" so I couldn't have a same day appointment and had to wait for the next available telephone call.

So instead I had to wait a week and a half for a telephone appointment, which lasted 2 minutes because I explained I needed ongoing iron treatment and the GP said "Before we can discuss your ongoing treatment plan we need to book a blood test so we can find out your current iron level. I'll put you through to reception and they can book a blood test and then another appointment with me for 2 weeks time" ... all of which I knew a week and half before. My entire treatment was delayed 3 weeks and I took up an unnecessary appointment slot all because the system was so backwards that the receptionist couldn't ask the GP to authorise a blood test for someone with a blood issue needing ongoing treatment.

Understaffed, overworked, the pandemic strain and more.

I wish people with the means to do so would go private, leaving the NHS for those of us who can't do so. That way, they'd be under less strain, shorter waiting lists, leading to better care.
I know actual rich people who won't go private and I truly don't understand.

The mental health system is failing too. Been in A&E multiple times, seen MH, got promises of the home treatment team paying a visit when actively suicidal and sent home because no beds and 'medically fine'. They just say 'go home, get some sleep, have a cuppa'. Then HTT never show up.

@TheMagpie the nearest private hospital to me has had a massive recruitment drive for the last two years.

Like the NHS there is simply not enough qualified staff as people are retiring, going overseas (often to back to their or spouses country of origin) or doing something else.

@TizerorFizz have you seen someone chased by HMRC? No?

Then don't talk about doctors refusing to pay extra tax on their pensions.

Due to how HMRC chases people there are now doctors who refuse to work more hours simply because they don't want the additional stress of HMRC chasing them when the tax on their pensions contributions is calculated incorrectly.

@RedWingBoots
For heavens sake! You have posted a very strange comment.

A pension pot is taxed at source when it goes over £1.1milion. It’s the excess over that sum that is taxed and obviously reduces the size of the pot. The doctors won’t have any option but to pay just like anyone else with a large pension pot. Before the pension payments are made, the pot is taxed. It is therefore reduced in size! You don’t receive the full value of it so lots of people don’t work and add into their pensions any further to avoid the tax. The tax is not calculated incorrectly. It’s the same for everyone. The government clearly states what is due and the pension scheme has no option but to pay it. It’s true that doctors reduce their working hours to avoid the tax and they might well only be in their early 50s. The whole tax regime for high earners and their pensions is counter-productive when there are shortages in the workforce.

@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?

Yabu. You've got a free appointment with a Gp for your toddler.

'Working for profit sharpens services' lol. Like profit based utility companies have been a huge success
And what happens if you are that patient who has a need for complex costly investigations or
medication ? And you are in your late 60s ? Surely 'sharpening services' means considering how profitable it is to treat someone who is economically not very productive.
And in my experience sharpening services just means cutting to the bone....

@TizerorFizz my comment isn't strange if you know people who have been chased by HMRC over their tax returns and have tried to get information out of the NHS Pension Scheme.

Also the energy market was (/is) poorly regulated. The vast majority of the utility companies "supplying" energy to consumers are not producers and add nothing to the chain of supply.