Do the general public know how bad the conditions in the NHS are?

[Gakatsbsk]

Hello

Expecting to be roasted.

However, I’m an NHS staff nurse. Qualified almost 2 years. I’ve worked through the pandemic. I initially worked in England and now work in a different UK nation - which is better but only because England was so poor.

My union is about to start a consultative ballot for industrial action in light of the nhs pay offer. I have had two family ‘acquaintances’ (who do not work or have immediate family that work for the nhs) complain in one breath about delayed appointments, delayed A+E waiting times, cancelled surgeries etc but then in another tell me that nurses going on strike is disgusting, lucky to have a job, NHS more secure employment etc. These are of course English Tory voters who said this

For reference, I have never and will never cross a picket line and will be voting in favour of industrial action (whatever form that takes due to emergency cover staffing etc).

When I was a few weeks qualified as a nurse I was looking after double the safe ratio of patients in my speciality. Completely unsupported, me and my (equally junior) colleagues having to consult google for solutions to our patients problem, if a medical emergency occurred (in ICU there should always be medical cover - this isn’t the case) we had to pull a buzzer, put out a page and get on with it until a medic appeared. This has not improved post pandemic.

In my current workplace (same speciality area), different country we are the only part of the hospital that is safe staffed, because of this every single day nurses and HCAs are sent to general wards, A+E and different hospitals often to be the only RN on a ward for 30 patients. There is such a crisis of care home beds, and ward beds that patients are staying in critical Care for weeks waiting on a ward bed. On the wards patients aren’t able to be washed each day as there might only be 1-3 staff members for 30-40 patients, meds rounds take 4 hours and ultimately patients who are sick go unnoticed until they are peri arrest. Nurses from day shift often have to stay on to night shift as there is no night shift nurse available.

I have only had negatives from the general public - it’s our fault for having degrees and being too posh to wash, bring the matrons back, etc etc. our colleagues who trained in the 80s and 90s pre degree say it is the worst it has ever been for safety and staffing. Racism and xenophobia towards our brilliant overseas colleagues is rife when they keep the NHS clinging on by a shoestring.

Four and a half years ago I was a first year student nurse and times were hard for the NHS, it has only got worse and worse for my patients since then. For the sake of my patients I will take industrial action.

However, it is so concerning how anti union, anti public sector and pro Tory the English public seem to have become? The decisions and government of Westminster negatively affect every nhs patient and worker in the UK. Just look at the widespread abuse, disdain and disgust directed at the RMT workers recently. I fear the same or worse for NHS workers.

So, is this NHS worker wrong for not enjoying being told to be grateful to work for the NHS? Is there any future for the public sector of the UK?

I apologise if I seem to have generalised England but I am English and from a northern Tory heartland. An area completely brainwashed.

CAMHS is a shitshow (to put it politely).

@mmmmmmghturep that isn't a thing anymore

@Dominuse
A paramedic I know had his glasses broken by a patient was told to get some more by his boss and bill the nhs be used they were broken in the line of duty. He needed 3 weeks off work whilst waiting for his new glasses. He got half the invoice back 2 years later. Private firms charge the bath whatever the f they want probably because it takes so long to be paid.

My own trust got charged £400 for 2 padlocks last year, and they paid it! It's obscene

I felt horrible the other month. I spent a week in hospital, and one hca who knew I was naked behind the curtain because I was being moved to cardiac critical care and she asked me to get dressed, I did complain about that because where is the dignity in that? She just opened the curtain, "left it open so the woman over the way could see me naked, looked at me and got my paperwork. 2 mins either side and I would have maintained some dignity.

I made a complaint to pals about it because I didn't get very far on the ward. I felt bad but that's very basic care isn't it? To
Expect that you won't have your entire body exposed to the whole ward? I'm a nurse and wouldn't have expected any hca I work with to do that

Adult mental healrh foes one step further into the shitahow bracket.adult mental health service is fucking disgusting.
The worst thing is they get away with it.wirh kids theres at least some chance of it being monitored or heard or felt sorrow for.
Adults don't get treated.they get chucked away,chucked Around or worse abused or left completely.

@cricketwidoww I had similar when I was in hospital once. Nurse flung open the curtains moment's after asking me to change. I objected and was told she had seen it all; when I responded that may be so but I was not used to showing it all she demonstrated the carefully curated NHS eye roll. I can think of no other sector or profession where individuals would retain their employment for being so rude.

To me when nurses strike they don't only strike for their salary but also for their condition of work. Their condition of work is our condition of care, there is only one word for it : awful. There is no point complaining as a patient if the nurses themselves are not listened too. The only way is to strike. 20 years ago I remember my father striking as a nurse with a brassard written on it "striking". Because of duty of care he would still go to work, but would make everyone, patient and alike understand that he was defiantly raising his voice against the work condition. I remember flu season when he would come home, and he did not even put his foot through the door he would be paged to go back because of short staffing. At that time the danger was the lack of sleep, by whatever means the wards should never be understaffed. Now it comes to a point were anything goes. I see that a lot of people there do not understand that if a ward is understaffed it's like being in a war zone and you are at risk for your life at any given time. Forget about getting your meal on time or a bath. What is a scandal is the number of people who would gladly get trained and who don't. Nursing should be free in return for a number of years of services, and nurses cannot do the hca jobs. Yes they are too skilled for that, yes they have too much work to do, and yes the paperload is crazy. HCA is a one year course in France that is fully funded, it helps you get on track to be a nurse if you want to, and it puts food on the table without asking for benefits. France has the same problem, we just have more staff, so seemingly for now, it is still working come what may. But healthcare is a very lucrative business, The NHS is being purposefully destroyed (the money put is simply not enough) and I do not believe that we will ever get a better level of care, just more expensive. IMHO. The care system needs more bed, it's a structural problem linked to demographic that has been forecast 20 years ago. Nothing has been done, nothing is being done about it. And it's going to get worse. It takes great courage for nurses to strike. I really hope that the government will listen. It's not only a wage issue.

I can understand why it's extremely stressful working in the NHS.

I was chatting to a fellow parent last night, who's a consultant and his son is about to start his medicine degree. He was bemoaning the lack of doctors being trained in the U.K. and that we have to rely on such a large proportion of overseas doctors because we're not training enough.

I'm lucky enough to have private insurance so don't use the NHS where possible. I appreciate that lack of staffing takes its toll on NHS employees and they're working very hard in difficult conditions.

But some of the rudeness and inefficiency is frustrating from a patient point of view. It wouldn't be tolerated in the private sector. In fact, if a receptionist in our firm spoke to me in the way that I, and others, have been spoken to in the NHS, they'd be sacked. The post earlier referring to overpaying for a bulb and blind is also symptomatic of poor procurement. Some of my good friends are NHS consultants and they tear their hair out at some of the inefficiencies.

I think major reform is needed, we need to stop treating it as the sacred cow and look at the alternatives in France and Germany. The best outcome is an improvement in patient care and working conditions for staff. People seem to fixate on not mirroring the US (which I understand) and ignoring the better set-ups in continental Europe.

My children both have disabilities and health conditions. We’ve had to use the NHS quite a lot and have experienced a really mixed bag of some good care, and a troubling amount of terrible care.

I have also worked in the NHS.

I do not support the NHS and do not believe the problems can be fixed with money alone. Many of the issues are cultural.

People talk about the NHS being a political football, which it is. But it has also become a hugely political organisation in itself. This is dangerous.

We need to start looking at moving to a system more like France or Australia.

ps. I’m not a Tory.

@Gakatsbsk 40k ? It’s a 3 year degree at £9,000 a year, isn’t it? So £27,000.

its common knowledge how much nurses earn so I really don’t get the surprise when people qualify and earn these wages?

It's utterly useless when it comes to a lot of health problems. I'm trying to get help again for something and keep getting offered things I've either had or stuff I can't have.

And the constant battle to get a proper diagnosis.

@Gakatsbsk I am one of those nurses who provide IV therapies at home. I am one of those nurses who are treating exacerbations of long term conditions at home. I also cover out of hours palliative care, unplanned district nurse calls.
The community isn't much better and we often get forgotten about from the hospitals we are attached to and how many people are very sick in the community.
The whole care service needs an overhaul, including home carer and care homes the staff also get paid very poorly for the amount of work they are expected to do.
I have worked in acute medical wards for 4 years prior to my current job role in the community.

I agree that moving to a European system would be ideal. But the Tories will take us down an American path and the existing NHS is miles better than that option.

I hold Labour just as responsible for this mess. They have been a weak and divided opposition when we needed them most.

Maybe op had some maintenance loans? Still ... it's the same debt every other student gets but with a guaranteed job that you can end up on a very decent salary on.

I am actually in favour of cancelling nurse student debt though after a number of years working for the NHS, or reintroducing proper bursaries, rather than just importing our nurses from countries that need them

I agree about the culture but it's by design. The NHS is not able to do what legislation states it has to, there isn't enough money and they way its set up is needlessly convoluted.

Then you hire senior managers and directors to do the literal impossible. The only people who are going to be successful in these roles are bullshitters. People who are happy to lie and say they can in fact do the impossible. Not only that but they are successfully doing it now. I've worked very closely with senior NHS leadership and I have never met a more disingenuous bunch. They don't give a single fuck about what is actually happening, all they care about is what they can plausibly say is happening. This stems from the chronic underfunding for what they are expected to do. Nobody with any integrity lasts 2 minutes in those roles.

It's text book managed decline.

People complaining about poor care we hate it too. When I was a HCA there was 2 of us to look after 30 patients. I had to transfer patients on my own when it should be two members of staff. I had one patient crying for the toilet while I was in the middle of transferring another and she sadly wet herself.

I had no staff member to call it was just me I was responsible for getting 15 people washed , dressed and fed . I didn't even have time to offer a shower. I now work in a small mental health older persons ward there's 8 patients , 2 nurses and 8 HCAs. It's so much better and more pay.

My friend in a&e and her colleagues cry regularly due to the pressures they're under. They tell me it's like being flogged everyday. This is unsustainable for most people. High stress turns most nice people into not nice people. I've witnessed it often enough in nurses and doctors.

Over the years I've become more frustrated by the expectation from the senior grey suits and what they want from nurses. They ask for more and more but no extra staff. New ideas based on optimal staffing, I'm a nurse of 40 years I've never had optimal staffing anywhere. Nurses who are sick or pregnant or on maternity leave dont get replaced so the remaining staff get extra workload. The new ideas are maybe good in principal but WE DONT HAVE THE STAFF TO DELIVER IT.

At one meeting I said cant we just try to give good care instead of spreading ourselves so thin that nobody gets good care , this went down like a lead balloon and my 'attitude' wasnt in keeping with the desired team ethos.

My current job we weren't able to undertake alot of our role because of covid and staff shortages . At one point we had less than half capacity staff, not covid related. We were firefighting daily, management gave us another time consuming task to do, that was a trial for 3 months , a year later we are still doing it. We queried why in the middle of pandemic this was being asked especially with so few staff, we never got an answer. The coal face opinion doesnt matter or is ignored.

New legislation has handed over more paperwork. Instead of a dedicated team they hand it to the nurses. This is an incredibly time consuming task, and it isnt related to direct patient care on a day to day basis. Management is so far removed from what is happening on the coal face that they think it is a reasonable expectation then complain about poor results.

My bil has been a patient recently he is a recent ex gp. He didnt tell anyone he was a gp, said staff lovely but under ridiculous pressure. Friend said local gp ended up in a+e couldn't believe how bad it was, friend said , then stop sending every sore finger to this department.

My mother, my elderly uncle myself and my brother have all been recent recipients of the hes,there system , the care wasnt optimal but the staff were pleasant. The sub optimal care wasnt down to the nurses lack of attention to detail there just weren't enough of them.

My biggest issue with privatisation in this country isn't the concept as such, it just doesn't seem as though we are awfully good at it. I cannot think of a single privatised industry where the consumer has ended up benefiting ?

lowdownnhs.info/analysis/long-read/the-history-of-privatisation-second-in-a-series-by-john-lister/

The above is quite a long read but very interesting and does go some way to explaining the issues surrounding social care provision.

I've asked but no one has answered.

Those who are critical of the NHS (some with good reason, some not so much, some entirely ignorant)

How would you fix it? How would you improve conditions and care?

Don't just say move to a European system because that is not currently an option. Its not even being looked at

However I would be interested to know the cost differences. And how they fund elderly and social care. (Again I did ask but no one answered)

The UK has one of the lowest spends per person on health care globally and one of the lowest % of GDP spends on health care.

The fact millions upon millions of nhs pts receive good and even sometime excellent care (which is mostly ignored on these threads) is actually a miracle and down to the hard work of all the staff.

Interesting questions. In my opinion the NHS needs to roll out far more customer service and basic equality training to its staff. Further there needs to be an emphasis on actually measuring and monitoring shortfalls and a move away from graph after graph that somehow indicates needs are being met by massaging figures. The politics need to be taken out of it and a cross party commission needs to be set up to review the reform. I would also add that the culture of victimising the whistle-blower needs to cease that was behind the significant failings in Telford, Birmingham, Bristol and St George's cardiology the latter of which was unfounded and the chap who carried out all the unnecessary sbreast surgery and went to prison . Problems need to be dealt with as soon as they are identified. The problems will only be dealt with when the patriarchal hierarchy and power of consultants is challenged. Switch the emphasis from chest feeding and people with wombs to basic equality of outcomes and care between men and women.

It needs to stop being entirely free at the point of delivery and there needs to be much more emphasis on clarity of expectations and patient care. Overall there needs to be more honesty and CEOs need to own the failures, admit when they cannot provide optimal services due to resources and stop the mountains of data that obfuscated when a shit service is being delivered. The CEOs need to take their eyes off the next appointment and the potential gong and fix them on what patients are actually receiving and what they are not and should be.

As NHS employees are too often unable to complain because of potential punitive action so to are patients when they do not have choices and complaints are the tip of a bigger iceberg than that which sank the Titanic.

On the point of GDP only the cost of NHS provision is ever measured, never the cost of accessing it. The hours patients spend chasing referrals, sorting out admin errors, waiting for calls to be answered, etc. Only recently I had a 10.30 appointment. On arrival the delay was 45 minutes - after 45 minutes it was announced as 1.5 hours. When I said I'd go to my car to deal with work calls I was told I couldn't because it might not be another 45 minutes. There was no apology for the delay because patients are just fodder with no jobs or other responsibilities. Like those in the NHS my work doesn't go away when I am not doing it, it has to be caught up. There is zero respect for patient time and zero cognizance that many patients who are messed about or have sub-optimal treatment leading to incapacity lose money and if it goes on for too long being unable to work is picked up by the state. That is not factored in to the overall GDP cost.

@Gakatsbsk
Is part of the problem be that old people are kept alive at all costs even if their standard of live is practically zero? I get that the government have made a mess of the NHS but there must be other issues in play too.

ds has multiple disabilities the day to day care is generally outstanding (other than dieticians and CAMHs) but the issue is the buracracy and lack of communication.

Ds had a consultants appointment last week but the consultant wasn’t able to access his recent bloods because they had been done by another trust (we are under ar least 3) so his options where arrange more bloods or waste his time phoning the other hospital to get them and check them. So now more time is wasted because of lack of joint up systems

It is although it sounds awful. I have done an advanced directive and I would implore other people to do the same if they want this . I have requested in the event I lose permanent mental capacity due to a neurodegenerative disease or a severe brain injury they do not offer me mechanical ventilation, artificial nutrition including peg or build up drinks or antibiotics. Pain relief and sedatives only.

You can live with dementia for over 10 years and I don't want that.

Totally agree about senior management. I spent two years in a very senior role thinking naively I could make a difference by working in the NHS. Boy was I wrong. I burnt out and had to leave after two years. I was being asked to do and say things that went against my professional ethics so I have gone back into external consultancy.