The NHS is not living with COVID, it's dying from it

[EmbarrassingHadrosaurus]

Most people (including many in the NHS) are so tired of it that they are wilfully pushing it to the back of their minds, but now is the time to face the fact that the nation’s attempt to “live with covid” is the straw that is breaking the NHS’s back.

In 2020 and 2021 the NHS coped with pandemic peaks by stopping or slowing much of its routine work. 2022 was meant to be the year of full speed recovery, when we would build back better and fairer, when record waiting lists in elective care, cancer diagnosis and treatment, and mental health would begin to reduce, and the workload on primary care would begin to ease.
…
Above all, the government must stop gaslighting the public and be honest about the threat the pandemic still poses to them and the NHS. Being honest with the public will have two positive results, it will encourage the public to modify behaviour and, we hope, provoke urgent reflection about how the NHS is in such a mess so soon after the nation was applauding it on their doorsteps.

Joint editorial from major Health Services journal and the BMJ. Free to read: www.hsj.co.uk/coronavirus/the-nhs-is-not-living-with-covid-its-dying-from-it/7032824.article

What measures would you be prepared to support to get the NHS back to some form of functioning for everyone who needs it for non-COVID reasons?

Why is it solely the NHS’s fault?

When you have a government who deliberately roused the rabble by heralding “Freedom Day” - (how do you go back to restrictions after that kind of messaging?)

when you have a child like populace, many who post on here, who say “we have to live with COVID” followed by “I won’t ever be wearing a face nappy again” or “I bloody hate those muzzles, never going to happen”

what is the NHS supposed to do when many in this country want to live in a forum of cognitive dissonance or denial?

Regrettably the NHS was in trouble way before covid. An ageing population, patients presenting with more complex illnesses and multiple co-morbidities, lack of secondary care, chronic underfunding and continuous political interference to name a few contributing factors.

Massively increasing funding and staffing levels and pay.

Massively increasing funding for social care and staffing levels and pay for those in social care

That's what we need to fix the nhs.

The covid response exacerbated an existing problem.

nope, not buying that

what do you want.....lockdowns again??

Being completely honest here, absolutely none. The NHS has been utterly abysmal in terms of care for various members of my family and most of it was pre-Covid so as far as I’m concerned it hasn’t been functioning for quite some time.

A few examples: elderly grandparent admitted after a fall, due to mouth cancer they had a plate in order to speak and eat. Hospital lost it so didn’t feed her for 5 days. She died very quickly in their ‘care’ and had been active and happy pre-admission.

Another grandparent dropped while being moved and had the huge flap of skin that was a result stuck down with micropore tape and the family weren’t told.

My sister told that her DVT was a calf sprain and to go home and rest.

There are many more that quite frankly should never have happened.

Every health care system in the world is struggling.

Its not unique to the nhs.

Its a combination of years of mismanagement, poor funding, ageing unhealthy populations and covid

The nhs also has the added bonus of complete misuse and unrealistic expectations

I think it would be helpful if well working virtual care app is developed. I believe some could be diagnosed over the video or through questionnaires. I think this could reduce the number of unnecessary visits to see the GP but patients can still get prescription.

I thought that there was a fair amount missing from the editorial. I'd like to see at least an attempt to quantify the benefits/costs of reinstituting pandemic control measures before they are called for by influential journals and editors.

I have no difficulty believing the NHS is currently unable to serve people's needs well: there are lots of threads about it.

I'd like to know what measures can actually alleviate those problems.

Okay would like to see much greater emphasis on prevention. That would require massive societal changes though, including focus on not only poverty, but mental health, and modern messaging from on-high.

The government were very willing to use manipulation to manage behaviour in lockdown. They should apply the same expertise to make positive societal changes and encourage self care where possible, freeing up the NHS resource for non preventable illness and injury.

@EmbarrassingHadrosaurus

I'd like to know what measures can actually alleviate those problems.

Money.

Appropriate funding, pay and staffing levels.

Appropriate social care.

Appropriate COTE

Absolutely none whatsoever. Actually, I would be prepared to have a booster jab say every 6 months if that helped, but beyond that no.

Whilst it’s not the fault of frontline staff in the NHS, it isn’t fit for purpose and wasn’t pre pandemic. Pumping more money in and locking down for the rest of our lives won’t solve that.

Appropriate COTE

Blame it on the fact that it's >44C in my area, but I'm temporarily blanking on COTE and can't find it with a quick Google.

Care of the elderly

The NHS has been struggling for years, covid has just accelerated things. Keen to hear your ideas though OP? How are you going to:

Find the money to invest in rationalising and modernising the estate. I don't mean updating buildings (although some need it), but I mean reopening community hospitals and minor injury units etc so that people can seek care in appropriate environments without breaking GP surgeries and A&E.

Solve the issue of masses and masses of qualified healthcare staff leaving the NHS every week, high is leading to chronic and frankly terrifying shortages?

Invest in appropriate care in the community and early intervention for stuff that later causes mass issues for the NHS. Diabetes, addiction etc are all very different but also present very different issues for a crumbling health services. There are some glaring things that could and should be done to break the cycle of people reaching crisis point before being able to access anything.

What would you do about the fact ambulances are often used for things such as mental health crisis when the staff aren't specifically trained in this and it can tie up an ambulance for hours; would you support MH ambulances where paramedics have full training and a MH top up so they can also treat a range of physical injuries but can offer better care and others then won't die waiting for an ambulance? Similar for things like elderly falls- there are more suitable vehicles that could manage these calls.

How would you educate the public about the appropriate care to seek? People do misuse many services.

Most relevant I suppose- how are you going to eradicate covid? As is people are still dying in hospital, many who go in for other things and would survive had they not caught covid. This isn't just the elderly either as some find them dispensible, but children, adults and others who have a range of conditions.

We need more money in social care. I work on elderly care/dementia.
Out of 28 patients, 22 are medically fit awaiting placements.
Those people will be with us for months. Our longest stayer was 7 months.
Sort social care , which yes is the tip of the iceberg .
And people stop abusing a&e for a cut finger or grazed knee.
The nhs basher squad will be here shortly.

The death rate is rising especially for some groups. Because of lockdowns some folks will die sooner. We have had a higher death rate than other countries for some years but that is levelling out. We're all going to see loved ones gone too soon

I think YABU.

It's certainly true the NHS is struggling. As are the health services in many places.

What they have in common is that many were basically on the edge before. There are a lot of reasons for that, poor management and chronic underfunding being two.

There have also been significant demographic changes, changes in the way people work, generalized changes in management structures across many sectors, and really significant changes in people's expectations of the medical system.

All of those are serious and need to be addressed.

And then covid is having some effect. Some of this is due to the after effects of covid management, people have been avoiding doctors and not dealing with issues for two years, and now they are, and the back-ups and waiting lists are out of control. It's difficult to see how they will ever catch up. Huge amounts of money wee spent on things like testing.

But the idea that the answer would be to continue to somehow restrict people? Covid is endemic. Masks have little effect in general population use, that is pretty clear now if it wasn't before. There is so much exposure around and so many people who have no symptoms that isolating people who get sick isn't really very helpful.

The only thing that seems to really work are very strict lockdown type scenarios where people do not meet up to spread it. And even with that, as soon as people go back to normal activity it just starts again. And the bad effects of that, including people not getting necessary medical treatments, are considerable.

Getting rid of tick box non value add elements

Examples of services that are manned by frankly inadequate staff who are literally nothing more than a tick that something has been done are dieticians and a friend's experience of the over 50s health check.

The main struggle the NHS is facing is staff recruitment and retention. Working for the NHS is not attractive any longer. It's a vicious circle, the more services are reduced, and staff can't be replaced, the more stressed are those who remain, until they themselves decide to leave.

What we need is make working for the NHS attractive again so that staff don't chose to go to work somewhere else for less money but less grief or even the same.

Older staff are leaving earlier than planned and younger people are not interested or don't last long.

I think the NHS was dying long before Covid and I would not agree more funding either - you could throw billions at it and it would all be subsumed with no real difference in outcomes. The whole system needs root and branch reform but no government is brave enough to tackle it head on.

We have this kind of program where I live. We do phone or Zoom type appointments (not zoom but a similar, but secure, platform.)

It has some utility, but it's not huge, and it doesn't save a lot of time for the doctors. In my experience when it is combined with a service that is basically struggling it also leads to cutting corners in care. For example, I am on a second round of antibiotics for a UTI at the moment. I really should have gone in and had a culture done. But since my GP is on vacation and I certainly can't get in to a walk in clinic as they are swamped, it's just not happening.

It's a small thing but not insignificant and I think very much the reason doctors have been wary in the past about these kinds of programs.

And in no way should any covid restrictions return. The NHS was 'on its knees' every winter pre covid, and will doubtless be every winter for the rest of time.

And I suspect that the public would freak out, so who could blame them? It would be an election losing project.

Nhs worker here
We are drowning as everything came to a standstill during the first pandemic

Waiting lists are ridiculous
Complaints sky high
People waiting ages to even see someone
Staff just exhausted

It's very very difficult for staff and patients but we just don't have enough staff that's the biggest problem

I agree with this. There are so many facets to the NHS and so many areas that could be improved but there doesn't seem to be the political will to do so.

I wouldn't accept any reintroduction of restrictions, much as the much-quoted "NHS Leaders" seem to think this is the answer to their problems. It's not, it just pushes the problems onto others because things like mask-wearing or social distancing don't come without a cost in terms of normal social interactions, mental health problems, damage to businesses and so on. I am immensely sorry for those struggling to do their best within the NHS, but restrictions are not the answer.