I think the NHS could be fixed, AIBU?

[Dreamer14]

i am inspired to write this thread after two events:

1. my kid needs to see a doctor for a face to face appointment. A part of her body needs examining, in person. I have tried the virtual GP service. They were useless. It’s also not possible to get a face to face appointment in my GP surgery without first doing a stupid phone appointment.
2. my relative has an infection. She’s had it before and knows she needs antibiotics. No one will help her. 111 say go to GP. GP say no appointments.

Surely we can do better than this?

Ideas I have;

• give people more choice about appointments… if it is inefficient to do a phone one let’s not force people to do it
• we need to open up more GP surgeries and hospitals
• We need a separate service for elderly people -so many don’t need to call 999 but have no choice as there is no help elsewhere
• we need to help mental health patients before crisis (watching Ambulance the other day, so many people calling 999)
• We need to get with the times… stop sending letters and start Emailing people. Or texting. The NHS IT systems and processes are shameful.
• payment for some services (I’m happy to pay a small amount to my GP)
• attract more people to NHS jobs. I’d love to work helping people. But I’m a mum of 3 and I can’t afford to retrain. Some of these jobs could be done on the job and salaried. I’m not gonna pay £30k to go to uni for 3 years to be a biomedical scientist.
• sort salaries out. How much do execs earn? How many woke jobs can we do away with?
• I think we should pick a few areas in the uk and trial different things In Each one. Then we can scale up if it works.
• strip it back to only crucial services. Nothing woke. If you want something doing that is beyond the list. You pay for it.
• I’m a supporter of people that want to pick when and how they die if they get given an awful diagnosis. There are many people that get diagnosed with terminal diseases and don’t want to suffer.

ultimately we need the government to spend more but we also need the nhs to spend better.

you do know that the "small contribution" setups cost more to administer than they bring in? so not only no new income but a net loss?

You would have to address the appalling waste of money that goes on, not least the PPF costs introduced by Tony Blair that we are still paying.
When you have a huge organisation it is almost impossible to keep track. I worked in one hospital for 10 years and I could write a book about the amount of theft, fraud and mind boggling financial stupidity I witnessed.

It needs a complete overhaul throwing money at it won't achieve anything I worked in the NHS for years so so much money was wasted ,they would do ridiculous things like refurbish a ward at the cost of £1000,000 only to then close the ward less then 12 months later

I agree with many of your suggestions but ultimately, if the NHS is to be saved and ressemble something that we all reminisce about, there needs to be two things happen side by side:

1. major investment (but from where? We are broke)


2. A major restructure (who will be brave enough to put this in motion and potentially make life changing decisions for people across the country?)

In my opinion, without these two things happening simultaneously, the NHS will
die a death and although may still exist to a point, it will not be what most people want or indeed expect.

I loved in France about 12 years ago and agree with the PP who said their system seems to work. I remember, even then, being shocked that I called the GP at 8am and had seen a doctor by 8.30am the same day!

@godmum56

if that’s the case then some of these things will need to be fully self funded for a while.

I think we need to go back to basics.

*lived in France

You haven't worked within the NHS have you?
The nhs is a huge, unwieldy organisation that would need to be stripped right back to enable any change to be made.
I was shocked at how difficult it was to get things done when I worked for a gp as a receptionist. It is very hard to make any decisions outside the allowed protocols and used to frustrate everyone involved.

Something as simple as an emergency admission to a hospital ward used to be done with a phone call from gp to the ward. Now it involves a phone call, a letter, a&e, etc.

In your examples above:

1. take the phonecard to triage best person to see your dc.
2. speak to the prescribing nurse for antibiotics, that doesn't need a gp. If any sudden changes then A&E.

I get the frustration, in March I had covid. I'm better now than I was but I'm not yet well, I have a follow up appointment with my gp next week that I booked a month ago as my breathing still isn't better. Having had the urgent treatment though, now I need to learn to manage the condition and the best way to live with it. That's why I'm going back, I think I will then need a referral possibly to a more specialist team which will take time.

The systems your gp is using are in place to help them do the best for you within a difficult system thats beyond breaking point, try to work with them where possible even if the system seems crazy to you.

For GP services, I would allow GPs to divide their available appointments in half, according to time of day. One half could be free, the other half they could charge what they like. They would be required on any given weekday to see one patient for free for each one they charged. They would continue to receive whatever they currently get from NHS for all appointments, so the paying patients would be topping that up.

Obviously the paid-for slots would have a shorter queue. They could also be at more convenient times of day, to suit working people.

The extra revenues would give an incentive for GP services to expand, though obviously it would take time, as you can't change the number of doctors overnight. In the long term, it should create enough of a market to eliminate shortages of appointments everywhere, including places that currently have a severe shortage of GPs.

How much more money? Funding isn't the issue it's the way it is spent. Give them more money they'll waste it on more middle management and will be frittered away via theft and fraud. The NHS is far too large an organisation to turn around at this point and it only gets by on the generosity of the people who work for it.

More money should be spent on prevention rather than waiting for people to get ill and treating them after the fact.

We're in the early stages of an economic collapse and simultaneous NHS overload because of our ageing population.

My first suggestion would be to hand the elder care budget we have that we give to councils over to the NHS so they can manage the high use group better. Bed blocking by the elderly with no place to go or who could be cared for just as well outside of a hospital for less cash, is a real problem.

We should overhaul official advice given to doctors about things that actually improve health in old age, instead of banging that stupid low fat/low calorie dietary advice drum.

We need to be handing out Metformin like candy to the middle aged to cut heart disease and cancer rates. Then we could raise the pension age because they'll be healthy for longer.

We also need to make it viable to have shorter qualification times for more basic categories of nursing or single speciality doctors. A full on three year degree course to learn to change a bed pan or take bloods isn't necessary.

Yes, this is normal. If you need a scan or an xray, blood test, the gp does the form and you will have it within a couple of days, often in the same building.
Things like contraception, smears etc are managed by specialist nurses. They can arrange scans and blood tests too if they think it necessary.

Charge for missed appointments. Before the pandemic my GP practice had hundreds of missed appointments every month. Sadly many people don't respect anything they perceive as 'free'.

I hate that people in the NHS get all defensive too. Most people I know that work in the NHS are hardworking. It’s not a personal dig at all but we need to fix it as it’s broken.

Fact - demand is infinite and resources are finite.

Fact - people get sick and die, and medical intervention only puts off the inevitable.

Fact - people's expectations have grown in line with medical advances.

IMO we need to reduce the demand on services by encouraging a culture of taking personal responsibility. Years of 'nanny state' philosophy has led to a generation that won't take responsibility for anything and rely on others to fix their problems.

We see it all over these threads - "the government should budget better", "the government should do XYZ".

How about the 24 stone, lager-drinking, kebab-eating smoker, making some lifestyle changes instead of complaining to their MP that they can't get a knee replacement?

Education is key here, and it should start in schools.

Of course it could be better. Just unlikely with a Liz Truss government. The option to go private if you have the money or insurance always will always reduce the incentive or willingness to do so.

For a decent service I’d pay- the problem is this country goes from free to extortionate very quickly.

We were saying exactly this back in 1970.
The trouble is, nobody in power listens to the professionals actually doing the job.
The low fat fad was possibly one of the most damaging influences on the rate of diabetes. I can't believe those products are still in food shops.

@OnlyFoolsnMothers true!

I had a consultant appointment (on phone for 20 minutes), ultrasound of my abdomen that took 10 mins, blood test and poo test. £900 on bupa.

they can do that now..all they need is to have the facilities in place to do it. No one is stopping them but they do have to have enough resource to offer care to all the NHS patients who they have in their register....and you can buy a private GP appointment now.

Because its incredibly hard to go to the treasury and say give me X amount and I will save you Y over the next 10 years. As someone mentioned above a large percentage of people take no accountability for their own health then expect to be bailed out by the NHS.

It can be fixed.
If I didn’t believe that, I couldn’t work my arse off every day for an organisation that gets slated so much, even when good things are happening. My service gets compliments daily. Take the NHS out of the arena of politics. Get rid of jobs like this…

beta.jobs.nhs.uk/candidate/jobadvert/D9465-22-1114

Looks like a lots of great sounding words for not a lot that will make a difference. If you want a better service, and to retain your staff, treat them well, pay them well, and the service will improve. Sadly, that stopped being the case more than a decade ago.

how about the weekend sports players who turn up at A and E with sport related injuries being told not to be so bloody stupid

I have a relative that is a junior doctor too. She says that the pay needs sorting for her. The standard pay is awful. But she says that some departments become very desperate and pay big bucks for just a single locum night shift.

I’d pay £10 for a gp appointment but this country will quickly say £50- like tuition fees