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.

I think a lot of problems are down to communication and resulting mismanagement of expectations. Loads of minor ailments can be diagnosed and treated via the chemist for example but lots of people don't realise or trust this route having been brought up with the idea that they should be sitting down in front of their GP.

I have a very serious chronic health condition. I'm probably not going to die from it but it needs a certain amount of monitoring to keep me well. I'm responsible for booking in appointments with the GP. It's not difficult to get one but you do need to know to log in at a particular time to get one. I think most people don't realise this. Similarly I am mostly fine with a phone call but sometimes need f2f. This is generally initiated by me but is never a problem because it is appropriate and needed.

So my point is that yes there is a lot wrong but there is also a lot that works but people just don't know as it is not communicated well.

If you can't earn 100k in the public sector all those who do will just move to private and leave those public sector jobs empty.

Public sector should be just as well paid as the private sector otherwise there is a talent gap.

I don't know why people automatically think changing the system means moving to the USA private system.
Health care in Spain, France, Germany is so much better and the cost seems to be fairly distributed.
There are pockets of excellence in the NHS that could easily be replicated across the service with a bit of joined up thinking. It is all so disjointed atm.
I have had really good care with my serious illnesses over the last few years, but I am very lucky to have a good GP and a very good local hospital plus a regional centre that I can access. Many people aren't so fortunate. My GP surgery is very good. My neighbour's GP surgery is dreadful. It is about a mile away from mine. There is no excuse that I can fathom.

I'd also like to say that as an NHS nurse in an understaffed area, we do work efficiently. If the domestics are too busy, we do their role for our area , same for many other roles. I'm

In my area of the UK there are far less non clinical managers. Administrators with NVQ qualifications are at band 4-7, more than frontline nurses but that's the under valuing of nursing for you.

But how would you ever attract the people who have the right skills and experience to do the job? I work with NHS Execs (and their deputies) and I really don't think they are particularly well paid given that they are responsible for an £800m+, highly regulated organisation, where life and death decisions are literally taken every day in the context of relentless, and increasingly extreme, operational pressure.

The only problem with the NHS is the lack of staff. There 40000 nurse vacancies and 14000 dr vacancies.

Up the pay and nurses will come back. Stop employing agency staff.

Once more staff come back in to the NHS it will have a snowball effect because others will know they won't be overworked nor delivering unsafe/inadequate care.

Keep up the 'extra' dr training places. In 2020 & 2021 training place were increased to 10500 per year. This year it's gone back down to 7500. How will that help?

If people made better lifestyle and health choices that would reduce the burden on the nhs freeing that money up for other things

If they just charged people for missed GP appointments that would save the NHS £216million pounds per year.

Good lord that would try the patience of a Saint

What idiot designs a process like that? It's a joke

I wouldn’t be surprised if healthcare is better in France and Germany, purely because they spend much more than us per capita.

stat.link/files/ae3016b9-en/36exif.xlsx

It's not just money though ... it's stripping our inefficiency (people included, for every person doing a cracking job under shit circumstances there is another not pulling their weight and happy to stay on the gravy train) too.

I’m really worried about the state of my GP surgery. Before COVID, I could usually get a GP appointment within a week and had face-to-face medication reviews every three months.

Now, I don’t have medication reviews at all and have to wait about three weeks for a phone appointment with the GP. I haven’t seen him in person for about two years. The nurses have taken on much of the GP’s workload, but I can be waiting weeks for a nurse appointment.

Will thing ever return to normal, or is this the result of the new system?

There are more than enough people willing to be biomedical scientists with biomedical science degrees. The problem is the shortage of trainee positions and lack of investment in training, like most other jobs in the NHS. They do have apprenticeships too though and each position gets something crazy like 100 applicants, meanwhile there’s a shortage of biomedical scientists because they are retiring faster than they can be trained….

To assist recruitment they should stop insisting nurses have degrees. Some people just want to nurse and care for people and are lost to the NHS as they don’t have the qualifications or financial resources to do a degree .

OP said nothing about social care. I can't see any PP here mentioned social care.

50 people in Ipswich hospital alone this morning, waiting for a social care package to be discharged, mostly to own homes not residential care homes (Today Programme, 8:10-818 this morning) The single most useful thing we could do to help NHS is get good domicilliary social care.

Just imagine what could happen in "the system" if that hospital could free 50 acute beds instantly. People could move out of A&E faster. People could get admitted sooner for non-urgent procedures. GPs wouldn't have repeated calls from people managing chronic conditions in community because they can't yet see a consultant.

Set aside all other ideas. Focus on the social care crisis.

I think YANBU to say the NHS can be fixed, so I voted YANBU even though I did not agree with your list of ideas at all. Basically the NHS needs to be fixed by funding it properly so it can build more hospitals, buy more high value equipment and ambulances, and create more HCP jobs.

All your ideas are rearranging deck chairs on the Titanic type ideas. They won’t fix the root problem and that is chronic underfunding so that supply cannot meet demand.

Sorry you've had these experiences OP.

The system is shockingly unfit for purpose. Your account is the tip of a mighty iceberg.

CAMHS is flailing. Children who I support with severe mental health difficulties and suicidal intent are turned away- an actual attempt has to be made to be seen. Even then they tend to be seen once and turned away. Otherwise it's a waiting list of over a year.

Children who clearly have asd or adhd have to wait at least 3 years for an assessment- even where a medical professional has highlighted an urgent need for assessment. Given that adhd responds beautifully to medication and therapy in most people this is ridiculous- 3 years of chaotic brain, failure to meet potential, anxiety, school disruption etc..

I am post menopausal and had unexplained bleeding beginning 24 months ago. This should have been seen on an urgent 2 week wait. . I still have not been seen despite my GP begging our local gynae clinic. So I live with daily spotting. Many other women live in excruciating pain.

Getting an nhs dental appointment is impossible.

People are waiting hours and hours for ambulances and paramedics are traumatised by the situation.

None of this stuff is news to anyone anymore. The dire situation is well known. No changes are forthcoming. No ministers are taking drastic action- or even mediocre action.

I don't think anyone in government intends to fix the NHS.

However, if they didn't all have access to private healthcare I'm quite sure that they wouldn't have allowed this shambles to happen. It's a case of "I'm alright Jack".....

Totally agree with attracting more people. I actually wrote to the NMC a few weeks ago with suggestions.

I think they would attract more nurses and midwives by making the actual degree a lot easier. They need to do away with essays and dissertations. There are so many people that are not academic but would be great carers but because they cannot pass their essay or dissertation they can't pass the course. It's ridiculous. The course should be about drug calculation, human anatomy and biology and emergency medicine not about writing a 3000 word load of crap that isn't relevant in the nursing field.
Also they should make their hours more flexible for single parents or carers imo.
There are many that cannot work nights and weekends because of childcare but can do the other hours. It can be fixed but they won't look at that

Regarding the 3 years - EXACTLY!!
It's infuriating

Why should people working in the public sector be under paid?

Its that attitude that has resulted in the recruitment and retention crisis we have now in all areas of care

And the idea that nursing shouldn't be a degree is also a load of rubbish.

It absolutely needs to be. There's lots of roles that provide care but don't need a degree that people can do.

There should be massive ultra processed food tax and that tax should go towards NHS care of obesity diseases and subsidies for fruit and vegetables.

There needs to be more of an emphasis on treating mental health issues very early before they start causing all kinds of other costly problems.

Caring needs to be seen as a good career choice and much better paid. Care homes need to stop being privatised. Why do the care home owners all drive around in Ferraris (or other supercars)?

I think the training and different grades of staff could be overhauled, but ultimately, all HCPs should be paid a living wage. I am old enough to have trained the old fashioned way, although I completed my degree and post grad qualifications later on in life. I think a lot of HCP training would lend itself very well to the new apprenticeship style degrees. So what if if it takes 6 years? More people would have the chance to train and most HCPs want a career for many years.

The NHS can be brilliant. I had a recall from a mammogram and the staff in the breast assessment unit were fantastic - the perfect mix of professional and reassuring, and have left me being absolutely sure that I will receive the appropriate treatment for what looks like a small cancer, to the extent that I am genuinely not worried.

It can also be dire. We eventually went to see a private consultant regarding my DD's PCOS, as she was being continually brushed to one side (told to exercise more, when she was going to two classes a day!), and it was having a massive impact on her mental health. One meeting with her consultant, one prescription (on-going) and she's a different person.

I was waiting to take an 88 year old friend home after surgery for bowel cancer. He was in the 'discharge lounge ' - an empty room with a few hard, upright chairs scattered around. It was after 5 pm and he'd been there since 11 am. I'd sent his wife home, because she was exhausted. The hold up was waiting for medication, which they couldn't sort out because the person who had done the discharge notes had gone missing. Not off duty - literally missing. After 6 hours, he was told he didn't need the medication after all, and could go home.

A friend's son has recently qualified as a GP. He's not taking any of the jobs he's been offered, as he can earn nearly £1,000 a day as a locum. It's mad!

Just to add, this isn't a new situation. My DF was in hospital 28 years ago, waiting for the cardiac ward to do something, as he was very sick. He was there for 10 days, at which point my DM contacted the surgeon who had done his first bypass, and he did the second within a matter of days - privately.

I remember Dad saying that he'd heard a rhyme 'If health were a thing that money could buy, the rich would live and the poor would die' - and he was shocked that he could see the truth of this. But this was nearly 30 years ago.