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.

OP, you are not proposing fixing the NHS, you are proposing completely dismantling it, doing away with the majority of its services, and charging for those which remain, which of course undermines the entire point of the NHS and makes it not the NHS anymore.

I'm also wondering about your fixation with "woke" jobs. How many of these do you think exist in the NHS? Can you give an actual example of an actual job title that exists in the NHS that you consider a "woke job"?

Complete lack of understanding of what nurses do or how skilled a job it is or what it requires. If you want to care for people without a nursing degree, HCA roles exist but you won't be able to do what a nurse does because you won't have the training if you don't have a nursing degree.

The way to fix the NHS is to fund it properly and make it attractive to work for, ie decent pay and conditions, bring back bursaries for people who want to train in skilled roles, and staff effectively so people aren't worked to the point of burn out.

I have had cancer care and mental health crisis care under the NHS this year and it has been excellent and lifesaving. The problem is not the NHS, it's that the value of it and its staff are not recognised by those in power (who can afford private health care).

@stayathomegardener What an experience! I am so glad you persisted.I have had different GP’s having lived in several different areas. Some GP’s seem resistant to private referrals and play the ‘I don’t know how to do this’ game. My previous GP had no issue with private referrals. My most recent GP seems to have some sort of ideological objection to private health care.For several years I happily paid £100 every six months to get a chronic eye condition monitored by a consultant. The consultant would then write to my GP so they could prescribe the eye drops I needed. Exactly the same procedure as if I was seeing the consultant on the NHS. My new GP decided they wouldn’t prescribe the eye drops anymore (they are prescription only). This was because I was seeing the consultant privately at his private clinic in the evenings. My GP insisted that they refer me to the SAME consultant via the NHS. This was a long drawn out process involving phone appointments and speaking to the GP’s and hospital receptionists. These appointments would take place at the local extremely busy hospital. I now see the consultant for free, taking up a space another patient could have had. The appointment times are often inconvenient for me. The GP now issues the prescription I need. What a waste of time and resources!

The government needs to stop giving so much NHS money to private companies. The NHS has been privatised by stealth and so much money gets siphoned off in profit. Bring things like drug development in house. Stop private companies being able to re- patent existing drugs and then overcharge for their use. Maybe even try to stop people getting ill in the first place. What doesn't need to happen is that we all pay even more so drug companies and the like can raise their prices and make even more money

Jacob is that you 😒 What are you defining as woke? If it's D&I they are incredibly important for staff and patients for example Black women are 5x more likely to die in childbirth if a D&I Officer can educate on medical racism and saves lives that's a win.

We're in a cost of living crisis people are choosing between heating homes or eating and now you want to throw in paying for the GP? This would cause more medical issues and be more costly for the nhs.

I work in public health what impacts the nhs is wider than the nhs for example parents not vaccinating their children because they might have to work an extra shift to put food on the table on the only day there's free appointments. Likewise with the nhs and mental health crisis peoples lives impact their health we are chronically underpaid in this country which impacts people such as not been able to afford healthier food gyms etc food deserts are a real problem it's costly to the nhs in terms of poor mental health obesity etc but the government doesn't advocate for better living conditions.

it can't just be an nhs problem op

strip it back to only crucial services. Nothing woke. If you want something doing that is beyond the list. You pay for it.

What do you mean by "woke"? What is an example of this kind of treatment? Fertility treatment? Surgery to rebuild a woman's breasts after mastectomy? Breast reduction surgery to get breasts down to a size where women aren't in constant pain? Tattoo removal which enable someone to turn their life around and get a job without some kind of hideous gang tattoo from their early teens standing in their way? Are those essential or "woke"?

@Goforgo

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.

Why the fuck should I have to pay more for food i enjoy when I know when to put the pork down and stop shovelling shit down my gullet.

@UseOfWeapons totally agree!! There are 3 members of my family work for same trust, my son calls these NHS Non Jobs! There are far too many people at this level...... looking at all you matrons on that amount who do sod all but tell people to wash their hands (we are adults, we know when we need to wash our hands) and pose for twitter feed photos doing things that they would never in a thousand years do, like giving out meals! They would do far better to employ more band 2s with the same money so elderly people can actually go to the toilet when they want rather than putting them in incontinence pads😤 I could go on about the amount of waste but my post would be so long nobody would read it.

@Dreamer14 Anyone who think that getting rid of "woke" jobs in the NHS is some sort of route to "saving" the NHS needs to step away from daily mail/express. What do you actually define as a "woke" NHS job btw - interested in your opinion not some cut and paste tabloid shit?

Pay nurses a better salary. Go back to training nurses the old way with so it is not graduates only, with training on the wards and in hospital classroom. Provide nursing homes so cost of accommodation is not prohibitive.
Bring back convalescent homes and geriatric hospitals.

@KatieB55 they are actually, they are called nursing associates and start at band 4 I believe. They are also starting some apprentice schemes soon in therapies, I'm not too sure how I feel about this until they start, I just hope it doesn't mean downgrading just to save money on what are already quite low paid jobs but at least saves people having to pay university fees and gives them a salary whilst learning.

I completely agree with you. Why does nursing need a degree now? We need to shot the recovering people who don't need masses of care into convalescent units with lower costs.

because nursing is more complex role now as medical science has advanced that why they need higher level education in nursing

there is the other route to work towards a nursing role associate nursing

I could tell in 2002 that staffing would be a huge issue going forward.

At the age of 17 I wanted to be a Royal Naval Nurse however they changed the rules and I was too short.

Two years after I graduated I really wished I had taken up nursing which was my original plan rather than a creative subject.

I looked into every avenue of funding to become an NHS nurse. There was absolutely nothing to support the average learner. At the time, they were putting all their efforts into recruiting 42,000 overseas nurses by 2003.

My aunt was a nursing sister from 1960-1985 she part funded her training but she said there was a lot more support including greatly subsided nursing accommodation and cafes providing hot meals. She dedicated her life to nursing at the time and the social aspect of being a nurse was also a good thing.

They need to support future learners. They need to cut out all the useless roles and cut down on the amount of ridiculous paperwork and unnecessary admin.

I paid privately for surgery a few years ago and was astounded at getting scans the same day as seeing the specialist and then going back to see the specialist straight after. No need for several letters and admin to plan it all.

Nursing needs to be a degree course because, believe it or not, it involves much more than changing bed pans and taking bloods.

It also already is 50/50 clinical placements and classroom based

Knew we’d get on to degree bashing.

My mother trained in 81, my aunty 89, other aunty 91. The ‘glory days’ pre degree. They had to train for three years and complete (difficult) exams, this was rigorous training and as difficult as a degree. Getting rid of a degree still has a 3 year wait for new nurses.

St/Ns provide much of NHS services, they should be paid but this bee in the bonnet about degrees is misguided and often from people who don't truly understand the role of staff nurse or the previous training.

I 100% support bringing back enrolled nurses (I know there's NAs but not in my area of UK). Two years of training with certification similar to a diploma / fd / HND.

I think all nursing should be paid 3 year degree apprenticeships. It effectively is arm.

I'm a critical care nurse, the level of critical thinking required is high. A degree has 1) strengthened my critical thinking skills 2) removed an institutional element (work in a hospital, trained by a hospital, often never leave) and

3. enrages an element of the public who can't see the real issues in the NHS. I was assaulted in work by a patient who told my ward manager they wouldn't have assaulted me if id trained in the old days as I wouldve done what he asked (he asked me to wank him off).

I operate ventilators, CRRT filters and so much more equipment. Analyse ECGs, ABGs, obs. Assess students (this was done by sisters back in the day - confirmed by my 3 sources). Provide all patient care to my patients. Advocate and liaise with the whole MDT and much more.

Getting rid of a degree changes nothing - 3 year training is 3 year training.

Nursing is failing to retain that’s the biggest issue. The attitude of the governments and public doesn’t help. There is an ageing population. Patients are sicker, more complex. Resources aren't keeping up.

@ITUnurse

100% support bringing back enrolled nurses

I dont

Because all that would achieve would be dilute nursing staff.

Oh, you don't need 3 band 5s

You can have 1 band 5 and 2 E/Ns.

No thanks.

Student nurses are ‘trained’ on the wards?

As a student only a few years ago. These were my placements:
Y1 - 10 weeks Nursing home, 8 weeks Elderly ward, 8 weeks surgical ward, 6 weeks Rheum ward.
Y2 - 6 weeks general medical ward, 6 weeks Derm and Diabetes ward, 4 weeks psychiatric ward (adult trained but extra experience), 6 weeks District Nurses and 4 weeks A&E
Y3 - 6 weeks surgical HDU and followed by 6 months HDU/ITU (albeit an extra few weeks due to covid).

I 100% agree regarding homes for nurses.

Geriatric long stay wards in the 80s and 90s were rife for abuse, I don't disagree with the principle but we must not return to this.

@Topgub

That's fair enough but the staffing is already dilute. The wards at my work run with 1RN, 2 on a ‘good’ day. The role of RN now incorporates lots of the role of junior doctors. HCA's undertaking extended roles deserve the recognition and role.
However, I appreciate it's not a failsafe idea.

We need to sort primary care and social care out. The NHS is screwed partly because of the lack of social care providers.

We needs GPs who are open more than 9-5 Monday to Friday. They need to up their game IT wise so photos and videos are actually received on time by the practise so where possible the doctors can diagnose over the phone.
Automatic in person appointments for babies and the elderly.

We need a pick me up off the floor service for the elderly who are unharmed but cannot get up. Rather than them waiting hours and hours for an ambulance.

We need a better transitional care system to enable people to leave hospital when they are medically fit but not yet well enough to manage independently on their own.

I'm an independent personal assistant. This week alone I have had over 20 referrals just from social services looking for care for patients who they are trying to get discharged from hospital. We are full. As are most of the other locations providers.

Do you know what a staff nurse does? 3 years of training is 3 years of training. Your pre degree nurses are also failing to be retained.

Who do you propose staffs these additional homes and wards?

It can’t be fixed without fixing social care. No government has taken social care seriously for the entire of my adult life. There’s no point pumping more and more billions into the NHS while cutting local authority budgets more and more.

But that doesn't solve the amount of inpatients? The overwhelmed hospitals? It's not just money but staff and resources

Nursing needs to be a degree course because, believe it or not, it involves much more than changing bed pans and taking bloods.

Indeed - I think a nurse’s job used to be more the equivalent to what now is a healthcare assistant’s role (not that they only take bloods and change bed pans). Medicine has moved on, and yes a nurse needs to be highly qualified to fulfil what the role now requires. Same with midwifery. It’s not the 1930s anymore.