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Share your dilemmas and get honest opinions from other Mumsnetters.

The state of the NHS right now is terrifying

493 replies

Faciadipasta · 04/11/2022 07:25

I am feeling genuinely scared for us as a country health care wise. I was reading today about a chap who died of internal bleeding while his family were kept on hold to 999 for 10 minutes as nobody even answered the phone.
Then there are all the people who die while waiting for an ambulance to arrive, because they are all lined up.outside the hospitals unable to offload their patients.
People can't see a GP at all, so there are bound to be loads who are dying of things that could have been prevented if they'd been seen. Waits at A and E are enormous and they don't even have enough chairs so people with serious injuries or illnesses are having to just sit on the floors in the corridors.
We're actually starting to feel like one of those warzone countries that you see on the news and it is scaring me shitless.
I mean even in the US you wouldn't just be left to die because there was nobody to answer the phone although admittedly you'd probably end up bankrupt for paying back the care, but at least you wouldn't be dead!
I personally feel like we have no care, no safety net. And it's scary.
Will it get better? What can be done?

OP posts:
ThirstyMeeples · 04/11/2022 12:20

thenosehasit
We don't interpret hospital blood tests. The responsibility lies with the requesting doctor.
mobiledesktop I'm struggling to know how to respond to you. A bright 6th former is an almost ridiculous response to the discussion we've been having. It shows you have a pretty poor grasp of what we do. And this insistence of working 5 days is starting to sound like a stuck record.
I'm genuinely sorry that the service is so bad in some areas and I don't minimise the experience patients at all. It scares me to think of my own relatives getting sick.
But I'm trying to give you some insight to how things are on the other side. I don't expect anyone to have pity for me at all but simple 'solutions' like 'just work more days' or employ a 6th former are not in any way feasible. (for the reasons I've mentioned)

Mobiledesktop · 04/11/2022 12:24

Yes, I agree. 8 - 9 a day, 5 days a week. With a supervisor overseeing their output.
That's how you make sure your getting your monies worth.
Call their bluff.
I don't for a second believe that GP's are working 12 - 13 hours a day.
They will always have another excuse and nothing will ever change.
Everyone pretty much agrees that the NHS is in crisis but whenever a suggestion is made about how to make things better they throw their arms up and say " we can't possibly do that"
This country needs a strong politician to take them on.
New contracts, no more part time. There not 16 year olds.

ThirstyMeeples · 04/11/2022 12:24

Hi OP,
I'm sorry to have derailed your thread slightly! Thanks for being supportive. I'm sorry it's so hard to access care for you and your family x
Ps the AI idea is interesting..... I'm sure that's the future. There have been discussions about it in the past. But GP is v nuanced and not always black and white.
The patients are the bit I love best by far. In my ideal world, I'd get rid of paperwork, see patients for 8 hours and somehow screw the rest!

Topgub · 04/11/2022 12:29

@TheNosehasit

No

Nurses cannot take 1 hour lunches.

They aren't paid to and they absolutely don't have the time.

I'm also not sure why you think what police officers do is relevant.

Topgub · 04/11/2022 12:32

@Mobiledesktop

I'm sure gps will bite your hand off for that deal.

Quite what we'd do with the backlog of work not completed, I'm not sure

medianewbie · 04/11/2022 12:32

Afterfire · 04/11/2022 07:54

The government wants us to start blaming each other for this mess. They want us to sit there and say so and so is abusing the system / causing delays etc. There will always be time wasters but equally the vast majority of those who are turning up with ailments that their Gp should manage are doing so because they cannot see their GP. The whole thing is a complete and utter mess.

My ex bil had a heart attack last week. He was working in someone’s garden and collapsed with chest pains. The family called 999 and they waited an HOUR for an ambulance. He then waited 6 hours outside the hospital to be seen. He’s been in hospital since, waiting to be transferred to a specialist hospital to find out what caused his heart attack and have treatment. He’s been waiting for days now. Not even given painkillers. Just monitored and waiting.

Total mess. And yet people keep voting conservative.

My ex H had a suspected heart attack 6 years ago. History of heat issues. Paramedics attended within 10mins (it was 2am & we are 5m from a rural Hospital). He was blue lighted in. 3 hours later he phoned to say in a taxi. He'd been on a trolley in the corridor. A nurse had 'done basic obs' said he seemed okay & told him to go home.

I'm sorry for your experience too.

Kendodd · 04/11/2022 12:34

ThirstyMeeples · 04/11/2022 12:24

Hi OP,
I'm sorry to have derailed your thread slightly! Thanks for being supportive. I'm sorry it's so hard to access care for you and your family x
Ps the AI idea is interesting..... I'm sure that's the future. There have been discussions about it in the past. But GP is v nuanced and not always black and white.
The patients are the bit I love best by far. In my ideal world, I'd get rid of paperwork, see patients for 8 hours and somehow screw the rest!

I know it's not my thread, but I don't think you've derailed it. I think clueless idiots who know nothing about a GP job and listen or learn from people who do, have derailed it.

medianewbie · 04/11/2022 12:38

SmokedHaddockChowder · 04/11/2022 08:18

Anecdotally, both of my parents have had cancer this year and have been seen swiftly and been given an excellent level of service throughout. So it definitely depends on your location and the department that you need. But A&E is a total horror show.

Anecdotally my Mother died of Cancer in May: was seen 10 times over the previous 8m & her cancer only dx 4 wks before she died when she was way beyond help (& had lost 5st). Horrific.
I am glad your parents experience was different. It is SUCH a postcode lottery.

Kendodd · 04/11/2022 12:44

Changerofthename1 · 04/11/2022 11:59

I’m old enough to remember GPs doing house visits and during the night. I think they were a lot more respected when they were a lot more available.

Me too.
I have a Ukrainian family living with me, she was astonished a doctor wouldn't come out to see her 8yo child with a (very, very minor, temp 38c) cold. They also to routine annual health checks there, six monthly for children. I looked up the numbers, Ukrainian do worse than us on every health measure. They have a lot more doctors though . I came to the conclusion that Ukraine spends its health budget on the healthy, whereas we spent ours on the sick. Spending money on the healthy isn't completely to be knocked, these are the majority and the ones paying the bills. My guest was very happy with the service she got in Ukraine, and very unhappy here. She also believed cancer, just about 100% kills you if you get it.

Moraxella · 04/11/2022 12:52

Mobiledesktop · 04/11/2022 12:24

Yes, I agree. 8 - 9 a day, 5 days a week. With a supervisor overseeing their output.
That's how you make sure your getting your monies worth.
Call their bluff.
I don't for a second believe that GP's are working 12 - 13 hours a day.
They will always have another excuse and nothing will ever change.
Everyone pretty much agrees that the NHS is in crisis but whenever a suggestion is made about how to make things better they throw their arms up and say " we can't possibly do that"
This country needs a strong politician to take them on.
New contracts, no more part time. There not 16 year olds.

I’m a part time doctor, my basic days are 10hrs (plus commute), my on calls are 13 (plus commute). It’s physically impossible to find childcare that covers the amount of hours a full time doctor does a week. A nanny can’t work >14hrs a day while I get to and from work. Lots of doctors have partners who are also medical so it’s not as easy as ensuring someone is at home. A large % of docs are women; if you ban part time you will just have a lot of doctors quitting which doesn’t solve everything. Also I’m 60% and do 35 hrs a week if that gives you any indication as to how many hours part time really is.

Faciadipasta · 04/11/2022 12:55

Anyone know why you have to live within a GPs catchment btw when they don't do house calls anyway? I used to be at a different practice that was a LOT easier to get an appointment at, then we moved half a mile away and the first practice wouldn't allow us to stay with them because we were out of area. I wish we could have done

OP posts:
Battlecat98 · 04/11/2022 13:02

nothingcomestonothing · 04/11/2022 08:05

The level of 'sickness' is off the scale.

That's because we are short 1000s of nurses, so the ones who are there are desperately over worked. Then theh burn out, and down the spiral we go.

Also, you still get paid 'shift' and various other allowances when you are off ill.

No you don't.

It heavily relies on 'bank' nurses that cost an absolute fortune.

No they don't, they get paid the same as the other nurses, they're on the same terms and conditions and often are the same nurses who work full time then have agreed to do a bank shift becuase they feel responsiblity towards their colleagues who will otherwise be left struggling if the shift isn't filled.

Why go fur an 'official' NHS job, when you can get paid the same for 2 day's work?

I think you're thinking of agency, not bank, and of course the big fees go to the agency not the nurse.

The truth is, A LOT is staff know how to play the system like a fiddle

That is not my experience. Every day I see staff run ragged, wards chronically and acutely understaffed to the point that both front line and managers openly acknowledge its not safe. I see them routinely working unpaid overtime, in fact I don't know the last time I saw a nurse leave on time. Is it a surprise some burnout and go off sick? They are worked til they drop.

Decisions are openly being made now that will result in patients dying, mainly beciase they are warehoused in unsuitable areas to get them out of a&e. Eg opening day areas as wards, with no crash cover, no bathrooms, no piped oxygen. Becuase its that, or have people stuck in ambulances outside a&e and therefore others dying in the street because the ambulances can't offload and get to them.

Its bloody scary, but it's not the fault of lazy cunning nurses. Ffs.__

Thanks for this as a NHS nurse this is the reality and everything you have said is true. We don't get paid a penny extra for sickness and overtime does not exist. The trust I work for do not offer any incentive to work extra so wards are left short.

Staff are leaving droves yes their is alot of sickness due to MH issues, burnout and just some who cannot face another day.

The Tories are allowing this to happen, we can all see the poor access to primary care so secondary care tries to pick it up, ambulances are overworked and people are dying because of this. Absolutely nothing is being done to address this. When I attend staff/bed meetings there is no sustainable plan because no one knows what to do. We have just announced our winter pressure plan and we are just kicking the can down the road. We are opening escalation areas but no attempt to get proper staffing in, just pinch from already depleted areas.

It's not just money, re organisation and prioritisation is needed. A robust plan to get more Drs and nurses is vital. It is collapsing. There will be lots of unnecessary deaths, it's dreadful, we have been advised due to lack of staff that we need to prioritise the sickest of our patients whilst the others have to wait. For me that means post op observations/pain relief helping patients to the toilet and to eat and drink. We will then be treating these patients for dehydration/kidney injury and malnutrition. Don't even get me started on how we provide end of life care.

This is not scare mongering it's is actually happening. I only stay because I can't leave another vacancy, and, I am too aware myself and family might need to access care.

ThirstyMeeples · 04/11/2022 13:04

faciadipasta
It's generally to do with home visits although it varies between practices. Our practice accepts out of area patients with the caveat of no HV but some practices don't. The only other reason is if it crosses a border so you wouldn't be able to refer to the local services.
We do still do HV but, as time is so precious, generally only the housebound or very elderly if acutely unwell get them.

TheNosehasit · 04/11/2022 13:05

Kendodd · 04/11/2022 12:16

Could AI be developed to look at that stuff? I get that to train a person might take years, but could AI manage it?
My fear, with AI (and I (layman) think it could be very useful in healthcare) is that AI will pick up lots of the legwork interpretating test results, and the government would just say 'right, we can cut the number of staff now' so we'd actually be in no better position.

AI is what has landed us where we are. Algorithms.

TheNosehasit · 04/11/2022 13:08

Hobbi · 04/11/2022 12:19

Thankfully, they deal with actual medicine. There's no such thing as 'alternative medicine.' If it's clinically proven to work, it's medicine. I'd be interested to hear of any methods they should use that they don't that are actually supported by evidence. The things you've listed so far are placebos at best.

I don't give a fuck if it's a placebo effect or another effect but if acupuncture allows me to sleep, I'm going for that.

TheNosehasit · 04/11/2022 13:14

ThirstyMeeples · 04/11/2022 12:20

thenosehasit
We don't interpret hospital blood tests. The responsibility lies with the requesting doctor.
mobiledesktop I'm struggling to know how to respond to you. A bright 6th former is an almost ridiculous response to the discussion we've been having. It shows you have a pretty poor grasp of what we do. And this insistence of working 5 days is starting to sound like a stuck record.
I'm genuinely sorry that the service is so bad in some areas and I don't minimise the experience patients at all. It scares me to think of my own relatives getting sick.
But I'm trying to give you some insight to how things are on the other side. I don't expect anyone to have pity for me at all but simple 'solutions' like 'just work more days' or employ a 6th former are not in any way feasible. (for the reasons I've mentioned)

Except hospital doctors assume that you read the results and that you act on their discharge summary recommendations.

If I have a cardiologist and an oncologist, the onus is on the GP to coordinate that information sharing. Often you can be under specialisms in different hospitals so they don't know that you are also experiencing whatever whatever.
The GP is supposed to coordinate the care and to coordinate the information sharing.

That doesn't happen.

beonmywaythen · 04/11/2022 13:14

Agreed 😢😓

TheNosehasit · 04/11/2022 13:17

ThirstyMeeples · 04/11/2022 12:20

thenosehasit
We don't interpret hospital blood tests. The responsibility lies with the requesting doctor.
mobiledesktop I'm struggling to know how to respond to you. A bright 6th former is an almost ridiculous response to the discussion we've been having. It shows you have a pretty poor grasp of what we do. And this insistence of working 5 days is starting to sound like a stuck record.
I'm genuinely sorry that the service is so bad in some areas and I don't minimise the experience patients at all. It scares me to think of my own relatives getting sick.
But I'm trying to give you some insight to how things are on the other side. I don't expect anyone to have pity for me at all but simple 'solutions' like 'just work more days' or employ a 6th former are not in any way feasible. (for the reasons I've mentioned)

You also don't act on the recommendations of the hospital doctors because your administrators file them neatly and you never get sight of the hospital doctors' recommendations to refer.

ThirstyMeeples · 04/11/2022 13:18

thenosehasit
That's incorrect. If the information is relevant to the oncologist, the cardiologist should share it directly. We do not act as an admin service for secondary care.
If we are referring to another specialist (that is unconnected to the 1st) we generally enclose all the relevant info.we always act on the discharge information that is relevant to us but it is the duty of the specialist to communicate it to the other interested specialities.

ThirstyMeeples · 04/11/2022 13:19

thenosehasit
Your information is entirely incorrect. If there are any actions on the letter, it comes to the GP.

Prestissimo · 04/11/2022 13:19

We do do house calls - I did three yesterday having triaged four more and dealt with them on the phone.

We only visit patients who are genuinely housebound though - always a bone of contention. It takes a lot longer to visit someone than for them to visit us, so if someone goes out to the hairdresser/the shops/Sunday dinner with the family then no, we don't visit unless they are acutely unwell (making them genuinely housebound). I certainly wouldn't expect to visit an 8 year-old at home as on the whole they're pretty portable ime, and if they're so sick they can't come to us they probably need an ambulance.

At the moment GP access is made worse by all the other problems in the NHS. Covid backlog/people who didn't see us then and so really need to see us now. Hospitals are busy so people are discharged prematurely so we spend time clearing all that up. We (in the practice, not me personally) spend hours chasing clinic letters that take weeks to arrive but the patient is requesting the recommended care literally on their way home from the appointment. Discharge summaries with only half the information we need. Patients told one thing and the letter says something else so we need to clarify. We chase hospital appointments to make sure people haven't been forgotten - the last letter we have says they'll be seen in six months and fifteen months later the patients wonders if they've been forgotten. I know one practice locally who have employed a full-time member of staff just to do all the secondary care chasing, which wouldn't need doing if hospital staff had enough time and headspace to do their jobs properly.

We are also managing the huge number of patients who really need to see a specialist, and have indeed been referred, but the wait is over a year and so they come back to us asking for something in the meantime. I don't blame them but I often have nothing more to offer.

I agree with a pp who said that pharmacists aren't used enough. We have a local scheme where we can signpost patients to a booked pharmacy appointment for minor illness but I'm not sure what has gone wrong there - most are simply bounced back to us after a phone call. Doesn't help anyone.

We know we're not doing the best job we can because there is too much work and not enough of us to do it. I promise we're working really hard. As others have said routine days are 12-13hrs and still the work isn't all done. We have streamlined what we can but the demand just far outreaches our supply. None of us enjoy knowing that patients can't get through on the phones, or that people have to wait days or weeks to be seen by us. The decisions we are making are often literally on the basis of who can wait most safely, nothing else. I'm not asking for pity or sympathy, just a realistic recognition that we're not sitting around fiddling while Rome burns.

And so our appointments are full and so other patients go to A+E and so A+E is busier and so people are discharged too early and so they come to see us, and on and on it goes.

I don't know what the solution is, frankly. I don't think the genie can be put back in the bottle, so something radical will need to be done. Whether any government will have the courage or the insight to do this (instead of just rearranging the deckchairs) remains to be seen.

Pollymollydolly · 04/11/2022 13:26

Nomoreflyingducks no worries, it’s my fault - I didn’t quote properly so it wasn’t clear!

TheNosehasit · 04/11/2022 13:29

ThirstyMeeples · 04/11/2022 13:19

thenosehasit
Your information is entirely incorrect. If there are any actions on the letter, it comes to the GP.

Exactly. Except you don't see the reports, read then or act on them.

Prestissimo · 04/11/2022 13:32

@TheNosehasit I'm not sure why axe you're grinding here, but we really do read and act on hospital post - every day

Midwifetob2024 · 04/11/2022 13:37

@Lentilweaver it already is my lovely. I personally know people who have travelled to Poland and Turkey for dental procedures.

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