If clinicians can be drafted in to answer 999 calls today…

[Treedecsandtinsel]

If clinicians were able to be drafted in today to answer 999 calls today during the paramedic strike, AIBU to think the government could have taken the same action earlier when we started to see ambulances stuck outside hospitals and no-one available to get to other emergencies?

I stopped to chat to some paramedics on the picket line at my local ambulance station today. They wanted to be clear that they had been responding to calls when needed but that they are certain that having clinicians answering 999 calls has helped to manage the calls coming through to them. So they asked why on earth that wasn’t arranged before?

AIBU to think that this government has just shown that it has been sitting about watching the ambulance lines getting longer and longer when more could have been done?

It doesn’t sound a good idea. But listening this morning overall calls were down hugely. So the public’s behaviour did change

@MarshaBradyo that is certainly true, calls to ambulance services were down as were self presentations to A&E. However, there are concerns that the 'missing' numbers will come back through the system today and tomorrow, and that a proportion of people will be more acutely unwell than if they'd attended yesterday.

This is at the time when the NHS is usually doing its big decant before Christmas. The days after boxing day are always incredibly busy, and we will have more strikes to manage from Wednesday next week. In my organisation we have been running the last two days as a critical incident (as we are again today) which meant much less work has been done, including standing down some routine activity which just makes the backlogs worse.

It would make a big difference if there weren't shedloads of patients who are medically fit to be discharged but awaiting assessment by adult social care. That would free up beds and speed up the throughput of A&E patients who need to be admitted, enabling swifter handovers on arrival at A&E and getting the paramedics back on the road.

But councils have had their government grant cut year after year for a decade or more so they don't have the money to employ enough people to get the assessments done promptly. All this stuff is joined up, and not all of the problem is within the NHS.

Having said that, improved pay will improve retention. I know a paramedic who has recently left the service to become a PIP assessor for the company that holds the DWP contract. It's better paid (£42k to start, rising to £46k on satisfactory completion of training), no unsocial hours, and far less stressful. Two of his colleagues have done or are doing the same. It's not a job I'd ever do, but I can see how attractive it is for nurses or paramedics.

Actually we had hospital managers musing about “how many more discharges” we had during the junior doctors’ strike, and insinuating it would be better if we got rid of “inefficient” junior doctors altogether and just had consultants delivering the service. Heard similar comments from patients too.

The point about the effect on other services to having consultants writing discharge letters and putting in cannulas had to be made pretty strongly.

If this is true then one really has to wonder about the intelligence of these hospital managers. How do they think people become consultants? Magically, presumably. They magically pop into existence, fully trained and with years of experience. And junior doctors remain junior doctors forever?!? 🤔

Afterthought: and they need to bring back training bursaries too, and write off student debt after, eg 10 years' NHS service.

This!!!!!!!!!

I am ex NHS and for me it was the working practice and lack of support that made me walk away. Retention is a huge issue along with the constant reorganisations. I lost count of how many reorganisations we had since 2013, how many times I had to reapply for my own job, how many times I was prevented from getting on and doing the job I was paid to do and how many excess hours I worked for no extra pay. I never lost sight of we were there for the benefit of patients but sadly within the chaos I knew that patients were not getting what they deserved. I just couldn’t do it any more.