The state of the NHS laid bare in one video... Pinderfields General Hospital, Wakefield, West Yorkshire

[PeppaPigOinkOinkOink]

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Video posted outside Pinderfields General Hospital a couple of hours ago. No capacity in resus areas, no trollies to offload patients from ambulances. Which in turn means people in the community waiting hours and hours for emergency 999 calls.

People say health care professionals went into the job knowing what they was getting into.. not one nurse I know (or Dr or paramedic or HCA) went into their job knowing this would be their reality. This is why people are leaving, why people are striking. Its not just about pay, its about working conditions. Pay does play a part admittedly, the pay doesn't marry up with the level of responsibility, the level of stress, the level of upset caused by knowing you're going home after knowing not one patient has had your absolute best all day.. because its impossible to achieve.

This is the reality of the NHS 💔

This is the correct answer and should be reposted every single time these threads repeat.

Another one declared - South East

www.getsurrey.co.uk/news/health/east-surrey-hospital-declares-critical-25853422

Nothing short of criminal and those that support them now are as well.

The problem is that population level health interventions haven't been implemented early or well enough. Early interventions, at age 0-5, are effective. We have lots of research out there telling us that if you place public health population level interventions in early life they create less upstream stress on the system.

The elderly who are coming through and placing mass stress on a stretched system now? They didn't have population level health interventions - they grew up with poor diets, smoking, higher alcohol consumption, zero mental health support and were the first generation of regular car users and a sedentary life style caused by jobs becoming automated. Now they are trying to access a system that allows them free entry at a clinical event (NHS), limited capacity for clinical resolution but a very difficult pathway out into a social care system that is being crushed under the weight of demand.

The biggest indicators of poor health outcomes are poverty and a lack of education about health and wellbeing. This stuff isn't difficult to deal with - it can and does work but it isn't politically popular. Take UBI for instance. People do not want generally to pay for others who they see as 'less' and some people do not want 'others' even entering the system to support how it works. Money isn't what is needed. It is a cultural and collective shift in mindset and systems thinking but I can't see it happening in our generation.

When will the government do something significant to help?

lol

It’s not just shout the elderly. We’re also saving more babies that we wouldn’t have previously, earlier and earlier. A lot of them have long term health conditions, cerebral palsy, tracheostomies, long term ventilation, chronic lung disease. They have long term care packages, physio, OT, endless medications and any sign of a chest infection puts them in hospital. It’s only going to increase as medicine advances.

It's not even about money, it's about management and joined up thinking.

There's a huge problem with (privatised) social care not meeting the needs of the ageing population (in no small part because the pay is so shit and we cut off our supply of people prepared to do a very difficult job for low pay). This leads to hospital beds being full of elderly patients who don't really need to be there (is it 1/6 beds? ) so there's nowhere to put people coming in. Hence queues of ambulances.

www.bma.org.uk/bma-media-centre/bma-warns-of-social-care-crisis-as-current-system-is-deeply-flawed-and-in-need-of-urgent-reform

There are a huge number of vacancies unfilled in the NHS so hospitals are struggling to manage and end up spending far more filling the gaps with agency staff than they would if they could just pay a decent wage to permanent staff.

www.theguardian.com/society/2022/sep/01/nhs-vacancies-in-england-at-staggering-new-high-as-almost-10-of-posts-empty

There is a shortage of GPs meaning they are struggling to see everyone that needs to be seen so people are ending up sicker so go to A&E or desperate to see someone so go to A&E so that now the understaffed A&E is spread even thinner.

www.health.org.uk/news-and-comment/charts-and-infographics/the-gp-shortfall-in-numbers

Meanwhile we are still in the throes of a global pandemic. Contrary to popular belief covid has not gone away. Although I saw on the news there are more flu patients than covid in hospital now we must remember that the covid patients are there in addition to and not instead of the flu patients. There is also a backlog of missed appointments to get through, people who tried to do the right thing by not being seen when actually they really should have been and now they are more unwell and need more treatment than before. Flu and RSV viruses circulating more freely after they were also suppressed by lockdown. Not to mention the high numbers of medical staff suffering from long covid and unable to work as they used to.

inews.co.uk/news/health/soaring-cold-flu-covid-rates-christmas-nhs-2033795?ico=in-line_link

Having a healthy population is of benefit for us all. People who are too unwell to work are not contributing and need care.

Our spending per person on healthcare is not huge in this country. The US system (favoured by key Tories) is far more expensive.

en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

The whole system needs to adapt for todays lifestyle and population. There needs to be a distinction drawn between ongoing healthcare needs for the sick/people with manageable conditions and elderly Vs the acute needs of the working or ailment free population.

In their current iteration, GPs should exist for management of ongoing conditions like epilepsy, diabetes, cancer for eg, and for management of the community care needs for the infirm and elderly. They should manage the community side of care and work with the district nurses, end of life nurses, carers etc.

There should be health hubs in an easily accessed place in each town with a drop in and appt based service with doctors, larger towns could have a minor injuries, some nurses, clinics for things like phlebotomy and contraception, midwifery. Somewhere to take your kid when they have a rash or temperature. Broad things that you don't need to discuss with a specific GP. Appointments could be given from a central call centre.

Oh and for the love of god bring back children's centres in a useful capacity. An ounce of prevention is worth a pound of cure and all that!

I'd also add the national service frameworks for older people, coronary heart disease and cancer which brought in co-ordinated evidence based treatments and established targets to measure outcomes.

The co-ordination was needed because shamefully even though the evidence for interventions was clear, patients were not systematically being given them. Even cheaper than chips aspirin was only prescribed if someone remembered.

On the other hand they also fucked up the GP contract by allowing them to opt out of out of hours care and brought in the financial disaster that was PFI. Labour also oversaw the expansion of privatised social care.

It's not as simple as labour good/Tory bad but people had better health outcomes under Blair and Brown. A shame the funding wasn't thought through.

The ideological reforms implemented by Andrew Lansley against a backdrop of reduced funding have been catastrophic though. I remember arguing with external consultants that their proposed targets to reduce hospital admissions to save money were unrealistic (and frankly insane) against a background of an ageing population and was told I was being too negative. Plenty of people like me pointed out the obvious flaws but politicians didn't want to hear them.

And we are still there. The Tories are still infected by their right wing who want to defund the NHS further and get rich off the back of it. Again see social care as an example of what a disaster that is. Meanwhile labour promise everything to get into power but haven't got a credible plan to fund it.

This is shocking but there has been a complete lack of social care, leading to issues with bed blocking, combined with winter peaks of respiratory illnesses - for many years now.
I don't quite understand why things are suddenly so much worse right now.
Is it linked to Covid/Brexit in some way? For instance, there simply aren't care workers to provide the care packages in the community, due to people having to go home or leaving the workforce due to poor pay/conditions, which means more beds are blocked?
I don't remember it being even quite so awful even during Covid.
Would be great to hear from those in the NHS/Social care why they think things seemed to have fallen off a cliff...

It's not as simple as labour good/Tory bad but people had better health outcomes under Blair and Brown.

Many did not.

Social care is the elephant in the room. The population of elderly people now are using the vast majority of healthcare resources so the health of the people they need to be fit to work to support them suffers. Ultimately they didn't pay enough tax in their lifetimes to fund the care and healthcare they need and the younger generation cannot afford to do this for them.

Agree with PP that ongoing elederly care for multiple morbidities should be separated from GP access for others. In many countries children have a paediatrician as their GP, same day appts. Perhaps at over retirement age there should be separate GP practices specialising in elderly care, and then everyone can see someone appropriate.

Ultimately the model doesn't work. That's why all of the successful healthcare systems in Europe where people are seen in a timely manner, and health outcomes are far, far better, for a not significant difference in investment per head of population considering the difference in service, are much better.

Everyone I know who is still living here who is an EU national (not as many as a few years ago, of course...) flies home every time they need to see a dentist or doctor. That speaks volumes. Although they all work and pay tax here, doing so has saved some of their lives! They'd have been dead if they waited here to be seen by the NHS that they pay for.

Sadly I think many more people will die here needlessly before we adopt a sensible health model like those on most of the continent. One that actually works.

And, as @sst1234 said upthread, the reason the young can't afford to fund this now for the elderly is because of mismanagement of the entire economy. Healthcare should have been restructured properly: as in rip it up and start again and copy what works elsewhere. But also how will this be paid for? Where is the automation? Where is the investment in productivity? What were the plans for energy and food security?

The British people complain about the services but seem to have very little engagement in why the situation is like this. Does anybody even know what the balance of payments deficit is? Why not? If you want good services then ask your MPs about this and what they are doing about it. Oh, and voting for a £40bn hole in the budget and saying "I'm happy to be poorer" is probably not a good plan.

Funding is NOT the issue. Management is the problem. The spend put in does not align to the service given. There needs to be full reform of the NHS

Funding is definitely an issue. Other healthcare systems that are often mentioned for emulating - Germany, France, Australia, Denmark etc all have higher government funding per head as a proportion of GDP than the UK do, alongside some form of insurance/co-pay. The NHS will not improve if it is not properly funded.

Thought needs to be given to how the funding is used of course - the best funded healthcare system in the world is in the US but that is not a system to emulate.

Most of Europe have a better system cos privatisation as a choice plays a part, it's time for a real debate from all parties the sacred cow of the NHS is not working

@Forever42 Having just come back from living in Denmark- it does not have a pay in insurance system. It operates like the NHS- but it is a much smaller place admittedly with a much healthier population in my opinion and much higher levels of tax. You also don't have council tax or NI

Agree completely. And PIP claims are at record highs too. The Tories have completely trashed the nation's health and wellbeing.

Maybe if the country hadn't spaffed£400 billion on a Brexit that has no significant benefits of any kind for all but those at the offshore level or in very specific shortage sectors like HGV driving or building (and even then the only benefit is higher wages due to a shortage) and also driven away hundreds of thousands of hard working young Europeans there would be more money and people in the system for both productivity and tax take. Those that voted for it simply didn't think through 'all' the implications. We are not a country that had people not able to get work , we are a country where those who can and want to work were working in the main. It doesn't matter if we had £15 an hour minimum wage- some people would rather get by not working

Privatisation is happening, read mum's net and many people are already paying to see specialists or private dentists. The government are running it into the ground so those that can stop using the NHS and those less fortunate left with a basic service that will mainly keep them alive.

@Idtotallybangdreamoftheendlessnotgonnalie Bravo!! How it works in Germany

The chances of being in an emergency situation are reduced if you can pay privately for health screening and early intervention of any emerging health issues; not to mention that the wealthy can generally afford a healthier lifestyle.

At the moment it is becoming a bit USA like- with non of the USAs advantages.

Jesus! Local hospital ☹️