If you work in the NHS, how would you fix it?

[startingitallagain]

Or AIBU to think it can't be fixed and we're gradually slipping down the slope of eventually not having an NHS?

I do absolutely understand how many staff within the NHS are struggling to cope under the pressure, with many leaving due to their own mental/physical health issues that the job has caused.

This has been inspired by another thread where the poster can't get a GP appt for their father who has terminal cancer and can't keep food down (and hasn't been able to for a number of weeks). www.mumsnet.com/talk/am_i_being_unreasonable/4708090-to-wonder-what-my-gp-surgery-is-actually-doing?page=1

With elderly parents myself and having to occasionally battle for them to get care, I find the prospect of getting older in this country quite terrifying, so much so I think I'd rather plan for euthanasia if I was facing end of life and no care!

Is it funding? Is it lack of staff? Would more money solve the issue? WWYD?
(As an aside I remember watching the documentary 'Can Gerry Robinson Fix the NHS?' a number of years back - made interesting viewing about the issues then!)

Money won't solve the nhs. No idea what will.

For me there's a myriad of many things, but the main ones:

Reopen community hospitals, minor injury units (and staff them 24/7), and go back to holding clinics in the community.

In addition to ambulances as we know them, reintroduce adequately staffed and suitable vehicles to safely assess and if necessary transport those who have had falls, mental health ambulances, and invest more in training for call handlers to more effectively triage calls. Also an education piece to the public.

Improve staff retention, pay isn't the only way but is a key way and the easiest start point. The nhs is nothing without its staff- you can have the fanciest equipment and tonnes of beds but it's useless without appropriately trained staff. There are tonnes of other things that would need to be done but that's probably another thread.

Government invest in social care to avoid people being 'stuck' in hospital. Also invest in societal things that affect health.

Get rid of the fucking "internal market" the amount of money wasted because badgers are by department and the bean counters to administer it.
Of course there has to be a budget but fuck me! patient goes to theatres needs ITU they will need to have hourly urine measurements.
Say that catheter bag costs £5 and a silicone catheter because they will need it in a while call that 50p
Only theatre won't pay for them as it's out of their budget so they put in a normal catheter and urine bag total price 60p but they also need to use a sterile set and a member of staff call that £4
Then they go to ITU 4 hours later and it's all removed and replaced - the waste also costs money to remove.
Happening between wards, outpatients, GP surgeries to hospital, vice versa, theatre to ITU, ITU to wards will all manner of items and staff time.
Staff treated like shit and hounded when they try to call it out.
Paying for parking considered for important to invest in than equipment, constant rebranding... sons nurse said the other day he hasn't moved desks in 15 years but is on his 5th employer none who will invest because they only have the contract for 3 years so what is the point, and the paperwork and signs, phone numbers, policies and procedure's all get chucked out, rebranded and cost thousands.
This is just a start

We need to manage the population growth.

As a NHS worker, I fear it is beyond fixing. Though I pray I am wrong! I feel like it is much worse than the public can even imagine and morale is incredibly low. Staffing issues need to be addressed but understandably people do not want to work for such low paid/ high stress jobs. Pressure on existing staff is reaching breaking point and conditions on the front line are horrific. I am grateful that I don’t work on the wards but the respect I have for my colleagues is infinite. Change is required from the top to the bottom and there needs to be a HUGE cash injection. There is also a lack of care home facilities which means patients that are well enough to be discharged but aren’t able to live alone are taking up bed spaces because there’s nowhere else for them to go. It’s such a sad state of affairs. I also truly worry about our future!

There is a huge amounts of waste in time and resource. We have old antiquated paper based processes. Doing anything is time consuming for clinicians.

It carries a lot of "dead wood" staff members who are constantly off sick and unable to do their jobs.

I would say it needs a better stricter HR, huge initial outlay to have a great digital system (rather than lots of individual systems that do not talk to each other). A lean/QI team to look at all our processes.

I like your ideas @Pianofar but that sounds a lot like more cash needed and a need to recruit more staff - can it be done? What would entice those that have left the system to come back to it? Or should we be looking to recruit from abroad*?

(*As an aside I'm not NHS but I did recently require emergency surgery and two of the three Docs involved were all Eastern Bloc - I received fantastic care and am very grateful.)

This plus massive investment in social care as it's own department.

Pay social care workers the same as their equivalent nhs workers. This would improve social care recruitment and retention, reducing hospital bed blocking and improving person centred care/safeguarding/consistency of care throughout health and social care sector.

We also need to finance the nhs and social care sector properly. Aim to copy the German system rather than the rubbish American system.

properly funding individuals social care packages would be a start

I know a couple of people who are relatively 'high up' in the NHS. Their absence record is definitely higher than average.

@GreenDanglyearrings Am I right in thinking though that a joined up IT system is an issue simply because there's too much data for it to be handled efficiently and the system would therefore keep crashing all the time as peopled queried the data and added to it? I know my local GP practice always moan about their system, keeps glitching and crashes. That must be so frustrating to work with!

Otherwise I agree, a system that everyone in the NHS can access would be brilliant!

Have one nhs nationwide computer system rather than lots of different computer systems so that all trusts can share information properly.

We need to manage the population growth

You know birth rates are so low that the government is trying to work out how to get more women to have children?
People are living longer nowadays.

I am going to 100% agree with the social care aspect - seen this first hand with my own elderly parents - bloody nightmare all round and the stress for everyone involved was awful.

I think the “ manage the population growth “ was a dig at immigration, not birth rates.

There are so many excellent suggestions here. All wasted effort, though, as the government's agenda is to ignore all issues until people are glad to pay.

So at the moment I think the majority so far say it needs far more funding - would everyone pay more tax though to fund it? Conservatives aren't known for raising taxes so I guess that's not happening whilst they're in power.

Why can’t the NHS email appointments?
Instead of posting letters , which are a waste of the price of postage / admin staff / secretary / paper etc.
it’s a huge bugbear of mine , letter is posted out , can’t attend , have to physically call to reschedule , waste of time having to speak to appointment secretary etc. It’s SO antiquated

Legalise euthanasia- with strict controls. We cannot sustain millions of 80/90+ year olds with no quality of life and a myriad of health issues when they themselves don't want to live that way.

Honestly I despise the fact that DGran who's got dementia, has no choice but to waste away like a cabbage, when she's always said she would rather go on her terms. We don't treat animals like it, so why do we keep humans 'alive' at any cost, despite the quality of life being nil.

We need to get people to pay towards their healthcare and social care, sadly. With support for people who can't afford to pay, and charges for people who can.

Hospitals are at breaking point because of lack of social care. GPs have an unreasonable workload. People are going to A&E for things that should be addressed by their GP, or that they could go to a pharmacy for. Services which are free at the point of use tend not to be used wisely.

I agree
My DF has said so many times to not keep him going if anything happens but in reality this won’t be the case with current laws etc.

I don't think that helps at all. From what I can see, there's a lot of bed blocking by elderly who need some care at home rather than hospital, and we need the staff/cash for that. It's not the younger member of society that are causing the issue from what I can see. And having just recovered from surgery by DRs from the Easter Bloc myself, I sincerely hope it's not an immigration dig. Perhaps you can clarify though if I've misunderstood?

I get your point, but not everyone uses email. My elderly parents don't for example.

On the other hand, in the last week I had a txt to tell me that I needed to book my Health Check as per the letter that was sent out. I've had no letter though - guess it's in the postal backlog somewhere!

I think this varies by trust as I’m currently pregnant and I’ve received text messages for all my appointments. Our GP surgery always texts about appointments and the SALT team that my son uses sends emails. So much more efficient!