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!)

I lived in the US for a while and when I did visit hospital saw NO ambulances, and virtually no one in a wheelchair. I think it's assumed that people will get themselves there and around the hospital.

I do think that everyone seems able to get to edge of town supermarkets etc but then when ill expect an ambulance.

We need to be more independent.

Second thing - open the departments 24/7 - obviously needs more staff but expensive scanning equipment lies unused cos it's the weekend.

Some years ago, I read about a bog standard fridge costing around
£250 via procurement, when they could have bought the identicial model for less than £80 in Currys. If true, that's just mad.

Should add, it was needed for clinical purposes, not just to keep the milk in.

Honestly I despise the fact that DGran who's got dementia, has no choice but to waste away like a cabbage,

Well, I expect she could have taken herseelf off to Switzerland - but then wouldn't want to when she had most of her faculties. Perhaps we could write it into our Do Not Resusc form - that you want to go to Dignitas as soon as diagnosed with dementia. But if you have dementia you probably are unable to see the need for dignitas.

The software is available but can be very expensive and relies on all hospital trusts buying into it unfortunately...

I agree though, recently been sent between two hospitals and had to relay ALL the info twice as no one had anything.

I disagree with the sick pay. The minute they touch public sector benefits like 6 months sick and maternity pay is the minute MILLIONS will leave. We get paid like shit (all public sector), never get any rises, all overworked, if they remove that benefit there's no point to working there.
Public sector compensation has to be competitive or what's the point, we may as we work in the private sector and get better pay opportunities

I really think euthanasia will be legal within 10 years. We put a family dog to sleep this week. He wasn't old but he was incurably ill with something that would have inevitably led to a death full of suffering. Instead he slipped away peacefully on my mum's knee. All of us there, especially the vet, said this is better than what many people get.

If you charge people it's not used wisely either with people who can't afford it not accessing it when they need it

What happens if the person is on a low income and can't afford the fine? And won't it cost more to chase the fine up?

I do think that everyone seems able to get to edge of town supermarkets etc but then when ill expect an ambulance.

To be fair, if you're going shopping, you're likely to be well enough to drive yourself, but if ill or injured, you're not. Not everyone has family/friends who are able to give lifts at short notice.

And imagine the parking charges if you drove yourself to hospital and ended up being admitted for a couple of weeks? A taxi to my nearest hospital is iro £30, not everyone has £30 spare to get themselves to hospital.

It is beyond fixing until the political parties stop playing politics with it. Labour seen as the saviour and just flinging yet more money and then the Conservatives respond.
I'm fairly new to the NHS at mid to senior level .

More money isn't currently required....they have loads due to the vast vacancy factor so u spent salaries.
Up to 1/3 of our bed based is blocked with people not requiring treatment but need social care,whether support at home or care home. Not enough care home places (funding and can't recruit staff anyway) and isn't enough staff for domestic support for the same reason.

Put aside politics over pay rises...we simply can't recruit at junior levels....so ok hold the pay down to reduce inflation but the market is now in play. Why would someone work for £22k as a support worker when they can get £28k at Amazon...they may not want to but many can't pay their bills so have no choice.

Managers..many are needed but many are bordering on incompetent....wouldn't last 5 mins in many other public sector bodies and most definitely not private sectors.
Nurses..if going to promote them to management positions then they need training and mentoring....many of our Ward Managers are lovely people...competent nurses but useless mangers despite trying hard.
Finally....ensure we have training university spaces for nurses....I accept we may not fill them due to the pay issue but current half our nurse recruitment is scheduled to be from overseas where we are going out to entice them to the U.K., all being taken from developing countries that desperately need them more than we do which is just plain wrong in my view.

Would privatising it at this point be the only reasonable solution?

I feel like the govt is letting it burn in flames to push more people towards this.

Personally for me it's worked, a recent stay in hospital with poor conditions and burnt out staff meant I nearly died from things being missed/not managed quickly enough.

But I'm curious what NHS workers actually feel privatisation will do?

‘(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!)’

Not an aside @startingitallagain! I spoke earlier today about this very programme. I have searched high & low for it online. At the time I was highly impressed by the clarity of his thought & absolute determination to find out from frontline staff their practical observations about improvements of services, resources & processes. His business & leadership experience gave weight to his straight forward observations about what was required. At the same time, I was using early ‘lean’ methodologies in the tech sectors so Robinson made great sense.

I have seen ‘lean’ appear since in the NHS OD canon & the need for ‘difficult conversations’ to take place as there is a drive for change & Improvement. But the NHS is huge & suffers from operational & cultural inertia, & throwing money at it is not what is really required.

Honestly? I don’t even know. I’ve never, ever seen it anywhere near this bad. The demand is sky high and it’s not people misusing the service, they genuinely need to be there.

Not opposed to it in principle but am very opposed to the reality where I think it's impossible to get the right safeguards in place. What about people who feel they will be a burden on relatives or the state but this should not weigh into their decision making?
As people adjust to a new disability they could go through an initial period of depression while they adjust and realize the discrimination they now face. Having this option on the table could cut them off from years of a happy but different life.

Improve the recruitment process would be a good start.

My DD is a student nurse. She has been approved for bank HCA work. However, completing the HR tasks have been both time consuming and ridiculously slow. I fully understand the need for checks (I work for the LA), but most people would not be able to wait without work the time this has taken.

I think it would be an absolute disaster to legalise euthanasia within the context of failing health, social care and mental health systems. We need to get so many other things right first before we can open the door to euthanasia.

Maybe staff are sick because of the stress and pressure of being so overworked

All of these plus;
slim down the management structure, it’s ridiculous how top heavy it is.
bring back State Enrolled Nurse SEN training - one of the biggest mistakes was abolishing this (Project 2000 training was the beginning of the end imo)

Stop treating everyone for everything, especially older people with dementia. We need to keep dying people comfortable, but we need to stop sending every nursing home resident on a blood thinner into hospital for a CT scan of their head every time they fall over. No one is going to operate if they find a bleed- so what’s the point? In fact we need to stop all meds (except mood stabilizers and pain relief) on anyone going into a nursing home. Life expectancy in a nursing home is 18 months, how about we just keep these people comfortable? Would you want to spend the last 18m of your life surrounded by old people in a smelly home (they all smell-the homes, not the people)?
I know I’ll probably be roasted for this opinion, but we are spending insane amounts of money keeping dying people alive. People in NH are dying, just slowly. The euthanasia argument amuses me. We don’t even let dying people die, we aren’t even close to letting living ones die.
stop giving cancer patients last ditch treatments that cost ££££ and may buy them an extra 2 weeks of life - lying in bed and just about breathing (oncologists are external optimists).
we spend the most at the extremes of life. We need to start being a bit more selective about how we manage these people.
people will talk about less managers and less waste, and there is scope for improvement there too, but it’s the money we are haemorrhaging on keeping dying people alive that is killing the NHS.

Have said it for years, too many Chiefs and not enough Indians. Getting rid of many useless management positions would greatly help.

Large national IT system impossible for NHS?

Wonder how utility companies, rail networks, power stations. air traffic control manage large amounts of residential/commercial/real time data & keep operations performance at acceptable levels?

It gets done because it has to be done, & anything less is either commercial or a disaster. This requires commitment, resources & money.

The NHS has not yet decided to do it.

7 day a week GP/Nurse Practitioner services, stop people overwhelming A+E because they can’t get a GP appointment. Our GP surgery is utter crap since Covid hit, one GP sends you to Ambulatory Care or A+E ‘to be safe’ for the most minor of reasons-might just as well go straight there! (I wouldn’t and don’t)

‘…especially older people with dementia.’

?

The same could be said of babies born severely disabled them requiring a life time of care . Just because medical science can save them doesn't mean it should .

I received a letter, hand delivered (no postage mark, plain envelope) at 7pm the night before an appointment telling me it was cancelled last year. Surely a text message/phone call would have more efficient!