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!)

The nhs still owns a lot of the estate needed for these local hospitals, and with collaboration with the council could access venues to host clinics- we used to have a room in the library for diabetic clinics and it was great. In my experience these jobs are always more desirable for some as well- closer to home, different environment and pressures to main hospitals, usually more family friendly hours etc; we lost a lot of HCPs with each closure and scaling back of services as they didn't want to work shifts in a main hospital.

Lots of my colleagues have left to continue on with nursing but in the private sector or for agency, imo if things improved ie fairer pay which would naturally lead to better retention and so less stretched working conditions I think many could be enticed back. They love nursing, they haven't left it they've just left the nhs, but it would take major changes.

Recruiting from abroad is a tricky one for me. No shade or disrespect at all to those who come over, they are highly skilled, fantastic assets to the nhs and being realistic have kept it afloat! But there is the question of ethics. There's an informal agreement we are in along with other western countries that we won't exceed x amount of nurses from developing countries as this then depletes their healthcare systems; but we often go over that with no hesitation. Lots also aren't keen to fight for better pay because to them the pay is brilliant. This means the gov can continue to exploit this cheap labour whilst screwing over people here. To be clear, they are great assets but it's the way the government uses them to plug gaps and not improve pay and conditions for all that's the problem.

Essentially the most important part of the nhs is the staff, the government know this but seem loathe to actually do anything about it.

Do you work in the NHS? I didn’t know that triage nurses can’t send people home.

I agree with charging people for wasting time.

Also, on the job training would be great. I thought about retraining but there’s no way I could afford it with two small children at home.

People also need to better understand their own personal responsibility for their health. Eat less crap, exercise more. Sometimes I wonder if people just don’t want to take responsibility for themselves and expect others to sort out their health problems. I mean at the preventative point, like drinking and smoking less in the first place.

I’ve had two letters and a text reminding me to have my covid booster. I’m not having it, so that’s a waste, I should be able to register somewhere that I’m not having it to save that money.

Get rid of the Tory's, I have worked frontline in A&E under both Labour and Tory, the Tories have destroyed literally everything in this country. I have never seen it as bad, closing beds and wards, no social care, no primary care, GP's that are taking the mick, still binding behind Covid when everyone else gets on with it.

The whole point of the NHS was free at the point of contact, the Government want to privatise it and profit from it, hence why you will see a lot of our ministers now own shares in private medical firms.

They introduced charging all NHS students for their training. Why would anyone get themselves into 45K worth of debt for 25K per year?

Vote these lot out or get what you voted for.

Over thirty years nursing.
Too many people living too long often in very poor health.
And who would you charge for wasted time? Everyone? Children, those on benefits, pensioners? Or just the same poor sods in the middle.

I don't agree with all of this post as when you are the old confused 90 year old you are probably keen to hang on to the last weeks/ months of your life.

However, once in a Care Home people are treated with kid gloves - no normal life events, no stairs to climb (in case they fall), no covid allowed etc so they live much longer than they would at home. I feel this is unfair in a way - they have boring lives, the only interests are tv they can't follow, and busy staff to chat to. Their worldly goods gone, No friendy neighbours to wave to.

If someone has a fall or dies unexpectedly in the care home it reaches the front pages of our local newspaper. This needs to stop. We have inspectors, trust them to do their job and the homes to do their best despite shortages of staff etc. and don't unnaturally extend life.

@PoinsettiaPosturing ….there is a choice re old people, but 99% of the time when you ask relatives what they want they always want treatment. In my 22 year career I’ve had 2 families who have asked me not to treat their relatives with dementia and a UTI/chest infection. In both cases the patient died within 48hrs. In both cases the patient was still living at home, but the families were really struggling to cope and said they knew once their relative went into a NH their quality of life would deteriorate rapidly and we were just ‘delaying the inevitable’ and adding a heap of misery for everyone into the equation. Giving someone a dignified death is a huge privilege, one that’s mostly denied to healthcare workers by well meaning but misguided relatives.

@Virginiaplain ’the confused old 90 year old’
………living largely independently at home with an infection induced delirium = definitely treat.
……….living at home with 5 X day carers, bed bound and wearing incontinence pads or with a catheter…..and with an infection that is making their dementia worse…..well I wouldn’t want to keep going it that was me or either of my parents. But lots of relatives seem to think it’s an acceptable way to keep their relatives alive.

Bring back the bursary or fund university places for nurses. Increase training spaces for doctors and get rid of ridiculous pension tax rules for consultants. Increase international recruitment.

I'm ex-NHS and for me the absolute biggest thing needed is to invest in social care

@Wetnovember my mum told the doctors to stop treating my 84 Yr old grandmother with advanced dementia for pneumonia and just make her comfortable. A doctor told her it was absolutely the right decision. Not sure he was really supposed to say that but it's true.

@iloveeverykindofcat I’ve had arguments with colleagues who think it’s unethical not to treat the treatable. I hold the opposite view in selected cases.

@HeBeaverandSheBeaver

*Such a huge issue but I'd do the following

• We need to pay more tax to fund social care. End of. No bitching and moaning. We want an nhs it has to be done

1. Use said tax to fund care homes or convalescent homes with properly paid staff "*

I think the more tax ship has sailed. Huge tax rises are already lined up to reduced the deficit. The tax rate is going to be the highest ever since WW2. I'm afraid each government finds it easy to spend more but that option has run out..... Governments of whatever colour simply now have to cut spending as our economy is not growing....a harsh reality non of them like as they all love promising more spending to curry votes

In my trust the system that generates appointment letters was developed pre email - they can't be linked so can't be sent. The whole NHS needs better IT systems - what we work with is archaic.

Although, around 75% of my patients don't have access to email anyway.

@Wetnovember same. Her QOL was nil, she'd reached human life expectancy and was dying a natural death. For what reason would we prolong that.

Not only is legalising euthanasia the right thing to do morally, it will also have economic benefits for the NHS.

And reduce the thresholds at which people pay for their care. Why should other taxpayers start subsidising those in care homes for example who still have just over £23k sitting in the bank?
Down to the last £7.5k, enough for a funeral, and use up the rest.

I live in a small town within commuting distance of London. Both our 'local' hospitals to which many services have been centralised are a 1.5 hour bus journey away. The nearest walk in centre is a 2 hour bus journey away.

Improve local access to addiction and mental health services including OOH. Improve local access to minor injuries/walk in centres.

People are far more likely to get early and appropriate help if it is locally available. Without that local help then issues become crises. At that point it is far more likely that an ambulance will get called, a patient will then need to be admitted. Once admitted it is difficult for them to be discharged because there is limited local support.

We need to manage the population growth.

stop people living longer?

A genuine open and public consultation of what the public are willing to pay for. We can’t fund every single health need. What are the public willing to fund?

I'm ex-NHS and for me the absolute biggest thing needed is to invest in social care

Yes and older people are going to have pay more for it. Not just care homes but care in the home.

Reduce the waste. I worked in a medical records storage facility ( about the size of a supermarket) where we had rows and rows of medical notes I’m talking thousands with one piece of paper in (that was printed off the computer records so readily available without printing) for new babies. 99% of those records were never needed again. They just sat there at a cost of £1 per record in a giant warehouse that was rented. No private company would do that.
Stop paying for different things out of different pots. Sometimes whilst working I was getting paid my normal wage and sometimes 3x that for an extra clinic run to reduce waiting times. All in my normal hours. It was bonkers. But try and question it and suggest things and you were labelled a trouble caused by upper management. Most of who were useless but working out their years for their final salary pension. The whole system is so disjointed it doesn’t work together. I left as it was so stressful worked in a system that made no sense and you weren’t allowed to change.

A wealth tax is needed as opposed to more income tax burden as you will just get more & more young people going elsewhere to work. Think about what you are offering them currently; low wages, high tax, high house prices & later pension age all to fund older generations that have far more wealth then they would ever accumulate.

Train nurses doctors specialists without course fees.

pay social care staff the same as their nhs equivalent to up retention and recruitment, providing better consistency of care, better person centred care and better safeguarding with less bed blocking.

create a central register of social care workers with qualifications, training, career prospects.

get rid of those undertaking woke rejigging of words (online and paper information). The word woman and female needs to remain in nhs information

tax sugar, fast food, ready meals, tobacco, vapes, alcohol at a much higher level to reflect their real impact on health and linked cost to the nhs and social care.

Also bring back nurse training how it used to be. Big intakes. I applied to be a nurse but couldn’t get a place at a uni the same as half the people on my access course. So most went off and did other things.