To ask what can be done immediately to take the pressure off the NHS?

[Twinklenoseblows]

I've been reading stories about people waiting 4 days in A&E, people being taken into A&E in the back of a van with a broken hip as there are no ambulances ,and doctors and nurses pleading for something to be done right now as lives are at risk. But what can be done that would make a difference within the next week or two?

Promises of more money and more staff will presumably take years to filter through and make a difference.

I guess what is worrying me beyond the immediate crisis is that some bright spark in government is going to say we need a circuit breaker lockdown to reduce flu and covid admissions for the next few months to take some immediate pressure off. The thought fills me with horror so I'm hoping there is something else.

E.g. as a very short term measure could some people be diverted to make use of any spare private GP capacity to try to reduce the number of people going to A&E who could instead be dealt with by a GP if only they could get an appointment. Or is that madness?

You're joking, right?

British Rail was a by-word for unreliable and filthy service. And was strike ridden throughout the 1970s

I would LOVE to pay for my own private health insurance - but only if I could opt out of paying the health element of NI contributions.
If this was an option I think many people would do it, but I don’t want to pay 14% of my income on NI and then also fork out for private care.

The idea that not paying for contraception and abortion would save the NHS money is laughable. They save the NHS money. Same with preventive drugs for gay men, way cheaper than treating HIV. That comment is all about lifestyle judgement and nothing to do with saving the NHS money.

They also need to make cancelling/re-arranging easier. Far too often you ring the telephone number on the appointment letter and it is a disconnected number, or just rings out, or goes to answerphone and you leave a message which they ignore

This. I had a series of tellings-off by my local hospital for failing to attend appointments.

I’d called the number on the NHS letter repeatedly, during working hours, to reschedule. Nobody ever answered. I left voicemails with full details: my name, NHS number,date and time of appointment etc.

After receiving two snarky letters and not having been given a rescheduled appointment I called the PALS service, who put me in touch with the department manager. I was surprised by the answer. Her admin team didn’t think that it was their job to answer the phone. They didn’t think that it was their job to listen to voicemails either. Whose job is it then, I asked? Answer: “I don’t know, I can ask my team again to do it”. Ask. It’s laughable.

Look what we, as a country, managed during Covid. An army of volunteers happy to help with the vaccine roll-out. Why can't we open up the equivalent of Nightingales to house the bed-blockers, staffed with a few qualified medics but mainly with volunteers. Bed-blockers only need basic care, washing, bathing, help with feeding etc.

During Covid, the volunteers were DBS-checked and given first-aid training by St John Ambulance. That could happen again.

I'd like to think that the majority of the country would support an idea like this, given what we saw during Covid - millions of Thursday night clappers wanting to do whatever they could to support the NHS.

There’s no ‘health element’ of NICs. It’s just another tax. Most of it funds state pensions, if interested.

I’ve been here long enough to know who to bother with. And both parties will pay influencers. Those that go on about just one side having them sound biased.

As for health look at Europe not US. We don’t score well. And many people are reluctant to take responsibility.

This.

I run a Homecare business. We have lots of vacancies. Usually social services fill them very quickly. I have had vacancies for weeks! Why? Because they refuse to god damn pay for them! They want to pay £13.50 per hour for care inclusive of expenses!!! We are charging £21 an hour! We are not making very much profit at that rate.
Since covid our costs have risen dramatically. Fuel prices, PPE, insurance have all gone up.

We can't run at a loss. I have reduced the cost to social services once to £18. I can't go lower. That is us working at cost!

I have been told by both the council and social services that they will not be funding any more care packages above £13.50 until the start of the next financial year!

And that lady's and gents is your problem right there!

GP surgeries open until later and on Saturday with a walk in option for those who work full time.
Strip back what the NHS provides with charges for optional/ cosmetic surgeries ie those that are life enhancing not life dependent or life changing.
A joined up National IT system, my local health board still uses paper records.
Also the work ethic. I know of people who work in the NHS who abuse the sick leave, do the bare minimum because of poor management above them.

I think an immediate action they should do is turf out all the people from a&e who really don't need to be there, and turf out all the people who are taking up beds who don't need them. Get all patients on an NHS portal then stop having appointments to discuss results and instead upload them with a brief report and only do appointments for life threatening test results. Stop the intermediary consultant appointments where you're told what you already know and just go straight to treatment. Start charging people for treatment who repeatedly use the NHS for self inflicted illnesses. Introduce euthanasia so people like my grandma can die with dignity instead of being forced to live on for years in pain being pumped with all sorts of drugs designed to make her last as long as possible with no improvement in her wellbeing. The cost, time and resources spent forcing my grandma to live was appalling, and there was no benefit for her. It was only pain and she died in pain.

Agree. Seen stories of people sleeping in the floor for four days. Therefore not an emergency.

That’s because the questionable results of Labour’s open door immigration policy which kicked off in 1997 had not come to fruition yet.

The Council estate I grew up in during the 80s and early 90s was a wonderful mix of nationalities: Caribbean, Spanish, Pakistani, Chinese, Filipino, English, Irish, etc. The vast, vast majority of these worked.

From 1997 the 2 North African families who lived there increased to become 95% of the whole block. Every time a non l-NA family moved out, they were replaced with a NA family. Apart from the issue of ghettoisation, I also noted that the new residents did not work (neither mum nor dad) and had between 6-9 children per family.

If this pattern in my estate was repeated across the UK, well, of course there is a burden on the NHS which it cannot cope with.

Many will be up in arms about this, but it’s mine, and many others, lived experience.

Ok, well, whatever element of my overall tax burden goes to the NHS - I’d like that back please to use for my own private healthcare. Even if I end up paying more, it will be for a better service.

Our local hospital major A and E has once again declared "don't come to a and e" unless life threatening.

Last week they had a nurse and consultant on the door turning people away, signposting then to the minor a and e which can deal with most trauma, broken bones, stitches, head injuries and so on, or to contact 111 for GP OOHS/GP services.

They also as a city run a "drunk tank hospital" in the city centre in a porta cabin, it's staffed by St Johns ambulance and some nurses. It has been operational for a few years now

This seems to have significantly reduced the Friday night and Saturday night drinks attending major a and e. St Johns ambulance will transport them if needed to minors, or they basically just sit in the porta cabin till they sober up enough to get in a taxi that pick up when called from the porta cabin. I think they will also dress minor wounds and do paper stitches if required.

But imagine the money that takes, all because people can't drink responsibly 🤦🏻‍♀️

I don't know the demographics breakdown of the volunteers. Were these mostly retired people or people who were on furlough?

I shouldn't think many employers would be OK about subsidising a national volunteer force to help the NHS, especially when so many have labour shortages of their own.

If it's mostly retired people, I don't know how many of them would be fit enough to do safe manual handling of the sort of people who need to be discharged with a social care package. Or whether these temporary facilities would have all the hoists and other safety features that would be useful.

Immediately I’ve no idea but long term it needs to start at the beginning. Care workers need to be paid more and have better employment packages in order to recruit more staff. My adult child lives in a residential setting and the fees are over £6k per week due to having to use a high amount of agency staff, once fully staffed the fees will drop to around £4K. There’s a saving of £2k per week for just one person. If there were more staff available then places that have stopped taking new residents due to staffing could do so freeing up hospital beds.

Many people use A&E when it’s not necessary so maybe more walk in centres for minor problems or better access to their GP.

i also think the NHS is badly managed. Too many chiefs and not enough Indians.

You are obviously fairly young. Insurance is a business, young healthy people pay way less. In the US there is an enormous jump in people getting cancer treatment when they turn 65 as people at 64 and younger wait until they can get heavily subsidised care at 65 years old. The main cause of bankruptcy in the US is healthcare costs. And the US does terrible against lots of health outcomes. The US system makes insurance companies rich, it does not deliver good health care.

I get a GP appointment the same or next day in the UK.

I honestly don't know what else we can do at this point. We need more doctors, nurses and other health professionals, both in hospitals and GP surgeries. They've all been driven out due to the poor working conditions, people seem to have forgotten what Covid was like. The government have reduced the funding for students so the amount of new health professionals coming in isn't enough to cover the amount of people leaving. In short there's no sense having more beds if there are no staff to care for the patients in those beds. Even for GPs the demand is far higher than their capacity. Most "part time" GPs I know work full time hours and are quite often working and sending emails at midnight and on weekends.

Social care needs some major investment to help meet their demand, and to discharge patients who need social care input rather than medical care.

It's strategic underfunding and I honestly don't see a way out of this, particularly short term.

I would make every Member of Parliament / person in government responsible for making big decisions, spend a week working as /shadowing a Health Care Assistant in the NHS and be paid accordingly.

I think if they saw what it was like that could be the quickest route to real change.... (I could be wrong).

Totally agree. This is a problem engineered by bad decisions.

In June when people were discussing the situation this winter, there was an obvious exodus of staff to other sectors that were able to pay real cost of living increases. I asked what councils were planning to do. All they were offering was extra "training". Seriously, no one in govt has any idea how much difference small amounts of money can make when you're on the breadline.

Just to confirm the WHO defines infertility as:

a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse.

There a great number of medical reasons people may need help to conceive. And access is already fairly restricted on the NHS depending on where you live.

There are far greater 'drains' on NHS than assisted conception.

It’s illegal for parties to pay influencers. There tend to be more right/libertarian astroturfers not because the left are purer in some way, there’s just less cash around for them to do that stuff because mysteriously the ultra rich tend not to want to fund astroturfing for centre or left ideologies. Though of course there are some astroturfers funded by foreign agents whose aim is primarily disruption, so they may adopt left wing viewpoints.

In terms of health - the Dutch are some of the healthiest people in Europe. Absolutely, like them, we should fund everyone to have home assistance for a couple of weeks after birth, so they learn healthy parenting habits. We should make sure the kids see a paediatrician or children’s nurse regularly. We should invest to make every route a safe cycling route for children and we should fund safe cycling training in schools, so children and their parents take a healthy travel method everywhere. Local authorities should have enough funding to fund kids to do swimming lessons and a sports club if their families can’t afford it. We should fund a playground in every neighbourhood and fund traffic and crime reduction so that kids can play outside safely. That’s the sort of stuff we need to do, rather than just shout ‘be as healthy as the Dutch’ at people.

The question is what solutions can immediately take off the pressure.
Suggestions of increasing gp practice hours/days, changing nhs admin procedures etc are not immediate solutions at all.
Without more staff gp practices can’t open more hours. Staff training takes time and needs to outstrip staff loss to yield any benefit.
Literally the only immediate solution is a huge public info campaign stopping people from wasting doctors time. Or a mammoth influx of cash. Even the cash wouldn’t have immediate benefit.

@SquashesPumpkinsAutumnBliss yes absolutely this is the other side of the coin of wasted time and resources. Proper treatment once would save a further 3 or 4 unnecessary follow ups. But changing this whole area in the nhs is much needed but certainly not immediate.

Some of this sounds good but I’d prefer if people stopped waiting before helping themselves. It’s just looking for people to blame.

The information is there, just lack of personal responsibility. There’s no reason why many can be aware of health without all that but others can’t.