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?

I've just has a pop up from SKY who are reporting the Health Secretary as blaming flu, Strep A and covid for NHS pressures.

This was entirely predictable, and indeed predicted.

So the short term steps needed now are
a) Evusheld for the immune compromised
b) masks in all healthcare settings
c) consider masks in other enclosed spaces (eg public transport)

@BradfordGirl
Online portals won't work with everyone. Same back home. My grandmother still gets her invites via mail. But significant portion of population has the access and ability to use the Internet and has opted to use that. But this obviously requires investment in computer system

Not an immediate solution but the country is overwhelmed with people. Stop immigration. Don't care what colour or creed or where they come from. This is not racist just that we can't cope with anymore people needing the service. Quite prepared to be shot down and told about all the immigrant nurses, doctors and so on but these are in the minority. Just too many people to look after already. Also get rid of middle managers who contribute nothing but just take the salary.

It’s not nonsense, it’s common sense. Your forebears built this country and probably also fought and died for it in a couple of world wars. You have a claim. Mine didn’t, I’m only 2nd gen and would be happy to pay more into the NHS to reflect my family’s lack of heritage and input to this nation. Let’s not forget what the NHS was started for.

I’ve had lots of great care from immigrant NHS workers, but you must be deliberately obtuse not to recognise the heaving strain that those who aren’t “doctors and engineers” put on the system. Your view seems to suggest that there are more immigrants working in the NHS than live in the UK in total.

And let’s not forget all “immigrants” aren’t equal in terms of being “useful” or “productive” citizens. For every doctor or nurse from overseas how many do we have from places where 50% of the population don’t contribute because the culture is for women not to work but to raise large families? Not a lot of taxes coming from those types to prop up the NHS.

There are those who bring gains and those who are drains and they can’t all be lumped into one group. The NHS is under many pressures and this is just part of the picture, but one that can’t be addressed in polite society.

Leccy "It’s not nonsense, it’s common sense. Your forebears built this country and probably also fought and died for it in a couple of world wars. You have a claim. Mine didn’t, I’m only 2nd gen and would be happy to pay more into the NHS to reflect my family’s lack of heritage and input to this nation. Let’s not forget what the NHS was started for."

so, you want a system where we have to prove details of ancestry in order to prove how much we should pay to the NHS.

there's, I dunno, 67Million people in the UK.....aside from the warped thinking, how big a job do you think that is? Might as well empty the Pacific with a ladle.

So the short term steps needed now are
a) Evusheld for the immune compromised
b) masks in all healthcare settings

I'd be pleased to be wrong but I thought most of the clinical evidence shows that Evusheld isn't effective as either a treatment for COVID-19 nor as a preventative. I'd be grateful for a link that shows otherwise (CEV family members).

Can I ask how you're defining "immune compromised," please? The Evusheld campaign refers to the #Forgotten500K. The McInnis report back in July 2022 (? - I think I gave the link upthread) identified a CEV group of @ 150K (e.g., people undergoing current systemic chemotherapy, people who've had a solid organ transplant and are on anti-rejection drugs, people with particular cancers). Some people class everyone above a certain age as "immune compromised" or vulnerable.

The PANORAMIC trial for Paxlovid (an antiviral oral drug combination) defines people as vulnerable if they're more than 50 years old or are younger and have one of a list of conditions. This definition would mean that more than 26million people in England (I think) might be eligible, looking at ONS data. I don't think you could get that many drugs in the short term, even if it were affordable.

This. Absolutely. But this is very unpopular. That's why we have a huge obesity problem because no one wants to take responsibility for their own health.

@scotnurse 100%. And it's not just taking responsibility for weight, and drink etc. It's knowing how to treat common health conditions.

Colds, headaches etc do not usually need A&E. Educating people to use services appropriately, and finding those early intervention services, would help quickly.

Any other ideas as to how to run a system where more people take out than put in? The books just don’t balance. You can’t just keep throwing money at it when the need will always outstrip the infrastructure. And when so many of the users have not and will not ever contribute. The collapse is coming, sadly. What will happen then to those who can’t afford private care?

Glad to hear it! Cos the 80s and before them was a free for all. Be interesting to know when the cut off happened.

Speaking of obesity and weight loss.

HelenaDove · 06/01/2019 23:54
OP im sorry to hear this. Ive had gallstones . Mine was after weight loss so i wasnt consuming fatty food.
I lost 10 stone 16 years ago.. I got gallstones and it got so bad i couldnt eat SOLID food. i went through months and months of excrutiating pain and A + E admission. In and out of A + E for TEN MONTHS. then doctors coming to my home to give me morphine injections whenever i had an attack . Finally a doctor prescribed me morphine pills which melted under the tongue that i took every time i had an attack. First attack was 3 July 2002 Scan was on 19 Dec 2002 after months of A + E admissions . Early Feb 2003 i got a letter telling me id have to wait for ANOTHER YEAR. I cried my eyes out and actually considered suicide. It was only after a private consultation with a surgeon and then another admission to hospital and an NHS appointment with the same surgeon that my op was promised within 6 weeks It was done 5 weeks later on 28 April 2003.id lost 8 stone by the time i had my op. The surgeon and two doctors told me it was caused by losing weight too fast. (slimming world) The pain was excrutiating and the first attack appeared after id lost nearly 4 stone. Back then i had no idea fast weight loss could cause gallstones I was losing a stone a month and whenever i did try to slow it down i either stayed the same or gained.
I actually did seriously consider suicide especially after i got the letter telling me id have to wait ANOTHER YEAR. I thought it was beyond cruel especially when id lost the weight by myself with willpower
i believe due to mixing tramadol with as many over the counter drugs as i could in the early months to stop the pain i have been left with long term issues and its also left a bitter taste in the mouth TBH. Im grateful for the NHS but i was in so much pain i was thinking of overdosing (which i was bloody close to anyway) i also think the fact i won Class Slimmer of the Year and started to appear in our local papers may have been a factor in me getting the op sooner than that awful letter said but i shall never know.

I have a chronic condition autoimmune disease. and all last year my meds started to fail me.
This led to a serious decline in my health in December.
A&E did not check my bloods and sent me to Out of Hours GP.
My specialist team realised the only way to get me the care I needed was to book me a camera. They are hard to get due to staffing levels. So I was stuck at home waiting for a cancellation. Finally and luckily I got one. I was admitted on 13th December.

Please tell me how I could change my lifestyle? Autoimmune diseases don't discriminate.

Neither do failing meds.
Yours was the third comment I read after opening the post and I really hope you have discovered how ignorant your comment is.

According to the supermarkets and water companies there’s closer to 90 million based on consumption.

Anyone notice how the 2021 census is being painfully drip fed to us to soften the blows?

If most people paid their way via NICs (not disabled, long term sick, elderly (who’ve paid their way already)) there would be plenty funding for the NHS. So who isn’t paying up?

Those of you that want extended GP opening hours - how do you propose these are staffed? We already open 10-12 hours a day, 5 days a week with one Saturday morning a month. Out of Hours cover the rest of the time.

We just don’t have the capacity to open any more hours. Interestingly when we surveyed our patients asking what hours they would prefer or want changing 98% were happy with what was on offer… elderly people especially don’t like coming out after dark or early in the morning.

That is just your experience. I recently had to take a relative from overseas to A&E for an x-ray and blood tests. The reception staff refused to take any details of country of residence or health insurance, and would only accept my home address. The paperwork listed my relative as a British citizen living at my address, so no money will be reclaimed. My relative was expecting to pay by credit card, and claim on their insurance when home, but the reception staff are also unable to do that.

@scaredoff When I was an A and E , I saw a woman with a cracked acrylic false nail. She had waited 5 hours and as the only doctor in the department I saw everyone else first. She insisted on being seen and waited until 4am. I offered to cut off the split tip - she refused . I put a plaster on and suggested an ‘emergency nail technician ‘ the next day.

Stories about time wasters are true I’m afraid.

A good idea for the individual, no doubt- but as regards the NHS, it would just lead to more people living to 90 or more, and needing loads of age-related medical care. The biggest reason for increased demand on healthcare services is the ageing population.

And no, I'm NOT suggesting that we all neglect our health and die young to prevent the problems of ageing!!! Just that good health habits on their own will not save the NHS.

Actually, although obesity has increased, smoking has declined quite a lot in the last few decades; and the younger generation seem to drink less alcohol than older people, though it will take some time for the latter to translate into improvements in health.

Your forebears built this country and probably also fought and died for it in a couple of world wars.

Let's note that many immigrants are from countries that used to belong to the British Empire, and whose residents certainly made big contributions to the British economy, and fought and died alongside the British in the world wars.

Leccy not entirely sure you are serious
yes, lots of ideas re NHS inefficiency and funding, most of which are kn this thread

your 90million figure wouldn't surprise - but you can't think there's efficiency in getting everyone to contribute via proving heritage.

Thank you, that's my situation.

I don’t quite get the relevance of this. Are you quoting your own four year old post, made under a different username? What point are you making?

I haven't got answers but can tell you about my daughter's A&E experience a few weeks ago.

My daughter's at Uni and had been told not to try to register with a GP in her Uni town as they were over subscribed.
All students were told that if they got ill, they needed to go home.

In October she had a UTI and thought it would go away on its own if she drank plenty of water etc. A week later she had really bad back pain, fever and vomiting. I told her to call our GP and try to get an appt and I would go and get her. She tried for ages and eventually was told that she'd missed the opportunity to have an appt that day and to call again tomorrow.

In the meantime, she managed to talk to a private GP over the phone and they told her to go to A&E. We got to A&E at 19:30 and were seen fairly quickly but we were just being triaged and were told to go back to the waiting room. Two hours later she was seen again and asked to give a urine sample. They took blood and left a cannula in her arm - no explanation as to why. Two hours after that she had her temperature and blood pressure taken in the waiting room.

She was finally seen properly at 02:30. The doctor didn't have any notes about her, didn't have the blood test results or the urine sample results so had to go and find them which took up some time. He then said she had a kidney infection and that she needed to stay in overnight on a drip. However, there were no beds. She was put in a corner of the waiting area, along with 5 other people on drips. We all had to sit up all night. Two of the other people on drips were in their eighties. I don't know how they coped.

My daughter finally got up to a ward at 11:30 and was then sent home at 14:30 via the pharmacy for an hour's wait for her prescription. She still wasn't particularly well and was still being sick in the car on the way home but she was better off out of the hospital.

There were many addicts and homeless people in A&E. They weren't a problem and I felt very sorry for them but if there was more support for people with those problems they wouldn't have to be in A&E trying to keep warm or getting help for their addictions.

I can't fault the staff that were on duty. I don't know how they cope with working in those circumstances every day. They did their best. There were just too many people and not enough staff. If my daughter had been able to see a GP, she wouldn't have ended up in A&E. If the homeless people and addicts were better supported, they wouldn't have been there either. All these services have been gradually run down for years and it's now so bad, I don't think there are any quick fixes.

No one was complaining in A&E. Everyone could see what a dire situation it was for staff working there.

Not read the full thread so sorry if this is a repeat.

The only thing that would put a temporary band aid over the current crisis is to pull in the military medics and round up volunteers for care duties in rehabilitation wards away from hospitals. Not sure where they would be able to do this - Maybe a big tent in a field!

Considering a lot of them had to cover Xmas strikes and are pretty pissed off losing Xmas with families I can't see it being a popular or long term solution.

Maybe the MP's could do a bit of volunteering! I love to see Boris cleaning bed pans!

How did you deduce that she was talking about you? She was clearly talking about people who are fat because they eat too much etc.

I can think of at least one nation who requires people to prove their heritage, and they’re doing great! Although a bit questionable when they segregated maternity wards 🤷‍♀️