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?

Are people arriving at A+E being screened on arrival? Many don't need to be at A+E

At ours, on arrival, they ask two questions

1. What happened?
2. When did it happen?

Some people get sent to the GP side. Otherwise, then we’ve waited 4+ hours for a HCA to take the temperature, blood pressure and pulse; and they ask the pain score out of 10. Not that they give any pain relief, even if it’s 10/10. Then we’ve waited again for between 1 - 4 hours to see a doctor, about suspected head/neck injury and broken bones.

Such an interesting thread to read, especially today as we are trying to arrange care for DH's grandmother.

Most of the ideas would either not have an immediate impact in terms of either taking time to implement or focus on long term prevention. Crucially important, but no impact on the immediate crisis.

If the spare capacity in private social care as described in @justgettingthroughtheday's post is a nationwide thing, their suggestion of simply paying the going rate for homecare costs would surely offer a solution that would clear beds quickly. The short term cost would be very high, but I'd be surprised if it didn't even out when the total cost to the public was calculated a year or so down the line.

This might buy time for some of the excellent medium and long term solutions to start having an effect.

Agreed. As others have already said, social care is the main issue.
My mum was in hospital for weeks while a care package was set up. I took the advice on here of not accepting a discharge to my house temporarily as it would mean it could be many months before a care package was sorted. She did not need to be there. She needed paid carers.

They're not talking about people like that. They're talking about those who eat and drink too much, those that don't exercise, etc.

We have no idea how many of those people are self medicating with food, alcohol or smoking. It’s too simplistic to think, that telling people to stop doing the thing, that makes their life bearable, is going to work, without addressing the causes like food/fuel poverty, abusive relationships, too much caring, poor housing, the stress of low paid jobs, where people are treated like robots by their employers…..We also have little idea, what their genes are doing to them. Nobody can go to their GP and ask for genetic testing.

Quite apart from the recessive gene variant, DH and I both carry, which causes a craving for carbohydrates among its many effects; we have been told DD, DH and his family probably have polygenic familial hyperlipidaemia. Three consultant cardiologists told DH in his 30s, he could exercise and eat like a rabbit for the rest of his life and it would not bring down his high cholesterol. Only statins would! This turned out to be true.

Lecturing people like him on diet and exercise is useless. DD2 is stick thin and has high cholesterol in her 20s.

I’ve just posted this on another thread but it’s relevant to this one too…. Sorry it’s long but I’m just so worried at the moment.

I have a few chronic conditions and one of them creates a pain that mimics a heart attack and it can go on for days ( I know it’s not a heart attack so I will stay at home for as long as I can in agony in case it eases off - sometimes it does so of it’s own accord but it’s very unpredictable)

I have a pain protocol put in place by my pain consultant a few years ago and have had to enact it probably 3/4 times a year. This means when it’s clear it’s not subsiding, I need acute care in the form of IV pain management plus an oxycodone injection - all of which helps me to cope until the pain drops to a level I can manage at home, where I remain on bed rest for however many days.

Now here’s the stickler - IV pain relief and the oxy injection can ONLY be done by A and E. I’ve rang the MIU places nearby and both have said nope, you must attend A and E as they aren’t equipped. Our local A and E is hell on Earth currently - as an ex NHS HCA I know well what that means…. I do not want to add to the problem so I sit at home in full flare and in agonising pain for days because that’s still better than waiting in A and E but sometimes I give in to the pain and get my treatment as prescribed.

I hate going over there, I hate being a burden BUT the last two times I’ve been in I’ve been on a hard chair or the floor for hours yet there’s been drunks laying on beds sleeping happily!!!! Makes me fucking rage!!! It shouldn’t be allowed. It’s not fair that I have a condition through no fault of my own - one that’s ruined my career, my mental health and my life - yet put off going for the treatment I need at A and E because I know what he’ll awaits me and the stress of seeing people there lounging around, snapping at the amazing staff and being generally cuntish and abusive to them when they’ve got too pissed or too high and can’t handle themselves…. Where’s the fucking personal responsibility here?!?

I have had to completely change my life to lessen the risk of serious flares, and my co diction has now led to several others being discovered last year. Yet I feel guilty as hell when I DO access the service and now I’m thinking, “why the hell should I feel bad when there’s utterly irresponsible arseholes out there who take ZERO responsibility for their own health?!”

And to be fair, that’s not just drunks and people on drugs - there’s a fair few out there who really should be taking their health seriously and don’t and then expect the NHS to pick up the pieces time and time again - it’s bloody wrong.

Sorry for the rant but I’m flaring at the moment - luckily a low level one with pain of 6/7 which is just above my daily level… but I worry it’ll escalate as it sometimes does and how the hell I going to access the medication I need and is onl6 available at one place which currently has 18 ambulances outside plus all the other people inside?! Scary, upsetting but also ridiculous that a GP or OOH Dr can’t give me an injection elsewhere!

Only part of the problem but Banning agency - short term gap - long term these agency staff will have to get substantive or bank roles, with the loss of their £300 a day agency shifts, they still have rent and mortgages to pay. Agencies ship these staff all over the country - who profits ? not the tax payer for sure, 3 substantive nurses for every agency. Recruit with a bursary, give nurses 7 per cent, empty the beds filled with patients waiting for care in the community, give community carers £15 an hour, Elder care is hard and heavy that's burning people out, of 60 beds in my little hospital 50 are waiting for care in the community.

I think the best thing anyone can do for the NHS is immediately stop reading the Daily effing Mail....

Honestly, reading some of these threads you'd think that thin people/non drinkers/smokers are basically immortal and never darken the NHS's door,

I don’t read it but are you saying you want masks back?

Particularly amusing after someone commented up thread that the most common cluster of issues that come in to A&E are mental health ones. But it's still the fat people's fault!

Its always the fat peoples fault...or the immigrants.
For everything apparently.

Obesity is a huge burden though on the NHS, I don't know why a fact is seen as offensive.

It doesn't mean its peoples 'fault' in all cases, there are a lot of societal and other reasons why people are overweight and little to no support for them. Can bet though if we had to pay for healthcare at point of use people on the whole would take a lot more responsibility for their health.

@Snowmoab How is that idea that if people had to pay they would take more responsibility for their health working out in the United States? One of the fattest countries in the world.

@verdantverdure no, I think masks are an excellent idea. But the front page was presented in such a way to look deliberately goady....

@Gingernaut Our surgery will not let you put in a repeat prescription until right before its due. Pharmacist at Boots also told me that they now dont order meds until they know what they need beforehand.

Well seen as though our levels of obesity are rising faster than those in the US now you tell me? If people were faced with crippling bills for medication and care due to their weight absolutely more would lose weight.

NHS needs to do the hip and knee replacements on their books so people can get their mobility back then.

@Snowmoab I have seen that argument before about rising at a faster rate. But I understand arithmetic so I know that argument is bollocks.

Little lesson - if for ease 1% of a population is obese in country A but increases to 3% being obese and
10% of a population in country B is obese but rises to 22%
Obesity in country A is rising at a much faster rate than in country B. Even though the level of obesity in country B is far higher than in country A - 3% compared to 22%.

The US is a clear example of how paying for healthcare has no impact on peoples personal responsibility. That is because the reasons for peoples lifestyle behaviour is complex and not as easily changed as the mantra of personal responsibility suggests. All that happens is that people die younger. The US has a much lower life expectancy than Britain.

Are you suggesting most people who are obese are so as they're waiting for hip and knee replacements?

Obesity has been normalised in the US. Going that way here.

Some will have gained weight while waiting yes. Some have been waiting for three + years. Sorry if that pisses on your patient blaming chips. You do realise that the NHS is a service not a church!!!

There are seven million on the waiting list Not all will be hip or knee but some will be.

But its all the fault of the pesky patients. Covid and the time since has taught me the left can be just as nasty as the right.

That is because the reasons for peoples lifestyle behaviour is complex and not as easily changed as the mantra of personal responsibility

It's the western diet of junk food. This is a good article demonstrating what happens when you are bombarded with adverts for crap and fast food chains opening up on your doorstep.

www.japantimes.co.jp/news/2022/05/24/national/okinawa-life-expectancy/

It's true to say that obesity may be the reason some people need a QDS double handed POC as against a single handed POC

Yes being fat is never anyone's own fault is it, they are just waiting for hip replacements. I acknowledge its not the 'fault' of patients, but I don't know why people can't say that obesity is a huge burden on the NHS because it is.