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AIBU?

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Original poster

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

756 replies

Twinklenoseblows · 02/01/2023 22:46

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?

OP posts:
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BradfordGirl · 05/01/2023 10:55

The issuing of medication from pharmacies rose when they introduced free prescriptions in Scotland. Pharmacists say they already get people coming in to ask if the medicine they have been prescribed is really necessary.

When I was young and unemployed I was really skint and would have tried to manage without my inhaler if I had to pay for it. Stupid I know, but I know I would have done this. And probably ended up at A and E instead.

Pleasepleasepleaseno · 05/01/2023 11:08

But asthma inhalers are not on the free prescriptions list. So by that logic they should be free to everyone.
I think that's the main thing I don't understand really. Why are some groups of illnesses covered and not others, and some groups of people and not others? Obviously there is no doubt under 18s and low income should be free but I can't understand the conflicting logic on the rest of it

IndieK1d · 05/01/2023 11:11

Wasn't with the exception of cancer, that list drawn up in the 60s? Still makes no sense - if you have one of the conditions listed, all your medication is free.

BradfordGirl · 05/01/2023 11:13

Pleasepleasepleaseno · 05/01/2023 11:08

But asthma inhalers are not on the free prescriptions list. So by that logic they should be free to everyone.
I think that's the main thing I don't understand really. Why are some groups of illnesses covered and not others, and some groups of people and not others? Obviously there is no doubt under 18s and low income should be free but I can't understand the conflicting logic on the rest of it

I think they should be. But I got my inhaler free as I had such a low income.

BradfordGirl · 05/01/2023 11:15

@IndieK1d All the medication is free because with those conditions it is hard to say what other health issues are also related. So Diabetes can cause a whole load of health issues. So separating out what medication is for diabetes and the issues it causes and what is not would cost too much time. Cheaper just to give everything free.

WorriedWarrier · 05/01/2023 19:16

BradfordGirl · 05/01/2023 10:55

The issuing of medication from pharmacies rose when they introduced free prescriptions in Scotland. Pharmacists say they already get people coming in to ask if the medicine they have been prescribed is really necessary.

When I was young and unemployed I was really skint and would have tried to manage without my inhaler if I had to pay for it. Stupid I know, but I know I would have done this. And probably ended up at A and E instead.

If you are on a low income you apply for a HC1 form and get free prescriptions

BradfordGirl · 05/01/2023 19:18

@WorriedWarrier I know, I did that in the past. But there will still be people who struggle with the cost not entitled to free prescriptions or who have sent it off but not yet been approved.

WorriedWarrier · 05/01/2023 19:23

BradfordGirl · 05/01/2023 19:18

@WorriedWarrier I know, I did that in the past. But there will still be people who struggle with the cost not entitled to free prescriptions or who have sent it off but not yet been approved.

Those on a low income will be covered…. Why do people expected such poor management of their life/ finances to always be a woo story.

also a bit annoying what you wrote..

BradfordGirl · 05/01/2023 19:29

@WorriedWarrier You can think what you like. When prescription medication became free in Scotland, the amount of prescribed medication issued by pharmacists increased. There has been research about the amount of issued prescriptions that are never filled. That is for a number of reasons, including money.

Xenia · 05/01/2023 19:30

The best quicket thing to do is remove every bed blocking patient to a Nightingale or private hospital.

Kazzyhoward · 05/01/2023 19:33

Xenia · 05/01/2023 19:30

The best quicket thing to do is remove every bed blocking patient to a Nightingale or private hospital.

Where do you find the staff to look after them?

ToWhitToWhoo · 05/01/2023 19:35

Rather than cutting services for everyone, or worse for those who are deemed 'undeserving', I think those who can should be paying in more, whether through taxes, national insurance, employer- or state-subsidized private insurance, or means-tested individual contributions for some services, or any combination of these.

I'm no fan of Theresa May, but there may be no alternative to something like her proposed so-called 'dementia tax' if health and social care are to remain/ become sustainable.

ToWhitToWhoo · 05/01/2023 19:47

Xenia · 05/01/2023 19:30

The best quicket thing to do is remove every bed blocking patient to a Nightingale or private hospital.

But they don't just need beds; they need nurses and/or carers. Many could go home with the right support in place. Others need care home facilities. A Nightingale hospital without the staff won't solve the basic problem,

verdantverdure · 05/01/2023 21:07

Do some people still think the Nightingale hospitals were real?

Zone2NorthLondon · 05/01/2023 21:16

Step down accommodation to provide treatment and reablement for the DTOC clients . An acute bed costs @£2500 whereas care provision elsewhere is a £1000. However it need care staff to provide the re-ablement prior to dc home

OT and Physio to assist with patient flow and and hospital discharge to free up beds

Block provision of bed in other setting eg hotels with care staff to support

swift identification of problems with dc eg no utilities, disrepair et and address those issues promptly

Greatly · 05/01/2023 21:22

verdantverdure · 05/01/2023 21:07

Do some people still think the Nightingale hospitals were real?

Weren't they?

verdantverdure · 05/01/2023 21:29

@Greatly

No.

RandomCatGenerator · 05/01/2023 22:06

@verdantverdure do you think they were just…made up? They definitely got built.

verdantverdure · 05/01/2023 22:09

RandomCatGenerator · 05/01/2023 22:06

@verdantverdure do you think they were just…made up? They definitely got built.

They weren't hospitals though were they? They weren't equipped to treat patients and most of them never treated

verdantverdure · 05/01/2023 22:09

Any.

Pleasepleasepleaseno · 05/01/2023 22:25

There's another post on here about someone who called an ambulance for their floppy baby. The call was classed as a cat 1 for a 9 month old and the call handler told the parents the wait was STILL 5 hours. A 5 HOUR WAIT FOR A NON RESPONSIVE BABY. I honestly think there is nothing we can do to save the NHS. It's too far gone. How could it have got this bad so fast?

raffegiraffe · 05/01/2023 22:49

mrsnoodle55 · 04/01/2023 23:23

Coming back to this thread raises some interesting ideas- wouldn’t it be great if Rishi read it 🙄

I had to come back to offer a glimpse into one of the big issues ; today I went, on 999 calls/blue lights, to 6 patients. 5 in care homes, one in sheltered accommodation. Ages of 90, 93, 94, 2 patients of 88 yrs old and finally a 95 year old lady.

All 6 people ended up going in. This is pretty rare tbh. This isn’t intended to be an agist post, merely an insight. 2 of these patients had complex and life threatening problems (very rapid heart rate and sepsis), quite rightly required treatment in hospital. The other 4 patients invoked lengthy phone calls to GP’s, OOH’s…. The result being that the tunnel visioned risk averse culture we exist in removed all common sense. In they went. Not necessarily the fault of the other HCP’s/GP’s I spoke too- more that short term risk trumps the long term risks that we all know about, but no-one can quantify those so in they go.

The risk to the individual patient at that exact time trumped the huge extended risk to them in terms of a lengthy hospital stay, the inevitable 15 hr wait on the corridor, the huge slump in mobility once in hospital, the risk of acquiring HAP, covid, you name it, the big risk of not making it out. So the 94 year old with dementia who may have had a stroke at some point in the night, so way out of any treatment window, was sent in by the GP, from a comfy bed, in her care home, with carers who maybe even have time to feed/toilet her, to a hospital corridor for an 18 hour wait, to (fingers crossed) end up on a stroke ward, to be eventually discharged a shell of her former self.

We- families, partners, children of the elderly, HCP’s, need to wise up to the fact that sending our elderly relatives to hospital ‘to be checked on’ is sometimes the worst possible decision. We need a huge education campaign. Sending people to hospital should have a definite aim- not just be the default position to shift risk to someone else. The vision of distressed elderly people, languishing on the corridors of my A and E, is an imagine that chills me to my soul.

I couldn't agree with this more

SmokeyPaprika · 06/01/2023 06:23

The decision not to be treated really needs to come from the person themselves so we need to write our DNR etc stuff - I doubt many of you have or that your relatives have. We are stuck in our 'I hope it doesnt' happen to me' mind set.

The other thing is to get GPs to attend Care Homes. My relative in a Care Home has never seen nor heard from a GP in 3.5 years.

user1795437 · 06/01/2023 06:33

verdantverdure · 05/01/2023 21:07

Do some people still think the Nightingale hospitals were real?

I think they were real but for if you were going out feet first so very basic

FangedFrisbee · 06/01/2023 06:38

The nightingale hospitals were 'real' but they wanted us icu staff to staff it and transport the patient, and stay and look after them.
Then they changed the criteria to only if they weren't on oxygen!!

Waste of space.

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