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 don't work in the NHS so this might be a dumb idea but if we have staffing shortages, why not open up the nightingales and make it much easier for highly skilled overseas workers to come and staff them. We opened up the country in an emergency for many Ukrainians. Why can't we do the same for overseas medics?

Like I said, might be a dumb idea! It's just that lots of people seem to want to come and work in the UK but the entry requirements are pretty tough.

Just this week I’ve dealt with -

Elderly woman due to go home with care package starting that night. Transport didn’t arrive. Son was at the hospital and we asked him if he could drive her home, “no” because he was going in the other direction. She had to stay with us another night. No need for transport other than entitled behaviour on the family members behalf

Wife who refused to have her husband home on the day of his discharge because she was worried he might have covid. He didn’t, we’d tested. When she realised we were going to discharge him regardless she changed her story and said she now couldn’t cope with him. He’s still in hospital as of this morning. Medically fit and spends the morning in the costa downstairs reading the paper, waiting for “assessment”

Ive got nearly a two week wait for ramps to be installed. A week for a wheelchair. Physio and OT sickness which means any patient who has to be signed off as PT/OT fit is still in the hospital and can’t leave.

Ive got an ex-criminal taking up a side room for over 3 weeks because he’s homeless and we can’t discharge to the street but we also can’t find him anywhere to stay due to bail conditions

Ive got emergency trauma boards full of patients who’ve broken limbs over Xmas whilst pissed

Two nurse strike dates this month and significant staff sickness.

And a partridge in a fucking pear tree

@Fireyflies to be honest you’re probably right in that you’d think the prospect of sitting on a chair/floor for an entire night with a trivial or minor issue would be enough of a deterrent. But having seen the waiting rooms/corridors the last few months I honestly think it would be worth a try. Something has to happen, it’s frighteningly dangerous and unsafe.

The reaction I see multiple times on a daily basis makes me think a nominal charge might have a significant effect. Many patients with trivial issues are horrified at the suggestion of getting a lift/taxi to a/e as they don’t want to pay. They don’t want to buy their own paracetamol. They want to be seen the first day of their sore throat, after they have vomited once, for their tiny cuts. They don’t want to try common sense and basic home remedies. They want CHECKING OUT NOW!!! My trust (I hugely disagree with this idea BTW), now tell us to offer PAID taxis for taking trivial stuff to hospital, to free up ambulances. So now we have to offer this as an option through gritted teeth, to people who 5 mins earlier had been totally against the idea of getting a taxi until they found it was free. The whole system is being abused left, right and centre, on an unimaginable scale.

The first thing they need to do is control immigration.

I know someone who saw a GP at the end of the week with a problem they had had for a few weeks. Went to A&e 2 days later was kept there for 6 hrs and sent home with paracetamol. Came back to see the GP again a few days later annoyed a&e hadn't done anything. Thats 2 GP appts and an assessment in a&e in 7 days. People r impatient and want their problems resolved immediately even when clearly not an emergency.

Bed blocking and the lack of social care packages and the way culturally care of the older person can't always fall on family members. For various reasons for example adult children are usually working and cannot give their full attention to their elderly parents.

Patient behaviours very tricky to change and social care would be my issues to tackle

@Yellowshirt yeah deffo. Increase the number of trained medical and nursing staff from Europe and the rest of the world. Like before brexit.

Because people voted for brexit and the fast majority of European nurses and doctors basically got sent 'home'. 500 Spanish nurses alone in my local trust.

Immediate solution is for families to take responsibility for their medically fit for discharge relatives rather than relying on social care.

It astounds me how quickly the numbers of ED attendances dropped over covid.

if you forget about the covid admissions suddenly all those ouchy fingers and my kid hit their head two days ago people suddenly didn’t need ED anymore

Weird cause it also happens on Christmas, during big football matches and a number of other significant days of the year. It’s like suddenly people can care for themselves

Source?

You beat me to it about the Nightingales. They were set up pretty quickly during Covid. Why can’t they be used as convalescent homes now, even if this is just an emergency measure?

@Durango agreed. It's like the night the arena bombing happened in Manchester and I had to go out into the waiting room and basically tell people we'd enacted a major emergency protocol because of the bombing and half the a&e department got up and left. We only had broken bones and cardiac patients left.

We had staff discharging patients on the wards so the theatre teams could actually work on the patients, we needed up with nearly 75% of the hospital discharged with all the medically fit patients told to leave. No one complained.

It was hell on earth that night, but the way a&e emptied was unbelievable

Everyone wants a better nhs but no one is willing to pay for it.

Laughable. You mean get rid of the few remaining staff??

1. Use common sense for managing own illness
2. look after our old people ourselves instead of expecting the state to provide care

Thats me sorted out healthcentres, A&E, bedblocking and social care.

And where will the extra staff (clinical and non clinical) come from for extra gp appointments?

We barely have enough staff to cope with the appointments we offer 8.30am to 5pm.

Durango I used to work at a hospital that trialled invoicing patients per night if they didnt leave when they were medically fit. Amazing how the relatives rallied round to avoid the fee.

No meaningful solution is instant. That does not mean we shouldn't bother to make the improvements that will start to filter through. But it is naive to believe any problem.that has been over a decade in the making has an instant solution.

I asked a ai chat bit and got this response

There are several measures that could be taken to help alleviate pressure on the NHS:

Increase funding: providing additional funding to the NHS can help it to hire more staff and purchase additional resources, which can help to improve its overall capacity.

Increase capacity: this could include building more hospitals or investing in new technologies that allow for more efficient delivery of care.

Encourage healthy living: promoting healthy lifestyle choices, such as regular exercise and a healthy diet, can help to prevent the need for medical treatment in the first place.

Improve access to primary care: providing more access to primary care services, such as GPs and pharmacists, can help to reduce the burden on hospitals by enabling patients to receive treatment at an earlier stage.

Implement more effective triage systems: ensuring that patients are treated in order of need, rather than on a first-come-first-served basis, can help to ensure that those who are most in need receive care more quickly.

No staff. Unless you want to bring in the army and vets and airstewardesses (like in Covid).

Haven't stopped wearing masks in clinical settings...

Nonsense.

Hardly any of these ideas are short term solutions.my short term solutions would be
Cancel elective operations and non urgent out patients appts being advised by local NHS trust managers on when they could restart.
Increase (if possible) access to GP appts in centralised locations. God knows why any GP would sign up for this tho. Man the locations with prescriber trained paramedics, pharmacists physios and nurses if easier to recruit. Which tbh they are not.
Publisise private prescription options. If those who can afford it pay for a private telephone consultation it's frees up the NHS service for others, but lot's of people still seem to think you need to go via a gp for a prescription.
Medical staff to liaise with one relative only. We can't be giving feedback to every visitor with a question. It takes ages. One named relative needs to take responsibility.
But actually I don't think that anything can/will be done and my honest advice would be if anyone can pay for healthcare or any part of it privately, they should do.

My nonsense reply was to the person who blamed immigration.

Some really bizarre comments on here like stop funding abortions? That is ridiculous as well as having fewer children. People are we have an ageing population which is costly to the nhs. We need more people to have babies.

the 'so called obesity crisis' actually we should focus on health, not just fat people there, a skinny people who have a terrible diet and cost the NHS money. secondly, we're in a cost of living crisis this government doesn't care about how people don't have much money. The last thing people need is more taxes on cheaper foods. Food deserts are a real issue, add in people working 2/3 jobs just to survive there's no wonder people aren't eating healthy. Tackling poverty and income related issues would need to be done first.

also diversity and inclusion people are important as there are Severe racial health inequalities D&I people help to close some of these gaps

THIS