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?

We have an ageing population which need more care, hospital and primary care. At the same time as our ageing population grew funding for the NHS since 2010 was rising only 1-2% over inflation so effectively more people to care and the lowest annual increases in funding since the NHS’s inception 74 years ago. The doctor in this Twitter thread explains it in more detail. twitter.com/peteneville65/status/1609907691912298497?s=61&t=PfnVM44-LF8dXHdXUM2B0A

@Lmgify It would make zero difference and in fact would make things worse.
You need extra staff to take the payment. What do you do if people refuse to pay? Security at GP surgeries to throw them out?
If people pay £10 for an appointment they would not accept being rushed in and out in 3 minutes but would demand their monies worth. And some people would just leave concerns until it got worse. All those people cancer charities urge to get checked out for rectal bleeding, lumps or cervical smears would in too many cases not bother, only to cost more money to treat when they do go to the GP.

If you want to charge to reduce demand you have to charge a lot so people just put up with lots of illnesses and in some cases accept dying younger. So £50 for a GP appointment - okay I won't bother getting checked out for what I think might be diabetes. £5000 for a visit to A and E. Okay I think I can manage my child's asthma attack at home okay myself.

In the doctor’s Twitter thread I posted above he explains how 33% of hospital beds are taken up by patients fit to discharge but need care packages at home. Local councils are responsible for care but under austerity they had their funding cut significantly hence delayed and inadequate social care. The govt need to give more money for social care for a start. The collapse we are seeing currently all leads back to the inadequate funding for the NHS and social care these last 12 years.

What could we do to make an immediate difference? Make someone/people responsible for the massive NHS wastage. My mil was given 14 zimmer frames ffs. And they refused to take them back!!! Insane.

My local hospital are requesting people return loaned equipment as they are short of it.
Although I do not understand how your MIL even accepted so many zimmer frames in the first place. Unless she said she did not have one and was given them every time she was discharged from hospital.

@dottycat123 ok so you think hospital staff should be able to turn away people 'who need to be there without fear of complaints and investigation do you?, well you can sod right off, 4 years ago I was turned away by a Triage Nurse in A&E because she didn't think I needed to be there, luckily I got an emergency appointment at my GP next day who sent me straight back there - I had SEPSIS, I was in hospital for 12 days and I nearly died, if I had died don't you think my husband would have the right to complain about the Nurse, or that there shouldn't have been an investigation? - wouldn't you complain, wouldn't you want an investigation if that had happened to a member of your family? I bet you would, as it was the only reason I didn't complain was that when I did get to hospital they followed the Sepsis protocol to the letter and the treatment I got was amazing.

www.instagram.com/p/Cm6MfFzIubx/?igshid=YmMyMTA2M2Y=

write to your MP. People are dying, where is our government to come up with solutions to fix it?

Every penny of inheritance tax that the government pockets to go straight to local authorities for their social and elderly care budget. Use latest consensus to allocate according to how many over 75 in each local authority etc
Then use the funds to pay care staff properly.
On a societal level start building elderly adaptive housing on a large scale that is easy, warm with GP and care access. Encourage elderly out of inadequate housing by age 75 with certain financial incentives.
Don’t overmedicate and prolong life beyond a certain age for the sake of it. Open discussions about palliative only care and DNRs from age 75. Every person to make a medical will in good time. Forms to be sent out by GPs.
The elderly population problem is here to stay.

If the press is right and people are retiring too early on a population level in reliance on the NHS and social care looking after them, then we will have to charge as a society. I think at this point I would happily pay for a privatised NHS if I believed it would be efficiently organised and run. However, I don’t trust the current government to privatise in the right way.

Martina Navratilova who has done a fair bit of healthy eating and exercise in her time has got cancer.

No amount of "people caring about their own health" will make us immortal.

We're all going to get something

We're all going to need these hospitals and those nurses one day.

Unless we just suffer and die quietly at home.

People are not retiring early thinking they will not have to pay for NHS and social care. They are retiring early because they have poor health and can't get decent treatment. The amount of over 50s not working and long term sick has shot up.

@verdantverdure A lot of people in countries where people have to pay do just die if they get cancer. Especially if it comes back as it has for Martina. Most insurance policies have a lifetime limit of expenditure, even very good ones. And cancer treatment is very expensive.
This is what the government wants. To forget about expensive treatments unless you can pay for them yourself.

75! The majority of the women in my family still have about 20 years left to live at that point! My grandmother is 80 next year, still fully mobile, with no health conditions.

She lives with my mum who's 57 and also no health issues!

I'm not signing DNR's for either at 75! When nan passes away I'll probably be in my early 50's and then I'll move in with mum, and my DS will be in his mid twenties off enjoying his life. But me and mum will keep eachother company and care for one another. Try not to kill eachother 🤣

For generations and generations, the women of this family have made it to their 90's without much issue.

Convalescent homes would solve most of it. IMO.

My consultant has seen there is actually more vaccine hesitancy contributing. She had 12 children under her care last year in our trust this year she has 221! That fucking huge.and not manageable. Even for someone as high up as her with a decent wage she is breaking.

And yes these are children in need of care.not non emergencies taking up space.

It isn’t about persuading people to sign DNRs too early, it is about creating a structure making people think early on about what they themselves may want when they are frail and very elderly. So have the discussion early whilst they are still able to consent.
It is about accepting that our population structure has changed and become top heavy and creating a structure for that life period. We have an education system for the very young. I think we have to have a good system in place for the last stage of life and have the discussions about quality of life and how people would want to die etc. much more openly.
I would have thought even the NHS has clear budgets on expensive cancer treatments which are weighed according to probable patient outcomes given age, health, family status etc anyway. There is always going to be another treatment you can do but often at the end stage, the treatments can be so harmful themselves that regardless of cost they just don’t make sense anymore. Many cancer patients get to this stage, regardless of what health care system they are in.

Absolute number one thing the NHS needs is people looking after themi. Eating your 7 fruit and veg per day, exercise and staying active into older age to avoid the majority of falls, hip fractures in elderly. Stop the UK culture of excessive drinking being highly thought of.

Make GP visits fee paying. A&E when intoxicated should carry a fixed fee too.

If you are a smoker/ heavy drinker/ obese then you have to start paying into an insurance scheme to gain full access to NHS services.

Do you understand chances and probability? Of course it won’t make us immortal but it will stop people needlessly clogging up hospitals with type 2 diabetes, strokes, heart attacks, high blood pressure etc.

You can’t say the word ‘obesity’ on here without being called a goady fucker but that along with elderly care is crippling the NHS.

I’m type 1 diabetic, so is my friend. I’ve always taken my duty to look after myself very seriously and over the years haven’t had a single A&E admission or anything beyond routine check-ups. My friend is in A&E with DKA or a severe hypo probably every 6 months, doesn’t look after herself and relies on the NHS to pick up after the fact she doesn’t want to manage her illness properly.

People need to take responsibility for themselves and stop using ‘mental health’ as an excuse.

@glasshole I like your name 💩 As for prayer for bariatric services. I agree. We shall call it Pray the cake away! It will change lives I tell you!

What’s your thoughts on the NHS in Wales - run by Labour and in Scotland run by the SNP?

I pay $60'a month for healthcare.
Anything preventative is completely free, and I also get free therapy. A routine GP appt is $35 and i can always get seen within 24-48 hours or call a nurse at the practice. Virtual doc appt for minor things is FREE. Same for my child. I've had an actual paediatric doctor available at the other end of the phone her whole life anytime day or night.
Generic meds are $4 a prescription.
The most I'll ever pay out of pocket in one year is probably $5k and that would only be if say I got very sick and needed a lot of treatment (and I have insurance for critical illness) so this is not a regular occurrence.
I have experienced the NHS and the American systems and I'd never go back to the NHS. For everyone who can afford it, make them pay up to an annual limit /cap. This can even be quite low. For those who can't afford it, and this threshold could be high, still provide it for free free.
Having a system where some people pay wouldn't be the end of the world especially if it meant a better service all around for all users of the system.

The private sector does everything better than the public sector. The public sector is run purely for the benefit of those who are employed by it.

This is absolute nonsense! Too many reasons why it's ridiculous to bother going into them all but if it was true then why does nobody want to do the most important roles then? Nurses? Nowhere near enough. GPs? Nowhere near enough. The fundamental issue with both these specialties is that no buggar wants to do it. Doesn't scream of a job 'run purely for the benefit of those working for it' I think most NHS would be much happier, much safer and much richer working for 'virgin health' tbh but they soldier on giving all they can give to the health service that's there to benefit the public

I think we need to use our military medics.

Get the covid base hospitals back to shift the backlog and flu/ chest infection/ medically fit.
Get the NHS under military control so it’s running top down with precision.
Cottage hospitals and respite care needs a huge overhaul and more spaces available.

Less waffle by those at the top on mega bucks more people doing useful patient led things, more hospitals. More docs and nurses paid for by salary saved by not paying waffling time wasters at the top of the rung.

In my limited view-
Bring back first aid training for parents of young children, it will drive down a lot of calls from concerned parents in many minor illness situations.

Roll out the services of pharmacists on behalf of the NHS, many already offer private services, for example Asthma control, STD treatments, urine infection treatment. If this included throat/chest/ear infections this would save much of the strain I'd assume.

Triage in A&E being able to send people to more appropriate services, like OOH and minor injuries walk in clinics if appropriate.

Truthfully, people do need to take a more hands on approach with their health too. Even small changes could make a massive difference to people's blood pressure/sugar levels and stress.

But the system needs restructuring and more money put into it. The NHS also needs to focus on treating its staff better, staff shortages are a massive part of the problem.

I agree with this