Page 9 | To ask what can be done immediately to take the pressure off the NHS?

Twinklenoseblows · 2023-01-02T22:46:34+00:00

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?

Supernormative · 03/01/2023 07:53

Allow elderly people with no capacity and complex comorbidities to die with dignity. I saw an interview recently with a doctor who said the main problem was the families, insisting on resuscitations and invasive treatments for their relatives with dementia and other issues. He has no option but to comply but could not believe the numbers of people who were wanting to put their relatives through hideous treatments for a few months more of existence. I have two aunts in care homes, neither of which know who they are or what they are doing. They live their lives in considerable distress. I hope for everyone's sake, including theirs, that they are allowed to die soon but no doubt the care homes and their children will continue to rush them into A&E every time there is an issue, to be patched up and sent back to hell.

We also need to immediately sort out the elderly care system and relieve the blocking of beds (which is not the patient's fault). Reopen the Nightingale hospitals and staff with the army to get people into these half way houses while long term care is being sorted.

More education for people about self-treatment. I work in health (private, functional, not medicine) and am amazed how much my seemingly educated clients rush off to the doctor to get something 'checked out'. You see it on Mumsnet all the time. Rushing kids off to A&E 'because you can never be too careful with a child and they will always see children'. Or the recent thread about someone who went to A&E a day or two after they thought their drink had been spiked and they were already feeling better. A total waste of resources. 111 also need to stop sending ambulances for everything under the sun because they are afraid of getting sued. Ambulances are not a taxi service, they are for people who can't be moved after an accident or where it is a genuine emergency, e.g. stopped breathing.

Better access to GPs and allowing pharmacists to prescribe basic things like antibiotics. They are allowed to do this in Scotland but not England. Total madness.

SellFridges · 03/01/2023 07:53

@Greatly I’d be happy (and would prefer) for taxes to be raised for all to pay for the services we need as a country. In the absence of a government who would do that, I’d like a way to save for care. I already have private medical insurance for my family.

WeakAsIAm · 03/01/2023 07:54

mrsnoodle55 · 02/01/2023 23:32

My view from the coal face- charge. I know this is a hugely unpopular idea. It’s too late for long term strategies/education/ improved SC packages etc; whilst all useful the effects of these aren’t immediate enough.

Charge- a reasonable fee for seeing a GP, attending A/E and ringing an ambulance. Other European countries have managed to find a way to balance the risk of those who literally cannot pay, against those who abuse the services. So why can’t we.

Those who aren’t seeing the daily abuse and misuse of the above services from the inside would be appalled at the things that are going on every day. The expectation, the mounds of unused ‘free’ medication stockpiled in large numbers of homes, ringing for an ambulance for a small cut but implying it’s akin to a partial amputation on the phone…. requiring a plaster to be stuck on it…..

The rows of people in A/E with coughs, colds, tiny injuries they did last week. People ringing 111 for advice for things that literally require baseline common sense, then exaggerating the issue so, woah surprise, A and E is recommended.

Charge- £10,£20 per visit, per appt. Watch all the above miraculously stop attending and ringing. It’s not rocket science. Longer term, fund GP appts, A and E attendance and ambulance use through an insurance system that INCLUDES those on pensions and benefits. In a means tested way of course. Like LITERALLY almost every other European country.

This 100%, from another frontline nurse sick and tired of 'treating' people with colds and other minor illnesses.
People need to stop expecting treatment for every little thing that goes wrong with them. Some things you just need to wait it out at home with OTC medication.

WorriedWarrier · 03/01/2023 08:00

Stop being over weight

Greatly · 03/01/2023 08:00

Totally agree @mrsnoodle55

cptartapp · 03/01/2023 08:00

mrsnoodle55 · 02/01/2023 23:32

My view from the coal face- charge. I know this is a hugely unpopular idea. It’s too late for long term strategies/education/ improved SC packages etc; whilst all useful the effects of these aren’t immediate enough.

Charge- a reasonable fee for seeing a GP, attending A/E and ringing an ambulance. Other European countries have managed to find a way to balance the risk of those who literally cannot pay, against those who abuse the services. So why can’t we.

Those who aren’t seeing the daily abuse and misuse of the above services from the inside would be appalled at the things that are going on every day. The expectation, the mounds of unused ‘free’ medication stockpiled in large numbers of homes, ringing for an ambulance for a small cut but implying it’s akin to a partial amputation on the phone…. requiring a plaster to be stuck on it…..

The rows of people in A/E with coughs, colds, tiny injuries they did last week. People ringing 111 for advice for things that literally require baseline common sense, then exaggerating the issue so, woah surprise, A and E is recommended.

Charge- £10,£20 per visit, per appt. Watch all the above miraculously stop attending and ringing. It’s not rocket science. Longer term, fund GP appts, A and E attendance and ambulance use through an insurance system that INCLUDES those on pensions and benefits. In a means tested way of course. Like LITERALLY almost every other European country.

Who would you charge? Everyone?
Or would those on benefits, children, the disabled, pensioners (by far the biggest user group) all be charged?
Or would it be just the poor sods in the middle yet again?

MintJulia · 03/01/2023 08:01

SellFridges · 03/01/2023 07:29

The key to sorting out the NHS, is sorting out social care. Too many old people think they can stay in their unsuitable accommodation for too long and don’t make plans for the future. They end up bed blocking as a result.

Their children cannot care for them as they are geographically dispersed, have their own young children, and have jobs to pay their bills.

Normalise downsizing
Incentivise saving for care (similar to health insurance or life policies)
Don’t vote Tory.

I'll be 60 this year. I'm trying to downsize. Single storey two bed homes are almost impossible to find.

I refuse to move to an over-priced retirement apartment with no outside space and rocketing service charges. I will not be exploited. To the point I've bought a tiny piece of land and applied to build a bungalow - my five year plan.

Housing policy !!

MintJulia · 03/01/2023 08:04

And, yes, I would charge for missed appointments.

I recently went for a mammogram. I got there early, expecting to wait and was see immediately. The previous SEVEN patients hadn't shown up. None had bothered to cancel their slots. I was told this is not unusual.

Stupid, selfish, wasteful and hideously expensive

Flammkuchen · 03/01/2023 08:07

Charge £10 per visit for GP appointments, £20 for A&E and £50 per day for stay in a hospital for anyone who is medically fit to leave. No exceptions, apart from halving costs for those on out of work benefits (not pensions).

It would reduce unnecessary appointments and give people a very strong incentive to get out of hospital quicker, or allow more funding if it is too inconvenient for them to look after their relatives.

Freysimo · 03/01/2023 08:16

RobertaFirmino · 02/01/2023 23:22

There are plenty of things people can do to help. I'm sure most people could do at least one of these things:
Don't vote Tory
Consider the need for A&E
Maintain a healthy weight
Quit the cigs
Reduce alcohol consumption
Take regular exercise
Do the exercises that the physio/specialist recommended
Have fewer children
Treat at home if you can
Buy your own meds if available OTC and affordable
Don't miss appointments
Campaign for change
Treat NHS staff with courtesy

People might say 'Well why should we have to do anything, it's up to the government to sort it out'. To that, I would reply that they are doing sweet FA to improve things so it's down to us.

'Don't vote Tory'. I live in Wales where NHS is managed by Welsh Labour. It's in a worse state than England's.

Stunningscreamer · 03/01/2023 08:20

Glittertrauma · 02/01/2023 23:09

Well to put it quite blunty, the NHS was never designed for the world we have now, where more people than ever live into their 80s and 90s with complex health issues that require long term support. We have an ageing population. No one wants to pay the level of tax that it would take to truly support the NHS. 10 years plus of a Conservative government that are actively committed to bringing state health care to its knees. Scientific breakthroughs creating the possibility of more complex treatments and surgeries that people expect to receive. Comprehensive financial mismanagement but a lot of NHS trusts. People having children later or through IVf leading to complex pregnancies and births with a lot more intervention. There are some very hard truths we just aren't prepared to face. Even an NHS that was properly funded and politically supported would be struggling. The simple truth is we all need to pay a lot more. And get a lot more strict on what is treated and what is not. But I don't think people want to hear that. They want low taxes and a bottomless pit of treatment.

This is a massive issue. People want functioning public services but don't want to pay higher income taxes. They want to be able to pass on all their inheritance to their children (much of which will have come from increase in property prices, not from savings from work) and not pay income tax on it while at the same time have top notch, free social care.

There is no government fund that comes from magic land. They only have money from our taxes. If we want decent public services, we have to pay for them through taxes. There aren't enough billionaires paying taxes in this country to fund our entire public services (most of those that are here are non doms anyway and probably pay less tax than us!). We all have to contribute.

And we all have to make the effort by not making frivolous demands on the NHS. Don't take up an appointment unless you really need it. Try and look after your own health. Cancel an appointment if you can't attend. Eat more healthily and do moderate excercise. It requires a collective effort.

Stunningscreamer · 03/01/2023 08:23

Freysimo · 03/01/2023 08:16

'Don't vote Tory'. I live in Wales where NHS is managed by Welsh Labour. It's in a worse state than England's.

Show quote history

I don't know why it's worse but I'm pretty sure the Welsh Government don't decide the number of medical student places or the rates of income tax which determines the NHS budgets.

MarshaBradyo · 03/01/2023 08:24

Stunningscreamer · 03/01/2023 08:23

I don't know why it's worse but I'm pretty sure the Welsh Government don't decide the number of medical student places or the rates of income tax which determines the NHS budgets.

Show quote history

Devolved systems can decide income tax. Scotland has increased theirs and Wales probably can too.

Stunningscreamer · 03/01/2023 08:24

Also when we had a national Labour Government public services were not falling apart in the way they are now.

Hongkongsuey · 03/01/2023 08:24

MintJulia · 03/01/2023 08:04

And, yes, I would charge for missed appointments.

I recently went for a mammogram. I got there early, expecting to wait and was see immediately. The previous SEVEN patients hadn't shown up. None had bothered to cancel their slots. I was told this is not unusual.

Stupid, selfish, wasteful and hideously expensive

I can see the point of charging for missed appointments made by the patient but screening letters are just sent out inviting women to attend. They also overbook, knowing a certain percentage of patients won’t turn up. So it doesn’t seem fair to charge for missing something not requested in the first place.

Cm078 · 03/01/2023 08:25

1 thing I know through working in a hospital would help. Pay carers more money so there are more carers out there for those medically fit to be discharged able to go home quicker. Some can wait weeks for a care package therefore holding a bed no longer needed. Sad, but that's the reality now.

FrizzledFrazzle · 03/01/2023 08:25

I don't think the problem is the NHS. I think it's the lack of social care facilities, so that people who have received NHS treatment but who need ongoing support are able to leave hospital with an at home package of care (support with washing/dressing/food prep etc).

A lot of the NHS issues at A&E / hospital are because people can't be discharged so there are no beds.

A fix for that would be massively increasing the social care budget for local authorities and training new support workers to meet demand. It's hard to recruit for care work so a pay increase might help. It might also help to make care workers a shortage occupation to allow international recruitment.

On the NHS front, I think the issues Cary regionally, but timely access to a GP would be a good start!

Spendonsend · 03/01/2023 08:32

I know this sounds silly, but i dont actually know what the problem is? I hear a lot of flu/covid/rsv patients are in hospital. Every year of my life the hospitals get stretched with flu. Maybe we need to reopen cottage hospitals for respiratory viruses.

I think housing is a big issue too. My mum has moved into a retirement flat. The service charge is enourmous and grows each year and doesnt cover much. If we want more people to downsize we need to build the type of housing they want.

sjxoxo · 03/01/2023 08:34

They need more money and more staff; now.
This has entirely been orchestrated by the Conservative government.. money was available very quickly during covid so no I don’t think it will take years to trickle down. It’s a choice from the government to let the NHS rot. Shame on the posters who think it’s the fault of the service users! Even if there are some people who go to A&E etc for inappropriate reasons, the system should be equipped to deal with some extra. It’s an entirely political choice- ten years in the making. x

olympicsrock · 03/01/2023 08:36

FlorenceAndTheVendingMachine · 03/01/2023 06:41

If the country stopped paying for every old frail person to be kept going til they are in their 90s we might have better health care for younger people.

My grandmother is in her early 90s and still completely sound of mind. Still cooks, goes shopping, etc. Has always led a healthy lifestyle and never been overweight in her entire life.

By contrast, I look at some of the unrepentant fatties that comprise our young and don't really feel they should be automatically prioritised based on their age.

Obviously, keeping a barely sentient person alive with expensive treatments doesn't seem a great use of resources, but where do you draw the line? If somebody is experiencing lots of health problems at a young age you could also argue that we just nip it in the bud rather than allow a whole life of expensive treatments. Unlike most elderly people they may not ever pay into the system if they're too fat/ill to work.

@FlorenceAndTheVendingMachine i don’t mean those like your grandmother who would score reasonably on the clinical frailty score. She clearly has good health and quality of life . I mean those who are dependent on others for all care.

Greatly · 03/01/2023 08:36

Shame on the posters who think it’s the fault of the service users!

Don't be so dramatic. Of course there are people at A and E that shouldn't be there or are just hugely pissed.

ButterBastardBeans · 03/01/2023 08:47

Staff in the NHS could do their jobs properly int he first place. My last eight trips to A & E and my Dh's last four have all been as a result of staff in the NHS failing to do their job correctly in the first place.

I haven't worked since 2017 because I had botched surgery. My DH has been let down even worse by the NHS. They are, root and branch, a shoddy joke.

RoseMadderAsHell · 03/01/2023 08:47

MintJulia · 03/01/2023 08:04

And, yes, I would charge for missed appointments.

I recently went for a mammogram. I got there early, expecting to wait and was see immediately. The previous SEVEN patients hadn't shown up. None had bothered to cancel their slots. I was told this is not unusual.

Stupid, selfish, wasteful and hideously expensive

It might be the NHS system at fault here, not the patient.
Routine mammogram appointments (with time and date) are sent out in our area.
As these appointments haven't been requested and for many are unexpected (they might not even bother to open the envelope assuming junk mail) the onus shouldn't be on women to cancel if not convenient/not wanted.
Perhaps the idea is that more women will attend if they don't have to phone and make an appointment, but it's bound to result in loads of missed appointments.

HelloDaisy · 03/01/2023 08:47

Supernormative · 03/01/2023 07:53

Allow elderly people with no capacity and complex comorbidities to die with dignity. I saw an interview recently with a doctor who said the main problem was the families, insisting on resuscitations and invasive treatments for their relatives with dementia and other issues. He has no option but to comply but could not believe the numbers of people who were wanting to put their relatives through hideous treatments for a few months more of existence. I have two aunts in care homes, neither of which know who they are or what they are doing. They live their lives in considerable distress. I hope for everyone's sake, including theirs, that they are allowed to die soon but no doubt the care homes and their children will continue to rush them into A&E every time there is an issue, to be patched up and sent back to hell.

We also need to immediately sort out the elderly care system and relieve the blocking of beds (which is not the patient's fault). Reopen the Nightingale hospitals and staff with the army to get people into these half way houses while long term care is being sorted.

More education for people about self-treatment. I work in health (private, functional, not medicine) and am amazed how much my seemingly educated clients rush off to the doctor to get something 'checked out'. You see it on Mumsnet all the time. Rushing kids off to A&E 'because you can never be too careful with a child and they will always see children'. Or the recent thread about someone who went to A&E a day or two after they thought their drink had been spiked and they were already feeling better. A total waste of resources. 111 also need to stop sending ambulances for everything under the sun because they are afraid of getting sued. Ambulances are not a taxi service, they are for people who can't be moved after an accident or where it is a genuine emergency, e.g. stopped breathing.

Better access to GPs and allowing pharmacists to prescribe basic things like antibiotics. They are allowed to do this in Scotland but not England. Total madness.

Well said, far better than I could have written it.

I used to run a nursing home and we hardly ever sent residents to hospital, only for falls resulting in broken bones, but it seems that we are now so afraid of death that we fight against it all the time, trying to prolong somebody’s life only for them to live in this half way hell for another few months.

My dad died at home and even though he was only 45 we would not have rushed him off to hospital at the end just to give him another few hours/days but allowed him to die at home with all of us, with dignity.

MarshaBradyo · 03/01/2023 08:48

Spendonsend · 03/01/2023 08:32

I know this sounds silly, but i dont actually know what the problem is? I hear a lot of flu/covid/rsv patients are in hospital. Every year of my life the hospitals get stretched with flu. Maybe we need to reopen cottage hospitals for respiratory viruses.

I think housing is a big issue too. My mum has moved into a retirement flat. The service charge is enourmous and grows each year and doesnt cover much. If we want more people to downsize we need to build the type of housing they want.

Extra flu / strep A and some Covid apparently