To think the NHS has already failed.

[Goingforplatinum]

5 hour wait for a cat1 ambulance for a child. Unresponsive patients being taken to hospital by neighbours. 90 hour wait in A&E, unsafe staffing on wards, 7 month wait for coil or implant fitting. The NHS isn't failing. We need to admit its failed

Maybe we should get a certain number of GP appointments a year free - say, 3 - then charged after that. That way nobody has zero recourse to a certain level of GP access, but it stops the time wasters. A few years ago (before covid) I was speaking to a GP at a party who said there are a lot of patients who make appointments almost constantly, they’re either hypochondriacs or enjoy it as an ‘outing’. He said his response is usually to book them a regular slot (say every 3 weeks) so they’ve always got an appointment booked, but stretches out the time between them a bit. To be honest I thought that was totally wrong, it made me quite cross some people get this level of ‘special treatment’ while less demanding people fall down the list of priorities.

As for the circulation issue most times it diabetic neuropathy.

No it isn't, most of the time it is due to wear and tear on the vascular and arterial systems, some of which can be improved with a referal to a specialist vascular surgeon and other times with compression hoisery or bandaging. Diabetic neuropathy makes up a tiny percentage of the 'poorly legs' I see and is often down to poor glyceamic control over the years.

either way this bloke didn’t have it, or I would be stunned if he did, he looked mid fifties.

a&e is a disgrace at the moment . I can’t even look the patients in the eyes I’m so ashamed of everything. I can’t even face going to work anymore . We had them on the corridor again this week .

@irene90 why are people needing to be nursed in a corridor in A&E ? why can't you move them to the appropriate ward ? Not sure how long you have worked here but we used to have a 4 hour limit thing in A&E ? What happens to people in the country you come from if they fall and injure themselves, so #NOF ? Do they have to wait for an ambulance on the floor for hours and hours ? Are they nursed in a corridor ? How do they get back home if they have mild dementia or develop delirium and need carers 3x daily ? It would be interesting to hear how social care works in other countries, are there intermeidiate/rehab beds in the community? or are family expected to take on the lions share of the care ? is social care and health care joined up ?

We also need to stop blaming everything on ‘mental health’. I have met very few overweight people who admit it’s because they like food, eat too much and struggle with the willpower to restrict it. However I’ve meant many who say it’s due to ‘mental health issues’, and further blaming the NHS for not setting up a serious of costly psychiatrist appointments to ‘work out why they’re eating too much’. We didn’t have this with smokers - it was a case of chuck the fags away and buy yourself some nicotine patches (smoking has massively reduced incidentally, since it became socially unacceptable

Am now wondering if you would have dismissed the mental health issues if they had done the opposite and restricted their food intake (anorexia)

either way this bloke didn’t have it, or I would be stunned if he did, he looked mid fifties.

Anybody who is over 50 and does a sedentary job ( desk job ) and leads a sedentary lifestyle, should probably think about wearing low level compression hoisery. If they are overweight, definitely.

The NHS has not failed. It is being failed by a cynical money grabbing government hell bent on destroying it for personal gain. They've been quite open about the intention.

@Flowersinthebasement

I would have thought that where a patient is ready to go home, they could be moved to an area away from the ward to wait for the discharge papers and any prescriptions etc.?

But it's not just a few hours that they're waiting. Sometimes it can be several days, especially at weekends. Where would they sleep whilst waiting for the prescription or for the ward doctor to sign the discharge papers?

When both my Mother and FIL were in/out of hospital several times, and even myself after C-section, we were all "ready" for discharge on the Friday morning, but still there over the weekend, treading water, until finally all the ducks were in place on the Monday afternoon. Hospital pharmacies are notorious for being slow (although they blame the doctors for not issuing the prescription soon enough), and we experienced lots of doctors not working on Fridays, hence no one to sign the paperwork! There's just no urgency!

To anyone saying the NHS hasn’t failed, or we have to wait for it to “totally collapse” - what exactly does that look like?

I don’t see that it can get much worse than closed hospitals, 2 day waits in A&E, continually postponed routine appointments, an inability to get a GP appointment, trying 111 and never getting a call back and no ambulances available….

What exactly else has to happen for it to be deemed a failure?!

To anyone saying the NHS hasn’t failed, or we have to wait for it to “totally collapse” - what exactly does that look like?

28 Days Later, I should imagine

@Kazzyhoward I used to work on a busy surgical ward and this is how it went. Ward round - consultant see's patient first thing in a morning and says you can go home today.Yippe thinks the patient and starts packing.
What isn't mentioned to them is that the Doctor who is in charge of completing the discharge paperwork needs to do another ward round on another ward before they can even think about doing it. Also they are a Obs/Gynae doctor so also on call for emergencies and theatre.
Now if the person is there for a completely planned surgery with a sort of defined discharge date and care pathway, then the Doctor can do a lot of the paperwork in advance, depending on any emergencies. Pharmacy will also have an idea of the medication they will need on discharge. So more straight forward.
We used to let people go without their meds and paperwork if they had someone who could pop back later ( always told them to ring first to check it was all on the ward ) and pick it up.
This worked really well for your ambulant, capacitous patient with a good support network of family or friends, who we were discharging with over the counter type medication.
We also had an alternative, an area where people could go and sit and get refreshments, whilst waiting for paperwork and medication, this was nurse led, I think it is pretty standard across NHS trusts as a way of freeing up beds.

I think the number of beds is a problem:

www.statista.com/statistics/473264/number-of-hospital-beds-in-the-united-kingdom-uk/

Unfortunately it is not easy to increase numbers. I think the reduction in bed numbers is due to lack of staff rather than costs or physical space.

I do get your point though @Kazzyhoward , nobody should be taking up a bed that isn't required simply because they are waiting for paperwork and medication, perhaps we need more Doctors and pharmacists ?

Exactly. Silent, creeping privatisation.

Unfortunately it is not easy to increase numbers. I think the reduction in bed numbers is due to lack of staff rather than costs or physical space.

The reduction in bed numbers is due to many factors, lots of people now have surgery as a day patient, which is brilliant, key hole surgery is generally quicker and less invasive and means less recovery time in hospital. It has revolutionised surgery. So the number of day patient beds has massively increased. This is a good thing.
What isn't such a good thing is the reduction in the number of all the other beds the NHS used to provide and which unfortunately are still needed, especially with an aging population.
When I started my training many moons ago the general hospital I trained in had three (30 bed ) mental health wards, two acute and one geriatric. Now there are no acute mental health beds. Everything is done in the community or miles and miles away or privately ( see recent news about how that has panned out) , so those people end up on general wards or surgical wards, being looked after by staff who have limited training in mental health.
We used to have a 30 bedded facility ( run by the local LA ) for step down and respite care, that has also gone, never to be replaced. We are clinging on to the limited rehab facilities by the skin of our teeth.
They got rid of the admission prevention team and chose to go down the discharge service route. Both are required in reality as anyone who has worked in the NHS for more than 5 minutes is aware. But you could argue that it is cheaper if someone never needs a bed in the first place ?

The NHS in England has just 100,000 acute and general medical beds for a population of over 56 million.

The Conservative manifesto said they would build 40 new hospitals. I think what they meant was that they would re-build hospitals, not provide the bed numbers of the equivalent of 40 average sized hospitals, if you have a Conservative MP maybe you could email them to clarify this ?

Down here, they built new hospitals decades ago, with fewer staff & beds than previous, they had the staff.

Easiest way to save large amounts of money is to cut back staff... less staff less beds.

The removal of the bursary was done to get less student nurses/ahp's ... even now, neither party will say they will re instate... why?

I don’t know, in my experience it was pretty dire in 2016, although, to be fair, I did get a bed after a few hours in A&E. No specialist available to do any investigation or diagnosis. Acute symptoms resolved overnight so I was discharged the following day with no follow up. Upon making enquiries with my GP about some kind of follow up, CBT was suggested for being overly anxious about my health. Years later I’ve finally seen a specialist and have been diagnosed with a chronic condition that has now needed several surgeries instead of one.
My point being, there have been issues for a while.

The Conservative manifesto said they would build 40 new hospitals. I think what they meant was that they would re-build hospitals, not provide the bed numbers of the equivalent of 40 average sized hospitals, if you have a Conservative MP maybe you could email them to clarify this

BJ had no intention of building 4 new hospitals let along 40, its just another long line broken promises.

The latest is 7000 new beds.. Where? ..and staffed by whom?

I'd bet they include beds in Hotels for discharged patients & the so called virtual beds in peoples homes as well.

@Throwawaytheusername

Thats standard tbf. If your acute symptoms stop, hospital is not the place for u. A follow up is arranged by primary care generally. Its very rare in my dept we arrange them. We discharge, send to gp, gp do referral to outpatients if needed. Ward staff dont have the access to make outpatient appointments. Consultants/drs on wards dont have time to sort referrals for everyone who needs it. Its a GPs role to do so. What you experienced sounds like a standard route to seeing the right people

@Throwawaytheusername 2016 was the point at which the NHS failed every single target it previously used to meet.

By then we'd had 6 years of below average funding and huge cuts in social care/council funding.

but yes the NHS has been dire for a while.

The latest is 7000 new beds.. Where? ..and staffed by whom?

Thought the exact same thing @Alexandra2001 they wouldn't be as sly as to include the virtual wards or beds in A&E corridors into that number would they ?

I don't like the word Failed as it implies lack of effort/skill of staff which in >90% of cases is not the case.

But it is definitely broken.

Believe me, Many did but Boris does his thing...

Our Chief exec got a much better and bigger job due to that absolute guff, I doubt they would have had any personal interest in publicly calling it out.

From the NHS England website;

Health chiefs will outline plans to prepare local services for additional pressure, by creating the equivalent of 7,000 more beds through a mixture of new hospital beds, ‘virtual ward’ spaces and initiatives to improve patient flow over the coming months.

New hospital beds, would be nice to know exactly how many of those 7,000 beds are actually brand spankety new hospital beds wouldn't it ? Virtual ward beds mentioned, what's the guess that this makes up for 6,900 ? and initiatives to improve patient flow ? you mean getting people disharged ? as opposed to not having them admitted in the first place ?