All the doctors I know are leaving. Are we going to be screwed for healthcare in 5 years time ?

[Gigihadr]

Our NHS now has some of the worst health outcomes out of 19 wealthy nations compared in an international study.
But in 2010 the NHS regularly ranked 1st or 2nd in most international studies.

The UK is under-doctored, we have a 3rd fewer doctors per 1000 people than Germany or Spain

Our government response to the doctors we have left has been to erode working conditions and pay, ensure they have record levels of inflation and rocketing student debt

They are moving to better paid, better resourced systems/employers (they are a competitive international commodity) and I can’t blame them for that.

AIBU to think we are utterly screwed? why are we just sitting back and watching this slow motion car crash ?

People seem to really resent that nurse's are progressing past making beds and handing out pills.

A nurses role has always been more than that, I think lots are ignorant to that as it is. It is possible to not be a huge fan of a largely undefined ANP role whilst recognising the fact that nurses are highly knowledgeable, competent and valuable HCPs that do more than personal care and making beds; it doesn't make me resentful it makes me realistic and concerned about the future of healthcare in this country.

However, if faced with a scenario where I needed care and the two staff on duty (heaven forbid) were an ANP whose specialist area of practice covered the issue I presented with or an FY2 who has been rotating around every 4 months and had only come across the condition once or twice, I would hope to see the specialist regardless of their job role.

Good for you, I wouldn't have the preference and that's fine.

@WetBandits I much prefer ANPs to PAs and the ones I work with now are excellent and have a clearly defined scope of practice and have taught me lots about the specialty. I think the issue many doctors have is that we’re paid less than many ANPs. Despite the fact that they have less responsibility that the registrar.

A good ANP who is proud of their nursing/paramedic etc background rather than being a “doctor lite” well trained in their area is worth their weight in gold. The ones proud to be their own profession who work within clearly defined scope are completely different to PAs.

This is what you get for voting Tory. Turkeys voting for Christmas.

Two of my DCs friends finished med school in last few years. One is going into med tech and the other looking at Australia

What help is that then? They cannot even prescribe.

It was always going to happen under this gov

I rarely find it meaningful on a practical level to discuss the pros and cons of various experiments to delegate tasks to variously imaginative or wishful HPC roles. A good nurse is always better than a bad one, and comparing say a good eg both skilled and experienced nurse to a bad doctor is not something real people do clinically. It would be so nice wouldn't it if every person we hired was the best ever whatever they are. Like everyone else new staff are judged on their individual merits because if you have either time or inclination to judge them on their uniform, you yourself are probably being carried by your team. You cannot expect people not to be sceptical about your skills when you arrive, however nobody will object to or obstruct anyone who eases the delivery of treatment to the hordes that present themselves, whatever your job title is. When you cannot cater to an over-populated system, you have to change the menu and hope more people survive than not.

The nurse practioners at my GP surgery are excellent, knowledgable and professional and I've had great care from them over the years.

However they just took on a PA. I saw him recently for some alarming symptoms. He seemed bored and basically said come back in 3 weeks if not better. After three weeks I saw a GP who was appalled and referred me to hospital on a 2ww. So three weeks wasted on a possible cancer diagnosis.

What help is that then? They cannot even prescribe.

Would you be happy if they were giving training to be able to prescribe?

I had to have an hand xray once at A&E. I knew it needed an xray, the nurse knew it would need an xray but had to wait for the doctor to confirm it. What a waste of everyones time.

I don't see how PA can be workable without them taking responsibility for their own actions and decisions. Otherwise they are wasting doctors time not helping them.

Yep, exactly that! You’ve hit the nail bang on the head.

FWIW I think it’s sickening what junior doctors are paid for the responsibility they are expected to shoulder (and a lot of people don’t realise that ‘junior’ can mean anything from FY1 to ST8!)

However, a lot of people seem to be fighting the issue from the wrong angle; junior doctors should be paid fairly for what they do regardless of what other HCPs are being paid.

Please report this. Hope you are ok.

I didn't and never have yet- I'm also in Wales where its not looking good despite being run by Labour - heard SNP Scotland NHS has problems.

https://www.bbc.co.uk/news/uk-wales-65616395

I'd hope a UK Labour government will turn on the money taps for NHS - and that will help and did hear shadow health secretary say they knew reform was needed but didn't get into details which this far put from election isn't a surprise.

However I've heard political commentators start to say behind scenes Labour are starting to worried that unrealistic expectation on what they can do may well fuck over once they do get in.

Well what I would say is that Labour would have a heck of a job to turn around the shit show that the Tories have made of the NHS. However they did it before…. Having said that though I think things are much harder now because of other worldwide pressures.

What they could do is have honest, and possibly brutally frank, conversations with the public about the state of the NHS and what might be needed to rescue it. We need a Government that can at least tell the truth and stop pretending everything is just hunky dory!

Exactly this.

Our government seems obsessed with getting people to live longer and longer.

We don't want people to live in to their 80s. It will bankrupt us even more than we are bankrupt at the moment.

Completely agree.
I'm retired now, early, on ill health grounds, but if I hadn't been treated like complete shit by my employers and been already sick of seeing healthcare in this country going to hell in a handcart then there might well have been some way if keeping me making some kind of contribution even if I couldn't do my old job again.
I qualified in the 80s and worked ridiculous hours often with inadequate supervision. I am not advocating a return to those days, but I actually felt happier and more valued as a junior doctor in those days than I did as a senior consultant when I retired. And it's not all about money, it's about working conditions, feeling like you are valued and that you are able to do a good job. I am not saying money doesn't matter, and i was, in real terms, considerably less well paid when I retired than in my first years as a Consultant which isn't really how anyone expects their career to go, but that wasn't my biggest gripe. If I underwent some kind of miracle and was returned to health tomorrow I wouldn't go back to work, not for double the salary, unless the conditions changed dramatically.
The changes you describe are hailed as the answer whereas they are in fact part of the problem. Nursing has shot itself in the foot in my opinion. The only career progression for nurses these days is into management or one of these roles. Good nurses are not valued as good nurses any more. Jobs that used to be done by doctors are done increasingly by nurses or AHPs and their work is done increasingly by HCAs. Of course there are some excellent people in all these roles but overall the standard of care is falling in my experience. I have felt very unsafe as a patient in our local hospital in the last few years and the ANPs at our GP surgery have made several serious errors with the care of members of my family that, had I not known they were wrong and used my influence to get them into hospital would have been very serious and on one occasion definitely fatal. Obviously "normal" people can't do that though and it's a huge worry. Care is increasingly task orientated and delivered by people who may have skills in that particular task but don't have the breadth or depth of knowledge to provide holistic care and thus, in my experience, frequently miss significant things that fall outside their remit.
It wasn't money that made me glad to leave. It was being asked to do more and more with less and less whilst under ever more scrutiny. It was being told which patients to prioritise by managers with little or no clinical experience- certainly not compared to me - or being threatened with disciplinary action because I missed mandatory fire safety training on account of being a bit busy trying to save someone's life at the time. It was sleeping on my office floor on call because I daren't go home as the staffing on my Unit was inadequate both in terms of numbers and skills, or being one of the few actual medical staff on duty on a Bank Holiday and not being able to get any hot food despite being there for 20 hours. Whatever you pay people it won't solve recruitment and retention if actually going to work remains so stressful. Despite my poor physical health I am actually happier now than I have been in at least a decade. I do miss patient care, but I don't miss being an NHS employee in the slightest. And I am not alone. More or less every doctor I know around my age is aiming to leave as soon as they can afford to and wouldn't encourage anyone into the profession now.

But we voted for £350 million for NHS....

... didn't we???

Labour in Wales doesn’t inspire confidence but some will say it will be different

I’m not sure where the funds will come from, based on what they’ve said so far

Well some fools thought they were….

I wonder if they are feeling a little short changed now?

Why has this turned into an anp bashing thread?

within my area of practice, I examine, diagnose, carry out procedures from cannulas to intubation, teach the former to junior doctors, prescribe, lead at resuscitations… the list goes on but I stress is confined to my narrow area of practice in which I’ve worked for 2 decades.

It’s nice to know that my band 8a salary which is as far as I’ll ever go is resented by colleagues who I support in their campaign for a fair salary. I am not a pretend doctor and have never claimed to be. I am however a knowledgeable specialist in my field and see this as what the anp role is as it’s best.

Consultants have now voted to strike as well… says it all really

Definitely not being unreasonable, this is a very valid concern. Doctors in this country have been squeezed to breaking point by endless pay cuts and increasing workload, and the pandemic thrown into the mix and understandably they have had enough. Hence why they are striking for better pay (initially) to improve retention and morale. Public support of doctor strikes is mixed, but ultimately - as you have said - it will be the public who suffer. If you feel worried about the future of the NHS and the continued exodus of doctors l encourage you to support the junior doctors and consultants strikes in any way you can - social media, writing to MPs etc.

I mean, but honestly, why do we want to preserve a healthcare system that is ranked so poorly in healthcare outcomes? We have to start again with this.

Is it?

By a decent margin too. There's no one to act down as it were to cover these, I wonder if it'll finally make the government take these strikes seriously (doubtful sadly).