To think you don't quite realise how badly the NHS is suffering until you witness it first hand

[DaisyCat33]

My parents are sitting in A&E today. They've just hit 12 hours. My dad was sent there by his GP for severe neck pain this morning. He's had morphine and an MRI scan, but they're now endlessly waiting to see a Dr about results. He hasn't even got a bed to lay on, despite debilitating neck pain. Many people are standing or sitting on the floor.

The couple sitting next to them have been there since 3am, for difficultly breathing.

I'm shocked. Honestly I knew the NHS had it's issues, but this bad?! It's frightening. I also had an email the other day saying my NHS dentist is closing, and it's basically a "well sorry no dentist for you any more, bye bye"

I don't really know the point of this thread really, I just feel shocked and upset that this is how it is. And I think a lot of people don't even realise? My parents definitely didn't until today. They are losing the will to live sat in that hospital.

Does anyone else just feel utterly helpless and anxious about this?

https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/nhs-budget-nutshell

There is appalling mismanagement - particularly in A&E where IME no prioritisation takes place and the deli-counter principle holds sway. But please, no more funding until someone with a clue gets a grip with using the money properly.
Here's how a couple of trillion pounds has been spent over this government and I spent two days in A&E as a patient before a week as an in-patient worrying about people around me who were in even worse shape than me.

Very scary times indeed. I am not sure why your practice closes at 5pm as all the ones I know close at 6.30pm. There's barely any funding for weekdays let alone the weekends, sadly. Most GPs are working flat out and are burnt out and exhausted. Patients are complex, there are language barriers, numbers of patients are ever increasing. It's truly sad and awful.

The root cause of most things that are wrong in this country right now is Brexit. No one talks about it, certainly not mainstream media due to Brexit fatigue.

The NHS is understaffed due to Brexit. Social care is understaffed due to Brexit. The migrant boats are due to Brexit. The mass layoffs at the steel plant is due to Brexit. The depletion of our fishing industry is due to Brexit. The weak economy is due to Brexit. There hasn’t been one single positive to date.

I’m not saying everything was perfect before Brexit, the NHS has been underfunded for years, but that one decision had such far reaching consequences that tipped precarious situations over the edge. No impact studies were carried out before deciding to have a referendum, which in my opinion was the highest form of gross negligence by David Cameron and his government.

In decades to come young students will be studying the dramatic economic impact and appalling mismanagement of our country during these times and they will be amazed we did this to ourselves.

Real terms funding is going up - as that chart shows

" I cannot understand why GP surgeries are not open longer and 7 days a week, I'm guessing there is a shortage of medical staff to do this and budget cuts thrown in too?"

It shouldn't be necessary for GPs to work Saturdays and Sundays. A bit later in the evening would help people who work. I'm abroad and getting a GP appointment is pretty easy, depending on who the GP is, but they don't work weekends. The UK basically just needs more GPs. There aren't enough per person.

I think there must be some simple ways to save money in the NHS. Dh had a call yesterday to book an appointment at the hospital. He was told details of the appointment would be confirmed by email and post. When he said an email was sufficient he was told they had to send a letter too. Can understand some people prefer a letter but I imagine a lot would be quite happy with just an email or text nowadays if they are asked.

It is all so depressing.

I have been an NHS consultant for almost 30 years and have seen things go downhill. I have never taken a day off sick and I do no private work. I am genuinely dedicated to the NHS and to be a good colleague and doctor to my patients.

If we had more staff, there would be an instant improvement. Having a couple of extra GPs in a practice or a couple of extra nurses on shift on a ward and of course things will improve. People are inefficient and irritable when under pressure. That is why we see nurses walking past old people crying out for pain relief, which is heartbreaking. With insufficient staffing comes low morale, and people leave. Of course that is stating the obvious.

There is definitely inefficiency. It is ridiculous that the three hospitals I work with, which are in a five mile radius of each other, have different IT systems so you can’t access the other hospitals’ investigations and notes. This is indefensible. When our junior doctors move from one neighbouring trust to another to work, they have to repeat all their blood tests from scratch for occupational health clearance. Just ridiculous.

And you cannot view healthcare in isolation. The NHS is undoubtedly affected by social problems. If people are not adequately housed, if children aren’t receiving support at home, if poverty is leading to an increase in drug and alcohol problems etc, there is a knock-on effect for the NHS which becomes the first port of call for many.

Yes there are time-wasters. Like my elderly mum heading to A and E because her gum was still bleeding three hours after a tooth extraction. It took my brothers and I screeching down the phone at her to stop her doing this. She was fine. But there have always been people like this, and the NHS coped.

GP surgeries can only do so much. If people do not want to become GPs, then what resources we have are spread thinly. I do liaison work with a few GP practices and I have to say they are fabulous. They really seem to know their patients and care. I wonder if as usual, London has better resources than elsewhere as people still want to come and live and work here.

Somewhat controversially, and it’s not the biggest issue, is that we are shit at getting rid of crap staff. I have worked in many teams and there has always been at least one awful staff member. Incompetent, lazy, rude or all three. We cannot get rid of them. HR does everything possible to make us ‘support’ them and accede to their demands, for fear of the staff citing discrimination or threatening legal action. I have had enough of this. There are so many fabulous colleagues of all disciplines that these rubbish individuals let us down badly when they deliver shit care. NHS staff are all not ‘heroes’.

Another contentious point is that I think the standard of nursing training has gone downhill. When I speak to senior nurses, they are horrified at the quality of some newly qualified nurses coming from our local institution. They arrange interviews and see that many new nurses are lacking basic maths and English. They said there is no way these nurses are leaving university ready to give medication to patients.

One thing though, however shit it is for staff, we cannot allow rudeness. I have never been rude to a patient or relative and have no tolerance for staff who are. However busy and tired we are.

I think we all need to pay more tax or we have to institute a charge. Look to other countries and take the best of those and implement a change. People used to think that no government would want to be the one to ‘dismantle’ the NHS and start charging people. I actually think that now when people see the reality of what we are dealing with, many people might be more willing to pay for better and more reliable service.

I am sure I have more things to comment on, but that’s all I can think of at this point.

@endofthelinefinally I agree. I fully support the French system. We have a home there and it's exponentially better. At least the staff are generally polite.

DH and I have worked for 70+ years between us and have been heavily taxed, making high contributions. We would not be prepared to pay a penny more for NHS inefficiency and significantly to be messed around endlessly and wastefully at the hands of those who seem to behave as though all patients ts are pig ignorant pieces of sh1t with a few exceptions. The NHS could not speak to people as they speak to patients in any other sector and keep their jobs.

I am utterly sick of it, avoid it where possible and do not in the least belive it's about lack of funding/resources. If there's money for rainbow crossings and LED massive tellys, it's hard to believe they're short of money. Oh and I think I read something about £10,000,000 on equality tsars. Is that to stop staff addressing all the men patients ts as Mr and the women by their first names?

The whole sh1t show is farcical. I am old and have no recollection of it working well with better attitudes in the 80s or 90s and let's not forget Blair ran riot with PFI and established a new layer of bureaucracy in the form of PCTs. It wasn't great under Labour at all.

I don't want to be angry with anyone. I want very ill people in a hospital to be looked after properly- kept clean, their dignity thought of, their notes read, medical staff to do their job competently, all staff to work hard. I am sick of excuses. The staff were lazy - that was a huge part of the problem. Read what happened. None of them wanted to do basic things but they weren't doing anything else. They were sat or stood chatting or on phones while patients waited and the place was filthy.

In the UK it’s best to go to a minor injuries clinic if you have a suspected fracture instead of A&E. We’ve been 4 times in the past 4 years and it’s around an hour to be seen, x-rayed, seen again, and on our way with crutches/sling. Last visit was a couple of months ago.

I worked with a chap who had spent many years in the NHS he always described it as a black hole and said no matter how many billions you throw at it, it will disappear. He also said that Blair giving financial control to GPs made things worse.

I do don’t know if what he was saying was correct but I do k ow the preferred supplier system is so complex that when companies get on the list they can charge what they like and do.

My his and was in hospital a few years ago and his wound became infected and required a special dressing the hospital said the dressing are over £400 each. I did an internet search and could have bought the dressing for more than half that figure. I fear that the NHS is paying far more for equipment than it needs to. Of course that is one incidence.

Not all GPs are inaccessible.

You can get a same day telephone appointment and if the doctor thinks it's urgent, a doctor will see you the same day. They will send a prescription electronically to the pharmacy and you can generally collect it the same day. You can get a non-urgent F2F appt within a fortnight.

I haven't needed to go to A&E for ages, but I gather it's pretty grim. Part of the problem is lack of beds for people who need to be admitted, who then have to wait in A&E for hours and need monitoring, so they're taking up staff time in A&E when they should be on a ward. This has a knock-on effect on waiting times.

A big part of the problem is that patients who are medically fit for discharge but may need social care support have long waits for assessments, so are bed-blocking. The pressure on adult social care is down to local authorities to fix, not the NHS. If adult social care was merged with the NHS, they might be prepared to throw resources at getting assessments done and provision in place, which would ease pressure elsewhere in the NHS.

But all of these problems have their roots in lack of resources. I hope people bear in mind the damage austerity has done to vital services come election time.

It’s not the GP’s - they’re totally overloaded as well. It would ease the pressure a bit but it’s not the big problem facing AE right now. Minor things turning up to AE can be relatively quickly and easily dealt with - yeah you might have to wait but you’ll get seen in time. The overwhelming problem is that there are not enough beds in the hospitals for patients that need admission, so the department fills up with patients. Leaving no room to bring the new ones in from the waiting room or off the ambulances. Hospitals are under huge pressure to release ambulances, so staff are pressured to take the ambulance patients first and the ones in the waiting room wait even longer. Patients stacked up on corridors in AE, patients put as extras in the middle of hospital bays on the wards, patients squeezed into resus areas as extras without any monitoring devices or equipment. Acute and Emergency services in the NHS are absolutely and completely broken at this point. It’s horrific working in this system as well - being asked to essentially triage who is the most sick out of a whole room of sick people so they get the sole bed you have. Then the ambulance brings in someone worse, or someone has a heart attack in the waiting room. Waiting for the complaints and coroners referrals to come in. Realising this isn’t what you trained for and it isn’t what your patients deserve. Heartbreaking.

@Supernova23 she can't drive and it happened in the middle of the night, and they have 2 kids under 5. She ended up ringing a friend to take him who was able to drive.

Yes, Blair made things worse with his PFI nonsense. But I can say for definite that things overall were better. We had much lower criteria to allocate community staff to patients. Now the criteria are so high that people are told just to stay with their GPs and they don’t qualify for support from specialist nurses or consultant review.

Also, regarding social care, things like surestart centres offered a lot of support for families. Without these kind of services, the mental and physical health of new mums and their kids can deteriorate and they start to become a ‘burden’ on the NHS. So I can say that I have definitely seen a deterioration. No equality tsars where I work. Thank goodness..

I don’t care which government improves things. But I would certainly like one of them to have a go.

Oh - and it’s not just social care either. It’s that we have far fewer hospital beds than are needed full stop. We run at a ridiculously high bed occupancy rate. But it’s easier to say ‘GP’s’ or ‘social care’ or ‘bed blockers’ than actually pay for bigger hospitals with more staff and more beds.

@AppleLights we’re still paying billions on PFI which has an impact no doubt but the bigger question for those who think Labour will fix all this is what with?

There’s no extra funding

I honestly don’t think any government is interested in fixing it. I think privatisation is the goal for all parties although it would be electoral suicide for Labour to admit that. And honestly, I don’t think things can get any worse - but then I’ve been saying that for years and they’ve steadily deteriorated.

I very recently had excellent, prompt live saving treatment on the NHS but I do agree that in other areas it is very bad. I am especially concerned about many older people I know who seem to be on never ending waiting lists with no idea of when they will be seen about joint replacements, breathing difficulties and so on and I am talking people who have been waiting for years and years in misery and still have no appointment although they are assured they are on the list.

It was in the radio yesterday that in parts of the UK an elderly person can wait up to 5 years to see a specialist for a joint replacement and then another 5 years for the surgery and that many then pass away before they get the help they need! Those who can afford it are going private but those who don't have the money have to wait in pain with ever shrinking lives and declining health which may not be the case if they had the surgery or treatment they need sooner.

I hope I am wrong but sometimes I worry that elderly people are being deprioritised for treatment.

It is insane that we have to use a stationery provider which is so much more expensive than Amazon for example. These things should not be allowed.

We have one, and it's fantastic. You can often be seen in a few minutes (but not on Sunday mornings, when it tends to be quite busy with injured footballers and rugby players). I think most of the towns in the rural parts of the county have one.

Sadly, there isn't one in the nearby city, because they have A&E. I think it would be worthwhile them opening one, it would divert a lot of the minor stuff.

"The root cause of most things that are wrong in this country right now is Brexit. No one talks about it, certainly not mainstream media due to Brexit fatigue."

I'm one of the biggest Remoaners you'll find, but the NHS's problems started way before Brexit.

Before Brexit, my GP surgery insisted that I could only get an appointment 2 weeks before the day I wanted it so even if I said I could wait longer because it wasn't urgent, they insisted on this stupid 2 weeks thing. I couldn't get an appointment 2 weeks from Thursday if I was asking for it on Wednesday, only 2 weeks from Wednesday. I couldn't get one in 3 or 4 weeks because it had to be two weeks from the day of asking for the appointment.
Calling at 8am for cancellation and never getting through has also been going on for years in some surgeries, depending on the doctor-patient ratio in that area.

The problem with the NHS is extremely complex but IMHO broadly relates to gross underfunding and to a lesser extent an incoherent system.

1. Most people's first contact for a health issue should be with a GP. But it can be tough to get an appointment. There are simply not enough GPs. I live in an area where thousands of new homes have been built in a short timespan more than doubling the size of the town. All the residents of the new estates can no longer sign up with a GP in the area and have to appeal to the local ICG. Even if housebuilders incorporate a medical building into the estates - where do the GP's come from - even if by some miracle there is funding, they are not easy to recruit.

2. When you have been either referred to a hospital consultant or are under one, again waiting times to see said specialist or for treatment can be enormous. For example, I know people waiting 5 years for rheumatology consultation. In the wait for either a consult or treatment, we can still get very ill. At this point we are often beyond the bounds of GP knowledge and so end up in A&E to be triaged.

3. Some of us have very complex health issues. For example I am on immune modifying medication. If I get an infection, it can take hold very fast. I need to be able to see a GP within 24 hours. (My solution is that I use a private GP service as I can afford it). But this always raises issues around continuity of care. Gone are the days when you had a set GP who got to know you and sometimes could put the disparate pieces of a puzzle together faster. But continuity of care can be important in all settings - the number of times I have had tests redone as the latest doctor does not believe that certain anomalies are normal for me.

4. Dentistry is actually a real health concern. Anyone who has ever had horrific toothache will understand how unbearable the pain can be. To me the pain is far worse than childbirth, sepsis and anything else. No wonder people end up in A&E with severe dental issues. Not to mention the fact that infections can be severe and life threatening in some circumstances.

5. Social care - there are many people taking up hospital beds who ideally would be in well supported adult social care. If taking up beds in hospitals, others get operations cancelled and fall back into category 2 and needing emergency help to manage until treatment is given.

6. Ageing population - we cannot get away from the fact that many are living longer than 50 years ago or when the NHS was conceived. We can keep people alive longer due to the wonders of medicine but the elderly tend to have more complex health issues, let alone conditions like dementia which often mean families can't cope but there is no social care provision.

7. Private health care and insurance doesn't always help. For example a lot of BUPA policies will pay for an initial consult, tests and a follow up consult. If you have a chronic condition you will need to be referred back to the NHS for treatment. Again what do you do if you have issues on a long waiting list? Then you have issues like my GP would not prescribe anything recommended by a private consultant even basic things like blood pressure medication - they would ask you to get an NHS diagnosis - so your private diagnosis has not taken the pressure off the NHS at all.

8. Different policies in different areas. In my county, GPs no longer do any blood tests as they don't get funding for them. Instead we have to attend the local hospital - which for many can be a £60 taxi ride (it's rural.) It's an odd county with 2 hospitals but I go to a specialist hospital in the next county where I live. Under local policy my GP can also refuse to work with any NHS hospitals - so won't prescribe or monitor (blood tests or pressure for example) for an NHS consultant. So this means collecting prescriptions from the hospital and wasting hospital clinic time on monitoring blood pressure (taking appointments away from those waiting to see a specialist). The right to chose does not exist in my county therefore. This also illustrates different parts of the NHS causing each other issues as they are all trying to cut costs and offload onto other areas.

9. Lack of mental health provision - this is an enormous issue. Patients awaiting treatment can spend days if not weeks in A&E waiting for a specialist bed which could be anywhere in the country. Services are vastly under funded for children and adults alike. For example in my area, a child has to have had an attempt serious enough for hospital treatment just to get an initial CAMH appointment - and there is still a year's wait for any therapeutic appointments. No catching it early. I suspect this will mean this generation of children will have worse issues than those before. Plus we need to consider that a huge amount of police time is spent dealing with mental health issues.

10. A&E - there aren't the words. I do feel it's a bit of survival of the fittest/warzone etc. It's the mop up for every other area and bears the brunt of underfunding and issues in all other areas. It's no wonder people are literally dying waiting.

I have no answers but I will be voting for where I think change is most likely to come from. I could add a lot to the above but it's depressing enough already.

The purchasing system in the NHS is a racket IME. They are tied into designated suppliers who charge a lot more for things like stationery, for example than the local supermarket.