To think our obsession with the NHS has got out of hand?

[HFJ]

I think we’ve got to the stage of faux outrage, thinking that if the NHS did its job properly, old age would be cured and there’d be no deaths whatsoever.

This article caught my eye https://www.telegraph.co.uk/news/2024/06/20/ae-waits-cause-plane-load-of-deaths-every-week-doctors-say/

Essentially, according to the article, delays at A&E are causing 250 extra deaths a week. You’d expect these extra 250 people to show up in the national statistics. So I checked and found the answer here: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregisteredweeklyinenglandandwalesprovisional/weekending7june2024

I attached the key image. It very much looks to me like deaths are lower than average.

My worry is that this outrage is just being used to prep us for huge increases in tax ‘for the NHS’ and this will be at the expense of spending that would benefit young people, young families who are really struggling right now.

@Willmafrockfit @sazzy5 re training more doctors and staff. Read social media.
Some current final year medical students due to start their first job 1/8/24 still don't have a job to go to. After the 2 years foundation training, there is a fight for training places so doctors who would go into their third year are struggling to find a training place so are opting to go abroad, and there is so much in the medical press at the moment about GPs finishing their training unable to find a post albeit not in every area. All this due to lack of funding enabling hospitals,GP surgeries to recruit the numbers they need. I train GPs and I'm beginning the think what's the point because in some areas there is very little work and they just go abroad.
I don't have the answer, but working in the NHS I am so demoralised.

There are, but thats also to do with being risk averse and fear of being sued

So for example, you cant give back medication, this is due to someone somewhere having been ill at some point back in the day due to medication re issued and the NHS doesnt want to be sued

You cant give back crutches and wheelchairs, not sure why that is but it will be part of some risk assessment reason I suspect

Procurement services have been outsourced, on a semi private system, because people bang on about 'value for money' and wanted PPIs, this has inevitably caused huge costs, little improvement, huge waste (I believe this was a Labour initiative too)

A lot of 'waste' is because there isnt the personnel to manage a situation, emails go unanswered, phone calls go unanswered

So Ive been chasing for example an MRI scan of my brain that took place 18 months ago, how much time has been used by the secretary answering and responding to my calls, a waste of her time and my time. Still no scan results. Hopefully I dont have some sort of brain tumour sitting there.

A friend of mines dad was admitted to hospital and was appalled when visiting him that a do not resuscitate form on his behalf with absolutely no discussion with him if his family. My friend was firstly assured by nurses and the doctor her dad had requested this and signed it but after she spoke to her dad and massively kicked off the doctor broke down and admitted it was her signature on the dnr and apologised. He’s now home and somewhat recovered but what about the people with no one to advocate for them? it’s like culling

I agree. I'm in N.I and waiting times for A&E can be 24 hours. DH waited 15 hours with a broken arm.

No NHS dentistry either.

Friend has been waiting to see a neurologist since 2017!

@soupfiend Im aware of lots of the reasons why but nonetheless there are waste & procurement issues.

There’s a mixture of issues on the nhs.

1. ageing population so bigger and more poorly population to treat.
2. Underfunded for the bigger population.
3. Poor allocation of funds. My best friend is a band 8 and on over 50K. Shes a nurse but now sits in the office as a site manager doing rotas and overseeing bed allocations along with 10 other band 8 nurses and clinicians. The job is 3 days a week for 12 hours. She said herself realistically you could train up admins to do her job and it is WAY easier than being a frontline nurse. Shes also a prescriber. So you’ve got at least 10-13 nurses/clinicians doing an overpaid admin job and lost those skilled clinicians off the front line. There are TONS of these jobs in every trust. Office jobs that are overpaid and staffs only way to get more money/promotion is to take these jobs so we lose skilled workers off the frontline treating patients and also waste tons of money in the process.
4. Not enough qualified skilled doctors, nurses, midwife’s etc. No point in opening up more trusts or getting more beds if you don’t have the skilled staff to staff the beds.

Therefore there is not one problem but a combination of issues requiring an overall reform.

My SIL is going through hell at the minute. She’s only 30 but is shitting blood daily with a bloated stomach and now weighs 7 stone. She has been referred to the 2 week wait pathway a few weeks ago. However the earliest they can see her is the last week of July. She has had to pay privately to get her scans earlier and travel to the next city to do so next week. Luckily my BIL has a good job so they can afford it. However if she didn’t have the resources she’d just be at the mercy of the system. The GP is worried sick about it too but nothing they can do. If you got some of the qualified and skilled staff out of the offices and actually onto the front line to do what they were trained to do, maybe she could be scanned quicker. It’s a terrible state of affairs.

@Abitorangelooking i have just finished a placement in a Scottish hospital A&E unfortunately it is not like that here, loads being nursed in corridors, ambulances queuing etc as very little flow through the rest of the hospital which inevitably holds up those in the waiting room. This is due to the fact we have the highest number of elderly in Scotland and so much of it is social issues as well as the usual fractures, breathing and heart issues

I was referred for something, after the initial letter with my appointment details I was sent a text saying it would now be a phone appointment “DO NOT COME”. On the day I had got an annoyed doctor phoning me asking where I was, apparently the the text should not have been sent. I was sent another letter for an appointment when I was away. Phoned the rebooking service to move my appointment, I then get a letter saying as I have missed the appointment I need to redo my referral. I phoned back the rebooking service, and as I had the details of who I spoke to previously they could look it all up & see it was an error so I was reinstated. Such a waste of time & energy for all involved.

It’s a social care issue too as often they can discharge patients.

20 weeks pregnant with chest pain and an abnormal ECG. But I could walk and talk. I had to sit in the waiting room, which was heaving, for 15 hours before I saw a doctor.

Needed a repeat ECG every 30 minutes but the nurse literally said “it won’t be that often though, we are too busy”.

they finally admitted me to a ward at 7am when they had another change of staff

14 years of out of hand, out of control, lazy Tory government landed us here.

YABU @HFJ.

@Mammacita1 an admin cannot be a prescriber, it takes a lot of training, and is an aid to waiting for a doctor to prescribe, if a band 8 has been trained,
that cannot be palmed off to admin

The thing about children waiting years for treatment is that it's a much bigger percentage of their lives than an adult waiting for the same length of time. Also with my son who was meant to have an operation aged 8, which we knew would need to happen when he was born. He was 8 when he went on the waiting list (covid delays) and his operation got cancelled when he was 9 and again when he was 10. He now has another condition which needs to not be flaring up when he has the operation or it will be cancelled again. Ds is now 11 and going to secondary school in September. The operation is most likely not going to be done in time so we now have to deal with him recovering and being less mobile in secondary school rather than primary which is going to be a lot more complicated.

@Willmafrockfit of course an admin can’t become a prescriber FFS.

im saying my friend was a nurse and a prescriber. But now she’s been promoted she works in an office essentially doing a job an admin can do. She looks at rotas and bed flow. Shes a band 8.

So we have lost a skilled nurse prescriber that could be on the floor treating patients but instead she is now doing an admin job for more pay and less stress.

There are loads of these managerial/office type posts in trusts across the nhs.

most band 8 nurses are paid a band 8 to become managerial roles, including rotas.
you want her back on the shop floor?
you want her doing a lower role?

I don't consider myself to be obsessed with the NHS but my experience of the care recieved by relatives and friends of varied ages has given me cause for deep concern. If you've had little or no cause to use it, or being fortunate to recieve an unusually good experience for whatever reason, I think its hard to imagine the scale of deterioration. Its not about elderly people selfishly not wanting to die. It's people of all ages who can't get the treatment they need in a timely manner to save their lives, get them out of pain and give them some quality of life. It's so much worse than it was, and anyone with the potential to need it should be very concerned indeed.

@Willmafrockfit Youve massively missed the point so I’m probably wasting my time explaining this to you.

In order for skilled frontline staff to progress and get better pay, they have to come away from what they’re actually trained to do to do admin roles. Roles that are either unnecessary or could essentially be given to a trained up admin worker on a lower band. Thus saving money.

Frontline skilled workers should be financially incentivised to stay doing patient care we which is essential to treatment of patients, whereas admin is required but not required to be carried out by the limited qualified clinicians we do have.

My friend said herself you don’t need to be a qualified nurse or prescriber to do her job. Just a very organised administrative team could do the job at a band 4/5. There is nothing medical to her job anymore and it’s way easier than being on the frontline treating patients. Drinking coffees, having lunch breaks and doing spreadsheets and making calls.

You could have a ward desperately understaffed and requiring 10 more nurses in order to run safely and knock off wait times/bed availability and treat an extra 20-30 patients a week.
But they have no funding or qualified nurses/clinicians for these posts available. However there actually is an extra 60-80 qualified nurses that could do that role in the same hospital but instead there sat in the office upstairs being paid double the money to do office tasks.

That makes 0 economic sense.

If it’s a private company go ahead and have all the admin workers you want for your business. But this isn’t a private company, it’s the nhs funded by tax payers for treatment. It needs to be economical.

The NHS needs a total reform. It is one of the biggest employers in the world and is quite frankly unmanageable. It’s size is unsustainable.

Some interesting points on this thread.

I agree with the poster who points out that privatisation won't miraculously fix the NHS either- GPs and host of community services are already not NHS and are already nor working. I find this more terrifying as I think the situation is a lot worse than many have realised.

There are a host of issues in UK healthcare. My list is:

• underfunding
• lack of effective social care provision (home carers, care homes etc)
• obesity crisis
• drug and alcohol misuse
• IT systems that are not fit for purpose and don't join up with each other
• too few clinicians in front line services
• a lack of experienced clinicians and the ongoing haemorrhage of staff
• government decision to remove training bursaries for healthcare students
• huge amounts of waste
• too many demands on clinical and front line admin/support staff
• agenda for change encouraging experienced clinicians off the front line/no pay incentive to stay frontline
• high instances of violence & aggression from patients and visitors (including unintentionally)
• GP crisis (lack of GPs, problems getting appointments)
• Inexperienced and ineffective leadership in lots of departments
• difficult and long process to fire staff who are incompetent or bully others
• poor communication between staff, different departments and different trusts

I'm sure I have missed off many more.

My concern is that is a massive and complicated list to sort out and goes far deeper than the NHS.

Edited for formatting

the nhs decided some time ago to promote nurses as management, like it was a good thing.
some of whom are very much out of their depth.
otoh, management without clinical experience were also out of their depth.
your friend may say an admin person could write a prescription but perhaps she should put her money where her mouth is and go back to the wards @Mammacita1 - doubtful

agree @Saintmariesleuth

each department in the hospital is crazy in that they all have their own processes and computer systems.
you struggle to find out if a patient has an appointment in another speciality for example

The Europeans on the whole pay more, so they are actually throwing more money at it…

@Willmafrockfit I’m not sure if you have reading comprehension issues or being wilfully ignorant.

My friend is no longer prescribing in her job as she is doing an ADMIN job now.

That is my whole point. She was trained up to be prescribing and a masters in nhs pay. But rather than use those skills to prescribe she is now sat in an office NOT prescribing.

jheeeeze the comprehension on this site is actually shocking.

@Mammacita1 you are being very rude to me