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.

We’ll have to agree to disagree. I’m not making an assumption, I have both friends and close family in the NHS in both medical and non-medical roles and I know in detail about their roles and those of many colleagues. I’m not saying reception staff, for example, aren’t valuable but they’re more easily replaced than medical staff. Certainly staff such as finance and HR don’t deserve public adulation for their office jobs just because their employer happens to be the NHS.

@Ladylaylayday
Interestingly the children's school health service you have linked is an example of private companies (albeit a CIC) providing health service to the NHS.
Contrast it with the mental health paramedics which appears to be a collaboration between several nhs organisations with extra input from voluntary sector organisations

I think this reflects the nhs provision. When we access care it isn't always NHS but might be a private company providing care through a contract with the NHS.

I do wonder how much money is wasted going through procurement, paying shareholders when services are provided by private companies using nhs funds.

Oh, and I'm well aware of availability or lack thereof in my area. Lived experience of it. 2 friends who couldn't access the mental health care they needed. Taken to a&e. Left there for hours and hours. Walked out and killed themselves.

Best mate - alcohol dependant due to mental health issues. Has been waiting a year for a place in detox. Desperate for help, desperate to get dry, but losing hope every day whilst killing themselves with vodka.

3 local children denied CAHMS help as not deemed serious enough. Killed themselves.

Friend's child with serious eating disorder - again not deemed serious enough for CAHMS help.

There is NOT enough early help available.

Where do you live?

Really? I'm 52 and not had a general health check ever

North west. That's about as specific I'll be on here.

My receptionists, secretaries and admin support deserve adulation. If not from the public from me! I couldn't do my job without them and it's getting hard to replace them if they leave. Who wants to be paid minimum wage to be shouted at when you could do a similar job, with less stress and more perks such as WFH.

NHS Health Check - NHS (www.nhs.uk)

If you haven't been invited and you think you're eligible, contact your GP surgery.

@Mabelface I agree with all the mental health stories you have shared.
Children's mental health gets bounced back to schools.
Adult mental health is online CBT and just doesn't suit everyone but there appears to be no flexibility in the approach to individualise treatment. We've had referrals for suicidal patients rejected because 'it is a consenting service so if they don't consent to be seen they won't be seen'
I'm NW too.
Despairing.

Thanks @chocolatenutcase CBT isn't suitable for beyond mild depression and anxiety. It gives a "toolbox" of coping mechanisms. If you struggle to use that toolbox, then that just reinforces feelings of worthlessness.

There needs to be much more availability for person centred therapy at the earliest possible time. Crack this, then you have people with better mental health, more able to work and oh look! Fewer people needing to receive sickness benefits. For me, it's a no brainer.

The Sunderland Royal Hospital (NHS) has an entire ward dedicated to weight-loss surgery. It's on YouTube.
Every year it deals with hundreds of adults who have eaten themselves silly, developed desperate health complications due to morbid obesity, given up on self-restraint but expect the NHS to put it right for them, like the consultants, dieticians and nursing staff have access to a Magic Wand.
The NHS was NEVER intended for entirely preventable conditions like this.

I work for the NHS, people are dying as a result of delays in ED. I’ve been in senior management meetings and this is an issue; obviously one we want to avoid but unfortunately we have been poorly managed and underfunded for years. Some of these patients may have died anyway (we will never know) but some wouldn’t have.

ED staff should just be able to concentrate on the new patients coming through the doors but they are also having to look after all the bed waiters who are stuck in ED for days waiting for a bed on a ward. A few years ago all hell would break loose if someone was in ED for over 12 hrs, now I see patients who have been stuck there for 2-3 days sometimes. It’s awful. On the wards we will take 2 or 3 extra patients where we can squeeze them in but then we are full but in ED they just keep coming in. I feel sorry for the staff and the patients.

Not true.

CBT can also be trauma-focused for PTSD. Excellent evidence base and recommended by NICE.

Can also be adapted for numerous other MH conditions; What is CBT? (babcp.com)

I won't link all the evidence for every MH condition as you can Google.

@Ladylaylayday I'm not going to argue with you on this. Lived experience is very different to what's written down. NICE doesn't always get it right. I go on my own, my family's, my friends and wider peer group experiences. A lot more consultation needs to take place here.

Your experiences are different to mine. That doesn't make mine wrong.

You do realise that the majority of these people have eating disorders, don't you? No one wakes up one morning and decides they're going to eat themselves to morbidity. This goes back to more early mental health availability needed.

No , you're wrong when you state CBT "isn't suitable beyond mild depression and anxiety".

There's no argument to be had because there are dozens of research trials worldwide demonstrating it's effectiveness for many other conditions including PTSD, schizophrenia, eating disorders..

You thinking it wasn't helpful for you or your friends and family is exactly what you said; your experience and only your experience.

And i'm not minimising your experience; just saying you're categorically incorrect in stating CBT "isn't suitable beyond mild depression and anxiety".

It's misinformation and why so many complain there isn't MH treatment or therapy available when there is; which helps many many people. When what they should say is it wasn't helpful for them.

Because of all the misinformation and negative attitudes towards CBT you even get people saying there is no help available for them when they've been offered CBT but won't even try it because they think it won't help.

Well, explain this for me. How do the proffered maximum 6 to 12 prescribed sessions do? Hmmm, just at the point of opening up, then told that's it, can't have any more, put back into the community when only the surface has been scratched, leaving you more raw and vulnerable than when you started.

How does that show success? It doesn't.

Whilst I said that my view was simplistic, it doesn't mean that I'm simple. I read widely, I talk to people, I research. I don't just take my information from public bodies and research papers at face value.

All I did was make a list of suggestions that could help our people and healthcare system.

And all I did was say many are already available.

And are evidence based to be effective over 6-12 sessions.

They're therapies with little evidence that more sessions = more results. Though usually, if you're benefiting from it, it can be extended up to 20.

Because what you're saying is what a lot of people say "well 6-12 sessions won't be enough for me, I know that already"

It's a therapy, it's not likely to be a cure for all of your worries. concerns, childhood adverse experience etc. It's supposed to be focused on the most pressing symptoms to help you cope better, manage better, feel better.

That's where a lot of people go wrong, they think that to help a MH problem, they need 'therapy' where they'll need to analyse everything that's ever gone wrong for them or everything they think or feel.

You mentioned earlier, you want person-centred psychotherapy. Which could take a huge amount of time - yours and the therapists- and cost a huge amount of money.

Why do you think it would take more than 12 sessions for you to even open up? and so how many sessions do you think you would need? And do you think it would even help?

Some people respond very quickly, some people don't. Some people won't respond to CBT and can be referred on to different or longer therapies. Some people won't respond at all no matter how many sessions or therapies are given.

There's never going to be a system on the NHS where everyone has bespoke open-ended psychotherapy which could take years. With no evidence it'll lead to better outcomes.

That's not the same thing as appropriate, evidence based help not being available which does help many people.

I know many, many people who have benefitted from CBT. For all sorts of MH conditions, with all sorts of complexities and neurodevelopmental differences and childhood traumas.

I also know some people who've been in psychotherapy for years (paid privately) who think it's doing them good and it seems to be; and some who seem to be exactly how they were before starting it, if not worse.

"sigh" I have neither the patience, time or crayons to continue this with you. You do you, I'll do me.

Thank you and goodnight.

I'm really happy with how my son has been treat on the NHS. I don't think his outcome would be better under any other system.
I don't post this on threads where someone is worried about the health treatment that either they or a loved one needs because that would be incredibly hurtful and unhelpful.

I would happily pay more tax towards the NHS, social care, education etc. I expect that there are ways that the NHS could be more efficient or offer better outcomes. I don't see how privatisation would achieve that. I can't think of anything where privatising a public service has improved it (or actually saved the public money).

Apart from anything else, why privatise one public service while at the same time be having conversations about nationalising water and rail services?

At last! Someone who sees the trees through the wood.. and looks at the detail rather than the sensationalised newspaper headlines 🤓 x

When I started working in a department 15 years ago, I had one admin staff that used to organise the pxs for our group. They used to understand the issues, fill in relevant forms, request routine tests and type letters. Worked well. Had a relationship with the pxs and the team we worked in..

Now we have 6 admin staff, with 2 of them paid at a higher rate because they are the admin managers.They can't fill in the forms, our nurses have to do this now (they are overwhelmed). They don't type letters because this is automated, which means I type them in clinic. I think the new admin answer the phones and get results from other hospitals. There's a lot of just organising waiting lists and attending meetings about which pxs need to be seen quickest. This is not based on clinical need, it's about making sure the targets are met. The old admin tasks are undertaken by my very highly qualified nurses or the resident drs. As a result, the resident drs and nurses are doing the less skilled work and learn so so much less clinical medicine. The admin seem to be involved in lots of management meetings, they aren't a part of the front line team in the way they were.