How would you fix the NHS?

[PinkFruitbat]

The Government is asking for ideas on how to fix the NHS.

https://change.nhs.uk/en-GB/

What would you do to fix it?

We need community, not geriatric, rehabilitation centres. Orthopedic problems take a long time to recover from and require lengthy stays and even longer periods of rehabilitation. Put them back into the community.

No, if an elderly person is in hospital for more than 28 days pension credit can be affected.
I agree with your comment about living in the country for a certain length of time though.

Where do we get the staff from to man these places ?

Well i guess that is up to the government to sort out.

It's my understanding that only Attendance Allowance or other disability benefits would stop. i guess this may affect pension credit amounts if they get severe disability premium though. Pension credit continues for a year.

We need our eyes firmly on the fact that the population is aging. Sort social care. I'd make it better paid to attract staff and yes, we'd have to pay for that in taxes.
Someone upthread mentioned specialist hospitals for the elderly. At first I thought yes. Then I realised this is tricky. What is elderly? Do we class it by age (in which case what is the threadhold age?) or by types of illness? Tricky. But in theory perhaps a good thing to look at. I know geriatric medicine is a Cinderella speciality. Let's elevate it. It might benefit all of us.
I'd also invest in public health and public health messaging. I don't know the best way of delivering this but let's dig down. We've had huge success in cutting smoking so can we pull similar levers for obesity?

@Leniriefenstahl use the PAs for that and get actual doctors back in GPs surgeries

Apparently there are medical students in this country who can't get jobs. Why the hell not? It's absolutely scandalous that young people who have worked their fingers to the bone to get to and through med school can't get jobs while we have such long waiting lists. I think it's similar for nurses.

I would partly privatise it immediately, incentivise the public to take out insurance, cut out a lot of the NHS services, cut waste, allow a better referrals process that doesn’t involve GP gatekeepers, expand GP hours but pay them more to incentivise them and require all GPs to modernise with streamlined technology.

Then I would focus on public services to improve health and disincentivise unhealthy habits. Invest in development which is designed around walking and cycling, improve walking routes, widen pavements, improve cycling routes, set up bike buses and walking buses for schools, expand public fitness centres and pools. Invest in really healthy school and college meals and teach children about healthy eating by offering them delicious healthy food. Then tax sugar, tax ready meals, tax fast food, block fast food near schools and colleges, tax alcohol, ban cigarettes and ban vapes.

The public would hate me but I am not messing about!

Do you know many PAs there are currently ? Do you think the medical profession will agree to this ? You’re dealing with massive vested interests like the BMA. What about nursing staff numbers ? Will you pay them more to attract decent candidates ?

What waste ?
I think you better call Wes. You seem to be magicking up millions to fund these great ideas that no one wants to pay for.

If this charging was based on who gets free prescriptions, then 95% of appointments would be free. The working population, the main ones funding the NHS, would be the only ones excluded from, free at point of need, treatment.

@Leniriefenstahl

The millions I am conjuring up will be covered by the part privatisation/ part insurance model I am implementing, plus the reduction in scope of what the NHS does. I won’t repeat what waste I will cut because there are plenty of posts about waste upthread.

Wes and I are catching up tomorrow. 😁

@Leniriefenstahl funnily enough yes I do think nurses should be paid better

More emphasis on healthy lifestyles and prevention - rid the country of the attitude of "I'll do what I want because there'll be a drug/jab to cure it!"

Stop cosmetic and lifestyle procedures (or at least charge for them).

Better organisation and management, stop all the wasted time/effort and inefficiency.

Make it "patient centred" rather than all about targets and box ticking where patients are nothing but a RTX number on their screen!

Integrate it. I have two chronic health conditions, and have to suffer dealing with two different hospital trusts and the GP (and their primary care trust). They're incapable of communicating with each other, so it's a constant battle to get one of the three to actually deal with things as they always glibly tell me to ask one of the others whenever I have a new problem. It's just loads of buck passing which wastes everyone's time!

Offer enhanced services at a cost to compete with the private sector and enable the NHS to actually make some profit on better services, i.e. higher spec hearing aids, charge for a side room, etc.

Having experienced French Swedish & UK health systems in the 2000s, really don't get the love for the NHS under Blair, yes loads better than it is now but how they rated it top of the list is beyond me.... eg our cancer survival rates have always been shite, as has AE waits...... & we had few NHS Dentists under Labour either...now we have none.

We need to stop prescriptions for cheap to buy things like paracetamol,ibuprofen and aspirin as they're so cheap over the counter

I'd certainly pay the better doctors and nurses more, simply for being better. At the moment, it seems everyone is paid the same (on the same scale) whether they care or not, whether they're competent or not. How about a performance related pay enhancement based on patient satisfaction, positive outcomes, etc?

Not sure at all why some of the really crap doctors and nurses I've endured are paid the same as the really good ones.

Also to add often in the chemist I appear to be the only one paying for a prescription,many times I've counted and it's generally 1 or 2 in 10 that pay

As bad, for those on high incomes NI (which let's face it, is just a tax) contributions drop from 8% to 2%.

Some suggestions from survey responders so far have apparently included changing ambulance sirens to blast out healthy eating messages and for Wes Streeting to be fired from a cannon.

A fantastic public ‘conversation’. Really useful. 👍

A lot of people have prepayment cards now

Better admin and communication

Too many appointments are lost because letters take days to get to the Post Room and then possibly days to get out of the Post Room on 2nd Class Post

Too many patients change their phone numbers and then complain when they don't know about appointments

Too many appointments are lost because many mobile phones aren't 'smart', the patient's don't tell us and we don't check before sending links and downloadable items

Emails aren't utilised as often ad they should be and patients don't think to tell us about them

How would that work in high stress situations, where death is the usual outcome and family members aren't in the best place to give unbiased feedback?

Unfortunately, PRP is often used to reduce the wage bill.....

Good management and adequate staffing should allow poor staff to be retrained or moved out of healthcare...

But atm such are the staff shortages, management can't afford to get rid of anyone...

...and many others, such as a NHS TV channel, giving Physio advice, are more in line with what the Govt wants from so called adults...

Asking the public for sensible suggestions can be a mistake...... ie Mcboaty nonsense...