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?

Sadly it's an indictment of British society.

How's privatisation working out for water, transport etc?
Also, I always think anyone advocating for private insurance model must have been fortunate enough to never have had to claim on their car or home insurance. The very first thing insurance companies do is try to find any possible way out of paying the claim.

Address and reduce the hugely disproportionate and unnecessary management structure and redirect finances to services that actually impact on patient outcomes/experience

Social care fell apart years ago and is dragging the NHS down with it. It's easy to complain about cancelled surgery but if there is no bed because there is no social care for the person currently using it, what's your answer? A hotel doesn't work if what the person needs is carers or a nursing home. Fix social care and the NHS would be in a far, far better state.
Yes this. And this leads into the ' community convalescence' issue as well. Elderly care separate from other care does not have to be for everyone, but where someone can't be discharged from hospital because they need rehab or a care package, they need to be discharged into a place they can get this, not stuck in a hospital bed that is needed for more urgent patients. Also, people stuck in hospital because there isn't a bed in a care home available. We need care homes as part of the NHS, not people paying through the nose for the care home owners' mercedes and fees for people who can't pay for their own care. This would lead to faster discharge rates as there would be places for people to go until they could go home.

Having worked in a company that provided the NHS there is a central procurement function. The problem being it can be cheaper for hospitals to go direct to suppliers believe it or not! The centralised procurement works on a top slice model, basically meaning our company funded the procurement function so the prices we gave them worked out higher than us supplying individual trusts directly. The procurement function wanted to make a profit from suppliers to fund its running (Barmy)

plus they didn’t always make the best clinical choices in products the nhs procured so they would come direct for a more reliable product that delivered more consistent outcomes vs Chinese tat the nhs replaced our brand with in an attempt to save money.

@Kendodd the part private / insurance model works in Australia. This doesn’t need to be a race to the bottom.

Oh, I don’t know about that. I suspect it’s the public saying “We know you’re doing this as a PR exercise. Seeing as you’re taking the piss out of us, we’ll take the piss out of you.”

Seems quite a sensible reaction from the public really.

Absolutely, there is too much tolerance of mediocre/poor staff. We have a 6 month probationary period where it's relatively easy to terminate a contract for poor performance, but after that the nhs makes it very difficult to get rid of people who despite all available support, are not providing a decent standard of care.

Measuring this is hard though, there were suggestions on this thread about linking these to measurable health improvements. However that's not always realistic - I work in paediatric palliative care, where clearly the outcome will never be a 'health improvement'. Our role is to make their journey easier, but it would be insensitive to ask for patient satisfaction after a child's death.

Yes, well, we are the nation that voted for Brexit so what did he expect!

It's 5% of prescriptions that are paid for apparently.

Just wanted to say thanks for doing what you do.

@Kendodd 5% 😳that's half the problem. Half the prescription charge and have everyone paying it.

I think this is often geographical, there isn't an excess in nurses and drs overall, but some areas have more than they need and some less, and understandably people don't always want to move to the higher need areas because they are very expensive and salaries do not cover cost, or some very deprived or rural areas due to lack of jobs being available for their spouses

@Thatsmyjob
Sadly it's normally medically exempt or on universal credit
I have a prepayment card which makes things more affordable

It's a very low percentage and awful people get paracetamol and the like on prescription

Make an on the job apprenticeship route to nursing through care homes. So if you didn't get the grades for the uni course, but prove to have all the necessary characteristics through a couple of years working in a care home you still have a route to nurse training.

Bring back on site hospital accommodation for staff.

@Bushmillsbabe that's not true anymore. Anyone from anywhere can apply for jobs in the NHS (only country in the world that doesn't prioritise its use trained staff).

This year 1,200 fully trained GPs couldn't get jobs, some now driving Ubers. To get a job after F2 now has a competition ratio of between 4:1 to 40:1 depending on speciality. Many resident doctor facing unemployment as there are not enough jobs.

Same with nurses. Many that qualified this year couldn't find work.

It's bonkers. We need these staff, but the NHS won't employ them for the jobs they have trained for. Be cheaper to employ them rather than use labour from red list countries.

@lovemycbf yeah the irony is that the elderly get the most prescriptions and don't pay for them! Yet have to pay a tenner on the rare occasion I get a prescription

Maybe we should allow people to buy more paracetamol at a time

@TigerRag it's to stop people killing themselves with it, so maybe not.

I think the limit is to reduce suicides and has apparently been successful in doing so.

@TigerRag easy way around that is to go to a couple of different shops.

So if I was a doctor applying for a job in a UK hospital, any doctor in the world could apply for that same job? Regardless of where they lived or if they needed a visa to come here or not?

@Kendodd yup. Madness isn't it.

Trying to sign up to complete the survey but they haven’t sent out the verification code to my email, tried a few different emails but nope! Anyone else had this problem?