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?

Send people away from A&E if they turn up with a cold. Unless their lips are blue and struggling to breathe.

"drink plenty of fluids, rest and take paracetamol" reception staff should say.

Get rid of a lot of the bureaucracy and red tape. Digitalise instead of paper systems which is more efficient and cost effective, empower pharmacies to do basic health checks to take load from gps, improve management, policies and get rid of middle management -eg if you want to do a job you have to get use list of subcontractors, even if they aren’t the most efficient and cost effective.

Increase wages (obtained through tax), create work life balance options so doctors and nurses don’t get burnt out, financial incentives for registrars and those training for doctors, nurses, physios, osteopaths etc…

Also - I wish they'd put the really important information right at the beginning of the letter.

I always have to search through the repetitive, corporate guff to find which of my issues it's about, what it's about (appointment/telephone/results etc etc), time and date.

And I'm not a TLDR person, so how others cope I don't know!

There sometimes seems to be a reluctance to be stern with those who deserve it (rude people, or people clogging up A & E) and a tendency to be stern with those who don't!

I admit this is a subjective, throw-away remark because I've had some horrible experiences recently with rude staff. I know that's not the whole picture. But I wish they'd put some of the ruder staff where they can deal with the nastier service-users....

You can't turn people away from a&e. It'll only take one or two bad mistakes to turn into very expensive claims.

"Oh that's not a broken ankle it's a sprain" - ends up being a bad fracture and the patient is disabled from the negligence, that's a claim.

"It's not a heart attack it's just indigestion" - patient dies, claim.

Just a few things we have in the French system in our area: For a hospital appointment you get a letter with a bar code to flash to check in when you arrive. On the letter is a phone number with a dedicated answering machine for cancellations. In a 999 type emergency you call the number, you give details of what has happened and they put you straight through to a duty doctor, who calls a local ambulance or fire brigade paramedics if needed. They run lots of tests then call the emergency doctor again to see if hospitalisation is needed. When you arrive at the hospital they know who you are and what needs to happen. The number of specialist clinics are increasing where you can see dermatologists, physios, dentists, cardiologists etc. For many of these you book online through a system called DoctoLib. You can also use this for GP appointments.

Bigger cost saving would be sharing other test results. My oh had a full suite of skeletal X-rays, mri and ct scan, bone marrow sample and numerous blood tests when first diagnosed with cancer. Referred to a different hospital for treatment and they insisted on doing them all again!

No the machines in the labs do a panel v. cheaply and v. quickly doing an isolated test is much more expensive e.g. just urea rather than " U&Es" ( urea and electrolyes) this test costs about 80p. The cost is taking the blood and the bottle.

This was on the public consultation page

I do find it ironic that the doctors and nurses will sit and lecture patients about their weight but most of the NHS staff is obese

Obesity affects every area of society...... not just nhs staff.

But this and other replies shows exactly why Labour shouldn't have bothered asking the public, too many stupid people in this country.

@Alexandra2001 it's a salient point though

As a fat person trying to access healthcare, the first response is always "well lose weight". Sometimes from an overweight nurse or doctor. How can they sit there and lecture about the benefits of losing weight when they won't?

NHS staff are also users of the NHS. They do not exist in a separate bubble from everyone else. They experience the same issues accessing services that you do. So some of them will struggle to get a GP appointment and when they do they will be told by their own GP or practice nurse to lose weight.

Yet they'll happily sit there lecturing and not do it themselves? If they're aware of the issues, why are they not taking action? The NHS hardly supports the messaging it puts out

I'd change that and prioritise NHS staff for medical treatments, whats the point of having a HCP off sick when he/she could be back at work quickly and treating patients?

We've an HCP in our village off long term sick, stuck on a waiting list, relatively simple operation but the longer it waits, the more complex it will become..... madness.

ALL workers need to be prioritised. Doesn't matter where they work, NHS or not, they're still needed to be back doing their normal day jobs without delay.

I don’t know what I’m talking about really, but I’ve always thought the 12 hour shifts were barbaric and dangerous, not to mention the entire hospital handing over at the same time. What about staggered 8.5 hour shifts (15 mins handover each side) which would be a lot more flexible for literally everyone. Also safer as you wouldn’t have tired people trying to dispense care.

I understand this but the fact remains.. the advice is not wrong and you re the one asking for healthcare.

Would be good if nhs staff had quick easy access to decent food, our local hospital seems to have fast food machines on every floor... the staff/public canteen is far too small, staff haven't got time to queue there and if they eat at their work stations, they'll be angrily accused of "doing nothing, sitting around eating..."

@Alexandra2001 meal prep like everyone else has to.

This is another problem. NHS staff are put on pedestals and they're treated as being better than the rest of the population

Of course but the system cannot prioritise ALL workers, so we have to prioritise.... as this will help get other workers back to work more quickly...

Its bonkers to have, as happened to my line manager, that his cancer biopsy was delayed because the hospital had one of the people who do this, off sick waiting for an operation.

By the time he had the tests, his cancer had advanced, meant he was off work for longer, more invasive treatment, luckily in remission but it took a long time, far longer than it should have.

But we can prioritise workers over non workers. Things like routine GP appointments, routine scans, blood tests, consultations, etc. Why make it difficult for worker X to get an appointment that's convenient around his work, i.e. early morning, late afternoon, but give those appointments to 80 year old Doris who can go any time of day, with the receptionist/appointment clerk not even thinking along those lines??

It goes right through the NHS. It's fundamentally based on "it's free so you'll get what you're given" whether it's appointments, service quality, etc. It's just fundamentally wrong to prioritise NHS own staff and give them special treatment when others can sometimes be regarded as nothing but a nuisance and who aren't given any consideration at all as to their needs/other commitments.

I'd liken it to the VAT on private school fiasco - people say that private schools shouldn't exist, so that those in positions of authority would ensure everyone got good schools. Same with the NHS. NHS staff and managers etc should be treated the same way as everyone else - only then would they think about the necessary changes, only once they've suffered the "NHS experience" would they understand how everyone else suffers.

Give them the time to take their meal times then? most don't, working through breaks & leaving work late.

Yes i put them on a pedestal because twice they've save my life... i have also found them to be calm, reassuring, empathetic .... the care 2 larger nurses gave my mum as she died over several weeks was utterly amazing.

I have never had any issues with HCP's and can only assume those that do, also have difficulty with other people they come across in their daily lives too.

@Alexandra2001 you need two hours a week to prep meals for the entire week.

Also, as I've said further up this thread, I've had issues with them. They're not all gods.

Develop our own pharmaceutical provision and research rather than buying from huge pharmaceuticals who have charged 6x the price for what they sell in other countries. Medicines being the second biggest expenditure after staff salaries.
Robust ways of getting money back from other countries when their citizens have been treated here.
Cosmetic treatments reversals/gone wrong patient takes out life cover should these need to be sorted by the NHS.

I can only speak for my own local GP practice, working people can be prioritised if they explain their work situation, i ve been offered appointment times to fit in around work.

But my point isn't about primary care, its about serious illness where nhs staff are off work for long periods, leading to cancelled appointments, missed diagnosis etc etc.

Far better for all workers, to get these people on the operating table and back to work. treating other workers etc more quickly.