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?

I've seen adverts for that where they emphasise that, for some people, Specsavers also arrange home visits for hearing tests etc.. (There's probably a fair amount of regional variation.)

www.specsavers.co.uk/home-visits/home-hearing-tests?

How so? By giving people these medications while they are overweight before the go on to develop serious complications of obesity you would be saving the NHS money. There is a lot of science around obesity which shows that once people are obese it’s incredibly difficult for them to lose weight and keep it off long term and then there are additional risks with weight yo-yoing. The GLP-1 medications help prevent the metabolic and hormonal changes obese people’s bodies experience when trying to lose weight e.g. their appetite increases, their non excercise thermogenesis reduces and so on it’s incredibly complex and not as simple as calories in and out. Anyone who thinks otherwise is simple ignorant of current research into obesity, genetic and how they interact in an obesogenic environment.

Obviously we should be doing all we can to prevent obesity in people who are not yet obese and encouraging other interventions but for those already obese the GLP-1 medications seem to the best option in a very long time and we should be using them.

@Lononin your original comment said it's a bad idea.

Ok my bad as they say, was meant to be “not a bad idea” apologies for my reply!

@Lononin no worries! As someone who's on the jabs it feels like every post about healthcare comes down to bashing those of us who are overweight and on them!

Communication.

If you say a referral will be made, make it.

Stop treating problems in isolation. It’s a waste of time.

Address the lack of continuity of care, follow up care.

Great that we have overseas workers but address written and spoken language barriers and check training standards.

Hand washing, it’s basic.

Wear a mask if working with a respiratory infection because your sickness record doesn’t support it.

Really listen to patients. Check understanding, allow time for information to be shared, questions, especially with the elderly.

Health visitors for the elderly, eg, to check lying and standing blood pressure, hydration, nutritional intake, skin, continence, warm, safe environment, level of independence, cognition, social support.

Drop in Health Centres for the sandwich generation. Easy access, welcoming places for busy people with health concerns to eg have a blood pressure check, weight, nutrition and exercise advice.

I don't think my (teen) kids have been 8 times in their life which is just as well because its literally impossible to get an appointment last time one of them did need a gp apt I ended up taking the morning of work and going to a walk in centre, after 3 wasted mornings of calling up and being in a queue.

Contrast to a colleague with health anxiety, I feel sure she must have our entire family allocation for her and her DC, and I'm amazed (and envious) that she seems to get appointments just about every week, with relative ease!

Although obviously I'm grateful and appreciate, luvky, that everyone is so far, fit and well in my family.

I'm so sorry for your loss @JenniferBooth

A friend had them try to push a "mildly uncomfortable" hysteroscopy without anaesthetic on her too - despite her telling them even smears are painful for her, and unrelated to her smear issues she'd had her DC via C section (I understand hysteroscopies can be more painful if a woman hasn't had a vaginal birth?)

Lucky for her she'd heard about the campaigns re painful hysteroscopies so she asked for a GA. She had to really battle for it.

I think one of the things that shocked me the most was the lack of honesty. She wasn't given informed consent. She only knew about the possibility of it being very painful because of her own awareness of the campaigns about it by other patients.

If charges were applied to DNAs because the patient could not contact the department, or the central booking office doesn’t do appointments in certain departments (why?) as phones are never answered or go straight to dead line. These fines should not apply.

Re loads of patients all being given the same appointment time. That happened to me once. Don't know if it's changed since then - it was about 10 years ago. I don't understand how they worked out what order to call people.

With GP practices, one big problem is the massive variation of quality between different practices (and unsurprisingly the good ones have tighter catchment areas). Also even within the same practice there's often one really good GP and/or one absolutely dreadful one. Unsurprisingly the good ones are almost impossible to get an appointment with, but the bad ones will have free appointments.

Thankyou @Windchimesandsong

That is EXACTLY how it has happened with me. Its only because of the campaigns that i have seen the truth about the procedure. Even with a GA some women have been left with permanant damage including to bladder and bowels and to their sexual function. Sexual function is as important to women as it is to men. There is not enough detailed study of womens anatomy by the medical profession. They know damn well how painful it is which is why they are so sneaky about it and try to spring it on us.

It should be done this way and the first one there is the first one seen. The later you are, the later you get seen.

Well, that's all totally sorted then.

Probably not a popular opinion but we should stop treating people over 85. No more operations, no drugs, no more extending existence at the detriment of wider society. Everyone has to die at some point, so if people know there is a cut off for state help then this will lead to many in society taking better care of themselves. Currently two fifths on the NHS budget is spent on over 65's, and that number will only continue to rise. The NHS is 11% of government spending, it's not sustainable on its current path. Put the saved money into palliative care and the care sector.

Well you will be pleased to know that my lovely dad was discharged on 16th September and died on 6 October.

@JenniferBooth I am very sorry to read that. My condolences.

My DM died suddenly in August. @titbumwillypoo , she was 89, and had worked in MH care until she was 78. She rarely went to the NHS, except for vaccinations. The last time she saw her doctor was eight months before she died. The only time she went to hospital was for a hysterectomy, and that was 40 years ago. Hardly a burden on the NHS.

I'd start by asking the staff where they could make savings in both time and money and then implement most of them.

It annoys me that you can't return crutches that have only been used for 3 days!

Also, they send me appointment letters through the post even though they've sent me the info by email and the letter arrives after I've been to the appointment anyway.

It's such a wasteful organisation.

Thankyou My condolences to you too.

Do you not think 'do nothing' is sometimes the appropriate choice?
Example - 84 year old in care home severe dementia, very frail. If a lump appeared in her breast, is it really in her best interests to send her to hospital for all kinds of tests? I don't think it is.
And you are right, I would think very differently if this lump was found in somebody ‘in the prime of her life’.

I don't agree.
I do think people need to come to terms with the fact old people die though and we can't, and shouldn't try to keep them alive, in terrible pain and distress for as long as possible. It's just plain cruelty.

You can return crutches!!

You/we/society can't determine a cut off point that applies to everyone. My DM was, until 24 hours before she died, fit and active. She spent Saturday tackling ants in her garden, and had an easy quiet day on sunday, went for an early night, and didn't wake on Monday. No pain, no stress, no terminal illness. The perfect exit, in her book.

My sadness is my bereavement, the loss of her, not sadness that her life was cut short. At 89, that's not an argument.

That does sound the perfect way to go.
Thankfully your mum was spared years in mental and physical agony in a care home.
Still alway sad when they go

There was a report on the radio recently about multiple incidences where people were unable to return crutches, or the hospital wouldn't accept them.