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?

But how do you know you need an X-ray without being seen by someone who examines you, takes your history then makes that call?

Every town should have a small cottage hospital with a minor injuries unit and 24 hour GP cover.

I had to take DD to our local big hospital to see an OOH doctor a few months ago and it was carnage. One reception for A&E, OOH doctors and minor injuries that was the size of your average living room. We had to sit on the floor for 3 hours.

This, you only have to look on mn to see the encouragement for this though!
'Take your elderly relatives keys from the hospital so they can't get home!'
'Refuse discharge!'.

I agree with fixing social care bring needed to fix the NHS. Faster discharge of patients. I also agree with the missed appointments thing, but I had to change an appointment recently. There were two numbers to ring. One was constantly engaged and one was no longer working. This was just under the 'every missed appointment costs us £180'. I ended up cancelling another appointment and just going because I'd wasted so much time trying to cancel the bloody appointment! Why is there not a dedicated cancellation line or a text/ online service? I do agree that there should be a 3 strikes and you're out for poor behaviour across the NHS like missed appointments, calling 999 for tampons, broken fingernails and all the other stupid things you hear about and abusing staff.
(Sirry about the quote- I was going to say something relevant and now I can't get rid of it!)

You don't, but your GP does, my mum had a fall a few months ago, the GP said they suspected a hairline fracture in the hand. This was not an emergency, it was 3 days after the event.

However the GP has no facility to send someone for a quick sit and wait X ray (they used to be able to) so we had to do 11 long hours in A&E

It could be so much more efficient, there are 3 streams of people, those who clearly need emergency attention, those with urgent minor injuries, and those who are clearly just there because they are concerned, particularly mums with small kids.

But everyone has to wait for the same triage, hence forming a bottle neck - if the minor injuries could go and sit and wait for a nurse to manage them in one place, and those with concerns could quite quickly see a doctor, the main unit could process the bigger issues quicker.

And the idiots who have clearly drunk themselves to oblivion should get a bill for the service.

i don’t know as I’m from a country where locals who use the healthcare are heavily subsidised by the government, however I know of people who use the UKs nhs for corrective botched surgery procedures … not sure of things like that should be entirely stopped or perhaps they have to pay for it maybe. A friend of mine went to turkey to get stuff done then said if anything went wrong, the UK would fox it anyway so… I think charging for certain self inflicted circumstances might be an idea/deterrent.

Better ways to contact hospital to reschedule/cancel appointments. As I had an awful time trying to reschedule a minor op as got the letter and it was when I was on holiday! Tried the 4 numbers listed on letter and no-one was answering on three of them and the other was dead! Guessing that there is no phone plugged in the latter. Rang the central booking line and explained that none of the numbers people were answering them. "Oh we don't do scheduling for that department" was the response.

I managed to get the secretary's number for the consultant in question from a friend of my DM's whose DM is under her at the hospital.

Then some people might need to cancel on the day as if they woke up full of cold, s&d or need to deal with a DC with these plus other things. Friend was supposed to be at hospital for 7am for surgery but kept up most of the night with D. The phonelines don't open til 9am! Fortunately, her DP drives past the hospital on the way to work - he starts at 7:45am and stopped off at the hospital, walked to the location as stated in letter and explained to the nurse team that she wasn't able to have surgery. They rescheduled for the following week after ringing my friend to confirm this.

I think the best thing we could do for the NHS is tax junk food 400% and pour the money into:
... making vegetables, oats, lentils etc cost about 1p per portion.
... Easy dinner recipe cards available in supermarkets - ie poach chicken, boil carrots, make mash.
... Cooking equipment available free to those on low incomes who don't have enough pans etc.
... Vouchers for tax exemption for the very few people who genuinely can't manage without ready meals (very elderly/disabled/etc).

If chocolate and ready meals cost five times as much, I would buy it for an occasional treat (rather than, ahem, every day). An occasional treat is how it should be.
I am a healthy weight and can manage this myself, so it's not necessary for me, but I'd be happy to pay more for unhealthy food if it means it saves the NHS and also helps other people be fitter, healthier, and hopefully happier.

@ThatCalmHelper GP's can refer people for x-rays, both urgently and for more routine checks.

Get rid of all the middle managers.

My local hospital was advertising for a "lived experience" manager on £100k a year. To tell people what it's like to have an operation!! That's a volunteer role.

The same hospital has 15 anti bullying managers. What's that about? You're adults. You don't need anti bullying managers.

Social care, social care, social care.

It needs such a complete overhaul, but I'd start with very early treatment and prevention. Unpalatable as it is, we absolutely must get in fop of all the damage people do to themselves and then expect the NHS to fix. People have to be "made" to feel responsible for their own health when we know what a difference taking care of yourself can make.

And stop waiting until things are really bad before peole can et any treatment. Treat things early and surely that's better (and cheaper) for everyone.

Consistency of care is also really important IMO. At the moment we treat all symptoms separately, rather than seeing that they're often all interlinked.

While I'm being controversial, I also think better "control" of sick notes is needed. I was signed off for the first time in 30 years last year and I basically told the receptionist what I wanted and they arranged it. I was shocked how easy it was to get signed off and the knock on effect in cost to the economy is huge. Obviously people who need the time should have it, but how many don't?

I wondered how long it would be before somebody blamed us fatties.

Look no further, folks. It's not sneaky underfunding to justify privatisation for the Tories rich mates, it's overweight people being too stupid to realise it's all those donuts they're eating apparently.

I'd overbook appointments.
Do what the airlines do. Have more people on the list in the knowledge not everyone turns up.

Look at procurement and make that work better.
Discharging from hospital... Need beds in safe care to wean people back to their own homes.

I'd go through the accounts to see what is being spent that could either be better spent or not spent at all. That's a huge job that needs doing.

So you don't think there's an obesity crisis?
Why all the demand and expectations for nhs to fund these new jabs?

I suspect this is a fishing exercise to see what the public will let private healthcare get away with.

We know why the NHS is struggling, we have an increasingly unequal and impoverished society and a we've cut funding to all our services. Combine that with Brexit and you've got a perfect storm.

@Pyroleus The thing with Healthy Start which is for parents on certain benefits and children under 4 to buy F&V, from birth formula milk and cows milk is now on a Mastercard and from the back, looks like a bank card.

Parents are spending everything on them now. As I remember going to a supermarket and used a manned till as needed cashback. Noticed the previous customer left her HS card on the card machine. I remember she bought cigs with this and nothing else. Handed the card over to the assistant that was serving me.

When Healthy Start was paper vouchers, it was easier for the supermarket staff to police as if the parent spent £10 on milk and f&v (chips don't count) and the rest on other stuff, they could take 2 lots of £4.25 vouchers. Then paid the balance with cash or bank card.

Aren’t they trying to form a cross party group to work out a solution to the social care crisis ? Heard it yesterday. Invited Tories, Lib Dem’s, Reform and Greens I think. Good idea as it creates consensus and less opportunity for politicking for the sake of it.
Sort out Social care and many of the problems the NHS faces will be resolved. Let’s be honest this will inevitably need massive financial investment. We really need to put our money where our mouth is…

I had treatment in the US. Everyone was fit, walked in checked details sat on chair or went straight in, took your clothes off ,lay on trolley, given relaxant, had procedure, left on trolley til medication wore off, sat outside in chair 10 mins, went to car driven home. Only staff were 2nurses and surgeon.
Obviously unfit patients went elsewhere but we were treated in about 2 hours-rattled through like a production line.

you were expected to get yourself there and back and have the intelligence to speak up or contact them later if any problems.
Upshot 90-120 treated per day.
Doubt it happens here.

Obesity costs the NHS £6.5 billion a year.

The NHS budget is £190 billion. It's not just obese people.

Reckon the shrinkflation is a cause of obesity. One bar of chocolate may not satisfy someone and have 2. This is about a third more than one pre shrunk bar. Not going to do it on one item, but the rest of their diet.

The UK needs to invest in preventative health care.

no junk food adverts, reduce drinking alcohol somehow (supermarket taxation?) etc

ive been in Spain and France this year and you rarely see junk food ads. The % of overweight people is much lower. Alcohol is less of an issue. Just didn’t see drunk people in the evenings.

the NHS is trying to fix people after years of damage to our bodies

I’m in at a&e fallen off my bike arms in agony can’t move/bend it. I need a X-ray not an ear exam.

Sort out wealth inequality/north south divide. Years of poverty, often back breaking NMW jobs or unemployment, stress. So much to sort out.