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?

This article covers quite a few

https://www.nursingtimes.net/archive/over-46m-wasted-on-unnecessary-jobs-in-health-service-01-04-2014/

Don't disagree but imagine what the media would do with this....

DM: Starmer to kill 1000s of Grannies...

Express: Labour Introduces the Sickness Tax...

...and thats before we get to the 100s of threads criticising Labour on MN

I honestly think it's beyond help. I've had a few dealings with doctors hospitals and nurses and it's just complete and. I think the only way now is to privatize it and we can all take out private insurance.

@Alexandra2001 let them, they'd just look stupid.

Fact of it is, I'm earning £12 an hour and pay for my prescriptions but my parents who bring in £1000s each month from pensions and rental properties get them free. It's baffling

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

My mum has said this (she is 85 by the way) but there's a difference between life-prolonging treatment and life-enhancing treatment. If someone is in pain, they should be treated. But maybe putting someone through nasty cancer treatment is a waste of effort. I think it depends on the fitness of the person concerned, clearly some 80 somethings are very fit and may live another 20 years with treatment. But I don't actually think medical staff are stupid, they won't operate on someone who's frail for no good reason. As an example my mum has a friend in his 90s with bowel cancer. To get rid of it, he'd need a stoma. They haven't done that because he'd probably die of sepsis in weeks. They gave him radio treatment to manage the symptoms and he's still alive two years post diagnosis and not really costing the NHS much at all. He still lives on his own and looks after himself.

The problem is more the bed-bound people with advanced dementia with zero quality of life who've no idea who they are or where they are and can't do anything but stare into space. Not sure what the point of keeping them alive is. MIL was like that for 4 years. It's cruel.

I agree, but Starmer could just ignore the media!

I do not know how doctors have managed to con the entire country into believing that it's acceptable for them to work Monday to Friday and never at weekends or bank holidays.

Health care is needed seven days a week 365 days a year.

I think it's disgusting that if you get sick on a Friday afternoon you can't even phone doctor until Monday and when you do you find yourself 25th in the queue and you will not get an appointment, so then you have to phone again on the Tuesday you could literally be sick for nearly a week before you could even speak to a doctor.

I agree with previous poster who says there should be a cottage hospital type of thing with 24 hour a day small injuries pharmacy and the doctor on call and on duty the whole time.

46m is such a tiny amount in terms of NHS spend that it is trivial and who says these jobs are pointless in anycase?

An energy efficiency manager could bring in huge savings given the price of electricity.

...and as the article states, a job title isn't a good indicator of that jobs role or importance in enabling HCP s to get on with their jobs instead of doing admin etc.

If a Doctor works on a W/E or a BH, they cannot be expected to be working during the week as well.... so less week day appointments.

& tbh if your able to wait a week before speaking to a GP, maybe you weren't that ill in the first place?

There is ooh Doctors, on line ones, MIU's most with an on call GP and as a last resort, A&E.... all Free.

Equality and diversity is essential in an organisation like the NHS.

@Alexandra2001 they can easily do shifts like they do at the hospital. The existence of OOH GPs shows that the potential for weeklong health care is there.

The answer is to have more drop in centres where you just go and wait to be seen. Where they exist, they seem to work quite well for non-emergencies.

As for the comment about not being ill if you can wait a week to speak to a doctor, what's the alternative if you get told you can't every time you phone up?

Separate out certain stuff, management and budget wise.

1. elderly care.
   A lot of this isn't about complex medical needs its managing incontinence & medications, dealing with dementia etc. It needs a very different, community led solution. At the moment poor social care is a big contributor to bed blocking in hospitals.

2. Mental health including camhs. The backlogs in this area are huge and there's a better need for specialised training etc. So much of this area overlaps with societal & environmental factors. IMHO there's been a huge (American led) tendency to over medicalise things like anxiety. As with elderly/social care, again the immediate and ongoing treatment needs are very different . It needs effective partnering with schools, social & community organisations and benefit agencies to work on prevention and effective treatment. There needs to be a joined up strategy considering everything from early years/childcare provision, education, social workers, access to exercise facilities, employment policies etc. Lots of things like anxiety & depression have contributory factors from things that happen in childhood & how people develop resilience & coping mechanisms, more needs to be done on prevention.

I'd even consider a Mental Health levy on employers.

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

My elderly parents & grandparents have all said this for years. I think we need to distinguish between pain relieving and palliative care and excessive/complex treatments for people already in poor health who in reality do not have a good quality of life or long to live.

I honestly think it's beyond help. I've had a few dealings with doctors hospitals and nurses and it's just complete and. I think the only way now is to privatize it and we can all take out private insurance.

Like the US? Its honestly not much better. My friend is there and has many of the same grumbles we have here. She is well off with good insurance, for others its worse. Systems requiring paid insurance tend to create blackspots whete the poor and vulnerable have little/no access to treatment despite being the ones who need it most.

But every region has MIU's where you just turn up and wait... there are also on line GP services.

So no one has to wait a week as was earlier claimed.... i had a red hot spreading mark on my leg & over a weekend, i had a free video consultation, GP diagnosed cellulitis, said i needed antibiotics, which i could get 1 days worth from and also pick up a prescription for the full course...

There are only so many HCPs, they take between 3years and 8 years to train up, so whilst we might want more MIUs, better AE's and more ward space, the reality is the UK has not invested in staff numbers, we've low numbers compared to head of population.

Hence Labour say it is a 10 year plan to fix, it is.

@Alexandra2001 but MIU is 8-6, everything is limited because people want to work a normal workday. The staff levels are there to staff it around the clock.

Agree about not keeping people alive if they have no quality of life and its not going to get better. though what constitutes no quality of life?

dont agree that you dont treat over 85's. some are very healthy others not (and may be better than say a 50 year old who hasnt looked after themselves)

get rid of wasteful spending. My IL's used to get fed lunch for free in one hospital whilst they attended a short medical appointment as out patients.

Yes, me too.
A doctor friend of mine thinks this as well. I think it would reduce GP visits for nonsense as well.
I think the only problem is that there is such huge amounts of poverty in the UK that some children would end up going without essential medicines because parents couldn't afford £4.50. Maybe pharmacists could have some sort of official line of credit they could give to get around this.

@Kendodd I've said multiple times that people who can't afford wouldn't have to pay.

But £4.50 is really not that much for a medicine.

Just read about taking out private medical insurance. so how will that work? After paying more than average tax for 40 years and having very little back in return I'm just about getting to the age when i will start needing more medical treatment. That means that insurance would be very expensive, we could probably just about afford it but most people probably couldnt at my age.

Very few people are net contributors.

Paying prescription charges would be a start. Fees for appointments that either go against the cost of a prescription or a refunded when you attend. More community based care.

No they are not, we ve 7 MIUs in Cornwall, very often an MIU will have to close or offer restricted opening due to lack of staff.

Normal hours are 8 til 8 and one in WEst Cornwall is open from 8am to Midnight.

On-line GP services are offered by the NHS 24/7 & there is also a ooh GP service for emergencies, usually a phone call or a first responder may be called.

@Alexandra2001 how do they managed to run OOH GPs if the staff aren't there?

It's laziness. Plain and simple. They want a 9-5.

sharpclawedkitten · Today 09:08

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

I agree - and I've lost many lovely elderly relatives and friends. Many hated the near-torture of constant hospital visits, scans, investigations, treatments etc etc and just wanted to be left in peace! Some said 'You've got to go some time!' and others 'I just want to be left in peace'.

Palliative care - of course. Alleviate symptoms and pain as far as possible. But putting aged people through gruelling chemo, endless hospital visits (incredibly stressful) or nagging them to stop smoking and drinking, change their diet etc when they've little else left to take pleasure from.

I'm not young myself, so I do understand the implications of what I'm saying here. It's not as if I'm 25 and just thinking 'old people don't matter'. Yes, they do - but keeping us all alive till we're 100 is ridiculous.