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?

Allow a family member to help with basic care where appropriate and if they want to help. I do think it could help reduce risk of secondary problems occurring due to a hospital admission.

For example, quality time could be spent encouraging adequate nutrition and hydration, sitting out, moving around, walking, conversation.

Far better than the occasional brief interaction with a health care professional that an elderly person might forget once they’ve been left alone.

Realistically, what does a fluid balance chart look like in an unwell, elderly patient if they’re on their own all day. How could this affect them over their admission, especially with the heating that they insist on blasting in this mild weather?

Simple things, but when you think of the cost of not addressing these problems, and the lack of resources to address them, why aren’t we doing more to involve families?

See the scandal of doing operations without anasthetic (hysteroscopies) its the scandal that refuses to break. And the angel rhetoric doesnt help

I do wonder if it’s a good idea to make patients to have the flu and Covid booster done at the same time, Most who have both are elderly or have health issues. People react badly to one injection so what about two together?

If the NHS sees a surge in patients being admitted as ill from having both vaccines a few days before. Then that is money wasted. As if had a week-10 day gap between vaccines, they may just be under the weather for a day or two, take it easy then, there would be no need for hospital admission

My dad died on 6 October three weeks after being discharged from hospital he was 88 had prostate cancer and died in a fall at home.
DB (who drives. I dont) starts work at 4 am Finishes at 3 pm and he has been over to see DM nearly every day after work. Ive been over a couple of times a week. DB is in a manual job not shuffling papers on a desk and gets tired. Last Friday he was mowing both lawns. DM is hard work because she is deaf and refuses hearing aids. I was trying to discuss Dads wake with her and i had to say the word wake ELEVEN times. Im worried its going to affect DBs health Its just not sustainable.

There's no compulsion to have both done at the same time. People are free to have them separately. It's not like the MMR where they have to be done as one (unless you go privately).

I had my Covid jab a couple of weeks ago and have my flu jab booked for a couple of weeks' time. I wanted a month between the two, and there was no problem at all booking them in that way.

I do think they pay nursing staff very poorly

As someone who works in a job that is considered minimum wage (although employer pays London living wage) and without any qualification, with the extra income I get from it. I am definitely on more than a level 5 nurse.

Something isn’t quite right when you look around at other employers who pay more than minimum wage for someone who doesn’t have even GCSEs

We are also free to take any other work.

The starting pay for a graduate nurse is around the average starting salary for an average graduate. And I believe they get extra for certain shift patterns, uniform provided, and overtime paid. It doesnt go up as quickly though as some other professions.

Its the same with a lot of roles, that you can earn more with no qualifications, especially ones that are highly unionised. Makes you wonder why people bother going to uni.

TBH most "nurses" on the ward are in fact HCA's and not band 5/6, so would fall into "low paid/over worked"

Incorrect. The set ratio of qualified to unqualified in the UK is between 70-30 for acute wards, and 60/40 for less acute wards.

I think the 'poorly paid nurses' trope is well outdated these days.
Yet still we as a nation persist in pushing it. I've even seen nurses described as 'low paid' on here and someone will always say the NHS's biggest priority should be to pay nurses more.
When I see either of the above, I am compelled to ask the poster if they actually know what nurses are paid. I think it is so hardwired into our psyche people parrot it without even knowing!

I’ve worked in the nhs for a lifetime..when loved ones come into hospital.. the family generally expect nurses to deal with all their personal care needs.. they do not contribute to their loved ones needs (except the precious few involved relatives, who do x).. Compare this to Spain.. who are In the top 5 for quality. Well above the UK. The family are expected to provide the personal care, and are expected to stay overnight for the duration. This frees up the degree qualified nurses do the technical nursing that they are actually trained to do.

And how many British employers would be happy with family taking time off work to do what they do in Spain. OH WAIT A MINUTE Lets do the litmus test. Would the NHS let those degree qualified nurses take time off work to do the same!!!!!!!!!!!!!!!!!

In short Would the NHS put its money where its mouth is!!!!!!!!!!!!!!!

And yet when i see posts on here saying that SOME nurses now think they are above doing personal care we see loads of posts underneath denying this.
But your posts prove that the former were right!

What happens about the personal care of patients who don't have family to come in and do this for them?

Nurses have the time to support them, rather than supporting everyone of the 30 patients. Those with families who help, make a huge difference to their loved by ones lives, as well as supporting nurses to care for those who are less fortunate because they don’t have families. Has anyone heard about ‘granny dumpers’.. it happens regularly in the nhs. And then there are the families who don’t allow their relative to be discharged to a nursing home because they don’t want mums/dads house to be used for care fees. So they make sure they are kept in hospital. This happens.

And 40"000 care workers left the profession due to the Covid vaccine mandate. A fact which must never be mentioned.

Reality is that women would need to be taking time off work or leaving paid employment to do it, as it would become expected.

My mother had ten admissions in her last seven months. It was disruptive to work to keep going to see how she was doing but I managed the 150-mile drive as often as I possibly could because obviously I was extremely worried about her. But I couldn’t possibly have been there every meal time and carried on with my work.

Is the state able to cope with the reduction in income tax from women this would result in? Because I know how it would go—huge pressure on women to be ‘good’ daughters.

They won't do shared care either. So if you eg get a private prescription for HRT they won't take over the prescriptions. And of course lots of people go privately for mental health help for themselves or their children.

Some people have said they won't even accept things from other NHS practitioners which seems absolutely ludicrous. I have no idea what they are playing at.

So far, nothing like that from my GP though.

@JenniferBooth I’m very sorry to hear about your experience with your father. Doesn’t sound like a safe discharge for him. Also time for your mother to find somewhere more manageable to live maybe.

@Memyaelf I do think we could learn a little bit from the Spanish. There are plenty of people who do actually have time to spare and I think they would like to be included in caregiving.

@JenniferBooth @Abra1t Obviously, not everyone’s able to help, but even knowing that just one patient is being cared for by a family member for a couple of hours could make all the difference to the amount of care staff can provide for the other patients.

My mum would definitely have done this for my dad. As would a lot of partners who may be retired and have the time.
To have a sensible discussion about the NHS, we need to move away from blocking every single suggestion with what ifs and buts.

When I was there i obviously helped my mother with personal care, and my father before then, when he was hospitalised. But I would have been seriously financially hit if it had been expected I could stay overnight, every night, and for every meal and wash over the ten admissions. Friends and our children could often help, but even so. Perhaps in Spain people live closer.

TBH, the wards don’t make it easy for you to, say, store the one type and flavour of yoghurt or ice cream a terminally ill parent will still actually eat and retrieve it and find a teaspoon when they have some appetite and would
enjoy eating it.

We helped with my mum, feeding, keeping her mouth moist, cleaning teeth and what she loved... having her hair brushed.... but she also needed regular turning, not something we could do, she needed regular toiletting, she was a proud woman, had we attempted this she would have been mortified.

The hospital staff were only too pleased to see us help.

However, from what we saw, over many weeks, is that most people in hospital did nt have regular multi visit days.

As for the Spanish health system: in rural areas, its very hit and miss & if we cast our minds back, didn't care staff abandon people in their care homes during CV... staff here inc my DD risked infection etc to give the best care they could do to residents and clients in the community.

@Abra1t a small cool box and bring your own teaspoon ? we bought in mums favourite stuff when she was willing to eat and the catering people (private company) assisted where they could.... Derriford Hospital did all they could, despite the staff shortages... i even spoke to one of the directors whilst having lunch, i saw him a few days later and he remembered me and the situation with our mum.

That and disposable spoons worked for yoghurt when I was there the next day, yes.

ice cream in hot July days was more of a challenge! In the days before her death I did a lot of runs out to the supermarket but when I had to go home for work we asked friends.

I agree. Too many barriers. Willing and able families are often going to be part of a patient’s support system in the community so why not think about how the process begin while they’re still in hospital? Maybe it would lead to safer discharges home.

*could

Patients are rushed into being discharged then bounce back because they were d/cd too soon. Costly.

Prevention! So many barriers and unavailability to care that would prevent more serious conditions.