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 would stop trying to keep the extremely elderly living in terrible pain and distress from dementia alive for as long as they possibly can. Bedbound 90 year old with dementia referred for cancer MRI scans etc. Never mind the money, it's just plain cruel. This sort of treatment WILL NEVER happen to me.

I would also prioritise the working population for treatment. We have to keep the workforce healthy for the greater good of society, they are the ones carrying the sick and elderly.

Although I understand your sentiment - I can't see how you would organise this.

Surgery for a heart attack shouldn't come before a workers bunions so they can get back to work on their feet - its extremely but how on earth would you decide.

Then would it be decided on how important their job was? A teacher get surgery before a dustbin person ?

The whole discharging process is a farce.

My MIL was blue lighted to A&E on New Years Eve. Spent 48 hours on a trolley in an A&E corridor because there were no beds. A nurse admitted she wouldn't be getting moved to a ward until the afternoon two days later because there'd be no discharges on New Years Day due or the day after due to admin staff needed for the discharge paperwork being on holiday and the hospital pharmacy having a skeleton staff and not doing discharge med issues.

Same happens at weekends. If you're not out by Friday lunchtime, you're still going to be there Monday morning for the same reasons. Happened to me, my OH, my mother and my FIL - all "signed off" by the doctor for discharge on the Friday, but with staff off Friday afternoon and only skeleton staff over weekend, it wasn't until Monday that the gears started turning.

It's why A&E is packed at weekends - it's full of people needing to go onto the wards but with no one being discharged, they're stuck languishing in A&E due to no beds.

It's that kind of thing that the NHS needs to tackle. It's basically a 4 day service in so many areas when it needs to be 7 days across the board.

That is insane! I didn’t even realise this was the case.

Waiting for the meds/pharmacy means up to half a day can be wasted.

Just like that. Don’t know if that’s because the process of giving out meds is not streamlined or because of lack of staff.

in any case it ought to be addressed.

Yes, so you were saying back in October of last year. We heard you the first time. And from the looks of things, your rigid thinking about the elderly hasn't changed, and in your mind they are all still bedbound, dementia-ridden and screaming in pain. Not sure how you think regurgitating your dystopian ideology yet again is contributing anything new to the thread.

I would be interested to see what happens to your viewpoint if and when you are unfortunate enough to find yourself in one of the social groups you're so keen to write off, though.

They don't. Me and OH never have them together. We ensure that there is at least a couple of weeks between bookings. When we arrive for the first, the nurse/pharmacist always asks if we want both together and we explain we'd rather have a gap between them. They always look surprised and then agree that it's a good idea, as if they'd not thought of it before!

My OH is on long term chemotherapy drugs and spreads his drugs through the day so that not too much "hits" the body at the same time. He's on about 10 tablets per day and won't take more than one at a time, always tries to have a gap of an hour or two between them.

There is nothing good about prolonging the pain of general life for someone with advanced dementia, who is in a state of continual confusion, can't remember where they are, where they live, who you are, can't do anything for themselves (but think they can so causing lots of minor disasters). My MIL would forget literally within seconds and ask the same question continually, just seconds after you gave her an answer. Complete inability to absorb any information at all. She started thinking that her son was her husband and was convinced she'd never had children. Once she had been faffing with her bedside alarm clock and it went off in the middle of the night, she didn't know how to turn it off, so got a pair of scissors and cut the live power lead! She was constantly irritated and frustrated and forever saying she was going to put her head in the oven (electric) or jump out on the road in front of a bus (it wasn't on a bus route). It was cruel enough her being alive in that state, and there was no way on Earth that we'd have let her go through invasive medical procedures, or even scans/tests, and certainly not operations to prolong her life - she'd have been petrified of being in hospital, even for tests, as there's no way she'd have understood where she was or why she was there.

So who is going to provide and pay staff to work weekends, bank holidays or should existing staff work 7 days a week?

Patients are usually not discharged because there is simply no where for them to go.

also, your experience is not nationwide, my DD worked in cardio vascular, patients were, where practical, discharged across the week, if no one from the discharge team couldn't do it, clinical staff would, waste of their skill set but needs must... but when it takes 6 weeks to get a care package in place or when family can't/wont help or where the home isn't safe and is awaiting adaptations... what should the hospital do?

@taxguru Again not my experience... When my Mum had her stroke, she was was given palliative care only, my siblings wanted her to have a fluid drip as mum wasn't drinking enough, the hospital staff said "No, it would only prolong suffering"

It was of course the right thing to do, she'd had enough and wanted to die.

But its a very difficult decision for the hospital and family to make, as can be seen in the Assisted Dying bill, people value human life above all else.. well, they claim they do!!

Having dementia shouldn't lead to an automatic exclusion from medical treatment, where would you draw line on that?

So who is going to provide and pay staff to work weekends, bank holidays or should existing staff work 7 days a week?

The savings from not having bed blocking would surely cover the cost of some extra staff so everyone works 5 days out of 7 - the covering weekends

pharmacy
hospital transport
discharge staff

are surely needed 7 days a week

Add into that being in constant pain from open sores and multiple other painful health conditions and unable to eat solid food or toilet themselves. And yet these poor people only have to sniff and the doctors round with antibiotics for them because, we must extend this suffering for as long as possible, heaven forbid they might die.
And people like the PP act like they occupy the high ground wanting this sort of treatment for our very elderly. It's downright cruel. And don't just outright lie impling I want all old people dead. This hysteria, and lies is why this terrible treatment of our elderly continues. No reasonable, considered discussion, asking if keeping people alive for as long as possible in terrible pain and distress, is really in their best interests, is allowed to take place.

That was @ruethewhirl

It’s a bloody hospital. Or course they are needed over the weekend.

Do you think a bed on a ward is cheap?

Where dementia is present, I agree there could be scenarios where active treatment does no harm than good. But what's bugging me on this thread (and what I was referencing in my reply to pp) is that some people on here don't seem to want to answer the question about whether they also deem elderly people without dementia to be 'undeserving', so to speak, of treatment since they are no longer economically active. But I suspect I know how certain people on this thread would answer that question.

Where dementia is present, I agree there could be scenarios where active treatment does more harm than good. But what's bugging me on this thread (and what I was referencing in my reply to pp) is that some people on here keep harping on about dementia but don't seem to want to answer the question about whether they also deem elderly people without dementia to be 'undeserving', so to speak, of treatment since they are no longer economically active. But I suspect I know how certain people on this thread would answer that question anyway.

Nice sidestep. And possibly a nice bit of selective reading of my post(s) into the bargain.

What I want to know is, are you in agreement with refusal of treatment to elderly people with generally good quality of life without dementia? Because amidst all your frothing about treatment of people with dementia, I haven't seen a clear answer from you on this thread to that question.

That the NHS is under one system. One example is that if we have a woman from another trust, or who has been booked by another trust, we have to repeat their blood tests even if they have had them done already by the different trust. So the woman had to be inconvenienced, there's the cost of the blood tests and the staff taking the tests, just to get information that is already there. We also can't access notes from other trusts including scans so it takes time to get these. It's so frustrating. These are small things but it baffles me that we don't have in place one system all trust use.

I'm not the poster you're referring to, but I'll give you my answer based on both my personal experience of dementia and additionally, care for a n aging family member WITHOUT the disease. Later stage dementia sufferers have absolutely no quality of life and also have no awareness that there is anything " wrong" with them, thus reject any support or help which could make their and their carers lives easier. infact, due to the muddled thinking they'll often turn it around so believe you're conspiring against them or trying to ruin their lives. Can you imagine the toll this takes? To desperately love someone but become powerless to help and to receive constant accusations and be shouted/ sworn at continually all whilst still providing care that they need, but deny they do. It's horrendous. So I completely agree that active treatment does more h arm than good. On the other hand, an elderly person with physical ailments but who doesn't lack mental capacity, has every chance of enjoying a good quality of life and should never be denied treatment on the basis of age. I don't think anyone would think differently.

No sidestep from me, just another lie from you. In my posts I have described people suffering both dementia and terrible painful physical conditions. People without dementia, regardless of how much physical pain they're in or prognosis, are free to decide whatever they want for themselves. I believe some people with dementia actually live relatively happy lives, good for them. This idea, pushed by you, that I want them dead is nothing but a lie based on zero evidence. Then there are other people living in terrible distress with dementia, other painful conditions on top with zero chance of improvement. It is this group of people I think society needs to ask serious questions about if we are acting in their best interests, for example, treating with antibiotics if they get flu. Unfortunately, we can't have these important conversations because people like you try to shut them down with hysteria and lies.
To answer your question and make things absolutely clear for you, of course I do.

Of course I do think elderly people should be treated. Just not if it's only to extend pain and suffering and lengthen dying.

Thank you for finally answering on that point. I'd be interested to know where you think I've lied or accused anyone of wanting people dead though, because this is simply you incorrectly reading into my posts.

I also think it's rather ironic you're accusing me of trying to shut down discussion when you're using the word 'hysteria' (the age-old put-down used to try to shut women up) to describe the views of anyone who has the temerity to question or interrogate your views.

You didn't try to interrogate my views - this is what you said about me -

Yes, it is. And?