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 don't want to live in a country where we leave people to die in the streets because they are not native. Do you really?

I don’t want to finance the World Health Service either?

Do you?

If that was the direct choice then maybe, yes. The whole world is coming to use our crumbling NHS is a tad overestimate and there are checks when visitors not entitled to NHS care need hospital care but it's neither cost efficient or sensible to make primary care less accessible.

The investment needs to be in IT. The NHS IT systems are so woefully behind even what my kid's Nintendo switch can do that it's embarrassing. We could save so much money and time with better systems.

Oh, but it’s more effective to make. Primary care oversubscribed and out of reach for those who are paying for so we can accommodate millions who aren’t?

True but not for allied health, numbers, generally speaking, are falling, the drop out rate on my DD allied health course was over 60%.

They are not keeping up with demand, numbers lower than pre removal of the bursary, utterly short sighted, thanks once again to the Tories.

Those better systems would cost 10s perhaps even 100s of billions & unlike say a bank or other business, who can schedule IT cut overs for the weekend, the NHS has to be up and running 24/7.
Both old and new have run side by side, all bugs ironed out, seamlessly switched, then there is training on new systems, whilst fully operating the older ones.... which in most cases will not work on more modern operating systems.

All at the same time, as having a mtce team that is able to manage the new kit.

When i used to work in IT and went to a few hospitals, things like cat5/6 cabling, Full fibre internet, power, modern cloud based phone systems often didn't even exist, esp away from District Hospitals, often built long ago....

Our technicians became fewer and fewer as they retired/laid off, new ones not recruited, travelling huge distances, we'd use contractors, who would ring up tech support with "What do i do? not trained on this stuff/what does it look like?"

Its huge and why no Govt has done it... as recent events has shown, no one, even the wealthy, want to pay more tax.

I'm not sure this is true.
Loads of immigrants who live here full time go 'home' for medical and dental treatment.

Err we don't.... foreign workers, not resident, need health insurance/pay levies, even if working and paying taxes.

Yes there will tourists who use the NHS but the UK has reciprocal agreements with almost all of Europe.

Fwiw we have two Ukrainian families in the village, they go back to Ukraine for any dental work, such is the state of NHS dentistry/price of private treatment here, same as a chinese friend does, goes back to China for healthcare.

Emergency aside, few would wait years, if there is an alternative in their home country.

Some do.

The big majority don’t.

How about just getting patients email address and emailing them appointment times etc

More than once I have received an appointment for something where they have typed the letter up after my appointment had been
Then been told that is how things are done and when I receive the letter then I can phone up and book an appointment

So why go through all that waste of time and money making appointments, writing appointments and sending letters out if you are going to ring up and book an appointment over the phone.

Because it is the way it has always been

"Because it's the way it's always been" is exactly the reason the NHS is such a basket case in terms of admin and management.

It's madness how many different systems are in us by different depts in the same hospital. I.e. my OH gets a variety of appointments via his GP, hospital day treatment unit, oncology unit, radiology dept for scans, and orthopaedic dept - all different methods. Some write a letter with a random appt that you then have to phone to change, others just write a letter with a (different) phone number to ring to make an appointment, some write with a link to a website to book an appointment online, some "ping" an appointment via the NHS app, some phone him up, it's madness. And of course, the various different phone numbers given to contact them to cancel/change appointments are barely ever answered, sometimes they don't respond when you leave a message, sometimes there isn't even an answering service.

It seems each individual part of the NHS want to do it their own way and there's no standardisation across the hospital/local trusts.

Not everyone has access to the internet, many people don't have an email address and many are illiterate

Consent must be explicitly confirmed before anyone tries to contact people by landline, mobile or email

Most appointment letters are typed up and sent by Band 2 drongos like me - there are so few people prepared to work for that kind of money, that there is almost a four week backlog for someone to get around to typing letters

Most appointment letters are typed up and sent by Band 2 drongos like me - there are so few people prepared to work for that kind of money, that there is almost a four week backlog for someone to get around to typing letters

Sounds like a nice WFh job

I believe some of the phone numbers on letters don’t have a phone plugged into the socket for that number. As just rings.

The NHS keep going on about the number of missed appointments. Well make it easier for patients to contact the hospital to inform that unable to to attend appointment. If a patient has SnD or Covid symptoms when they first wake up. Unable to contact the hospital as phone lines (if anyone answers them) open at 8am and the patient has appt at 8:30am.

Improve the ability for patients to change and cancel appointments before you moan about the number missed.

My parents visited the hospital for one of DM’s appointments. Whilst they were there, parents went to another building and to the department to change DF’s appointment as they were on holiday. He couldn’t get through to speak to someone

I have a friend who is unemployed and she would love to do things like this - either WFH or at hospital

I believe some of the phone numbers on letters don’t have a phone plugged into the socket for that number. As just rings.

Part timers and no will to form a 'wraparound' admin service

There aren't enough people to work from 8am to 6.30pm to answer the phones

Many secretaries and admin bods work mornings only or a couple of days a week

No one receives solid communications training and there is no formal training on how to set voicemail

Most businesses inc hospitals, will have an IP Cloud based phone system, VM may be licenced ie when the Phone system ordered, a set number of VM "seats" purchased, once used up, thats it.

Unless they buy more.... and if the system is no longer supported, then even that wont be possible...

On other systems, VM set-up is chargeable, no one on site can do this, an order has to be made, either done remotely or a technician sent, again if possible.

As for "Training" ha ha perhaps done initially, the people trained long gone... everyone else just gets by, without a clue of the systems capabilities.

When i first started in Telecoms, every larger site would have a Comms Manager, fully skilled up on the systems used, able to train, program user features.... but progress got rid of these.

Phone systems are the last things companies inc Hospitals, keep up to date and many are just add on's to their network systems.

Years ago I had to have a complicated dental extraction. It was booked for the day before a very important event. I rang every day for 6 weeks asking if there were any cancellations. Every day the person on the appointments line said no.
When I finally went for my extraction I mentioned how desperately I had hoped to get in earlier, the nurse said "Oh, they should have put you through to the clinic, we've had loads of cancellations".
I had to go to the event dosed up on antibiotics and pain killers, looking like a hamster. It is infuriating. Not to mention all those available slots not filled.