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 is badly designed questionnaire. No surprise there! It’s very prescriptive and you can clearly see what they already plan to do.

I answered it but it’s just a paper exercise.

I don't think that's feasible or can always work. There was an ex teacher in the Education role in 2001 and she couldn't perform as she was far too close to it. She resigned. Starmer has doctors he could call on but presumably they don't have the skill set.

Millions of people with no access to public funding register and use the system. That's a bit of an overstatement! Hansard 11 May 2023 says according to House of Commons Library, 1.6m people are given leave to remain wiithout recourse to public funds. So less than 2 million rather than"millions".

I had to provide proof of address because of the catchment area. Although when I moved, (there's 6 surgeries within the surgery group. Registered at one, moved and am now closer to another) I was told to just change my address. No proof needed

But I don't think she necessarily does. An elderly person is likely to need more support getting to the loo, for example, possibly encouragement with eating and drinking, smaller more nutritionally dense meals. An elderly person is more likely to have other medical needs and therefor drug interactions, more likely to be deaf and need staff who realise that they're deaf not stupid. "Hospital aquired delirium" is a real thing in older people. A lot of these are not purely nursing needs, and are porrly catered for in hospital, but are vital to return a person to the best health they are capable of.

I don't think the NHS can be "fixed" until adult social care is sorted out.

I agree. It’s a gimmick.

There will be yet more failure and disappointment in the NHS’s performance whatever the government does, because as a nation we’re too scared to admit that healthcare FATPOU has run out of road.

‘Lifestyle’ therapy will just make things worse.

Labour have had 14 years to come up with a plan. Streeting is extremely well paid and has a huge team of well paid staff working for him. To beg the general public for ideas is desperate and incompetent. Either do the job you're paid for or resign. If they don't, they'll be castigated for not asking the users of the service.

I would invest in more respite care as at the community hospital I work at it is very clear that many people are in because family need a break. It also puts people off caring for loved ones or taking them home to await care as they know there will be no break so the person just becomes a delayed discharge in hospital waiting for care.
One of my colleagues is from New Zealand and apparently if you are in hospital there over a certain amount of days they have to pay a small amount per day to cover the cost off their meals, electricity etc. I’m sure there’d be uproar here if that was suggested but if people were at home they’d have to buy their food etc so I’m not sure why it would be so awful.

I would also like there to be some sort of forum within each health board where ward managers could put up anything they didn’t need any more and others could take. It’s been mentioned before but wards could make their money go further if they had a bit more control over their money instead of having to use suppliers who charge double the price of Argos for the same item.

Unfortunately though a whole culture change is needed as people expect the NHS to sort all their problems and don’t want to take any responsibility for themselves.

Privatise it. Or at least set up a proper insurance system.

Yep and the NHS of 14 years ago, is nothing like the one we have now...

Its a 5min survey & about "buy in" for staff patients etc to have their say, i doubt it will have much impact on what they'll actually do.

Good to hear that Tory backers don't think its fixable.... what a good they ve done!!

And a minor injuries.walk in centre next door to every A&E, with A&E staff allowed to redirect people who've come to the wrong place.

I think we have to accept that some symptoms may be trivial but worrying to the layman, and so may end up unnecessarily at A&E through no real fault of the patient.

I’m sure there’d be uproar here if that was suggested but if people were at home they’d have to buy their food etc so I’m not sure why it would be so awful. While they're in hospital they'll still have to pay the runnng costs of their home, and they may spend less on food at home than they'll be charged in hospital. Meanwhile they'll not be earning, and their visitors (who are necessary for laundry, maybe helping to feed etc) are paying a fortune in travel costs. Not everyone is able to bear these extra costs of illness.

It hasn’t been fixable for decades. That’s why it’s never been fixed.

Massively fund primary care - there is no need for so many people ending up in A and E because they can’t see a doctor or they have deteriorated because they have been on a referral waiting list for months.

We need more health clinics where people can have stitches, simple tests, IV fluids/antibiotics etc without hospital admission.

The problem with wait lists being so long means it stores up issues that become worse and more costly over time. Tackle this and we may be able to stop “firefighting”.

It would also likely help the mental health of many people who are unwell but cannot get treatment - that would damage anyone’s mental health. Which again costs money to fix and reduces economic activity.

Agree with whoever said GPs on salaries so they have to work weekends.

Have consequences for useless rude medical staff - when a patient is admitted after having seen someone in primary care and not treated properly that cost should come out of the primary care budget. Would soon stop GPs giving the brush off and making it someone else’s problem.

And yes - NHS social care. In fact all NHS and social care budget should be one pot to stop the budget ping pong of making it another depts problem and wasting money to keep your budget active and not caring about the overall service outcome.

So the solution to lack of care is for overstressed relatives to take over care they aren't capable of doing (try visiting an elderly relative 3 times a day to supervise medicine, provide a meal, and assist to toilet) taking on top of a job and childcare) or discharge the patient into a situation where their health will decline? Mot much point in having treated them in the first place in that case.

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

🤣 (sarcasm) - our hospital was closed over 30 years ago!
It's still there, but you go for blood tests (8-13:00) X rays (9-15:00), midwife appointments and physio, ... you get the picture. Its for anyone who needs these services and is sent by their GP. Urgent care minor injuries and A&E are located in the next town 10 miles away.

Oh god where would I start? the NHS has so many fingers in so many pies and its a never ending circle, one department linked to the other and vice-versa.

GP surgeries are ridiculous which is why A&E is in the state its in.

A&E needs to toughen up on people and tell those who don't need A&E to go to their GP.. but as we all know, seeing an acuall GP now is like winning the lottery!

The Menal Health Service is drowning, another department which is overflowing and time and money is being spent on people who really don't need the service but there's nowhere else for them, and these people are clogging up the service for those who really need help!

Social Services are a joke!

And all of them work lovely monday to friday 9 to 5 jobs! (obvs apart from a&e). Its time to bring them all up to date and with the times. Work 24/7 like a lot of other people have too now! GP's should be available on weekends without having to sit and wait for hours on end, MH services should be available on weekends not just an OOH triage service and Social Workers need to be the same..

Better triage and more solutions for minor issues. So more GP/minor injury/walk in appointments.

All access should be via 111, which books your GP appointment for some time within the next 3 weeks depending on urgency at any practice within 5 miles of your home (closer for those with mobility issues).

They can also refer you to minor injuries/walk in centre who can then start managing their queue while you’re on your way there. You don’t get in without a 111 referral.

Similar for A&E - unless you come in by ambulance or are otherwise incapable of calling ahead (broadly assessed by you arriving walking and talking) you need a 111 referral.

Also, overhaul procurement. DH sells items that the NHS might use (think kitchen fittings). They won’t buy from him because he doesn’t offer a 3 year warranty. He sells to a reseller that does sell to the NHS at 100% mark up because they pretend to offer a three year warranty, but broadly because they’ve doubled the price they can afford to replace 50% of the items within 3 years and still break even. The failure rate isn’t that high. The NHS would be better off buying with a one year warranty at half the price.

Gosh, yes. Of course, you're right. Imagine paying for a service through non voluntary contributions and then asking asking for an explanation when it's not fit for purpose, how unreasonable!

Thank you for this. I am going to give this a watch. I really need to sort out my diet, I have two young kids and would like to be around for them.

Of course its fixable, other countries manage, why can't we? Kent at one time, would send knee and hip op patients to France, to a public hospital, so quick was the turn around that patients would get an appointment time before they'd even booked a ferry....

The reason is has gone down hill in the last decade is down to less funding than it needed for population growth, an aging population & waste on privatisations.

BUT it wasn't great under Blair either, we ve paid less per pp, into healthcare than our european counterparts for decades.

Then there is turning adult social care into a NMW job, in fact even lower paid as most carers need a car, which they have to provide tax and ins themselves.

Come on, we are putting a strain on the nhs and costing billions. I come from a family of "fatties". Pretty much everyone in my family is pre-diabetic or has type 2. Heart attacks and knee replacements are common. I don't think that suggesting preventitive measures regarding obesity is ridiculous at all.

It may not be a popular view, but other than in very, very rare cases being overweight is a personal matter and problem. We shouldn’t be spending hundreds of millions, possibly billions, on lifestyle change. The NHS cannot be expected to solve what we can solve ourselves.

Definitely no privatisation.

I'd merge health and social care properly, though. If you've worked in either, the endless ping pong of blame between them, and the "us versus them" culture is awful.