I know this isn’t the first thread, but the NHS is close to collapse

[Adropintheocean1]

I don’t want to be to outting, but basically I have some symptoms. GP suspected a condition due to these symptoms, and referred me to the hospital.

My hospital (large city) said we don’t test for this condition, please refer to x London hospital. London hospital said we are the only hospital dealing with this diagnosis, we are overwhelmed, we can’t see her. Suspected illness is not life threatening or limiting however does cause horrible chronic symptoms that need to be managed. So that’s it… GP seemed genuinely embarrassed. Basically if I want a diagnosis I need to go privately (can’t afford it.) GP said for a relatively poor area, his making as many private referrals as NHS ones.

Is it not time we got angry about this?

At the risk of sounding dumb but what is the benefit of having a X-ray to confirm a broken toe? The outcome is surely the same whether the toe is broken or not.

Funnily enough I sent a patient to the ED this week with a cut finger. With their underlying condition the early signs of infection could be catastrophic and end up costing not only their well-being but the NHS £30k+ a year in extra treatment.
20yrs ago, when social care was better funded to reduce bed blocking, ED would have dealt with it quickly and appropriately. Now with the ED delays, caused up stream due to no where to discharge patients, they were necessarily triaged by ED to next tier service (locally like minor injuries) and received appropriate treatment.
This sort of everyday occurrence doesn’t get shouted about but it’s happening every single day.

@LongDarkTeatime Oh and here is a government report showing how pharmaceutical companies were fined for overcharging the NHS. Still want to pretend this doesn’t happen?

www.gov.uk/government/news/cma-finds-drug-companies-overcharged-nhs#:~:text=In%20practice%2C%20the%20NHS%20was,money%20available%20for%20patient%20care.

I forever irritated by failings in the nhs re my conditions diabetes, and my Dh's and mums - dermatology, kidney stone removal etc. it's so shocking, multiple failures by nhs staff. So poor.

If you are using pharmaceutical companies to order a stapler, no wonder it was £25, and you need a head wobble 😂
If you are NHS you know full well NHS pharmaceutical contracts are negotiated at a national level and are in a completely different process to local surgical and stationary supplies.

@LongDarkTeatime I provided one example of how being locked info a contract with a set supplier allows them to overcharge. Would you like more? This happens with every single aspect of the NHS supply chain and there are numerous reports proving this.

What is a lifestyle ailment? Injury playing sports? Skiing? Horse riding? Falling off a ladder / slicing into a leg doing DIY?

Yes, you should have been given that advice, however I find it hard to comment regarding GPs to be honest, they get an awful lot of bashing and what they are expected to deliver in a 10 minute appointment is ridiculous. You can't adequately review a patient's clinical history, physical exam, read their imaging, do onward referrals and give appropriate safety netting advice in 10-15 minutes. They are pushed into delivering a poor service and this isn't their fault and not what they spent years of training and hard work to do. The reality is they end up doing a lot of this after hours and finishing late.

I think it goes without saying you shouldn't be refused follow up for this with neurology, much like OP it may be because this particular department are just full to capacity and can't accommodate any more patients in waiting lists which is a really worrying state to be in and I don't know the answer. It might be worth looking at other hospital waiting lists and asking your GP to refer you elsewhere. At my hospital we only have a neurologist once a week for clinic so I tend to recommend my patients get their GP to refer them to a larger specialist hospital that we know has better wait times.

I keep seeing these threads but my experience hasn’t been like the OPs at all. I have been referred to specialists at the hospital, had various x-rays and scans, and been treated with barely any wait at all. My condition is not life-threatening either but can lead to long-term disability if not treated, so perhaps that is why.

A company that proudly boasts they supply the NHS, not the one we use, and the price of their staplers.

But again that was ONE example. The NHS is overcharged for everything because they are not allowed to shop around and have to use the approved supplier.

Yes and you justified it with unrelated evidence. Local equipment contracts have nothing to do with national pharma tariffs.
I hear your frustration and feel my own when we can’t even order stationary via budgets but have to supply our own due to cuts.
How would you improve the negotiation of LOCAL equipment contracts? Don’t just complain, look into it and suggest something.

This is the NHS under Labour. Just continuing the decline under the Tories. It's not a surprise in the slightest. The NHS is not a priority for politicians, no matter how much they say it is. Top-level government is about ruling in a way that protects the elite, because those in power either are the elite or hope to become part of it.

Think about it, if you look at it very coldly, the NHS is mainly used by people who can't afford private healthcare. OK there are some examples of people using it simply because it's free, but for the majority of users, they don't have any choice. The typical NHS customer is not someone who is of any particular use to someone like Keir Starmer (or any senior politician). There is no personal benefit to the PM in helping an NHS patient, so their focus is on helping those who can bring personal benefit to them.

It's rubbish, it's getting worse and will continue to do so. Our political system is designed this way. Only when there is a sudden massive shock can change happen. That's how the NHS came into being - it needed the aftermath of a national catastrophe like WWII. Without the war, there would be no NHS. Terrible situations are what leads to (temporary) positive change.

It's broken, and most people agree, but when Wes Streeting said it, he was hauled over hot coals by NHS bosses.

A friend of mine went to the GP a year ago complaining of breathlessness. A whole year ago. When, almost a year later, she had barely moved forward, she paid privately. Turns out she likely has lung cancer. She's never even smoked.

We've just paid privately for an adhd assessment for our 14yo ds. We don't have time before his GCSEs to faff around. The thing that really grates is that GPs are being told not to take on shared care agreements following private diagnosis due to 'additional pressures' on prescribing any medication. Given the number of people who are now going private for diagnoses for ND and taking the pressure off waiting lists, you'd think they'd be trying to encourage not deter people, wouldn't you?

Same with my OH's cancer treatment. He has ongoing battles every month with the oncology dept and the hospital pharmacy to get appointments at the right time and in the right order and to get his chemotherapy drug prescriptions issued on the right date. It must take 10-15 phone calls every single month to different people to change the appointments they set (for the wrong dates and in the wrong order) and to chase the prescriptions to be approved and issued.

It "should" be simple and straightforward because it's a chain of events that happens every month, but the NHS is incapable of setting it up in order and not only does he have to phone several different people each month, he has to go through the whole rigmarole of explaining to them why appointment x has to be before appointment y and all z number of days before treatment start date - it's as if they've never heard of it before, as it's always different people he ends up talking to, as if it's the first time they've done it.

It's basically almost a full time job for one week every month as of course, it's hard to find the right people to talk to, messages are left for call backs which don't happen etc.

Sometimes, he ends up having to phone his "named" cancer nurse specialist who is really there for medical problems, but he has to get her to help him with the administration side of things when he gets nowhere after a few days of trying.

Sometimes, after a slight "tweak" to the drugs agreed with the haematologist, the prescription hasn't been changed, so he knows to check and question every little thing they do. Only this week, he picked up his prescription (which consists of several different drugs) to find two drugs missing - he knew he needed them and no discussions had been had to discontinue them, so again, he had to spend a morning phoning around trying to find who had changed the prescription and why, only to find it was yet another admin cock up, and that they should have been issued!

Luckily he's healthy enough and confident enough to take control, he knows what has to be done, by when, etc., so basically manages himself and his treatment is working exceptionally well - even his haematologist is surprised as she was talking about lifespan of 2-3 years when he was first diagnosed and that's now 7 years ago!

But we've said many times how awful it must be for people who are unwell and can't manage/advocate for themselves as they'd be at the mercy of the shambles, and would be turning up for wasted/unnecessary appointments, starting the monthly treatments late, risking the wrong prescriptions, etc. People who just blindly think the NHS "knows best" and just follow whatever appointments are made and drugs issued are at a real risk of damage to their health. It shouldn't be that way!

I think, also picking up on what some PPs have said, there are certain illnesses/injuries that are generally better dealt with by the NHS-e.g. generally they do seem good at dealing with life/death issues, certain illnesses where there are clear targets or protocols (e.g. in my area, not sure if it’s national, they really push smear tests, and breast lumps are investigated quickly if you’re deemed higher risk.) However, in my experience MH provision for serious illness and support for chronic illness has been very difficult if not impossible to get, even where these have been life-threatening. I’d be interested to hear from anyone with experience how these clinical decisions are made? Is it on a local/national level? It doesn’t seem to follow the same logic across all procedures e.g. if it’s a monetary argument, then supporting people with chronic illness so they are well enough to work would “logically” make more sense than continuing to provide expensive healthcare to someone who has a terminal condition, for example. If the “logic” is supposed to be treating those in most medical need, then getting rapid treatment to someone at imminent risk of suicide would be a priority, rather than e.g. giving lots of people statins. Who is making these decisions and on BBC what basis?

That's absolute rubbish.

Virtually everyone uses the NHS. A smallish percentage have private health insurance which will cover some ailments, but even then, they are reliant on the. NHS for most things.

My daughter's medical condition, for example cannot be treated privately in the UK (and if it did, out of pocket, after insurance costs in the USA usually exceed £100k)

Private is great for replacing joints but if you have a heart attack, a stroke, break your leg, then it's 100% NHS for everyone. Including Starmer.

Do you seriously think that if Starmer broke his leg, he'd be languishing on a trolley in A&E for 48 hours? He may be under the same NHS as everyone else, but he'd get a hell of a lot better treatment by the NHS just because of who he is!

I work in crit care. Have done for 25 years. Many of our patients are elderly and frail. In my experience if they have a condition that requires urgent surgery, they have it, whatever. And then can expect weeks and weeks of often traumatic medical intervention. Tracheostomy. CVC and art line insertion. Haemofiltration when kidneys fail. It’s relentless. We’ve got two patients in their 80s at the moment who’ve been with us 40 odd days, much recovered but static. Who knows if they’ll ever get home.

Certainly the ability to make sensible humane decisions seems to have left the building. Don’t know whether it’s a residual Covid guilt thing.
What I have also noticed is the lack of interaction between medical staff and patients. Even ward rounds are routinely held away from the patient, nurses aren’t involved in decision making, instructions written on the computer and not communicated.
I always thought that computerised records would make things easier. Now I seem to spend most of my time staring at a bloody screen, tick boxing. The patient comes second. I’m literally nursing an electronic box.
One of our band 7 managers had to look after 2 patients the other day, big shock as they are clinical in name only. Spend 90% of their time in the office or in meetings. She was ‘shocked’ at the amount of ‘paperwork’. I mean, really ?? That tells yo7 how divorced from reality they are.

The problem is that everybody wants it for free, costs have increased, even a £1-2 contribution for each appointment would help but as usual nobody wants to pay.

With the way the NHS operates, a £1/2 contribution would cost way more than it raises. That's because the NHS would set up new departments to handle the charge, i.e. new "patient facing" people to take the money/swipe the card, needing a second reception area/desk for every appointment, then back offices to process and record it, a small army to determine who was eligible for exemption, etc etc.

In a private organisation, the receptionist would be given a card reader and told to get everyone signing in to swipe or pay cash. Like they do in dentists, opticians, etc. But the NHS is incapable of doing anything simple and the bosses/unions would have an aneurism at the thought of someone doing "two jobs" as they'd see it, i.e. a receptionist booking someone in AND swiping a card at the same time! Don't forget the old adage of "one person one job" of the 70s unions.

Nope, but neither are the vast majority of the population. Most are treated in under 4hrs. 10% wait for 12hrs+. Only 0.5% or 1 in 200 are 24hrs or more.

You’re right costs have increased and at the same time the tariff paid by the Gov for individual procedures (eg ortho ops) decreased.
For quite a few years now Nobody’s attention seems to be on the % of budgets going into paying off PFIs. These were appalling over-inflated contracts which Trusts got locked in to. At the end the infrastructure either gets handed back to the now rich private equity people, or the NHS has to sign a new contract. Why is this not being shouted about rather than the underfunded staff trying to provide the best care they can?

@SinkToTheBottomWithYou went on a rant rather than answering your point. I agree with you re £1 or £2 (private will cost FAR more).
As others have raised (though I challenge how they raised it) certain internal workings also need to be addresses.

It seems that when money is given to the NHS the sharks gather round for a feeding frenzy😠

I thinkntye NHS is trying hard but sinking.

I'm on cancer treatment. My meds cost a fortune (free in exchange for my taxes).

I attend hospital currently for 4 days a week. We sit in a little room. There's 6 of us No privacy. We discuss our medical situations in front of other patients. We have medical procedures completed in front of each other.

There's no space nor staff . The dayward we should be on (with beds !!!!!) has been condemned.

Overhear conversations by staff about there being no space on day ward, or the wards so not able to accept new patients and can't take the patients who could leave the wards if the day care was available.... vicious circle.

And we need to take responsibility our own health better as a society. For example, in my small room we are all on cancer killing meds... one patient says "I'm not changing my lifestyle" after being on a big alcohol bender (talking over 10 pints), they come in twice a week to rehydrate (not have the cancer meds). The staff find it infuriating as its another space taken up that someone else can't use.