Addressing the elephant in the room; people abusing NHS, health and social care.

[Floogal]

I have seen a number of threads (here and on Facebook) bemoaning and worrying about the state of the NHS and social care in the UK. But what about how the general public treats it? Over the years, so many people used these services incorrectly, or even abused it in wanton fashion. There has been recent discussion about people who go to A&E mob handed. As well as a lady forcibly being evicted for overstaying at hospital

www.mumsnet.com/talk/_chat/5270258-woman-evicted-from-nhs-hospital-ward-after-being-stuck-for-18-months

I have been working at a council run rehabilitation unit. The majority of patients stay here after being discharged from hospital. They usually stay for around 3 weeks before they're well enough to go home (or sadly sometimes residential or nursing care). However, there is a noticeable minority of patients who seem to treat the place like a hotel. Eg,, staying in bed all morning, watching TV all day in their rooms, Refusing to join in group exercise classes, chatting on their mobiles. Socialising with their visitors for hours on end. I mean, they have plenty of free time in the afternoon and evening to chill out.
Indeed, some of the conversations I've heard make them seem entitled. For example , "I should like some tea and cakes brought to my room for when my guests arrive". Another lady kept ringing her bell as a carer made her tea in a mug, she wanted it put in a China cup. Another male patient turned away a physiotherapist who came in to see him. His reason for turning her away was "I haven't finished reading my morning paper". The best one was this woman complaining that she expects room service and that she's worked and paid her taxes. They're meant to be there for rehabilitation, not the Downton Abbey experience!
Also there are other patients who are ready to go home but are very reluctant to leave. Most likely as they get 3 free meals and company and attention. Which is understandable if they're lonely at home. But that's not what the service is for.
I believe this also contributes to the problem of bed blocking in hospital as patients can't leave hospital due to a lack of space at rehab.

You wouldn't believe the number of patients who decline my input because it isn't a convenient time (for example because they haven't finished the paper, don't like moving before 11) who then turn around and file a complaint that they weren't seen that day. It's thankless.

I’m genuinely so sorry to hear that.

Also angry. It took 5 months to be seen by NHS physio for shoulder injury that has massively affected my ability to work. I’m self employed and it cost me a lot of money (I had to go private so as to not loose my only income)

Levothyroxine and liothyronine are 2 different drugs, so you are comparing 2 different things. Example of where a drug manufacturer was inflating the price of their drugs (at bottom of page)

Also, different drugs cost different prices in different countries is not a surprise. Supermarkets have bulk buying power, but the price of food varies between even neighbouring countries.

I used to have to put up with endless written complaints about the wrong type of sandwich filling; we used to have ham cheese tuna egg, all made off the premises and completely out of my control, the view out of the window; onto another NHS building, how comfortable or not the arm chairs are, being offered a dessert spoon instead of a soup spoon to drink their soup, being offered breakfast too early: about 8 am, no croissant (I kid you not) only white brown toast, no fruit in the individual jam pots, the fact that they couldn’t swap peas for sweetcorn off the lunch time menu (again all prepared off site and outside of my control), insufficient variety of fruit at meal times apples, bananas and oranges were standard, the quality of the tea and coffee offered even more about the hot chocolate so I removed it, don’t get me started on those small cartons of orange for breakfast people wanted apple so were constantly complaining, or the variety of the biscuits available cheap digestive and bourbons. I could go on. In the end I resigned taking 30 + years experience in my field (still in the NHS but in a less demanding role) as I spent so much of my time replying to crappy complaints like this.

Almost laughed reading that. Unbelievable pettiness and entitlement.

Exactly, people abusing services slows it down for other people.

This is also very frustrating for me - I triage the new referrals so am aware of how many people are desperately waiting for an unacceptable amount of time. And then I regularly have mornings where 6 out of 8 will decline or fail to turn up. We do have a strict two declines and your out policy, but if someone complains then that policy is always forgotten by management and we get the blame. Genuinely sorry you had to go private, it isn't acceptable.

I have seen what you mean. It's interesting because I rarely see this in the private sector.

I do think that there’s a lot that the NHS and social care services could learn from the private sector about setting standards, commitment and individually accountability.

Almost no private provision takes patients on without being clear about the terms, whereas that seems standard within public services.

Making the expectations clear up front would also make it a more positive working environment.

I feel your frustrations OP. They echo mine as a tax payer.

Would it be very controversial to say we should have a mechanism of saying this is not a sensible use of resources for the NHS to answer this complaint? I really think it's death by a thousand cuts within the NHS workforce. It takes huge amounts of time to respond to these petty complaints. If we could have a triage level of "just out of our control", it would actually save a lot of time. We could ask them to speak with their MPs at their weekend surgeries instead 😂

Not a helpful post. Got to ask yourself why the NHS is finding it difficult to recruit. Who's going to look after you?

@Crispynoodle my mother was admitted from home following s stroke. She was disturbed and delusional. Drs misread the notes and thought arthritis said Alzheimer's. She deteriorated whilst in hospital to an alarming degree, physically and mentally. She received no treatment for the stroke and her rheumatoid arthritis medication was stopped. The ward had no knowledge despite being a patient in the same hospital for the last 15 years.

The hospital wanted a care home. She did not. We had POA and she was discharged home with no care package. The NHS finally agreed continuing care but she died before it was put in place. We paid for private carers but it was not enough. When the community nurse arrived to deliver end of life support she hugged me and cried. And railed about lack of care and leaving families with inadequate support.

We took mum home because she was dying in full view due to lack of support but no one cared. We couldn't stop her dying but at least we cared, shared memories and photos of when she was young, she spent time with her children and grandchildren. Not to avoid care home costs and protect inheritance. So insensitive.

This is so sad but very much the norm I'm afraid with elderly people.
At least you have comfort that she died feeling loved and cared for (emotionally as well as physically...so many people put greater emphasis on the latter)

Sorry that would be hilarious if it wasn't so sad.

What I will say is that in some hospitals the food is genuinely disgusting and not conducive to healing. My husband is not a picky eater in the slightest and found some of it unpalatable when he was in for a long while.

He would often opt for a jacket potato because at least that was not disgusting. It's been 10 years and he will still not eat jacket potatoes.

He has never once complained though.

@PocketSand
Not sure if my post was clear, but I agree with you that elderly people are all too often not cared for in hospital and rely on relatives "looking out" for them

It's seated exercises for crying out loud.

I was a 999 ambulance service call handler for a while. I was shocked at the amount of time waster calls we had from people not in an emergency situation. We still had to triage them. Wasting time while other calls backing up which might have been life/ death. People having a go when you tell them you're NOT sending an ambulance. We used to joke some people treat it like ordering an NHS Uber.

You think this post is in any way appropriate? Get another job

your contempt for the service users is disgusting

Yes. And if they can’t afford it they should die in the gutter

Missing an appointment gives the clinician a break. It’s not wasting resources , no resource is wasted.

GPs have Admin slots 'built in' to their calendars

Missed appointments are a frustrating waste of everybody's time, from the patient who could have had that appointment, but it had been booked by the no show, the staff who booked it in and the doctor who could have been seeing someone else

There are too many patients and not enough appointments, they are too precious to be wasted

OP, are you also aware of the abuse the system is exercising on quite a few of your patients?
Are you aware that they do work hard and pay their taxes to find that it is really difficult to get an appointment with a GP, that diagnosing takes ages, that then the local pharmacist may not have the medication you were prescribed, that specialists appointments and sugeries have mahoosive waiting lists, so by the time they make it, the conditions have got 10 times worst. Many patients lose movility, social connections, work, they miss on life events with their families, are in constant pain, nobody can tell them when this will end.
So, it is not surprising they are a bit broken by the time they make it to your department.

With the exception of the 75mcg tablets levothyroxine tablets are are 60p to 70p for 28. They would then be discounted by around 10% by the NHS. Add £1.27 dispensing fee . The 75mcg are about £2.60. Again less the discount.
Source February 2025 Drug Tariff.
I admit the liquid versions are eye wateringly expensive though.
The Portuguese ones sound expensive.
the original post about drug prices is typical of rubbish you see in the press.