To wonder what's happened to the NHS?

[Chefpig]

I went for surgery this afternoon. Waited three hours in a waiting room because there were no beds available. Uncomfortable, especially with pain, but couldn't be helped.

I expressed a wish to the anaesthetist for GA after much trauma from a attempted and failed spinal anaesthetic in the past. Anaesthetist told me that a spinal would be much better for recovery and I should at least trust them and give it a go. Being brave and talked out of a GA, I gave it a go. It was horrific. I have a real issue with things being put where I can't see and it was painful, especially when the electric shocks (?) started on one of my legs. In tears, I asked for a GA. I was told it was very near to being ready and I agreed to keep going with the spinal but after the second electric shock and me in complete panic mode, I begged for a GA and the lovely, wonderful nurse who held me throughout was fierce with the anaesthetist and insisted she stop and give me a GA. That nurse was an absolute angel and held me throughout. I'm now in absolute agony with pain in my leg. Not my surgery site - that's fine!

Back on the ward in a single room, I was left for over two hours without being asked if I wanted drink and food. I eventually buzzed to ask. I had obs done on the recovery unit but not since I've been back in my room and its now five and a half hours after surgery and theres only been two brief visits to me as I buzzed to use the loo with assistance. I waited for painkillers for an hour (not nurses fault at all, she's so busy) and my own tablets haven't been taken care of despite someone earlier saying they'd let the senior nurse know about them.

My details whiteboard hasn't been filled out (dont know if that matters) and the blinds in my room have blinds missing so no doubt across the way has seen my knickers and bare boobs several times.

Staff are absolutely lovely on the ward. They're They're doing their best but I can tell they have very little to give. They need my bed more than I do for a bloody good rest! They're run ragged. AIBU to expect our NHS to invest in staff and their wellbeing so they can care for patients better?

Too much management and too many people taking the piss. I dream of the day we go for the European model and charge for GP appointments

The same as what has happened to police, schools and waste management- it has been underfunded for years and is under resourced.
there will be lots of sickness as staff have unmanageable traumatic work loads and lack of skills as those who can are leaving.

the pay rises the staff get come from the budget so each time things appear positive it’s another blow

technology is improving but that costs money to keep up which is simply not there

Funding hasn't risen to match inflation and an aged population.

Since 2010 we spent less per year in real terms on the NHS.

We spend less pp than the EU average.

More hospitals are needing more upkeep and repairs due to aging / wear and tear.

My mother is 95 and gets wonderful service. What bugs me is that she is issued with kit (walking frames and sticks, large boxes of dressings when she only needed one) when no one checks to see what she already has.
So she has a pile of it. So wasteful.
And the problem is that we are, as a population, getting older and fatter.

And, as a previous poster said, the NHS are saddled with ruinous PPI contracts. Put in place by Blair's government.

I used to work for the NHS as a midwife. In my experience, you are treated really badly by management (who spend all their time sat in their offices). As a student I was meant to be supernumerary, but that never happened except for the birthing suite. The off duty and lack of patient ratios are shocking. I moved abroad in the end and the job was so easy. I would never consider working for the NHS again.

What i find unsettling is how rapidly it has unravelled.
I recently made a phone appointment. The first i could get is in a fortnight. Pre covid it would be within a week.

Wow.

You’re right about underfunding.
We absolutely need staff from other countries but in my hospital the standard of spoken English from some of them is terrible, this is dangerous.
NHS is very top heavy with management.
Every ward on every shift operates Sat minimum staffing so as soon as anyone phones in sick that area is unsafe.
Nurses have more responsibility than ever.
Our trust now has electronic drug rounds , this has added time to each drug round.
We have spent hundreds of thousands on IT systems no one uses.
Our infrastructure is falling to bits (lifts which regularly break down with patients in) but non money (allegedly) to repair.
Cheapest possible SLAs which are inadequate.
Severe lack of onward care , so around 100 people a day are in a bed they no longer need.

I could go on …

Absolutely @dreamingofgoodhair and there is a theory that because nursing was often traditionally a "pink job" wages were kept low so less budget needed on that than can be gotten away with now.

With respect, I don't recall too fab a service between 1997 and 2010/15. At least prior to Bliar we still had the notion of the family doctor. Durong the Bliar period both my DC were refused grommets on the NHS and I was refused a bladder repair arising from a botched NHS birth.

I don't think it's just underfunding. It's so massive and so un-joined up and fragmented and old fashioned. The comms and tech and systems are just not up to scratch. And poor practices are now so entrenched. It's so depressing. We have become used to accepting such a poor service which would never be accepted in any other area or situation.

What an absolute crock of shit! I don’t even know where to start with what bollocks this is 🙄. So he sold the NHS in secret for good press? Yes of course he did. Fuck sake.

I'm not a Tory, but I am an ex NHS worker of many years. Two of the most damaging changes to the NHS were made by Blair - the new GP contract and PFI.

God, get a grip. He's barely got his feet under the desk. Given the previous 13 years of underfunding Labour were never going to sort it out all at once.

Yes the GP contracts brought in by Blair were ill advised

And we have nurses promoted to managers who may have been great nurses but not great managers. Then managers who are not nurses who shuffle people around like tins of beans in Tesco.

Labour are in power now and have a term to show the difference. The NHS is still paying PFI back from last time.

Let’s see if they meet pro Labour expectations and it’s any different. Or it’s difficult to keep up with growing demand delivering more and elderly with complex needs.

having had a previous failed spinal doesn’t necessarily mean a second attempt would be difficult and it sounds like they’d got pretty close to the right spot this time. For quite a few operations there’s real advantage to having a spinal and in addition if someone’s had a difficult GA in the past often a spinal may be the safer option and at least worth a go.

completely normal to not have anything in the bedside whiteboard…patients complain about their details being visible. You can’t win.

Absolutely agree with underfunding both in terms of infrastructure and workforce.

We don't have a pipeline of consultants because we make it far too hard to access university courses, limited spaces available and you must have 4A*s at A level. Many applicants that meet these standards then get turned down. The numbers of students dropping out is very high. Lack of funding then means there isn't junior jobs for the people that do qualify. If we had better staffing models and more money we could support more junior doctors onto shift rotations. This would mean more clinical staff and better work life balance - we currently run junior doctors into the ground and then wonder why they quit or go elsewhere.

There have been numerous studies showing that the NHS has significantly less managers than needed and less than comparable health care institutions across the world. I dont think we have too many managers. The management vs clinical debate is old and tired. There's a role for both.

Unfortunately, the industry that is the NHS relies on rafts of data, admin, operational process and assurance. These shouldn't be the responsibility of our clinical teams. Nurses are taking on more of the work that consultants used to do, there isn't enough of them to also take on the work of management - we need our clinical staff delivering hands on clinical care. Management working on operational delivery and improvement planning and for all stakeholders to respect each other and work together.

Nail on the head. Hugely inefficient. DH has had multiple repeated tests, X-rays, scans etc because the results were lost or they scanned or X-ray-d the wrong thing. Very expensive cancer drugs issued and then told to throw away when they decided to change the dose or drug. It’s a complete circus of utter incompetence and no care for costs nor patients. It’s just a self serving fiasco now.

What do you mean by this?

And someone does have to go later/last on the list…when admissions are staggered it usually reduces theatre efficiency and then people complain because they have to wait longer for their operation dates.

Since labour have been in power we've had an up tick in junior doctor strikes, pay rises with no expectation of better performance.

The BMA needs disbanding, there needs to be a huge increase in medical school places and nursing places to British students only, with a lock in policy of having to then work a certain number of years for the NHS (or repay your training fees).

Private healthcare should be tax deductible, thereby easing pressure on the NHS.

Appointments should be prebooked with a bank card, if you fail to show up you get charged.

More temporary care homes to plug the social care gap and get people out of beds when they no longer need care.

Great post. The number of people that think doctors and nurses can run the NHS is insane. Most people have no idea how the NHS is run and seem to prefer a doctor to do admin rather than an administrator. Make it make sense!

Also, this isn't new. Before I met DH (28 years ago) his blind and deaf grandma was in hospital. The staff used to put food in front of her, then come and take it away trilling 'not hungry today Mrs X?'. If her husband wasn't there to help her she went hungry, but he wasn't allowed to stay with her all the time.