What has happened to the NHS?

[loveandroses]

Two stories:

• I recently had a breast cancer scare. The GP referred me for an emergency two week scan and said that if I didn't hear anything within a week I should call a number she gave me. After a week of hearing nothing I called and was told that I should hear from them within 4 weeks.

• DD has skin problems and was referred to a dermatologist. Every single appointment is by telephone. When I wrote to suggest we should at least have zoom calls this was ignored. They have never seen his skin!

This is madness. What is going on?

The NHS has been on its knees since before Covid. The pandemic just expedited the inevitable and shone the light on the gaping holes that have been shoddily patched/covered up.

Straw that broke the camels back.

The government need to admit that this is where we are and our expectations should be much lower for the immediate future. Even throwing money at the problem isn’t going to fix anything, there’s a shortage of qualified, experienced HCP’s, that takes time. Covid is looking increasingly likely to need a sub-specialism all of its own.

Underfunding. In one word.

We don't pay enough per head of population. The population is getting older and has more people with complex heaneeds who live longer than they did. The number of people who are too fat and therefore have health problems relating to that has increased also putting costs up. Women are having children later which also means more complications and more costs.

As a result of pressures from understaffing on the front line in clinical roles and more complex cases there are more negligence claims. This means more money spent on compensation and medical insurance. Hospitals which are doing worst therefore struggle to turn it around because they are handicapped by the penalties given out and get often caught in a catch 22.

Whilst money has been given to the nhs it hasn't been given to social care so medical beds get blocked by people who can't be discharged to bed at carehomes or home because they don't have support in place for that.

Add to that people having problems accessing GPs which was already an increasing issue particularly in some cities. This means preventative medicine isn't done so people present later with conditions which are more chronic and more serious rather than having early intervention and better management of their conditions.

Meanwhile everyone keeps complaining about taxes going up.

Then covid happened.

Everything is backlogged re: scans. Also there may be staff off sick or redeployed. It's shit and I hope everything is OK with you.

Dermatology needs to be face to be face or at least video. It's shit that it's not.

It's not the front line staffs fault. It's really the governments chronic underfunding. And not just this particular government. It's gone on for years and years and years.

Long term underfunding, and badly managed (not a pop at individual managers, but at the overall system of management and funding, and the insular approach to recruitment/dependence on short-term secondments that prevents a good flow of expertise into and out of the NHS from other sectors).

Chickens are truly coming home to roost right now.

There does seem to be a lack of common sense approaches that don't cost any or much money. Our Gp had a really good online booking system for appointments up to two months in advance and also a triage system on the website to get access to urgent appointments. Covid happened and they got rid of both and now nearly two years later still haven't put them back. You have to ring on the day, can't book in advance. The shortest I have waited is 45 minutes and once was over 2 hours. Why? They had a solution to this

Endemic acceptance of mediocrity by managers. Continual short-term patching up of gaps. Money spent in the easiest but the wrong places.

Clinical staff are mainly (but not all) very hard-working but understandably running out of goodwill.

More taxpayers’ money needs to come with re-organisation and major cull of been-there-for-ever-but-not-needed-and-not-effective middle and senior managers (generally aged 45+ , like to talk about their pensions, shrug their shoulders and accept the status quo/ bash the government).

I know of 3 people diagnosed with cancer in the last 12 months. All had scans within 2 weeks and all have had excellent and timely treatment. There are definitely major issues but in some areas the response and care is excellent.

We do need to pay more. We are not paying enough to sustain the level of service people expect, but no party wants to raise taxes. It's a big issue.

My Dh met someone recently who was boasting about his six figure salary and general perks as a manager for the NHS.
I know that all organizations need managers , but when you hear things like this it makes you wonder just how many are on these huge salaries
I'm sorry your having so much hassle op , I hope things look up , but covid has high lighted the many problems that the NHS has and it's people such as yourself that will suffer :(
I wished I had the answers.

Too many middle managers and made up middle roles recruited (given to yer mates) and not enough clinical and support staff, admin staff that are completely shat on so that they are burnt out. Forms to fill out forms to fill out forms. Complain so that there is evidence for more funding. Although I’m sure it will be spent on moaaar middle managers.

The Tory government! Next step persuade the public that private medical care is better....

It’s not all government related, how can you run a hospital on middle managers?

Its awful, my mum had a breast cancer scare and told she would have to wait up to 8 weeks. After 3 weeks we ended up paying £800 private, luckily everything was fine but all that extra time could cost someone their life who doesnt have the option to pay private.

We don't need to pay more money - it will just be swallowed up by the black hole.
We need a bloody revolution.

@loveandroses

Two stories:

• I recently had a breast cancer scare. The GP referred me for an emergency two week scan and said that if I didn't hear anything within a week I should call a number she gave me. After a week of hearing nothing I called and was told that I should hear from them within 4 weeks.

• DD has skin problems and was referred to a dermatologist. Every single appointment is by telephone. When I wrote to suggest we should at least have zoom calls this was ignored. They have never seen his skin!

This is madness. What is going on?

Too many people using it! Yes, it has been at its knees for years but is not just funding it is also that the country has grown in numbers. Not all pay in to run it. Now we have to add vaccines and free tests to add to the bill.

@poorbuthappy

We don't need to pay more money - it will just be swallowed up by the black hole. We need a bloody revolution.

Grow up!

Unfortunately everything seems to be by phone. I'd call and tell them it must be in person as you can't show them the issue over a phone call.

My DS needed an urgent heart scan during the first big lockdown when he was only a few weeks old referred by GP. They kept saying it would be phone call with paeds cardiologist. Long story short, the appointment kept being cancelled as paeds cardiologist was shielding and no one could do it on his behalf. In the end my DS ended up being taken into hospital twice by ambulance and then they finally agreed to scan him (one of the paeds cardiologist team did it) in a and e 4 days after his 2nd trip to hospital and found the issue but took numerous phone calls and the help of paramedics to get them to take it seriously and for someone to see him.

Thankfully hes doing amazingly well now bless him and is a happy little boy. If your not happy call and speak to the bookings line or a manager. I hope you both get the help you need soon.

@fournonblondes

Why? It seems like without massive change in the infrastructure of the government this will never be solved.
Simply paying more money every year does not improve the NHS.
In face you could go as far as to say that the more we pay the worse the service gets.
I would usually say vote for the opposing party in the next general election but since the Tories are managing to dismantle our entire society at breakneck speed something drastic needs to be done.

Is that better?

@RedToothBrush

We don't pay enough per head of population. The population is getting older and has more people with complex heaneeds who live longer than they did. The number of people who are too fat and therefore have health problems relating to that has increased also putting costs up. Women are having children later which also means more complications and more costs.

As a result of pressures from understaffing on the front line in clinical roles and more complex cases there are more negligence claims. This means more money spent on compensation and medical insurance. Hospitals which are doing worst therefore struggle to turn it around because they are handicapped by the penalties given out and get often caught in a catch 22.

Whilst money has been given to the nhs it hasn't been given to social care so medical beds get blocked by people who can't be discharged to bed at carehomes or home because they don't have support in place for that.

Add to that people having problems accessing GPs which was already an increasing issue particularly in some cities. This means preventative medicine isn't done so people present later with conditions which are more chronic and more serious rather than having early intervention and better management of their conditions.

Meanwhile everyone keeps complaining about taxes going up.

Then covid happened.

This is basically it in a nutshell, but also add lack of infrastructure.

The Population has grown massively and hospitals are woefully inadequate in size (and staffing especially clinical staff) to meet this growth.

Our hospital was at full capacity in winter with patients in corridors etc long before covid. And during both labour and the conservative governments.

Covid is basically the straw which broke the camel’s back. It added massive staffing issues: staff having to isolate (many have done 10 days multiple times), many staff retiring early, cev staff having to work from home, lack of space for distancing effectively therefore limited face to face appointments etc etc.

Add on poor pay levels (personally prior to the latest pay award my pay was unchanged from 2013) and changes being imposed to the pension which attracted many to work in the nhs in the first place.

Oh and (middle) management is awful. They really haven’t got a clue how things work day to day.

Oh and also wasted appointments are a huge problem in our department especially on the run up to Christmas.

We have so many cancellations on the same day which are all but impossible to fill. These patients all need to be rebooked. Also quite a few don’t turn up at all then phone and request another appointment which we have to give as it is our policy.

Also appointments which are sent by post are not received in time sometimes due to the poor postal times which can be a reason for the above.

I agree.

About 6 weeks ago I woke up with a racing heart and chest pains. I called my GP at 0800 and I got a call back about 1100. That may sound OK to some, but they thought I was having a heart attack. why wasn't I a priority? I was sent to A&E and told by the GP they would follow up with me a week later, but never did.

My A&E blood tests showed up some issues. I had to get someone external to look at it and tell me as my GP surgery didn't contact me after they got the results, despite the anomalies. After I chased them up I had further blood tests and had to chase up the results with them for 4 weeks. When I got them the GP said I had basically wasted their time as my blood results are not serious enough to warrant any immediate action and to test again in 6 months to see if had worsened.

Every time I went to my GP to do a blood test or pick up a prescription at the surgery, I was the only person there, or only one other, in mid afternoon on a week day. My GP is a supersurgery. The practice manager of my GP surgery has weekly front page articles in our local paper moaning about how hard it is for them and how people are complaining. Even our MP is looking into it.

I am now paying privately to have a medical and see a naturopath/ nutritionist before I become a stat on someones sheet.

@poorbuthappy

We don't need to pay more money - it will just be swallowed up by the black hole. We need a bloody revolution.

Providing healthcare isn’t immediately profitable on the whole. The wider effects of a decent system are, i.e a healthy workforce. Trying to generate a profit results in what we see in America.

Imho the rot truly set in when some bright spark decided that the NHS should model its finances and management on private business. You can cut costs to the bone (which is what has happened) but if you can’t provide the other side of the accounts and increase profits it’s simply never going to work. There are fines for numerous things in the NHS, missing targets mostly, so money is taken from NHS budgets to be paid to another NHS central budget. It’s ridiculous and costs so much to implement and monitor just to move figures around spreadsheets from one departments spreadsheet to another. There’s a marginal effect on making sure targets are hit but target pressure will only take you so far.

In my case DH, seeing the emotional state I was in, insisted I went for a private scan. This was the next day! Everything is OK thank god but that cost 450 quid plus the price of the consultant which we haven't even been billed for yet. The conspicuous thing is that it's the same consultant who you can't see for weeks on the NHS.

Severe long term staffing difficulties due chronic underfunding resulting in toxic working environments and high stress levels. Noone wants to work for us in a nutshell.