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?

Needs funding proper and privatising

@inmyslippers

Needs funding proper and privatising

I can't see privatisation helping anything. It's not helped social care, the railways or energy companies.

I think the NHS is fantastic and, as an idea, is great

However it is management heavy and we (the public) take it for granted

My dd had a podiatry appointment the other day and there were four, 4, podiatrists there who stayed for the duration of the appointment.

All I could think was , about the waiting list!

Not always a great use of resources imo

I also worry about the wastefulness, all these PCR tests how much will it cost us all (and my kids)

Not enough long stay beds, mental health beds, elderly care, maternity beds so parients cannot be moved from acute areas
Closure of community hospitals and carehomes
People living longer wand need more complex treatments
Lack of home care so patients can be diecharged home
Understaffing for years
Staff burnout so people leave or retire early
Private hospitals dont have a&e or deal with acute emergencies so private patients need to use nhs even though they have insurance
Too many managers and not enough clinical staff to look after patients safely

I know someone who is an nhs doctor and has been off with long covid for well over a year on full pay. Still off, not showing much sign of being ill now. They’ve been offered 2 different part time roles to ease them back into work. They’ve refused both as ‘unsuitable’. So still off, on full pay until they offer something they ‘like’ no wonder funding is lacking….

Because there are no staff. Staff leaving in drones due to poor working conditions and being overworked. No increases in real time NHS funding for over a decade. Population becoming more complex medically so they need more resource per head and complex care.
It goes on and on.

Private doesn’t mean better. It’s the same staff. Just shorter waiting lists

Long term underfunded.
Social care meaning elderly patients stay in unnecessarily and then patients from A&E get stuck on trolleys and then ambulances queue up outside.
Wards are only allowed to order paper clips for £5 from the approved supplier but you can buy them for 20p from Tesco.
Change, wards and doctors get into ruts and don’t want to change how they work.
I’ll get shouted at for this one, but nurses that only work night shifts and see it as a quiet shift. The good nurses use this time when it’s quiet to fill in the discharge paperwork and get patients gone. Every ward knows who does and doesn’t pull their weight ore covid.
Outpatients clinics. Does the clinic really need 4 nurses standing by the desk for 2 consultants? Huge waste of time and money.
Pre covid vomiting bug outbreaks. Have you seen the lack of cleanliness and infection control in some places?
Complaints, patients have really good suggestions about care etc, but they’re batted away or not seen as helpful.
Communication. If someone’s waiting for something, a quick call saying I’ve passed it on and it will be dealt with in x weeks is less time consuming and stops you having to field weekly calls.

Infrastructure. My local hospital is lucky if half its lifts are working, has been like this for 5 years, it’s appalling.

@Testarossa44

I know someone who is an nhs doctor and has been off with long covid for well over a year on full pay. Still off, not showing much sign of being ill now. They’ve been offered 2 different part time roles to ease them back into work. They’ve refused both as ‘unsuitable’. So still off, on full pay until they offer something they ‘like’ no wonder funding is lacking….

There are 120,000 NHS staff from all roles currently off with long covid. Please be nice to the long covid person, it isn’t that they deem themselves below the job, until you’ve had long covid or seen it destroy a healthy family members career, they are really trying to work and function but it is absolutely horrid and life changing.

@Theturnofthepoo

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.

This. As someone who’s family members work in the NHS. This is true. You could throw millions and millions at the NHS and it still wouldn’t improve it until you sort out the weak links and where it’s haemorrhaging money.

By weak links I want to make it clear I mean crap middle managers (and higher ones) NOT the staff on the ground or admin staff.

@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.

Exactly This

@CovidMakesThingsHarder

There are 120,000 NHS staff from all roles currently off with long covid.
Please be nice to the long covid person, it isn’t that they deem themselves below the job, until you’ve had long covid or seen it destroy a healthy family members career, they are really trying to work and function but it is absolutely horrid and life changing.

I know, I lost my dad on the 27th September to covid, he was fit and well one day and gone the next. It’s bloody horrific.

@Floundery

There are 120,000 NHS staff from all roles currently off with long covid

I'd be really interested to see some private sector figures. Long Covid seems to be a luxury that people with typical private sector sickness terms (2 weeks full pay, 2 weeks half pay, then SSP) can ill afford.

Those people lose their jobs, or take a cut in hours and pay like my relative has done. It’s not something people do for fun/get to opt in and out of, it’s absolutely crippling for some people, needing actual care.

@Testarossa44 I’m very sorry, it’s shit isn’t it.

It is a massive organisation that is long past its prime. It has some great parts (A&E, acute stuff), some bad parts (anything to do with cancer), and some parts that are just broken and desperately need fixing (primary care, dentistry, mental health). Throwing more money at it is part of the solution but not the main part. There needs to be more frontline staff and more efficient management. There needs to be more focus on core services and preventative care, and on getting on with it when potential problems are detected (had to wait a year....a YEAR....until I got seen for a lump). There needs to be less fear of displeasing doctors, nurses and everyone else when these inevitable changes are needed. It needs to stop being a sacred cow used as a political football. The fault isn't this government's. Or the last one. Or the one before that. It's the UK as a whole: the culture of mediocrity and plodding along. it's not the government that is the problem. I am the problem. YOU are the problem. Face up to it.

I can only speak for my little corner of the NHS but the way it is run is completely counter to any principles of common sense or efficiency. I agree with those saying there are too many middle managers, I’m sure they’re all very busy but I can’t distinguish one from the other, in terms of job titles or duties. Patient care should be at the centre of all decision making but it really isn’t. Admin, bureaucracy and ‘projects’ of all kinds rule, taking up vast amounts of management time.

It’s all very well railing against privatisation but the NHS is a behemoth. Quite a lot of what goes on day to day makes no sense because it doesn’t improve anything for any actual patients but it happens anyway. I hate it and can’t wait to leave.

Had the same issue with breast clinic a few weeks ago, also went private.
Took dd for a gp appointment - rather than further investigation they gave me a prescription…..it was when the pharmacist took me aside when I went to collect it and said that in her opinion dd was far too young for the tablets given and I should seek a second opinion….I looked into it and she was right. They prescribed hardcore medication to a 9yo rather than investigate and double check the cause.
I’m chronically ill myself too - my gp (different to dd’s) has actually been great but in his own words the waiting time for referrals abysmal and 3rd world.

@loveandroses

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.

Why's that conspicuous?

They have a job for the NHS. They work 40 hours per week as standard and have to offer to work a further 4 hours a week for the NHS if they want to do private work AND maintain pay progression etc.

I think NHS staff should be more than entitled to do any extra work that they want to do in their free time, for whatever the market rate that people are willing to pay is.

Gp surgeries spend too much time on paperwork much of which could be given to the patient.

In France any test results are the responsibility of the patient and the laboratory will tell you whether or not to consult your gp when they email them to you.
My mammogram scans and report are all held by me and I take them to my next scan.
Were treated like adults.
And it frees up the doctor's time.

The issue has been underfunding in the right areas, and bloated middle management layers.

We are spending record amounts of money on an aging population when in years gone by they would not have been treated. I was reading an article a couple of weeks ago about an 80 year old being given a surgery for cancer that would cost hundreds of thousands of pounds to give them an extra 6-12 months of life. Sadly sometimes I think we may have to see if this is a right use of funds.

The nhs contracts are a joke and the amount of money they spend on items is ridiculous, also the money that is wasted on items not suitable etc.....

The nhs needs complete reform and we need to look at countries like Germany, Australia et al for their systems. The nhs was a brilliant invention all those years ago. Now it needs total reform.

The vaccination site at our local major hospital was a lesson in basic ineptitude. Some complicated version of numbered musical chairs which you kept moving by a harried volunteer that was getting some jip from ungrateful low life sorts and half the incoming folk looked overweight, unhealthy and the sort of folk that the medical profession must despair of where do you start with trying to improve their health and life prospects.

Therein lies the problem of the pandemic and our society it's the appalling health of a significant minority that is causing the greatest pressure on our system and covid has finally toppled the NHS. If you can afford private then it's the only way to go now - your health or a holiday and I'm retired so can spend endless time trying to navigate the system. For the less savvy or time-limited folk it's no longer fit for purpose as wonderful and caring as so many of the staff most obviously are.

It’s been shit for years. We all need to pay more for it to be worthwhile having.

We don’t even bother using the NHS now as we have private healthcare we pay monthly for and then pay each time if any of us need to see a GP.

From the Kings Fund:

The NHS in England is a £100 billion-a-year-plus business. It sees 1 million patients every 36 hours, spending nearly £2 billion a week. Aside from the banks, the only companies with a larger turnover in the FTSE 100 are the two global oil giants Shell and BP. If the NHS were a country it would be around the thirtieth largest in the world.

If anything, our analysis seems to suggest that the NHS, particularly given the complexity of health care, is under- rather than over-managed.

From personal experience, a large proportion of management are actually ex-clinical staff, many ex-nurses, so the assertion that they don't know what goes on in hospitals, is also somewhat inaccurate.

However, also from personal experience, the number of incompetent staff who are "let go", seem to walk in to other jobs with ease, the ever-revolving door of NHS employment opportunity, because they won't recruit from industry, only from within their own cohorts.

I’m missing the point slightly here but if they’re capable of making a phone call, they are capable of doing zoom appointments.

Ok doesn’t need to be every single one as plenty of things can be discussed without being seen but you’d think they’d establish this when making the appointment - considering the receptionists need to know everything anyway - then mark those who need zoom instead of a call.

There’s no or very little cost difference and it takes 20 seconds to click on the icon on the screen any type someone’s email address in.

Perhaps infrastructure or security? I don’t know. But they’ve had coming on two years to work it out.
If you’re not offering face to face then at least offer video consultations!

You’ve got Elon Musk flying into space but we can’t get our GPs to work out the most basic of digital communications