Crisis in the NHS

[jonthefox]

2 minutes ago, Bryn said:

 

 

Sorry mate, I don't mean to be a cock but you have to laugh. Tissue viability refers to a clinical nurse specialist, whose sphere of expertise is deep or poor healing wounds. For example, arterial ulcers or diabetic ulcers. It's a senior, specialist nurse role.

Christ, even the Mrs didn't know that. 

My point remains though. Enough money,  just wasted.

[Carl the Llama]

If only there was some way we could guarantee, say, £350m/week of funding to the NHS... 

[jonthefox]

10 minutes ago, Carl the Llama said:

If only there was some way we could guarantee, say, £350m/week of funding to the NHS... 

Send the NHS to play in the Chinese league.

[MONreborn]

In 2010 satisfaction with the NHS was highest. Waiting times at record lows. But intentional mismanagement, reorganisation had led to managed decline. The tory bastards are getting it ready for privatisation. 

[Izzy]

3 hours ago, surrifox said:

Anything that is delivered free at the point of use runs the risk of being undervalued . I have some experience of the administration aspects of the NHS - based upon a very limited area of activity you would be staggered at the number of people booked for procedures ranging from scans to major ops who without any form of excuse fail to attend their appointment . This leaves expensive medical professionals booked and paid for with nothing to do on occasions . Trusts are spending a large amount contacting people to confirm their attendance  

it's utterly ridiculous 

Good point well made.

I had an appointment with a Consultant recently and had two letters, two phone calls AND a text reminder to attend. It felt like overkill but I definitely felt obliged to attend (I would have done anyway without all the reminders as it happens). I never really considered WHY they went to so much trouble to make sure I attended, but your post explains it really clearly. Thanks

[Parafox]

Gov't are now saying GP surgeries should open 12 hrs a day 7 days a week or lose their funding.

 

There is a definite link between lack of GP access and A&E attendance.

 

GP's won't be happy

[SystonFox]

14 hours ago, jonthefox said:

That was one ward in a unit of six , in one hospital, in one city. You get the picture I'm sure. The other point you quoted was the nurse. Doesn't paying someone that sort of figure to check the tissues are suitable seem ridiculous?. If you need anymore examples of NHS waste , I have a bag full of them. 

Tissue vialibilty nurse.

 

not Andrex checkerer

[Strokes]

12 hours ago, MONreborn said:

In 2010 satisfaction with the NHS was highest. Waiting times at record lows. But intentional mismanagement, reorganisation had led to managed decline. The tory bastards are getting it ready for privatisation. 

 

[MONreborn]

20 minutes ago, Strokes said:

 

Why is that funny? If you look at our countries spend as a percentage of our total yearly income  on the NHS compared to any other country in the EU it is amongst the lowest and will be the lowest by the time of 2020. The governent  has reduced the number of beds whilst demand is rising. I work in the NHS and can see it first hand. They in 2012 opened up the NHS for private investment - this is costing 11 billion out of the 100 billion budget to just administer. Blair and his cronies also contributed by PFI. Successive government are getting it ready for privatisation and a USA style insurance system. If you can afford it you will be covered. Although I fear it will be the middle classes which will be futter squeezed as politically the governent will have to say those in low or no pay dont pay. However, when will the governent realise we already have national insurance. Its an absolutely planned national disaster propagated by successive governments, planned by thatcher and co in the 80's and slowly applied and now accelerated by cameron and may's governemnts. Jeremy hunt, the man even wrote a book on how to privatise the NHS. 

[Sharpe's Fox]

GP's are under just as much pressure. Every week the government shows just a bit more that they don't have a clue how to run the service, or that they know exactly what they're doing to dismantle it. I don't know which is worse.

[yorkie1999]

14 hours ago, Carl the Llama said:

If only there was some way we could guarantee, say, £350m/week of funding to the NHS... 

The only place that 350 million is going is back into private industry to be siphoned off by mp's. Why waste it on rif raf.

[Rincewind]

To quote Theresa May 'Crisis? What crisis?'  To quote from a children's story, 'The emperor is wearing clothes.'

 

I wonder how many MP's of all parties have interests in the private pharmaceutical and medical industry? Of course they could not do it openly but I am sure there are a few. 

 

Here is one link.

 

http://nhap.org/what-you-can-do/facts-fingertips/links-between-mps-lords-and-private-healthcare/

 

I know the link is just over 2 years old but all these people would not have severed their links.

There is also a list showing links to peerages and donations.

Politics is a dirty business.

[Guest MattP]

14 hours ago, MONreborn said:

In 2010 satisfaction with the NHS was highest. Waiting times at record lows. But intentional mismanagement, reorganisation had led to managed decline. The tory bastards are getting it ready for privatisation. 

Wasn't if you died on a trolly at mid-Staffs.

[Bryn]

3 hours ago, Parafox said:

Gov't are now saying GP surgeries should open 12 hrs a day 7 days a week or lose their funding.

 

There is a definite link between lack of GP access and A&E attendance.

 

GP's won't be happy

 

Again showing their disgraceful lack of understanding. Do people really think General practitioners spend the time in between their surgery appointments twiddling their thumbs and playing golf?

 

My final placement of my second year of foundation training was in general practice. Let me tell you what my GP trainers typical day went like.

 

0700: Arrives at work. First patient arrives at 0830, occasionally at 0800. Needs to use that time to respond to all correspondence. This includes letters, both clinical and administrative (do not forget that in addition to being a clinician, a GP partner is also running a business and will likely also be a part of the Clinical Commissioning Group for the entire region's healthcare administration) and test results (including needing to cast on eye on anything organised by trainee doctors as he is responsible for their training so there can be be GPs in the future). Hundreds of documents requiring  analysis and actioning.

 

0830-1200: Morning surgery. Ten minute appointments. My GP trainer was committed to working with difficult patient groups in an inner city practice, including learning difficulty patients and the homeless. That is in addition to the overwhelming number of elderly patients, some of whom are poorly mobile and might take a full ten minutes just getting into the room and then getting undressed and dressed for examination if required. The fully qualified GPs take it in turns to supervise trainee doctors and medical students and so often have to see patients with them too, not to mention sometimes patients are taken ill in a general practice and require emergency treatment. Where emergency referral to hospital is required that entails sitting in a telephone system to get through, that can take ten minutes or more. All the while the phone won't stop ringing, the GP is responsible for looking after local nursing homes and triaging same day appointments (most appointments are same day now to meet acute needs, that is why you can't get a routine appointment for months). Clinic inevitably runs late.

 

1200-1400: That lovely lunch break the Daily Mail thinks GPs take. More correspondence and making of referrals. Fielding queries from district nurses. Home visits; yes, these are still a thing. Unwell patients with poor mobility must be seen at home, some are seen multiple times a week. Patients requiring end of life care must be reviewed and medications adjusted. The aforementioned nursing homes are visited. Lunch is eaten in the car or at the desk, if at all.

 

1400-1830: Evening surgery. As above. Usually ends late.

 

1830-????: I've known my GP trainers leave work at 9pm or later because they're still dealing with paperwork, referrals and still trying to sort out complex patients.

 

This isn't atypical.

 

Furthermore, pilots have shown that weekend and bank holiday appointments are rarely taken up. And as with the junior doctor contract issue, many GPs do work out of hours. Usually in any given area the practices team up and take it in turns to provide out of hours care.

 

General practice is already on its arse. It cannot fill its training posts because it is a broken system. It sees the overwhelming majority of NHS patients for a sliver of the budget and already deals with intense patient dissatisfaction, some of it highly unreasonable. These doctors need to eat, sleep and train sometimes, forcing them to work the hours the public think they don't already or fining them will finish the system off. If the Government wants to fulfil these lovely sound bites they need more doctors  and  more resources. It is simply yet another ignorant and callous attempt to shift blame for poor government onto frontline staff.

[Izzy]

21 minutes ago, Bryn said:

 

Again showing their disgraceful lack of understanding. Do people really think General practitioners spend the time in between their surgery appointments twiddling their thumbs and playing golf?

 

My final placement of my second year of foundation training was in general practice. Let me tell you what my GP trainers typical day went like.

 

0700: Arrives at work. First patient arrives at 0830, occasionally at 0800. Needs to use that time to respond to all correspondence. This includes letters, both clinical and administrative (do not forget that in addition to being a clinician, a GP partner is also running a business and will likely also be a part of the Clinical Commissioning Group for the entire region's healthcare administration) and test results (including needing to cast on eye on anything organised by trainee doctors as he is responsible for their training so there can be be GPs in the future). Hundreds of documents requiring  analysis and actioning.

 

0830-1200: Morning surgery. Ten minute appointments. My GP trainer was committed to working with difficult patient groups in an inner city practice, including learning difficulty patients and the homeless. That is in addition to the overwhelming number of elderly patients, some of whom are poorly mobile and might take a full ten minutes just getting into the room and then getting undressed and dressed for examination if required. The fully qualified GPs take it in turns to supervise trainee doctors and medical students and so often have to see patients with them too, not to mention sometimes patients are taken ill in a general practice and require emergency treatment. Where emergency referral to hospital is required that entails sitting in a telephone system to get through, that can take ten minutes or more. All the while the phone won't stop ringing, the GP is responsible for looking after local nursing homes and triaging same day appointments (most appointments are same day now to meet acute needs, that is why you can't get a routine appointment for months). Clinic inevitably runs late.

 

1200-1400: That lovely lunch break the Daily Mail thinks GPs take. More correspondence and making of referrals. Fielding queries from district nurses. Home visits; yes, these are still a thing. Unwell patients with poor mobility must be seen at home, some are seen multiple times a week. Patients requiring end of life care must be reviewed and medications adjusted. The aforementioned nursing homes are visited. Lunch is eaten in the car or at the desk, if at all.

 

1400-1830: Evening surgery. As above. Usually ends late.

 

1830-????: I've known my GP trainers leave work at 9pm or later because they're still dealing with paperwork, referrals and still trying to sort out complex patients.

 

This isn't atypical.

 

Furthermore, pilots have shown that weekend and bank holiday appointments are rarely taken up. And as with the junior doctor contract issue, many GPs do work out of hours. Usually in any given area the practices team up and take it in turns to provide out of hours care.

 

General practice is already on its arse. It cannot fill its training posts because it is a broken system. It sees the overwhelming majority of NHS patients for a sliver of the budget and already deals with intense patient dissatisfaction, some of it highly unreasonable. These doctors need to eat, sleep and train sometimes, forcing them to work the hours the public think they don't already or fining them will finish the system off. If the Government wants to fulfil these lovely sound bites they need more doctors  and  more resources. It is simply yet another ignorant and callous attempt to shift blame for poor government onto frontline staff.

Whenever my GP rings me to discuss my regular blood test results, it always after 8pm and he's always still at work. The bloke works his nuts off and is a bit of a local hero to many. 

[Webbo]

My mother's GP was a disgrace, wouldn't even do a home visit when she was dying in her bed, never arranged her care plan as he was supposed to do. I'm sure there are a lot of good GPS but there are plenty of w@nk<rs too.

[Bryn]

5 minutes ago, Webbo said:

My mother's GP was a disgrace, wouldn't even do a home visit when she was dying in her bed, never arranged her care plan as he was supposed to do. I'm sure there are a lot of good GPS but there are plenty of w@nk<rs too.

 

Yeah and this is something that bothers me, the lack of priority given to end-of-life care by many doctors. Senior doctors are actually often very poorly trained in palliative care; as a third year qualified doctor who did a palliative care placement as a foundation trainee I probably provide superior end-of-life care to many consultants. I think there will be a shift in the next few years because my generation of doctors are better trained and more aware.

 

There are defininitely subpar doctors, it is a slightly side issue though.

[MONreborn]

5 hours ago, Bryn said:

 

Yeah and this is something that bothers me, the lack of priority given to end-of-life care by many doctors. Senior doctors are actually often very poorly trained in palliative care; as a third year qualified doctor who did a palliative care placement as a foundation trainee I probably provide superior end-of-life care to many consultants. I think there will be a shift in the next few years because my generation of doctors are better trained and more aware.

 

There are defininitely subpar doctors, it is a slightly side issue though.

 

Where are you working Bryn? Ive just finished my FY2 last September. The increase in demand and decrease in resources has been palpable from starting even in 2014 to now. 

[Parafox]

On ‎1‎/‎14‎/‎2017 at 10:33, Parafox said:

Gov't are now saying GP surgeries should open 12 hrs a day 7 days a week or lose their funding.

 

There is a definite link between lack of GP access and A&E attendance.

 

GP's won't be happy

 

I think it's a smokescreen to blame GP's although that said, when I need to speak to a patients GP in order to safety net them if I intend to leave them at home, I often find surgeries are closed one afternoon a week and there's no-one to get advice from so that patient goes to A&E. Closing the whole surgery for half a day does seem bizarre.

 

It's not down to GP opening hours in particular, but the lack of social care and cuts in NHS funding, despite what they say about more money forthcoming. The Gov't won't admit that so seek to shift the blame elsewhere.

[Bryn]

On 14/01/2017 at 20:13, MONreborn said:

 

Where are you working Bryn? Ive just finished my FY2 last September. The increase in demand and decrease in resources has been palpable from starting even in 2014 to now. 

 

I'm not, took a break. Going back to Gloucester soon, looking at moving out to Australia when the time is right.

[Izzy]

I had yet another MRI scan today.

Just like before, the whole process and experience from start to finish was first class.

The NHS staff always do a wonderful job of explaining things to me and I feel genuinely cared for.

I keep reading about this NHS 'crisis' but I always find things incredibly efficient. Maybe I'm just lucky with my GP, Consultant and nurses, but I couldn't recommend them highly enough.

I always leave thinking how fortunate we are in this country to have the NHS. Whatever is causing the so called crisis, I hope they sort it out. But I've certainly never experienced it as the 'end user' if you like....

[Izzy]

Sat in the waiting room at John Radcliffe hospital Oxford now. The big screen info says 66,385 appointments were missed by patients in Oxfordshire hospitals alone last year. That equates to £9.5m or 360 extra nurses apparently.  And that's just one county. I get the whole 'NHS in crisis' thing but it made me realise we've also got our part to play too. Just found it interesting so thought I'd post it 

[The Guvnor]

This isn't discussed too often, was aware of this but had no idea how much this will cost the NHS, what a balls up.

http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html

 

 

[Strokes]

1 hour ago, The Guvnor said:

This isn't discussed too often, was aware of this but had no idea how much this will cost the NHS, what a balls up.

http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html

 

 

Yep and it's supposedly the tories that can't be trusted to run the NHS 

[ajthefox]

It makes for very grim reading, seeing the amount of money being charged for those hospitals that is no doubt lining someones pocket at the expense of so many sick people.

 

The Coventry/Warwickshire trust hospital was built for £369m and is costing £3.9 billion. How the fvck does that happen? Surely no-one agreed to a deal that meant paying 10 times as much? It's insane. This year's payment is just under a quarter of the build cost....