The NHS (National Health Service) Thread

[Parafox]

3 hours ago, Raj said:

My sister and I had anv appponitment at General at 1.30 yesterday to take my dad who has stage 4 kidney failure for a care plan consultation.

We got to his house rang his door numerous times, rang his telephone with no response( this is a common thing now as hes getting deaf too- hes about 86)I have the keys so let us in. Basically hes on the floor collapsed.

We ring 999 who say it's an EIGHT HOUR WAIT for an ambulance even though he'd  collapsed and with his fragile nature,(Hes about 6 stone now).

We rang General up to tell them about the appointment, they said we have cancelled it anyway due to the heat and ots now a telephone conference  call but didnt tell us!!

To say we were fuming is an understatement  as my sister drove down from Birmingham  especially.

Anyway we drove him down to AE and 1.30pm, but luckily we got seen and admitted into a bay by 6pm, which I suppose isnt too bad. We left him at 9pm as they said 50 patients are waiting for beds and it could take another 4-5 hours.

I walked around Infirmary  close to get a lift home and there were AMPLE ambulances  in the bays BUT they just dont have the resources when you get INTO hospital. I presume that's why it's an 8 hour wait?

Feel really sorry for the foot soldiers on the ground, the receptionists and initial people you see  at A and E especially as they seem non stop.

is this standard atm for people who work in nhs?

 

 

 

The "ample" ambulances in the bays would each have had a patient on board waiting to handover or the crew would be in A&E with their patient waiting for a clinician to hand over to. Crews are monitored for turnaround times as each arrival at hospital time is logged automatically as is the handover time. As a general rule in normal times, crews are expected to arrive, handover and call clear within 15 minutes. Hospital delays are preventing this from happening. It's common for crews to be waiting 6 hours to unload a patient. I know of some who have spent the entirety (and beyond) of their 12 hour shift waiting with a patient on board.

[Captain...]

On 17/07/2022 at 16:23, Fazzer 7 said:

In 2005 I ruptured my achilles tendon, It was a Spring Sunday around midday. My wife drove me to LRI. I was told the wait was 6-8 hours. We drove to Kettering and was seen almost immediately. Long waits at the bigger hospitals are nothing new. You’d have thought by now they could have had a better system in place. The NHS needs to evolve with the times instead of spending resources on bureaucracy and non medical staffing. 

 

55 minutes ago, Daggers said:

Err…sorry? When? Who shared this nugget of nonsense with you?

 

I can absolutely state there has been no point in the last decade where the wait time at KGH was 0 minutes. Sunday, it was missing 45 HCAs, 17 doctors and a whole host of admin staff. There was not one ED porter working at the start of the day. As a consequence it had breached yet again (an almost permanent condition) and had redirects requests in place to other regional Trusts - one of which was fully staffed but refused. Arguments ensued.

 

Staff can’t be found on whim because *checks notes* we told them all to f*** off with a braindead vote. Cover can’t be brought in because it either doesn’t exist, won’t work anti-social hours or tight budgets were destroyed by Covid. KGH currently functions on the last remaining strands of goodwill it has. It is not a paragon of the NHS functioning normally.

The above quoted anecdote, it was before the brain-dead vote. However I was just using it as an example where we can all find evidence of examples where the NHS I'd inefficient, badly run or seemingly non-sensical. However my point is...

 

 

On 17/07/2022 at 22:37, Captain... said:

I think my point was there is still room to improve the NHS, but politicians spend more time using it for their own political agenda and not focussing on making it the best health service it can be.

If the government stopped trying to find "solutions" to the "NHS problem" and accepted that to have an NHS fit for purpose we need to invest in staffing and actually build new hospitals and not just promise to to get elected.

[Raj]

1 hour ago, Parafox said:

The "ample" ambulances in the bays would each have had a patient on board waiting to handover or the crew would be in A&E with their patient waiting for a clinician to hand over to. Crews are monitored for turnaround times as each arrival at hospital time is logged automatically as is the handover time. As a general rule in normal times, crews are expected to arrive, handover and call clear within 15 minutes. Hospital delays are preventing this from happening. It's common for crews to be waiting 6 hours to unload a patient. I know of some who have spent the entirety (and beyond) of their 12 hour shift waiting with a patient on board.

Thanks for clarifying.Didnt know the situation with the ambulances in the bays.

12 hours to changeover in an ambulance?

Imagine that yesterday.

[Raj]

https://www.leicestermercury.co.uk/news/local-news/patients-held-hours-ambulances-outside-7351811

 

 

 

[Tommy G]

On 20/07/2022 at 06:52, Jon the Hat said:

Are they? I'm not so sure, especially given they have guaranteed funding and essentially no risk.

The execs are poorly paid - I meant

[kenny]

8 minutes ago, Tommy G said:

The execs are poorly paid - I meant

Chief execs are on £250k or so.

 

Regular execs are on £120-200k.

 

The secretary of state for health earns £145k for context.

[Tommy G]

6 minutes ago, kenny said:

Chief execs are on £250k or so.

 

Regular execs are on £120-200k.

 

The secretary of state for health earns £145k for context.

Exactly my point, in the private sector you could earn considerably more than that. 

 

 

[Raj]

The 3rd biggest employer on the planet after the chinese army and indian railways and every year more and more money pumped into it and it's still literally on its knees.

Tgey almost put a gun to your head to go private unless you want to wait for months.

We all have rose tinted spectacles when we talk about the nhs as no one is allowed to criticise it as if it's a holy grail.

Its broken.

[Alf Bentley]

1 hour ago, Raj said:

The 3rd biggest employer on the planet after the chinese army and indian railways and every year more and more money pumped into it and it's still literally on its knees.

Tgey almost put a gun to your head to go private unless you want to wait for months.

We all have rose tinted spectacles when we talk about the nhs as no one is allowed to criticise it as if it's a holy grail.

Its broken.

 

True, but multiple reasons for that (and I'm no NHS expert)....

- Aging population, so ever higher demand on NHS

- More money pumped in year-on-year, but not enough to match this increasing demand

- New treatments that often involve expensive equipment/medication

- Dysfunctional social care system, so thousands of old people well enough to be discharged stay in hospital needlessly bedblocking due to lack of social care

- The social care system is partly in crisis as successive govts have failed to address the problem and the Tories, in particular, have slashed funding to local govt, so care homes are barely viable, except for people with capital

- We've just had a 2-year pandemic, so there's a massive backlog of people needing postponed and sometimes urgent hospital treatment

- The Govt chose to cut funds paid to nurses during training

- For various reasons (Covid, Brexit, early retirements) we now have a tight labour market with a lot of vacancies. As lower-level NHS jobs are not well paid, there are recruitment/retention issues

- Increased inequality and poverty causes greater demand for healthcare

 

The NHS being "broken" is partly due to demographics and partly due to Covid backlogs, but an awful lot of it is due to the policy preferences of the Govts we keep electing: namely cutting tax for big business and the wealthy (with a few give-aways to keep the plebs on board) while slashing public spending on social care (and effectively on the NHS vis-a-vis increased need), as well as discouraging foreign labour via Brexit and yet doing sod-all to increase the supply of domestic labour.

[foxes1988]

2 hours ago, Raj said:

The 3rd biggest employer on the planet after the chinese army and indian railways and every year more and more money pumped into it and it's still literally on its knees.

Tgey almost put a gun to your head to go private unless you want to wait for months.

We all have rose tinted spectacles when we talk about the nhs as no one is allowed to criticise it as if it's a holy grail.

Its broken.

Nothing you've said here is unique to the UK.  all countries health care systems are at breaking point atm despite pumping more money in every year. The only reason the NHS is the 3rd biggest employer is our 'socialised' medicine.  Other countries have more in health care then we do but under different employers.

 

the benefit of this method is generally 'socialised' medicine is far more efficient for governance and financing costs then other methods such as the German, French or American methods.  Our problem has been for years we've under funded our system in comparison to the majority of the oecd and G7 countries

[BKLFox]

Whilst budgets are cut it still gets half the pie and anymore eats further into all the other sectors which we’ll then have threads on.

 

To start every single existing contract needs to be looked at, are they getting value for money, cleaning, catering, washing, supplies, consultancy in any field, those day care “taxi’s” that members of the public drive to get someone to a hospital then wait around & take them home, the daily rate is a joke & then everything else in between. 

 

We then as a population need to have a word with ourselves before going down and clogging up the A&E departments or GP surgery’s as in does it really need a visit, we also need to cut out the silly self inflicted things mainly caused by drink.

There is an annual cost paid out for medical negligence to the tune of £2bn+ that’s never mentioned and this will continue to get worse as more and more of those “law firms” entice us to make claims against the system.

 

I’ll mention the “deliberate health tourists” I know it won’t go down well with some but not sure why you wouldn’t fill up your car then allow someone else to drive it to empty for a week and hand it back would you.
These people travel to the UK with the sole intention of going to A&E for urgent, acute expensive surgery, this isn’t a bigotry comment it’s just highlighting another funding stream the NHS has to swallow.

 

Wages as pointed out above and I have before, 1 of largest employers in the world that’s a lot of the pot gone on Opex before a plaster is put on a child’s arm.

 

They can’t continue to chuck money at it, they need to be wise to where and what they spending it on.

[foxes1988]

1 hour ago, BKLFox said:

Whilst budgets are cut it still gets half the pie and anymore eats further into all the other sectors which we’ll then have threads on.

 

To start every single existing contract needs to be looked at, are they getting value for money, cleaning, catering, washing, supplies, consultancy in any field, those day care “taxi’s” that members of the public drive to get someone to a hospital then wait around & take them home, the daily rate is a joke & then everything else in between. 

 

We then as a population need to have a word with ourselves before going down and clogging up the A&E departments or GP surgery’s as in does it really need a visit, we also need to cut out the silly self inflicted things mainly caused by drink.

There is an annual cost paid out for medical negligence to the tune of £2bn+ that’s never mentioned and this will continue to get worse as more and more of those “law firms” entice us to make claims against the system.

 

I’ll mention the “deliberate health tourists” I know it won’t go down well with some but not sure why you wouldn’t fill up your car then allow someone else to drive it to empty for a week and hand it back would you.
These people travel to the UK with the sole intention of going to A&E for urgent, acute expensive surgery, this isn’t a bigotry comment it’s just highlighting another funding stream the NHS has to swallow.

 

Wages as pointed out above and I have before, 1 of largest employers in the world that’s a lot of the pot gone on Opex before a plaster is put on a child’s arm.

 

They can’t continue to chuck money at it, they need to be wise to where and what they spending it on.

It is a problem and they have put legislation in place to try and recoup money from helath tourists. Although the problem is largely overplayed. It costs the NHS at most 300million a year - or 0.3% of the nhs budget.  The majority of this is supposedly brits living abroad. So whilst Brits now living in Spain using the NHS when they travel back to the UK is annoying I'm not sure it's worth the costs and resources involved in stopping this when you consider many of them contributed to the UK taxes for many years and perhaps retired in Spain.

Edited 23 July 2022 by foxes1988

[BKLFox]

11 minutes ago, foxes1988 said:

It is a problem and they have put legislation in place to try and recoup money from helath tourists. Although the problem is largely overplayed. It costs the NHS at most 300million a year - or 0.3% of the nhs budget.  The majority of this is supposedly brits living abroad. So whilst Brits now living in Spain using the NHS when they travel back to the UK is annoying I'm not sure it's worth the costs and resources involved in stopping this when you consider many of them contributed to the UK taxes for many years and perhaps retired in Spain.

They can’t put a true figure on the deliberate health tourist could be £300m could be a lot more 🤷‍♂️ 

The cost of those everyday tourists just holiday is a lot higher at £1.8bn+ & I think it’s these costs they have a mutual agreement with with other nations but then that’s only about £500m recovered I assume monitored through the EHIC/GHIC scheme, watching sun sea & a&e we get our monies worth overseas also but just highlighting another cost the nhs has to swallow so let’s say shell out £2bn & only recover £500m so in the red either way.

[foxes1988]

6 minutes ago, BKLFox said:

They can’t put a true figure on the deliberate health tourist could be £300m could be a lot more 🤷‍♂️ 

The cost of those everyday tourists just holiday is a lot higher at £1.8bn+ & I think it’s these costs they have a mutual agreement with with other nations but then that’s only about £500m recovered I assume monitored through the EHIC/GHIC scheme, watching sun sea & a&e we get our monies worth overseas also but just highlighting another cost the nhs has to swallow so let’s say shell out £2bn & only recover £500m so in the red either way.

We do know roughly what the deliberate health tourist costthe uk as the department for health gave an estimate and it wasn't over 300 million. In actually fact it could be far less.  I agree that the NHS fails to claim back a significant chunk of foreign nationals that it could but they are not deliberate health tourists.

 

https://www.channel4.com/news/factcheck/factcheck-health-tourism-cost-nhs-billions

 

 

[Col city fan]

No staff. There’s a National shortage of staff across the whole MDT. 
We are relying on Agency staff and regular staff are leaving to join the Agencies (pick and choose your shifts, much better hourly rate).

Until there is some sort of parity in pay, this will just keep happening and my fear is that services may have to close

It’s a mess I’m afraid. The dedication is still there, the love of the job etc. It’s the other bits that are having such a huge impact.

[Col city fan]

8 hours ago, Alf Bentley said:

 

True, but multiple reasons for that (and I'm no NHS expert)....

- Aging population, so ever higher demand on NHS

- More money pumped in year-on-year, but not enough to match this increasing demand

- New treatments that often involve expensive equipment/medication

- Dysfunctional social care system, so thousands of old people well enough to be discharged stay in hospital needlessly bedblocking due to lack of social care

- The social care system is partly in crisis as successive govts have failed to address the problem and the Tories, in particular, have slashed funding to local govt, so care homes are barely viable, except for people with capital

- We've just had a 2-year pandemic, so there's a massive backlog of people needing postponed and sometimes urgent hospital treatment

- The Govt chose to cut funds paid to nurses during training

- For various reasons (Covid, Brexit, early retirements) we now have a tight labour market with a lot of vacancies. As lower-level NHS jobs are not well paid, there are recruitment/retention issues

- Increased inequality and poverty causes greater demand for healthcare

 

The NHS being "broken" is partly due to demographics and partly due to Covid backlogs, but an awful lot of it is due to the policy preferences of the Govts we keep electing: namely cutting tax for big business and the wealthy (with a few give-aways to keep the plebs on board) while slashing public spending on social care (and effectively on the NHS vis-a-vis increased need), as well as discouraging foreign labour via Brexit and yet doing sod-all to increase the supply of domestic labour.

All relevant and valid

👍

[sphericalfox]

6 hours ago, BKLFox said:

They can’t put a true figure on the deliberate health tourist could be £300m could be a lot more 🤷‍♂️ 

The cost of those everyday tourists just holiday is a lot higher at £1.8bn+ & I think it’s these costs they have a mutual agreement with with other nations but then that’s only about £500m recovered I assume monitored through the EHIC/GHIC scheme, watching sun sea & a&e we get our monies worth overseas also but just highlighting another cost the nhs has to swallow so let’s say shell out £2bn & only recover £500m so in the red either way.

Those are exaggerated numbers. There is a very small level of 'health tourism', and whilst on paper it looks like huge numbers, it's pennies in the overall budget of the NHS, and it would cost more to chase down the money in claims and legal claims than writing it off.

[BKLFox]

7 minutes ago, sphericalfox said:

Those are exaggerated numbers. There is a very small level of 'health tourism', and whilst on paper it looks like huge numbers, it's pennies in the overall budget of the NHS, and it would cost more to chase down the money in claims and legal claims than writing it off.

Do you do the books?

[sphericalfox]

12 minutes ago, BKLFox said:

Do you do the books?

I used to work in the NHS at every level including the Department for Health and in CCG finance.

[BKLFox]

1 hour ago, sphericalfox said:

I used to work in the NHS at every level including the Department for Health and in CCG finance.

Fair enough, I can only go over the many pages that quote these figures after studies done & as there is the deal for recovery of 500m it stands to reason the figure is higher than that which is looked to be recovered 

 

Point of my original post was to show hidden costs that are sucked from the nhs budget regardless of amount, they all add up

[filthyfox]

Well.  I was advised by mu consultant that I needed a CPAP machine.  This would ordinarily be available, for free on the NHS.

 

BUT, in Dorset there is no Doctor proficie t enough to issue one.  So, I spent £800 of my own money.

 

NHS is failing 

[Lcfcbl]

Why are people so against paying to look after their health? I spent around £20 on two prescriptions recently. My mate said "why are you paying when the smackheads get the methadone for free?"

I understand the point but I've just spent the equivalent amount of money to a round in a pub or a Domino's delivery to protect or better my health.

What is more important?

I think we are so used to having it for "free" (it's not free, it has to be paid for in some way i.e taxation) that people forget what's really important in life.

[leicsmac]

4 minutes ago, Lcfcbl said:

Why are people so against paying to look after their health? I spent around £20 on two prescriptions recently. My mate said "why are you paying when the smackheads get the methadone for free?"

I understand the point but I've just spent the equivalent amount of money to a round in a pub or a Domino's delivery to protect or better my health.

What is more important?

I think we are so used to having it for "free" (it's not free, it has to be paid for in some way i.e taxation) that people forget what's really important in life.

I would guess that at least some of them think that is a slippery slope to either having a lifetime of debt or (worse) not being treated at all because one can't afford to pay.

 

How much of a slippery slope that is is of course down to interpretation.

 

And while of course physical suffering and death are worse than any monetary issues, being forced into a lifetime of paying out for treatment for something that may not be your "fault" in the first place isn't exactly fun.

[Raj]

15 minutes ago, Lcfcbl said:

Why are people so against paying to look after their health? I spent around £20 on two prescriptions recently. My mate said "why are you paying when the smackheads get the methadone for free?"

I understand the point but I've just spent the equivalent amount of money to a round in a pub or a Domino's delivery to protect or better my health.

What is more important?

I think we are so used to having it for "free" (it's not free, it has to be paid for in some way i.e taxation) that people forget what's really important in life.

When i took my dad A+E on tuesday I'd  say 50% was people who havent looked after themselves or helped themselves in this situation I.e obese, smokers(there were loads of smokers who'd  nip out for a fag whilst still waiting to be seen, 3 hand cuffed prisoners assisted by coppers, and even a fee "high on drugs or alcohol" as they were overly hobby to the receptionists. The other 50% were elderly, genuine people just waiting for care.

 

I've worked for over 30 years, dont smoke , dont drink and try and look after myself.

Ive had one shoulder operation  done at spires in oadby via the NHS as they could accommodate me quicker.

I'd gladly move to private if I dont have to pay for the nhs. 

Give me any surplus money I've paid over the years and I'll go private and pay.

I'm sure others would do this to help the NHS  get back to its feet, then see what your left with.

 

[The Guvnor]

21 hours ago, Alf Bentley said:

 

True, but multiple reasons for that (and I'm no NHS expert)....

- Aging population, so ever higher demand on NHS

- More money pumped in year-on-year, but not enough to match this increasing demand

- New treatments that often involve expensive equipment/medication

- Dysfunctional social care system, so thousands of old people well enough to be discharged stay in hospital needlessly bedblocking due to lack of social care

- The social care system is partly in crisis as successive govts have failed to address the problem and the Tories, in particular, have slashed funding to local govt, so care homes are barely viable, except for people with capital

- We've just had a 2-year pandemic, so there's a massive backlog of people needing postponed and sometimes urgent hospital treatment

- The Govt chose to cut funds paid to nurses during training

- For various reasons (Covid, Brexit, early retirements) we now have a tight labour market with a lot of vacancies. As lower-level NHS jobs are not well paid, there are recruitment/retention issues

- Increased inequality and poverty causes greater demand for healthcare

 

The NHS being "broken" is partly due to demographics and partly due to Covid backlogs, but an awful lot of it is due to the policy preferences of the Govts we keep electing: namely cutting tax for big business and the wealthy (with a few give-aways to keep the plebs on board) while slashing public spending on social care (and effectively on the NHS vis-a-vis increased need), as well as discouraging foreign labour via Brexit and yet doing sod-all to increase the supply of domestic labour.

Add to that the legacy of private Financial Initiatives 

https://www.opendemocracy.net/en/ournhs/seven-things-everyone-should-know-about-private-finance-initiative/