It's not only paramedics who are struggling..
Having spent what seems like most of the day in chemists, firstly for MrsT and the MrT senior it would seem that GPs , chemists and drug suppliers are also in crisis!! One chemist dubbed today inhaler day due to the number dispensed and the fact they had none left including the one T senior needs 🙄
Whilst waiting for my stuff it was obvious that other people were suffering from shortages and the number of times "sorry" was used by chemists staff was unreal.
Then I went for diesel only to find my local Esso garage empty and others with pumps locked off!!
Due to the change in weather in a short period as it typical when that happens those with COPD really struggle so need more meds. Then there's those that stock up for over the Xmas period,
I'm asthmatic and not felt any change.
T senior however is 85 with well dodgy lungs, heart, joints etc, been through A&E 3 times so far this year. I was just prodding his GP who tends to diagnose via telephone as much as possible due to old man living out in the sticks!!
MrsT is on an immune system suppressant due to a degenerative illness, has had her flue jab but still been bed ridden since last Thurs with little improvement. Double does of The usual antibiotic prescribed yesterday.
T Jnr is also asthmatic but manage a 5ml run in Whinlatter forest on Saturday night having forgot his inhaler!!
My biggest issue is with the increase in wood burners 👿
I'm asthmatic and not felt any change.
I've picked up dozens the last week or so several in one night but most were COPD.
One local hospital to me has cancelled all elective surgery and handed the wards over to medical admissions as they are swamped with medical problems.
Another local A&E had ambulances queuing up as they couldn't be seen quick enough
Really mild autumn, now winters kicking in not really a surprise.
[i]Another local A&E had ambulances queuing up as they couldn't be seen quick enough [/i]
No, this is due to some stupid politician introducing the 4 hour 'rule'; consequentially if they're not let out of the Ambulance then the clock doesn't start 'ticking'. All they're done is tied up the Ambulance and crew, folk are still waiting (as they are busy).
We filled 17 empty trauma beds on Thursday night alone.
Acute medical ward in Aberdeen had a 2 hour wait to admit new patients last night, and they were the patients with confirmed admission between ward and GP.
I was also on scene waiting for a transporting ambulance for 45 minutes with a 12 year old knocked down by a car this morning.
Another local hospital to me had absolutely no spare beds yesterday.
B r I can assure it was nothing to do with 4hr wait. It was a lack of A&E doctors and volume
[i]B r I can assure it was nothing to do with 4hr wait. It was a lack of A&E doctors and volume [/i]
[b]At one hospital, Queen Elizabeth in Woolwich, 209 patients waited more than an hour in an ambulance between July and September. Over the same period across London, 5,852 patients waited in an ambulance for more than 30 minutes - double the 15-minute maximum.[/b]
Yes, but because of the 4-hour wait time now in A&E whereas previously the patients would've been brought to wait in A&E they are now still in the back of an ambulance - tying up that resource.
I saw it in the NHS I worked, where they'd employed extra Managers/Admin to 'chase' patient through so they didn't break the 4-hour 'rule'.
Loads of sticking-plaster solutions with no overall strategic aim.
B r - if you insist, but I know that not to be the case at the hospital I mention. When you don't have enough doctors, too many people arriving, no spare beds, it has **** all to do with avoiding 4hr breaches.
It's nothing to do with the 4h target most of the time in London, it's mainly down to a lack of beds in the A+E departments.
It also doesn't help that some areas have had their A+E's closed and others have had their services limited so you now have fewer hospitals and therefore fewer beds to deal with a larger volume of patients. It's been horrendous from an ambulance point of view so far this week so god only knows what it's going to be like this weekend when Christmas party season really kicks off.
If it's one or two weeks out of 52 where they reach maximum capacity then it sounds like the NHS is correctly sized. The rest of the year they are running with good contingency.
LHS - I wish it was the 1 or 2 weeks of the year, but it is not. For a year/ 6 months the system has been on the edges of capacity. It should be this over capacity at the moment. Jan/Feb should be the busy times.
Speak to anyone who works in the service and they say this is just the start of a huge failure of the system.
Not enough beds, doctors, nurses, cash...
Of course there is a General Election just around the corner so people are pinning their hopes on a big cash injection pre election.
BR - moving patients around from one location to another has been happening for at the last decade. When I went to A&E with Bilary Colic I was moved onto a ward only to be moved back into A&E later so that they could meet the waiting time targets. My Grandma was moved from one waiting list for an operation onto others so that she wasn't exceeding a waiting time. She died waiting for her op.
Trekster - This won't make you feel any better but I have been having inhalers virtually rammed down my throat. I was diagnosed with COPD (Asthma) while I had a chest infection. I've never had an Asthma attack before or since. I requested further tests at the hospital which all came back clear. The doctor still refused to remove the COPD from my medical records and chastises me for not renewing my inhaler that I have never used yet.
It's run like any other business, people will always make the case that they need more funding etc etc. I work very closely with a lot of people in the NHS and it's not as bad as being portrayed regarding capacity. Wages / retaining talent is a big big problem, capacity not so much.
[i]It's run like any other business, people will always make the case that they need more funding etc etc. I work very closely with a lot of people in the NHS and it's not as bad as being portrayed regarding capacity. Wages / retaining talent is a big big problem, capacity not so much. [/i]
Agree.
And in the NHS I worked audits consistently showed that +30% of patients should not have been occupying beds, but elsewhere in the 'care' system. I live in a Gods-Waiting Room type area.
For me it's really simple, moving budget from hospital into the care-home (ie budget follows patient) would help here.
My wife's in for a routine but fairly big surgery currently - she nearly wasn't admitted over a bed shortage and then was kept in recovery until late last night because the ward had no spare space where they were still discharging patients late on into the evening.
The NHS is fabulous but the bean counters and target based management manipulating numbers to hit targets, such as the ambulance case above, is disgraceful.
The NHS is fabulous but the bean counters and target based management manipulating numbers to hit targets, such as the ambulance case above, is [s]disgraceful[/s] human nature.
It's just down to systems which have no capacity, even for predicted events. Not enough A&E beds, not enough beds in the main admitting wards to receive people from A&E, not enough well people discharged efficiently into the community to free up those beds.
Sometimes that is due to lack of funding, sometimes due to inefficient systems at GP/hospital/local authority level, sometimes a combination of all of these.
This winter could well be a bit of an eye-opener, though. We got away with it last year due to the mild weather.
Flu should kick in properly after Christmas.
LHS - the hospital I work at has been running at over 97% occupancy for the last three months, and we are the only one locally that has never closed it's doors to admissions, so the others must have been even more full. We've cancelled elective surgery as all the surgical beds are full of emergency admissions and my department regularly seizes up now as we have outflow problems for the 'admitted' patients - nowhere for them to go meaning no space for me to see my own patients.
Don't come telling me there isn't a capacity problem... We've been having a winter crisis since September with several of our busiest weeks ever recorded and we haven't even hit the true busy period of January/February yet.
The Paeds (kids) ED dept in Derby is running at over 30K admissions per year, compared to 18K admisions when it opened 6 years ago
Most of this is from the GP's and walk in centres locally being crap and knowing that the kids will get seen quickly so they just send them in to the hospital without dealing with them themselves - somethign like 80% just get sent home, but it all clogs the system up
So not all the fault of the managers and system, some of it is our fault !
It's run like any other business, people will always make the case that they need more funding etc etc. I work very closely with a lot of people in the NHS and it's not as bad as being portrayed regarding capacity. Wages / retaining talent is a big big problem, capacity not so much.
I don't think the NHS needs more money, they just need to spend what they have better.
As for capacity, it's definitely a capacity issue, staff retention is a huge problem within the trust I work for but even if we were fully staffed, capacity would be as much a problem, if not more so.
Ambulance services and hospitals are seeing far higher numbers of patients, many of whom are very sick. They need hospital beds be that in A+E or on wards. If you don't have the beds then it's a capacity issue which can't be resolved by anything other than having more beds.
The problem is partly a simple numbers game, GP surgeries open from 8:00-18:00 5 days a week are providing only 50 hours front line service from a week of 168 hours, hence, A&E are picking up the rest.
You also need to look at why there has been a big increase in people using the NHS over the last 10+ years, obviously aging population will count for some, but you have to query whether NHS diagnosis and treatments are effective.
Last year found a cyclist fell off his bike, 45 mins for a paramedic, in a car another 45 mins for an air ambulance, nearest hospital about 6 miles away.
Earlier this year, 84 year old freind, fell over outside house, broken leg and hip.1.5 hour wait for an ambulance, they where all waiting to unload at A and E.
Patient collapased outside local hospital, 1.5 hrs for an ambulance to take her to a and e, lying on floor.
Lack of funds, slow handovers, no beds, poor management higher up the chain, patients wanting an ambulance when they could get a a taxi or a lift in a freinds car,just because theyve drunk to much or got a headache ,hurt their foot 3 weeks ago etc.
If it's one or two weeks out of 52 where they reach maximum capacity then it sounds like the NHS is correctly sized. The rest of the year they are running with good contingency.
😆
Really? Well I've worked in the NHS for 25 years, I've seen the workload increase each year. The last 5 years massively so and the last 2 years particularly this year at a fantastic rate. As a manager too I can access the stats at work, the figures are incredible. They've ran near, on and above max capacity in most hospitals around here for months. The sudden pressure that has happened over the last 2 weeks or particularly the last few days is at levels I've never seen.
Today was staggering, I've been in 3 hospitals today on this area. The first has people lining up in the corridors which is the norm every day all day and night for the last 18 months, the 2nd I waited over an hour to handover they had crew lined up the corridor something I've never seen. I've just got home where I left Dr_Death's hospital it was jammed in the waiting, as it is most days, I then opened the door into paeds which had people standing down the corridors waiting to be booked, in kids on trolley waiting to be seen. I've never seen it like that ever in that area.
You picked a good time to be off Dr_Death.
I work very closely with a lot of people in the NHS and it's not as bad as being portrayed regarding capacity.
It's worse if only the media knew.