[Closed] The NHS isnt working

Doctors are silly expensive because they are so highly trained, on a par with lawyers etc and compared to them we are cheap

Lots of old dr roles have been changed down over the last 10-15 years. Whilst it might be efficient to have more and more specialist nurses, we are getting more and more poorly trained drs because someone els clerks and examines the patient , takes the blood, puts the catheter in etc etc. We have noticed that the newer breed of gp trainees suffer with decision making in practice because theyve never had to make any. When its one patient per 10 min slot it really is sink or swim oclock.

There is no doubt this is also having a knock on effect on surgeon and physician training also.

15 minute calls!!!! 😯 I'm a visiting support worker and as rustyspanner says doing everything in the allotted time isn't easy when you have to do personal hygiene, meds, meals, washing, cleaning and recording, we get an hour and that's pushing it sometimes, 15minutes is insane, I met another support worker the other day who works for a private provider who didn't get traveling time between jobs, her visits could be upto fifteen miles apart and all her jobs were one after the other nonstop, for £6.80 an hour
She didn't have a company harrier jumpjet either, but her boss has a porsche, it's not good at the mo, 😕

Only it's not bollocks, it's trying to understand why patients don't get the care they deserve. Where's the bit where the nursing staff get to have their say?

And for what it is worth, for the most part, the care I have seen in my recent experiences of the NHS (too many and too sad to go into) have been very good.

Northwind.

Indeed I do think it is unreasonable. Have you got kids?

I did type a good few paragraphs of rant. But I shall pare it down to one point. The biggest bottleneck in the NHS is access to many expensive technologies they have on offer from 9 till 5, 5 days a week. Hundreds of millions of pounds of equipment sat idle for more than half the time Monday to Friday and almost certainly idle at the weekend. Tell me what industry in this country operates on similar lines? I am a Socialist at heart too!

Privatise it! That's proved the solution to the problems of every public service. I mean.... just look at the railways

They need to get a company like Southern Cross involved. They can show those public sector dullards how to do care and make a profit at the same time.

Schools and univercities have a lot of equipment, grounds and staff not being used for huge parts of the year, and every weekend as well.

[b]Northwind[/b] Having done 6 months Paediatric Casualty in a first world country (not this one or the US) I'd beg to disagree...

Northwind.

As a gp i would happily work weekends and evenings if the rota was sustainable and i wasnt working 90-100 hrs a week depressed / burnt out /and therefore providing poor care.

To access all services 24 / 7 7 days a week you would need a huge increae in the number of doctors / nurses/ x ray staff ... The list goes on and on to cover a tesco healthcare culture

The country cannot afford/ taxpayers arent willing to pay for this. Therefore most non emergency services are 8-6.

I caught CDiff from the hospital when I had my daughter and had to go back into hospital for a week in quarantine - I was still breastfeeding my new baby yet the nursing staff couldnt be bothered sometimes to bring in my meals (sometimes in a row too so I would go for a whole 24 hours with not even any water) and the nursing staff where shocking - very rude! when i asked for some water they told me to drink it out of the bathroom tap! - they constantly forgot my antibiotics and when I would buzz to remind them (I wasnt allowed out of the room) they would slam the doors. I was left in bloody sheets (they put my iv in wrong) and was refused anything to change my daughters nappy on. But the worst thing was that hardly any of the nurses washed their hands when leaving or wore the protective clothing they should have worn to come into the room and the obs equipment that was allocated to my quarantine room was taken out in the middle of the night so I dread to think how many others in the hospital caught cdiff. Im now very scared of ever having to go to hospital!

uphillcursing - Member

Northwind.

Indeed I do think it is unreasonable. Have you got kids?

No, but I was one once. Apologies, I hadn't realised this was one of those subjects where only parents can have an opinion.

But I think this highlights the problem... Any system whereby a five hour wait for a nonlifetheatening injury gets classed as "3rd world", is clearly never going to meet people's expectations.

danadem

Did you report any of that to the hospital?

i hate to be one of them moaners about the nhs but my mothers just come out of hospital and i'm not happy with what i saw, my mothers not that old either.
no water even after promises from the staff to bring it along, my mum didnt want to make a fuss..!!!.!!
medication delivered late and delayed.
they did tell me to leave though when i turned up and the rest of the family was still there as there was 5 of us in total, fine i except that and left but my blood boiled as earlier that day she had no water for a few hours!
the food was horid, but i guess you kinda except that, but the nurse did even complain about that.
some of the nurses were excellent though i'm not sure i could work in that environment, must be difficult but is that an excuse for not delivereing on the basics

Peeps complain when they get poor service at tesco, or a pub, or a hotel, yet when in hospital and theyre discharged they very rarely complain.

Reason being you can go to asda or morrisons or another pub, you have little chance of going to another hospital, if youre suddenly taken ill.

Same staff same ward, and probably same crap management.

Northwind.

Nothing to do with only parents being allowed an opinion. I can quite happily sit in A&E and wait my turn. I have had plenty practise over the years. When my child is sobbing with pain it awakens far more primitive emotions. Fundamentally 5 hours for a Paediatric case, even a minor injury is something more suited to Stalinist Russia than a 21st Century UK.

It may have changed as was there a while ago.

Having worked in Oz and UK as a hospital doctor over there they would have 7-8 nurses for the same number of patients that over here we would have three nurses.

As has been mentioned above the proliferation of specialist nurses has provided an excellent service. The downside is they are highly expensive - often per hour more than reasonably skilled junior doctors (i.e. anything below consultant). At the end of the day the more money you spend in one thing the more you have to save elsewhere - i.e. on ward staff.

The message very much seems to be that 'just' being a ward nurse is not good enough and unless you are in a specialist or management post you have not done well. It would be better if some of the very senior nursing staff could be kept on the wards.

uphillcursing - Member

Fundamentally 5 hours for a Paediatric case, even a minor injury is something more suited to Stalinist Russia than a 21st Century UK.

Don't agree in the slightest. I waited for longer when I was a kid, maybe we just had more realistic expectations.

The solution's simple though- the problem's been identified as them only having one pediatric consultant. So just have 2 on all the time, that'll only cost double and require twice as many doctors, easy.

A break is not a minor injury. especialy in a child. Should be dealth with as a priority and in less time than that.

TandemJeremy - Member

Should be dealth with as a priority and in less time than that.

And I agree. But third world? Come on now.

5 hours is too long for anyone to sit in A_E with a broken wrist, speshly a child, but what were the reasons for this? I'm sure staff din't leave the child there suffering on purpose, just to be nasty...

Mind you, I sat in A+E all night once with a half-severed finger before I received medical treatment. It was very unpleasant, but not as unpleasant as the experience of the two serious head injury cases that were brought in (with machines that go 'PING!'), the stabbing victim, the shooting victim and various other breaks and leakages...

But is it too long simply because nurses don't care?

Lots of slagging off going on here, but not many attempts at offering possible solutions....

Jet 26 you are spot on! Not enough staff end of! Nurses in aus were less stressed and narky because they werent so hard pushed as the ratios werent so high.

Things are going to get worse cos the cuts havent hit yet!

had some great service at a&e myself but its not about a&e so what if you break your arm from a bike accident and have to wait a few hours, it will mend, try being in hospital for weeks months with inadequate water food, care, dignity etc

Elfin - ok

Fewer Bigger A&E units (make capacity issues dealable with) Less NIMBY "don't close my unit" crap.

Triage by experienced Drs or Nurses freed from protocols - and I've seen this rubbish from a parent's side too.

Don't get rid of the 4 hour A&E target ( a Tory decision) as the evidence is that the death rate is higher in units (irrespective of turnover) with a >4 hour wait.

Stop making [i]all[/i] Nurses do degrees as part of their training. It's not necessary, and I really think it does make them miss some of the unique qualities that Nurses can bring as carers, clinicians and advocates.

Senior A&E staff present at night. In fact there is very little place for any Dr with less than 5 years under their belt in a Hospital at night.

Imaging needs to be running full on 24/7. A major cause for delays - but not in sensible countries.

Less management is not an issue - the NHS is under-managed compared with other Health Services and Private Sector industry. Crap unaccountable management is.

And hang any MP who bases his reelection policy on keeping his local St Shipman's open.

Elf,

There were no major incidents that came in that I could see. To early for the drunks but sadly just the wrong time of day to find fully staffed departments. One on duty radiographer so seven of the available X-ray rooms sat unused constituted nearly two hours of wait.

Let me put the same point in a slightly different way. Most of the people on here ride bikes between bouts of bitching on here. Some of them fall off and hurt themselves. How long have they had to wait to get access to an MRI scan? An ultrasound scan or a physio referral?

Lets have a straw poll out of interest.

Simple but unfashionable fact, the NHS is not actually valued realistically by a significant proportion of its service users. To see a GP, or have an ambulance attend, or to see an a&e doctor out of hours has a real monetary value that is simply not considered by many people, leading to abuse/misuse of services which in turn leads to resources being inefficiently allocated.
This could, IMO, be simply addressed by asking everyone to pay a small contribution towards the initial cost, even if we're only talking £20 or so. A kind of compulsory national insurance excess. Within my own sphere of experience, I know* that if ambulances were more expensive than taxis, their workload would drop by 60-70% overnight. I hear GPs and A&E staff tell similar stories of people unable/unwilling to engage their common sense and tying up services that could be better directed all the time.
So doctors are comparable to lawyers? I think so. However, imagine a world where access to lawyers was completely free for all for any trifling issue and the state picked up the tab, every time. An unaffordable model?
The NHS worked when it was appreciated for the amazing, valuable commodity that it is. Unfortunately that is no longer the case for large sections of society, and something has to give.
*i obviously don't [i]Know[/i] this, but would be willing to bet large quantities of cash, or body parts on it.

There were no major incidents that came in [b]that I could see[/b]

Well, I wasn't there, so can't offer an explanation, but I do know there's loads of stuff going on in hospitals that you [b]don't[/b] see, that affect things.

Fewer Bigger A&E units (make capacity issues dealable with) Less NIMBY "don't close my unit" crap.

Hmm; longer journeys by patients, ambulances out longer, longer response times, those in already cut-off locations even further from emergency health care, yeah, great idea.... 🙄

Actually, one thing I think would help in big cities especially poorer areas, is if patients could use taxis to get to A+E, in situations which aren't life-threatening but otherwise leave them unable to get to hospital under their own steam, and if the taxi fares could be reimbursed/paid at the hospital. This would mean that a broken leg, for example, could be ferried to hospital by taxi, which would, I imagine, cost far less than an ambulance journey. People I know who can afford to, have done this, as have I, but poorer people might not have this option and would have to call an ambulance. Surely this would relieve some of the burden on the ambulance service, and ultimately save a packet, not to mention helping out taxi and cab drivers.

Just an idea. Dunno if it would work or not.

Heh! Great minds, V8ninety... 😀

I hear GPs and A&E staff tell similar stories of people unable/unwilling to engage their common sense and tying up services that could be better directed all the time.

I know of one case, where an ambulance was despatched to an address, as the patient was apparently 'dying', only to get there and discover it was in fact an earache or toothache or something. 🙄 I'm sure there's loads of silliness like that. Another problem in the area I live in, is the ignorance of medical stuffs by certain sections of the community, which sees GPs and A+Es burdened by some very trivial matters which don't require medical attention at all, just a basic knowledge of how to treat certain things yourself/at home. This is down to education, and not everyone has had the privileged advantage (!) of a decent UK education. Unpopular with the Right and the bigots, education and information resources in other languages have actually helped see a reduction in the burden to the NHS for all sorts of health issues.

TBH there's loads of answers/possible solutions, but not enough people really thinking for themselves.

I work on an elderly care ward. The care couldn't be better - i'm always totally amazed by how good the nursing staff are - both qualified and unqualified.

I think one point that needs to be made here - that even on a really good ward plenty of our elderly patients are getting malnourished - mostly because its often part of the dementia process that the patients simply lose their appetite - no amount of forcing/encouraging them to eat makes any difference. I dont know whether this report addresses that issue?

If someone cannot feed themself - they need help being fed. Now lots of dementia patients will not eat that much as they detiorate. But I have heard enough from intelligent professional, and sometimes ex-nurse patients who have witnessed food being left out of reach of patients etc etc... to believe this story...

and the key issue is why some wards and hospitals succeed and others do not...

This could, IMO, be simply addressed by asking everyone to pay a small contribution towards the initial cost, even if we're only talking £20 or so. A kind of compulsory national insurance excess.

Can't say I'm in favour of that, BUT, how about just telling people how much(ish) their treatment might have cost them had they had to pay for it? (edit: of course I know they do pay for it, indirectly - but I mean if they had to pay directly as they used it)

Could be done per visit to the GP, or at the end of a stay in hospital - no need for much extra admin, just a quick print out / tally of the cost of a few procedures like you might get on a bill from the garage.

Might help some people to focus on what resources they are using and/or help people to decide whether or not they were actually getting value out of the NHS.

Well, I wasn't there, so can't offer an explanation, but I do know there's loads of stuff going on in hospitals that you don't see, that affect things.

Here are my thoughts (not that anyone will be interested):

Nursing is now a technology/process based job rather than the caring vocation it used to be.

The ludicrously expensive technology bought by the NHS sits idle for more than 50% of the week.

I can see the same consultant at the local Nuffield Hospital sometimes 12 weeks sooner than I can at the local NHS one for the same ailment. I can also see them when it suits me.

I know the people dealing with patients really care. It is the staffing levels, time quotas and bureaucracy that is killing the NHS not the front line staff.

Bugger! incoherent ranting again.

Elf, edumacation is definately part of the answer, but unfortunately 'educated' people can be just as guilty of under appreciating and misusing the NHS. In my personal experience, some of the worst (because it's disgusting that they don't know better) misusers of ambulance and primary are resources are GPs, sometimes at their own practice (999 because it's home time, anyone? Patients 'mis-sold' to admitting medics to wangle an inappropriate social admission...) but mainly the £100+ per hour, almost unaccountable out of hours locum GPs who will admit anyone, usually by ambulance, just for an easy life.
In the interests of balance, I think most GPs are hard working, concientious and just as frustrated as everyone else...

Can't say I'm in favour of that, BUT, how about just telling people how much(ish) their treatment might have cost them had they had to pay for it? (edit: of course I know they do pay for it, indirectly - but I mean if they had to pay directly as they used it)

Having recently spent 3 days in hospital, including A & E, for a cycling accident, I was pretty happy with how I was treated. My only observation was that some staff needed to work on their people skills.

Most people here don't seem to know the worst part about the US system... the fact that almost everyone's cover is actually limited. So even if you're covered you're only covered for so much money, then you're on your own. So basically crap cover for almost everyone.

Anyone who thinks the US system is good needs there head examined.

But not in the US as the care would not be as good and it would cost you a shed load.!!!

cinnamon_girl - Member

My only observation was that some staff needed to work on their people skills.

I think my ortho consultant might have been the inspiration for House MD. But he's good at bolting legs back on so I don't object too much.

Woah, rewind. There are people on here that think that the US health (doesn't) care system is GOOD? oh dear...

I can't see many people who do think that...

The issue is why our system isn't better.

The issue is why our system isn't better.

Perhaps a re-focusing of minds is in order here.

Privatise it! That's proved the solution to the problems of every public service. I mean.... just look at the railways

The issue is simply will privatisation in one form or another "improve" the service?

It's no coincidence that this kind of report comes along by at a time when the Government is looking to "reform" the NHS. So we all know their answer. Whats yours?

The only experience in the last few years as a customer was sitting in casualty for five hours with a child with a broken wrist

Perhaps the nursing staff were busy serving tea and biscuits on a ward somewhere? as seems to be the call.

Stoatsbrother - Member

I can't see many people who do think that...

The issue is why our system isn't better.

Money - pure and simple. We pay less for our healthcare than most comparable countries.

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash. Labour what doubled the real terms spend on healthcare? Everybody got a payrise.....

Oh and please, enough with all the Tory-hate. The Coalition is increasing health spending in real terms at a time when other departments are taking cuts of up to 25%. Labour policy at the election was to cut spending.

McBoo - your ideological hatred of the NHS shines thru.

its really simple we get the service we pay for - underfunded and overworked staff = gap s in care such as you highlighted.

When the NHS budget rises another 20% above inflation to match the levels of healthcare spending in say Germany or France then we will be able to have a similar quality system.

The service has vastly improved and increased its scope during the time labour funded it properly

The tories are making massive cuts in the money spent on care - partly buy wasting so much on reorganising it again and partly by stealth cuts. Thats the reality on the shop floor - massive cuts accross the board

The coalition are fattening up the nhs, by investing cash into new buildings and empire building for the sale of the century in the next few years, youve only got to look at the new names appearing on hospitals ,hospitals split into smaler parts for easier sale, all with their own car parks as well,instead of one hospital site, and one dedicated car park..