I work for the NHS – and it certainly ain’t perfect. I’ve just finished a weekend of nights in a busy city hospital, and acute care is being pushed to the absolute limit (in this respect, hot weather is as bad as the cold variety). At 3 in the morning, A&E was still rammed, ambos were parked up unable to offload and some patients who needed high dependency care were having to be nursed on general wards. The staff nurses on my team hadn’t taken a break for three nights running. In my view, their efforts were nothing short of heroic – but there is no getting around the fact that such conditions are likely to result in sub-optimal care. If there ain’t enough beds, and there ain’t enough boots on the ground, things will go wrong. It’s not necessarily a case of deliberate neglect (although I’m not disputing proven cases of poor practice) – it’s simple maths. And (as frontline staff have been screaming for years) the single biggest improvement to care on general wards would be to increase the trained nurse:patient ratio (at present it can be anything from 1:6-12!) – not that the UK is likely to commit to such a thing.

Meanwhile, this government & the schoolboy that is Jeremy Hunt are doing little to help matters. Indeed, their idiot reforms are making a difficult situation a whole lot worse, not least given that increasingly fragmented services are resulting in more pressure being placed upon A&E. Nor do I care much for the protestations of NuLab (current political “debate” being a slanging match about blame), on whose watch much damage was done (although some things improved). But what really fugging annoys me is the Daily Failograph/general media spin on all this. I’m not generally a tin-foil conspiracist, but the soundbite headlines & mis-reporting of mortality figures is pretty outrageous. Indeed, it does nothing to serve the cause of those who have suffered poor care, nor does it advance the kind of improvements that are needed.

Anyway, there’s an excellent blog post here:

http://skwalker1964.wordpress.com/2013/07/15/national-media-keogh-says-13k-nhs-deaths-keogh-er-no-i-dont/

You must have missed this then,

http://www.bbc.co.uk/news/health-23326410

Just perhaps if the overpaid management rolled their sleeves up and stopped walking round doing sod all and helped out on the wards, a lots of ward work doessnt need qualified staf, just staff WHO CARE ARE COMPASIONATE,and want to help people, not just wait their time out to claim their pensions.

Ex NHS staff member 3 different jobs, and the son of a father who suffered serious neglect and hospital based infections,

You must have missed this then

And, in turn, you must have missed this:

I work for the NHS – and it certainly ain’t perfect

I’ve had my share of run-ins with clipboard-wielding wasters & time-serving layabouts, and I’m more than aware of the need for patience & compassion, nor am I an apologist for neglect…. but that doesn’t remove from the issue here – the spurious reporting of mortality figures. Sir Keogh is (apparently) fuming.

Project-

also ex-NHS here. I don’t think your statement: “lots of ward work doessnt need qualified staf, just staff WHO CARE ARE COMPASIONATE” is entirely correct. Someone qualified invariably needs to supervise non-qualified staff activities to ensure that they are done correctly, or that any important elements related to the activity are done right.

For example, it doesn’t take a qualification as such to do a bed-bath, but without being able to recognise signs of pressure-area deterioration, important data about a patient’s condition will be missed.

That normally means some qualifications, or the supervision of an RGN, who’ll ultimately be culpable if said activity is not done to a standard and recorded as being done.

Personally, as an ex-RGN, I’d rather have done the activity myself than rely on others, which for me meant keeping the skill-mix firmly towards those highly-qualified. Takes a lot of money to do that though.

keeping the skill-mix firmly towards those highly-qualified

Indeed. Funny how DoH keep on ignoring this.

I think patients don’t really *care* who’s at fault.

They just want good service when they need it.

Like Cougar and his Yodel problems earlier – he doesn’t care if it’s a senior manager or a muppet doing the delivery that’s to blame he just wants what he’s paid for and expecting.

For example, it doesn’t take a qualification as such to do a bed-bath, but without being able to recognise signs of pressure-area deterioration, important data about a patient’s condition will be missed.

The care home my dad and another aunty where in, the staff didnt know how to chjeck for pressure sore but still filled in the forms saying everything was ok, and in one hospital my dad was in the sheets where so hard you could have used them as sandpaper.

You dont need to be qualified to fill water jugs, empty bins, wipe table tops, and talk to patients,serve food help patients to eat,answer the phone and numerous other jobs that need doing allowing qaualified and semi skilled staff to do other things they are trained to do.

Like i used to say to the mangement, one day you will be a patient, and want have your job to pull rank for better service for yourself.
When you see a fialed manager again, try trelling them that, and remind them a few days latter.

im sure i read that by the same measures overall NHS death rates are down by 30% in the last 10 years

Even by the standards of the present cabinet, Jeremy hunt stands out as a particularly odious little turd!

His reaction to all this is to rub his hands with glee at the opportunity for a bit of political point scoring, and justification for his stupid, pig-headed, ideologically driven ‘reforms’

I don’t think for a second that anyone in this government gives a toss about standards of care in the NHS. Or the conditions for staff. Their agenda for the NHS is simple and all encompassing. They want to dismantle it, and hand the lot over to their friends, for them to make lots of money from. And that’s it! Nothing else gets a look in!

My mum has recently retired as a health visitor, and you can’t get her on the subject of these ‘reforms’ without running the risk of her head exploding with rage!

Sad to hear that your Dad didn’t get the treatment he needed project. Seen it myself in my own family.

I think, though, that some of the examples you cite do need qualified staff to at least supervise or verify: eg, someone has to report back to qualified staff on things like fluid intake, and feeding someone who’s just had a stroke has to be done right or the patient will develop a potentially fatal aspiration pneumonia.

The fact is, higher levels of unqualified or lesser-qualified staff mneas more verification work, so doesn’t actually free up qualified staff to do more, so there’s definitely a skill-mix issue to be addressed. Too far one way (cheaper=towards high levels of unqualified supervised by lower numbers of qualified) or the other (dearer) won’t work.

Jeremy hunt stands out

There’s a good take on him here:

his idea of a “patient-in-chief” is to spend all his time complaining about the NHS rather than taking actions to improve it

The spin and points scoring the nhs is very similar to that seen in education. At the end of the day more staff are needed if anything is to significantly improve not a load of random ideological changes and more blame attributed to staff.

SIMPLE FACT: We elect the Government, and the what is being discussed here is about the distribution of finite resources as decided by us the electorate.

Personally I’ve had a good deal of experience (on the receiving end) of the NHS, and I have no real complaints that aren’t attributable to allocation of dosh, or more accurately lack of. I have no problem whatsoever in paying higher taxes to pay for the service to be maintained, and hopefully improved. I always take that into account when I vote, and for that reason
I make no secret of the fact that I’d rather have my scrotum removed by an HIV infected witch doctor with one half of a blunt pair of rusty scissors and without anesthetic, than vote for this current vile bunch of self interested butt wipes.

(Incidentally, I’ve never voted for New Lab either).

What I would like to know is where are all the Tory apologists now? I seem to remember the place being full of them before the last election.

Is there a tory in the house? Please step forward and defend the behavior of your Health Secretary immediately. Especially his behavior in the house today which was not only poor, but demonstrably inaccurate

The oily, smarmy little worm is on newsnight now. Once again proving that there really are no depths to which this lot won’t sink to further the interests of their rich friends. Loads of people may be dying unnecessarily! Hurray!!! We can try and pin it on the last lot, and win a few points! It’s all a rather jolly wheeze, isn’t it chaps?! When its all privatised we’ll all have jobs on the board of healthcare providers! Huzzah!!

the NHS should be about patient outcomes, not the staff nor the institutions (although they are key to getting the best outcomes). It’s clear that for a lot of people the outcomes of NHS treatment have been life shortening or changing due to the care they received

the arguments about the numbers are a diversion, Labour Health Ministers and the DoH have known about the issues since the early 2000’s and have been turning a blind eye to them. The current lot have some culpability but at least the issue is now in the public domain.

I assumes Gordon and Tony don’t have rich friends and sup pints of mild at the bar of their local, that will explain the list of former labour ministers joining the Tory ones in directorships

Now, come on – its hardly fair for the Labour party to accuse anyone of playing politics with the NHS, given they’ve used it as a stick to beat over the tories heads for the last 30 years!

(funnily enough, they’ve been accusing the Tories of being about the privatise the NHS for this whole period too – amazing how slowly the evil ones have gone about it, isn’t it)

So, lets get this straight – the report says that this has been going on for a good ten years, it says that over 1500 reports were made to Andy Burnham and the Labour government of unacceptable standards leading to deaths, and they did nothing –

Yet somehow its the Tories to blame! Outstanding!

Codybrennan – You highlighted about untrained Healthcare staff (HCA’s) nnot knowing about pressure areas. Would you agree that there should be a National training plan for all NHS Healthcare assistants? I for one would like to see this implemented.

I know in our trust, which i wont name. We have alot of Band 3’s doing observations and this is only a 2 hour lesson and then supervised by a RGN before being signed off and let loose with a Obs machine. Some don’t have an idea how to understand what is being shown.

Burnham was roasted on CH4 news last night by a patient representative body for ignoring repeated claims of hospital failures while he was in government. Funnily enough he had cancelled his planned appearance and was unable to appear on the programme.

there are 1700000 people working in the nhs.. Why do we need more?

(funnily enough, they’ve been accusing the Tories of being about the privatise the NHS for this whole period too – amazing how slowly the evil ones have gone about it, isn’t it)

They seem to be going about it remarkably quicker than pledged though, don’t they? What was it ****face said before the election? “I’ll cut the deficit, NOT the NHS”

Which bit of NOT do you thick Tories not understand?

there are 1700000 people working in the nhs.. Why do we need more?

Er, because its not enough?

totalshell – Member
there are 1700000 people working in the nhs.. Why do we need more?

The NHS deals with over 1 million patients every 36 hours.

now im sure macdonalds handles lots of customers too, but performing a triple bypass or even checking for bedsores requires a lot more skilled workers and support infrastructure

there are 1700000 people working in the nhs.. Why do we need more?

My wife has been working in the NHS now for a year, it’s not the lack of people nor money that’s the problem – but where/who these people are and where/how the money is spent.

I do though have sympathy with anyone trying to change it. It’s a vast organisation that must continue to work 24/7 while been improved, and every Govt is only concerned with a 2-3 year timescale – when it really needs a 10-20 year plan.

It’s also not helped by the various ‘interested’ parties, both internal and external plus private companies (and GP’s and Consultants) looking at picking off the best/profitable bits.

And with any organisation of this scale you will always find problems, as an ‘average’ needs everything from perfect to dire.

Well said b r. Probably the most sensible thing I’ve read on the subject….. ever.

Personally, I reckon most things in this country would benefit hugely from not having to do a U turn every few years. Not by any means perfect, but a good indication of long term planning and stabilty from up top can be seen in China, where the economic revolution wrought since Nixons vist in 1972 is nothing short of miraculous.

So, lets get this straight – the report says that this has been going on for a good ten years, it says that over 1500 reports were made to Andy Burnham and the Labour government of unacceptable standards leading to deaths, and they did nothing –

Yet somehow its the Tories to blame! Outstanding!

Out of interest the report does specifically point out that lack of investment in the 80’s and 90’s is a prime issue, and it does also suggest that new lab did go a long way to rectifying that, but hey why let that get in the way of your bias.

Zokes – don’t forget Call-me-Daves manifesto pledge

“There will be no top-down reorganisation of the NHS”

So how exactly would you describe the £3 billion ‘project’ going on at the moment then Dave?

(funnily enough, they’ve been accusing the Tories of being about the privatise the NHS for this whole period too – amazing how slowly the evil ones have gone about it, isn’t it)

They’re merely putting everything in place at the moment. And making sure its irreversible. They’re opening it up to EU competition law. So that everything will have to be put out to competitive tender from ‘any qualified provider’. So the private suppliers like Virgin Health will be able to mount expensive legal challenges to allow them to cherry pick what they can make money on, leaving an underfunded rump NHS to deal with the pesky long-term expensive stuff

The only winners here will be the usual multinationals and the lawyers, who are presently licking their lips at the prospect. Patient care won’t even figure! It’ll be a race to the bottom with the usual cost cutting, so that fat profits can be creamed off by the usual suspects

And all this in the week while G4S and Serco cover themselves in glory yet again. Apparently they’ve been ripping us all off for years. Who’d have thunk it?

You really couldn’t make it up

I do though have sympathy with anyone trying to change it. It’s a vast organisation that must continue to work 24/7 while been improved, and every Govt is only concerned with a 2-3 year timescale – when it really needs a 10-20 year plan.

I think NHS direct/111 is a prime example of that

orginally set up under nulab as a decentrailsed example of localism , and it was a disaster
so they had to centralise it and it was working well

but costing too much for gideon so they start it all over as 111 put everything out to tender as a model system of localism

that is absolutely useless and ends up costing the NHS even more because the idea of a computerised health check is a joke and standards vary wildly across the country heaping loads of pressure on A&Es already burdened with cuts and closures

the BMA warned hunt about all of this before launch but it seems health ministers like ignoring warnings

Are you all looking forward to being old, ill and in the care of the NHS?

Bet in can’t wait to be in the queue for Tameside or Stafford.

People in the NHS reckon the Govt is at stage 6 and about to start stage 7 of this:

Are you all looking forward to being old, ill and in the care of the NHS?

I’m 57, I’ve worked hard all my life, and saved hard too for my retirement. I can’t pretend I’m hard up, but the reality is I’ve had my first tranche of savings screwed by the debacle that was endowments. The savings vehicle of choice when I was a youngster. I ended up saving my arse off and getting back somewhat less than I’d put in. I’ve had a personal pension in place since I was 23. With the benefit of things like opting out of SERPS and what have you it transpires I would have been better to not have done that and saved nowt.

Frankly, I’m sick to the back teeth of the state of the place, my local high street looks like Beirut, my local hospital is a shambles. the local Police are at best ineffectual, the roads are crumbling.

I look at the bunch of muppets in charge, (of all persuasions), and frankly I’m on it and in full sympathy with the French peasants about the time of the “let them eat cake” moment.

I like most people of my age have contributed fulsomely, only to see it pissed away by a bunch of chinless gits at the top. something fundamental needs to change IMHO.

there are 1700000 people working in the nhs.. Why do we need more?

Er, because its not enough?

you need to get out more,visit any 24 hour hospital and the car parks are almost empty at nights and during weekends, yet people still require care and attention, the food still needs to be burnt and made indigestable, the cleaners still need to be there are do porters and others.

So all those missing vehicles must belong to office and clerical staff, perhaps make them work shifts, and have a huge cull of them.

When somebody goes into hospital, the things they most care about is
GOOD CARE,
SYMPATHETIC CAREING STAFF,
TRAINED STAFF,
CLEAN AND FREE FROM INFECTION,
AND ADEQUETELY RESOURSED WITH EQUIPMENT,
AND PROPPERLEY COOKED AND WHOLESOME FOOD, WITH A PROVISION OF FRESH WATER AND BED CLOTHES.

Theyre not concernerd about somebody sitting in an office pushing paper around, or typing stuff into a computer, unless it relates directly to their treatment.

project I think youve argued against yourself there

the point is that paperwork can wait till 9-5 and like it or not paperwork will always be required!

these reports have higlighted some serious failings but despite your tabloidesque use of capitals out of the entire country only these 14 hospitals were found to be seriously at fault

overall death rates (as measured by the same criteria used in the keogh study) have fallen by 30% in the last 10 years

“overall death rates (as measured by the same criteria used in the keogh study) have fallen by 30% in the last 10 years”

That’s very reassuring. Have you been to Stafford to present that one? Why not try Tameside, Huddersfield or even Kingsmill near Mansfield. Does that include having to phone your family or the police to get a drink of water from a nurse rather than drink the water in a vase of flowers? for every politically massaged statistic of any type theres actually people who could have been treated better. Stuff your stupid Labour Tory Lib crap. Many of us have had great benefit from the NHS and a good few of us have been very badly let down.

Many of us have had great benefit from the NHS and relatively, very a good few of us have been very badly let down.

for every politically massaged statistic of any type theres actually people who could have been treated better

So out of 60 million of us and an organisation of nearly 2 million employees not everyone got the best service.

I dont think anyone will dispute this but better to look for solutions.

Not trying to downplay some of the things which are indefensible but using atypical exemplars of bad service to denigrate a service and plan reforms is not that wise either.

We want to make sure everyone gets good treatment rather than do anything radical because a few did not.

Not sure a STW debate will bring much clarity to this emootive and complicated issue

hey mt, im not defending any of the failings and realise that there have been some terrible cases that ubdoubtedly deserve investigation and maybe even prosecution rather than denial and coverup

and liblabtory crap aside I think the issue is as much about how we treat the elderly in our society

most of these cases do seem to involve the elderly, why is it so easy for them to be ignored/neglected by staff? do we respect our elders enough that we give up free time to see to their needs? As my gran got older I was happy helping out with the gardening or fixing the garage but helping her go to the toilet- not so much.
I know that as her mind and body deteriorated it became increasingly difficult to look after her,
nhs carers that came to her home varied, some great some awful.
My mum lived nearest so the the responsibility mostly fell on her and by the time my gran moved a home my mum was conflicted over whether it was the right thing to do
even when she died, was I relieved that her suffering had finally ended or that a strenuous burden had been lifted from the family?

and liblabtory crap aside I think the issue is as much about how we treat the elderly in our society

most of these cases do seem to involve the elderly, why is it so easy for them to be ignored/neglected by staff? do we respect our elders enough that we give up free time to see to their needs?

even when she died, was I relieved that her suffering had finally ended or that a strenuous burden had been lifted from the family?

Some poignant questions kimbers. I have a few years experience of hospitals and elderly parents. Have just lost my Mum so am perhaps a tad touchy but do feel that the elderly are viewed as a nuisance by many nursing staff.

project – Member

So all those missing vehicles must belong to office and clerical staff, perhaps make them work shifts

What do you hope to achieve with that other than driving up costs and making it harder to recruit good staff?

You’re never going to get a sustainable long term development plan in place whilst it’s being overseen and approved by a political body which will always have its own agenda.
It was bad enough when I worked in local govt where the 5yr capital plan changed every year dependent upon which political party had control of the authority. Even a change in portfolio holder within the same party had big ramifications.
It’s just the same in the NHS where there doesn’t seem to be the willingness (or big enough swingers) from any government to make the investment in personnel and infrastructure to make the improvements required

I went from Private world to NHS, and I was initially shocked by the culuture of giving the answer that people wanted to hear, as opposed to the real answer (in my instance it was not to do with patient safety etc)

There does appear to be a culture in the NHS of reporting what is ‘expected’ etc.

At the end of the day the NHS is being asked to do more and more with less cash. Things do go wrong, and will continue to go wrong.

There does appear to be a political and media agenda at the moment to always blame the staff, and not the political decisions behind it. Personally I think this is on purpose to smooth the way for privatisation, the holy grail for the future of the NHS…

these reports have higlighted some serious failings but despite your tabloidesque use of capitals out of the entire country only these 14 hospitals were found to be seriously at fault

Hospital trusts that where named and shamed into hopefully sacking failed staff also run more than one hospital or clinic.
From sad and bitter experience, there are a whole tranch of idiots running hospitals, some who shouldnt be allowed to run a car wash, yet they get huge salaries, and when they get caught screwing up or manipulating figures they get moved aside or paid off very well.

And there are fantastioc staff who go the extra bit to help patients, who try and fight for better facilities, yet theyre ignored or troden upon.

There have ben so many reports into poor quality care, stafford, milton keynes, stoke manderville etc etc, and some even had a pervert working for them Jimmy saville, and yet few have been sacked, or had their registrations cancelled.

Now if it was a delivery driver, or a bike shop, numerous threats of retalionation would be made on here.

For some reason complaining about poor service in the nhs is seenn as so wrong.Even when somebody has died.