NHS
- Thread starter keith
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Wattie
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Right, I’ll start compiling a list for the Gold Coast.
1.philw696 + Mrs French
2.Bebs + Mrs Dutch
3.?
Ps. “Maturing” is non compulsory for admittance….in fact it’s totally discouraged.
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Wattie
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Sorry to hear of your experience. Hope your mother gets the treatment she deserves and that she makes a prompt recovery.
DLax69
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...sounds like something I could get behind.
Wattie
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3.DLax69 (anyone with 69 credentials is fast tracked)
mjheathcote
Centenary Club
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If it wasn't for the NHS five years ago, we wouldn't have our 13 year old son today.
RoaryRati
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So sorry to hear your news - let me know if I can help in any way.
conaero
Forum Owner
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All very disturbing stories and a special though for Helen this morning after her loss.
I think it’s important to mention that the staff of the NHS are amazing and caring people but yes, they are overrun these days due to poor management and funding. Throw in an ageing population and an open immigration policy and there simply is not enough support.
Living with a senior nurse specialist I get well versed on the issues and the wasted money that needs to be diverted to the frontline.
After a health scare a few years back I went private also as when it happens speed is everything
I think it’s important to mention that the staff of the NHS are amazing and caring people but yes, they are overrun these days due to poor management and funding. Throw in an ageing population and an open immigration policy and there simply is not enough support.
Living with a senior nurse specialist I get well versed on the issues and the wasted money that needs to be diverted to the frontline.
After a health scare a few years back I went private also as when it happens speed is everything
daverichardson
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Mentioned before somewhere
I took out Private health care with Aviva for about £1200pa this year in order to pre empt waiting times if I could? Not used it yet
I am a strong advocate for NHS but it just is not up to it so I took matters into my own hands
I took out Private health care with Aviva for about £1200pa this year in order to pre empt waiting times if I could? Not used it yet
I am a strong advocate for NHS but it just is not up to it so I took matters into my own hands
As ever these things are a lot more complex than first appears. Firstly, sympathies to all who have suffered and lost friends and relatives over this really rather strange last few years. I lost my father last year and fully understand. In fact I am now at the stage of my life where my black suit is quite popular.
In my experience acute care in the NHS has been excellent but it is the chronic care and maintenance stuff that struggles and this is where you can buy PMI or just self insurer to use modern parlance. The trouble, though, with trying to go private for anything exceptionally time critical is that the network is not present in the UK for short notice surgery outwith the NHS. You can go private for elective surgery but here in Edinburgh, for example, waits are very long as lots of people are doing this and it is still the same NHS surgeons doing the work and they are very busy. Going private for diagnostics and regular outpatient appointments is the best way of gaming the system if you can afford to but a lot of people cannot which means we have to fix what we have as it is meant to be universal.
In my experience acute care in the NHS has been excellent but it is the chronic care and maintenance stuff that struggles and this is where you can buy PMI or just self insurer to use modern parlance. The trouble, though, with trying to go private for anything exceptionally time critical is that the network is not present in the UK for short notice surgery outwith the NHS. You can go private for elective surgery but here in Edinburgh, for example, waits are very long as lots of people are doing this and it is still the same NHS surgeons doing the work and they are very busy. Going private for diagnostics and regular outpatient appointments is the best way of gaming the system if you can afford to but a lot of people cannot which means we have to fix what we have as it is meant to be universal.
Scaf
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Well said Matt
My daughter also works in the NHS and I know how many extra hours she and her colleagues put in.
It’s easy to concentrate on the negatives and forget the great work that is done, and I say that even though our own family have been badly let down recently with cancer diagnosis and lack of GP access.
I think most families will have experienced the very best that NHS can deliver and sadly some of us also the worse.
Your summary of lack of investment / poor management is spot on.
safrane
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PMI... Yes great until they get in wrong and rush you to the nearest A&E.
And remember most private Dr also work for the NHS, so the more of us who go private the bigger the draw from the source of all those Dr and Nurses and so the merry-go-round continues until the NHS is just there for emergency treatment.
But the biggest issue as with all Gov supplied services is the constant meddling and changes in priorities by Ministers.
And remember most private Dr also work for the NHS, so the more of us who go private the bigger the draw from the source of all those Dr and Nurses and so the merry-go-round continues until the NHS is just there for emergency treatment.
But the biggest issue as with all Gov supplied services is the constant meddling and changes in priorities by Ministers.
Doohickey
Velociraptor
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Really sorry to hear that Helen. Thoughts and sympathies from Helen and me.
mowlas
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Agree with a lot of the observations above. I have done quite a bit of work in the NHS and have seen the issues at close quarters and from the different perspectives of service provider Exec Teams, managers, clinicians, allied healthcare professionals and ancillary staff such as porters. In my work we directly engaged patients in different needs segments (followed their journeys over months) as well as looked at the associated costs and care outcomes. Here are my conclusions from the work we did.
1. As the clinical and social needs of patients have changed over time, the NHS has not been able to adapt because ALL their discretionary capacity for change/adaptation has been swallowed up by unnecessary, ideology-driven NHS transformations or as now, they simply have no capacity to meet minimal standards of care. When each transformation goes wrong, they spend the time between transformations trying to recover from them.
2. There is a vicious and measurable cyclical pattern of Trusts falling into deficit, making extremely short sighted savings that make patients worse and increase the burden of care (demand) for a health region. Chasing short term savings with badly thought through cuts is encouraged by NHS England and DOH (who are aided and abetted by big 4 management consultancies). Once the inevitable clinical standards start to fall the Care Quality Commission (CQC) will step in and put pressure on the service provider to improve standards. The service provider will do this but often this will require equally knee-jerk measures that further increase the financial deficit (e.g. hiring locum staff). Rinse and repeat - this cycle continues. The biggest problem with this cycle is that this ‘catch 22’ regulation set-up leads to the institutions overall growing their own burden of care with each cycle.
3. In the worst examples of short term changes driven out of (1) and (2) above, patients become infantilsed and their rates of deterioration (mentally and physically) accelerate. Some of specific patients we followed in the study went from older people who were living active lives, staying on top of their multiple long term illnesses to becoming shells of their former selves with significantly higher care needs within the space of weeks - especially during long term stays.
4. As we all know, governments have failed to plan for and grow the NHS workforce. Stupid things like removing the nurse’s training bursaries have led to a dramatic workforce gap. That was even before we lost a further 22,000 EU based NHS staff (as known at 2019) following the EU referendum. This massive gap exacerbates the issue described in (1) above
To slowly reverse these massively unhelpful dynamics within our healthcare system will require the following:
a) Integrate the regulation of the NHS so that each service provider can reasonably manage a gradual improvement in both costs and clinical care quality in an integrated way. Allow providers to state what capacity they need to continuously adapt and improve and avoid short term interventions. Support the providers with innovation techniques and methodologies used by successful tech and service companies. These techniques look at life through the patients (customer’s) lens and we often see that quality of life is found to also to equate to lower costs of care - happy to share examples of anyone wants). Quality of life over quantity of life is also the most economical for the NHS.
b) Stop with the wholesale transformations of the NHS!!! No more!
c) To be able to do (a) we need a massive influx of NHS clinical and social care (also clinical) staff (let’s not get into a debate about how we attract them to this country for obvious reasons - we just need to have that outcome). As part of this, the government needs to negotiate with the pay demands. Not meet the number but negotiate.
In conclusion, no the problem isn’t that old trope that there are too many managers, it’s the combination of what I’ve described above which I believe is what @safrane alludes to in his comment above. And we are bloody lucky that NHS staff continue to follow their vocation despite all the system hurdles put in front of their chief desire to simply make people better.
1. As the clinical and social needs of patients have changed over time, the NHS has not been able to adapt because ALL their discretionary capacity for change/adaptation has been swallowed up by unnecessary, ideology-driven NHS transformations or as now, they simply have no capacity to meet minimal standards of care. When each transformation goes wrong, they spend the time between transformations trying to recover from them.
2. There is a vicious and measurable cyclical pattern of Trusts falling into deficit, making extremely short sighted savings that make patients worse and increase the burden of care (demand) for a health region. Chasing short term savings with badly thought through cuts is encouraged by NHS England and DOH (who are aided and abetted by big 4 management consultancies). Once the inevitable clinical standards start to fall the Care Quality Commission (CQC) will step in and put pressure on the service provider to improve standards. The service provider will do this but often this will require equally knee-jerk measures that further increase the financial deficit (e.g. hiring locum staff). Rinse and repeat - this cycle continues. The biggest problem with this cycle is that this ‘catch 22’ regulation set-up leads to the institutions overall growing their own burden of care with each cycle.
3. In the worst examples of short term changes driven out of (1) and (2) above, patients become infantilsed and their rates of deterioration (mentally and physically) accelerate. Some of specific patients we followed in the study went from older people who were living active lives, staying on top of their multiple long term illnesses to becoming shells of their former selves with significantly higher care needs within the space of weeks - especially during long term stays.
4. As we all know, governments have failed to plan for and grow the NHS workforce. Stupid things like removing the nurse’s training bursaries have led to a dramatic workforce gap. That was even before we lost a further 22,000 EU based NHS staff (as known at 2019) following the EU referendum. This massive gap exacerbates the issue described in (1) above
To slowly reverse these massively unhelpful dynamics within our healthcare system will require the following:
a) Integrate the regulation of the NHS so that each service provider can reasonably manage a gradual improvement in both costs and clinical care quality in an integrated way. Allow providers to state what capacity they need to continuously adapt and improve and avoid short term interventions. Support the providers with innovation techniques and methodologies used by successful tech and service companies. These techniques look at life through the patients (customer’s) lens and we often see that quality of life is found to also to equate to lower costs of care - happy to share examples of anyone wants). Quality of life over quantity of life is also the most economical for the NHS.
b) Stop with the wholesale transformations of the NHS!!! No more!
c) To be able to do (a) we need a massive influx of NHS clinical and social care (also clinical) staff (let’s not get into a debate about how we attract them to this country for obvious reasons - we just need to have that outcome). As part of this, the government needs to negotiate with the pay demands. Not meet the number but negotiate.
In conclusion, no the problem isn’t that old trope that there are too many managers, it’s the combination of what I’ve described above which I believe is what @safrane alludes to in his comment above. And we are bloody lucky that NHS staff continue to follow their vocation despite all the system hurdles put in front of their chief desire to simply make people better.
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Mavster
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Do the best you can for your loved ones. The NHS ain't what it used to be. Don't rely on Ambulances turning up within minutes of a 999 call. There are 4 hours waits at A&E. FYI Monday morning at 8am is a quiet time at A&E in case you want to go there 
. Like I said before, its a messed up time now
. Like I said before, its a messed up time now
Scaf
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One practical thing that could be done now, is for the government / NHS England to set a cap on the hourly rate for agency workers, and associated admin costs.
There will always be the need for some agency cover, but it should not be so lucrative at any level, for NHS staff to leave and return via the agencies to earn more for less.
That is would keep more staff inside the NHS and save a fortune on the agency staff, money to be ploughed back into the NHS.
In our busienss (not healthcare) we pay agencies no more than 7% above our pay rate, allowing a margin for both the worker and the agency.
There will always be the need for some agency cover, but it should not be so lucrative at any level, for NHS staff to leave and return via the agencies to earn more for less.
That is would keep more staff inside the NHS and save a fortune on the agency staff, money to be ploughed back into the NHS.
In our busienss (not healthcare) we pay agencies no more than 7% above our pay rate, allowing a margin for both the worker and the agency.
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CatmanV2
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It seems to be a polarising situation where it's not possible to have a nuanced discussion. I will go private wherever possible because it's faster and more convenient for me. The service we've received to date has been exemplary, and we're not using NHS resources (other than as mentioned above) and still paying for them.
All of our experience of the NHS is that there are fabulous individuals mired in a system that is so far below the standard that would be expected of any commercial organisation as to be risible.
YMMV
C
All of our experience of the NHS is that there are fabulous individuals mired in a system that is so far below the standard that would be expected of any commercial organisation as to be risible.
YMMV
C