NHS

[lifes2short]

Care outside of hospitals is next to non-existent in this country.

My Dad has mixed dementia, and his decline is becoming more accelerated. Is there any care available for my poor mum who is his full time carer? Who I might add is absolutely shattered. She's no spring chicken at 76. She's seen a Dementia care liaison person twice in 4 years!!!! And still hasn't received any help.

The local day centre for people with Dementia to give carers a break for a few hours has closed due to funding cuts.
I worry, that all of this will kill my mum before my poor old dad dies from his disease.

that's shocking and really makes my blood boil

 

[Scaf]

I referenced that we had been let down by a GP.

Mother in law could not get face to face appointment for 8 months, useless diagnosis over the phone / video.

Turned out to be pancreatic cancer (went private to get diagnosis) far too late for treatment, we lost her 9weeks later.

 

[lifes2short]

what's the point of all the tv commercials about seeing a doctor if you suspect you have cancer because in reality you can't see a doctor these days quick enough and when you can they mis diagnose anyway, this may be a bit strong but in my opinion a lot of GP's have blood on their hands

 

[jasst]

Well, here is my story, and make of it what you will, Last spring I actually managed to see my GP about a chest infection, whilst I was there I mentioned to him about a small lump on my left cheek, didn't bother me and had got used to it, GP was however concerned and arranged for me to go to my local hospital (Dorchester) for investigation, the appointment came through after a few weeks. In total over the summer I had 2 ultrasounds, 3 fine needle biopsies and an MRI scan. Wait times for appointments were on the whole quick, they would quite often phone me with a cancelation for the next day. but after all these visits the results were inconclusive, so they transferred me to Poole Hospital, appointment came in a couple of weeks and they were successful in getting a sample at the first attempt. 2 weeks later appointment to see the consultant and he said the results were 80% ok, but they were unsure about the other 20% and the only way to be sure would be to have it removed, which they would do in about a month, and they did, appointment came for 29th August and they removed said lump, unfortunately it took over 4 weeks for them to get the results of the biopsy back, which was quite a worrying time, but thankfully turned out to be harmless. On the whole I don't think I can fault the service I have received.

 

[Felonious Crud]

what's the point of all the tv commercials about seeing a doctor if you suspect you have cancer because in reality you can't see a doctor these days quick enough and when you can they mis diagnose anyway, this may be a bit strong but in my opinion a lot of GP's have blood on their hands

When I had cancer the GP got me an appointment at the hospital (from memory) the following day or the one after. Either way, by the end of the same week I had been coshed over the head and cut open to attend to it.

I don't for one moment doubt the awfulness many are experiencing, but it would be massively disengenuous of me to not mention my own experience.

 

[CatmanV2]

Indeed. My suspect skin cancer was dealt with quickly and efficiently. It's one of the the 'big ticket' metrics....

C

 

[Oneball]

My experience is the opposite, when I had cancer the GP got me a hospital appointment quickly but the consultant there fobbed me off. Apparently he was known for it. He later actually ended up head of the department! Probably retired now on a cushy pension after many deaths.

My mum was the one who forced the issue with me and made me see someone else.

I have also had good experiences.

And here in is what I think is the biggest problem with the NHS; you aren’t allowed to criticise as ‘they’re all amazing’ where in reality there is good and bad, same as any profession.

 

[mowlas]

I think we can, should and do criticize the NHS when it goes wrong for us; and recognise when they get things right.

From my experience on working on all sides (commissioning, provision, regulation and patient outcomes) I’ve tried to simplify what I truly believe are the 4 root causes of why the NHS is slowly failing and 3 combined remedies to make it into a self-healing, resilient system that marries keeping people well with good quality of life with reduced costs of care.

https://www.sportsmaserati.com/index.php?threads/nhs.36394/post-957230

None of these require a wholesale structural reform (we’ve been through at least 4 in the last couple of decades) and certainly require no further privatisation.

We also need to stop the tyranny of the big management consultancies who aid and abet short-sighted, cost-saving initiatives that always increase the medium term costs and the overall burden (demand) of care (make people worse). Short-sighted interventions are hard wired into the way we regulate the NHS (explained in my post). The largest of these consultancies has an NDA with the DOHSC which means it’s next to impossible to expose and shine a light on the degree of money wasting and inexcusable back-scratching (for the sake of the forum and myself, I’m not using the word I want to use or naming the firm). It’s an absolute f***ing scandal.

 

[sionie1]

What I find frustrating is even recently wards are closed off to relatives for visiting. Last Xmas and this summer my mum was admitted, on neither occasion could I visit ( she didn't have anything infectious). From a hospital point of view, my old man worked in the Estates Department for 40 years of a trust with a few hospitals, some Victorian and others more modern. The waste and then the short sighted penny pinching by managers and accountants was what always frustrated him. Along with consultancies charging huge amounts of money for obvious advice that was never acted on. Towards the end of his career he always bemoaned the lack of the old style matron and the sheer amount of back office paper pushers on large salaries, feathering their nests.

As for GP's, 3 months I waited with symptoms the ads tell you ' might be nothing to worry about but get seen'. Getting them to answer the phone was the biggest challenge, you couldn't visit as they wouldn't open the doors unless you had an appointment and your name was down. I got into more select nightclubs easier than seeing my GP. . From my own circle of friends and family there are more on the ' it's not all it's cracked up to be' than there are on the ' aren't they all saints and saved the world, give them a clap and 10% discount'. Still, it's better than US version of healthcare, so I try and be thankful, it's a bit like car insurance isn't it, you hope you never need it and it's only when you do you find out if it's any good in your neck of the woods.

 

[safrane]

As I wrote earlier in the thread.

It is not Dr and Nurses who create all the forms that they spend huge ammonts of time filling out - that's down to the Gov.
They also don't ask for management consultants, that's down to a structure imposed by the Gov.
They also don't want nice work to be farmed off the the private sector... again its the Gov that wants that, the same goes for competing every 5 years to run the service.

I love the NHS, my family have dedicated their working lives to it, my partner is upstairs now like every night writing her clinic notes from today even after a 12 hour day as she does every night.

As the largest employer in the country you will get some good and some bad staff. The Govs response to that is to have more managers, consultants and forms.

Whilst people expect the NHS to pick up everything from smoking, eating, mental health, fertility, adrenaline sport injuries, drunks etc etc rather than the public taking responsibility for their own health along with an aging population no one wants to pay for, then obviously it will continue to be stressed to breaking point and struggle to cover priority care.

Spend a night shift in A&E as a volunteer and I am sure you will come away with your eyes opened at the **** they put up with.

Like so many threads and opinions they end up being polarised, so I won't post on this one again... and wish once more there was an ignore thread option, not just my keyboard one.

 

[Harry]

A subject very close to me at the moment. My Mum in law is 81 Yr old cancer patient (with myeloma). She lives on her own, 100 miles / 2 hr drive from me & Mrs. Myeloma, in time, seems to attack the bones / joints.
This week, it flared up, she was in agony, could hardly move around or lie down. Didn't sleep for 2 days, trying to ** bits of sleep sat in a chair.
Got so bad my wife had to leave work (she works full time) drive to hers, stay with her. GP will not see her except by phone appointment. Wife rang her an ambulance to get her to hospital. Took 6 hours to come. Once at hospital, spent rest of the day and night in a "overflow" room with loads of other patients (no beds available in wards or rooms) and eventually had a scan late that night. From scan, they "can't see anything", sent her home next day (yesterday) with a pocket full of morphine.

My wife is still at her place today. But she needs to be at work here really. And she is far from being a medical professional.

Mum in law is sat in a chair at home, confused in pain and doped up. No way capable of looking after herself.

There seems to be no care available.

Where we are today is: I just do not know what to do.

Get on to your mum in law’s county council’s social services (google the number) and tell them she is an emergency case and needs help immediately. You should also be able to fill in an online form for her for a referral to adult social care. The county council should be able to arrange care until you either employ someone privately to help her or she is means tested and can get it for free.
Also call Marie Curie and ask them for advice about emergency help. There is a lot of assistance out there, the hard bit is finding out how to get it. I had to do it for my parents.

 

[doodlebug]

My very elderly father went downhill on Tuesday evening, I called an ambulance which arrived in 15 minutes. We waited about an hour to be seen by a doctor and were in a spanking new resuss area within 2 hours of arriving. His care at the William Harvey, Ashford was excellent. Despite all the scare stories. Maybe it was because he was in acute care, but the nurses were highly trained and plentiful. Unfortunately he passed away in his sleep this morning. My sisters and I have nothing but praise for the NHS, it was a positive experience.

So sad to hear this Helen. Deepest condolences from Dianne and me.

 

[CatmanV2]

The county council should be able to arrange care until

...eventually, possibly AMHIK. Actually don't.

C

 

[philw696]

When my mother was in hospital for a few weeks in the Summer they discharged her into a care home for a few weeks.
She was adamant it was being paid for by her beloved Boris and then she got a bill for £9,000 when she got home.

 

[Phil H]

The NHS is collapsing, law enforcement in this country is a scandal, and privatised utility companies have licence to rape and pillage bill payers with scant regard for any quality of service or investment. As regards infrastructure, what is the point, for instance, of taxing private transport out of existence when public transport is non-existent in many parts of the country? Those are just a few of many examples of national failures.

Now, two weeks ago a road crew was filling potholes in my neck of the woods, and today the new patches are already sinking; I assume they were done on the cheap to fend off insurance claims for the time being, with an intention to do the job properly when the budget allows, and therein lies a problem.

Like the pothole issue, a lack of vision, short-termism, and the abject failure of successive governments to plan for the future have led the country to crisis point. One of my pet hates is HS2 for which the latest financial estimates predict a Phase 1 cost overrun of over £4bn on a baseline of £40bn, with only a 50% chance of even staying within that. What’s worse is that HS2 is not future proofing anything, and many people who it was said the project would benefit have been told they’re no longer in the plan. If it is finally finished it will only service a fraction of UK rail users so HS2 is nothing more than a fancy cash converter. By my reckoning, the Phase 1 cost overrun alone could pay the current average salary of 12,000 nurses for 10 years, or it could fund a few care homes to reduce bed blocking and stop people dying in A&E queues.

The NHS is a bloated organisation that would be vastly improved with less jobsworths, more clinicians, and some sense of financial probity, but it desperately needs a competent and trustworthy government to address that and the other issues that beset the UK; the trick is to find one.

 

[Oneball]

HS2 does plan for the future it’s just successive governments have “sold” it incorrectly to the public. The real argument for HS2 is around capacity increase to allow more freight. The problem with selling that argument is most people don’t realise they actually use the railways everyday.

 

[Phil H]

HS2 does plan for the future it’s just successive governments have “sold” it incorrectly to the public. The real argument for HS2 is around capacity increase to allow more freight. The problem with selling that argument is most people don’t realise they actually use the railways everyday.

Back in 2015 a House of Lords report said that "Rail freight is important to the UK economy, but it has largely been ignored during the development of plans for HS2" and since then freight users have repeatedly criticised the government for watering down the original plans and cancelling key parts of the project that affect their operations. A main criticism has been the lack of a holistic approach to the freight network; adding capacity is one thing, integration is another, and it seems to be the latter that's causing concern.

Not really my subject though, so I'm happy to be corrected.

 

[Oneball]

Back in 2015 House of Lords report said that "Rail freight is important to the UK economy, but it has largely been ignored during the development of plans for HS2" and since then freight users have repeatedly criticised the government for watering down the original plans and cancelling key parts of the project that affect their operations. A main criticism has been the lack of a holistic approach to the freight network; adding capacity is one thing, integration is another, and it seems to be the latter that's causing concern.

Not really my subject though, so I'm happy to be corrected.

As an engineer you don’t want freight and passenger traffic on the same railway so to me it makes sense not to use HS2 for freight. Every country that I know that has a high speed rail network does not use it for freight. The advantage is by moving passenger traffic onto HS2 you free capacity on the existing network

But there could be arguments that integrating it into a holistic network plan hasn’t been done. I don’t know. I’m not convinced on the operating model though as it’s very similar to what we have currently.

 

[P5Nij]

As an engineer you don’t want freight and passenger traffic on the same railway so to me it makes sense not to use HS2 for freight. Every country that I know that has a high speed rail network does not use it for freight. The advantage is by moving passenger traffic onto HS2 you free capacity on the existing network

But there could be arguments that integrating it into a holistic network plan hasn’t been done. I don’t know. I’m not convinced on the operating model though as it’s very similar to what we have currently.

As a freight train driver I can certainly confirm that it's all about increasing / improving traffic flow and capacity elsewhere. The southern half of the WCML is already back up to capacity after the covid 'interlude' despite what some commentators say about passenger numbers (this is my core route as it happens) and it's stacking up elsewhere, capacity on the recently upgraded Midland mainline and parts of the GW area are becoming a problem too. Our customers want us to run longer, heavier trains but the signal spacing doesn't allow for it in some areas, making the sections longer allows an increase in braking distance but it means less paths per hour (passenger and freight lobbying groups are always clamouring for more of the latter). Some of our customers also want us to run taller double stacked container trains but the cost would be horrendous to remodel all of the existing overbridges and tunnels en route. We live in a relatively small country with a very crowded rail network, Euston to Glasgow is just over 400 miles, that's the equivalent of a secondary branch line in some countries, the only answer is to build in more capacity, hence HS2 etc. A feasibility study was carried out on adding two extra lines to the existing WCML but it would be even more expensive and disruptive than building a separate new line elsewhere.

Upgrading / building new railheads is definitely part of the problem, although things are moving in the right direction on the WCML with DIRFT (near Crick) being extended over the other side of the A5 and a new terminal being built on the Northampton loop of the WCML very close J15A of the M1. In some areas real integration is impossible or difficult though, because of new residential and commercial builds going up on former railway land.

 

[Phil H]

As a freight train driver I can certainly confirm that it's all about increasing / improving traffic flow and capacity elsewhere. The southern half of the WCML is already back up to capacity after the covid 'interlude' despite what some commentators say about passenger numbers (this is my core route as it happens) and it's stacking up elsewhere, capacity on the recently upgraded Midland mainline and parts of the GW area are becoming a problem too. Our customers want us to run longer, heavier trains but the signal spacing doesn't allow for it in some areas, making the sections longer allows an increase in braking distance but it means less paths per hour (passenger and freight lobbying groups are always clamouring for more of the latter). Some of our customers also want us to run taller double stacked container trains but the cost would be horrendous to remodel all of the existing overbridges and tunnels en route. We live in a relatively small country with a very crowded rail network, Euston to Glasgow is just over 400 miles, that's the equivalent of a secondary branch line in some countries, the only answer is to build in more capacity, hence HS2 etc. A feasibility study was carried out on adding two extra lines to the existing WCML but it would be even more expensive and disruptive than building a separate new line elsewhere.

Upgrading / building new railheads is definitely part of the problem, although things are moving in the right direction on the WCML with DIRFT (near Crick) being extended over the other side of the A5 and a new terminal being built on the Northampton loop of the WCML very close J15A of the M1. In some areas real integration is impossible or difficult though, because of new residential and commercial builds going up on former railway land.

Given the limitations of working within our little island, what's your professional view of HS2 as regards planning and execution thus far?