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"NHS at breaking point, and broken"

tuga said:
You have to thank BrExit in part for that because not only businesses and the NHS are now struggling to recruit but the quality/performance of the few available candidates is very poor…
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In part, probably you’re right. I saw some poor quality NHS service in July this year, in an A and E in St Hellier Hospital in Sutton. My feeling was that it was institutional partly - that’s to say a de facto policy of ignoring distressed patients who were crying for information and reassurance - to the extent of rushing past while not even giving them eye contact. The nurses working at night were middle aged, one close to retirement she said, and I think there was a fair amount of disillusion and cynicism on their part too. I heard them hand over to the day staff and you could tell the night staff felt unsupported, abandoned to a thankless task. I felt so angry about it all that I made a complaint, only to receive a standard fobbing off letter.

And another example of institutional incompetence last year. I was referred to Guys dental hospital, they rejected the referral, and didn’t tell me or my dentist until I chased it. The dentist made a second referral to another dental hospital (St Helier again, but nothing to do with the above) who accepted it immediately - and then out of the blue Guys just gave me an appointment! So I had two appointments in different NHS hospitals. I was totally confused about how Guys could have changed their minds without offering any explanation, and indeed without any liaison with the referring dentist or me - a letter with a date and time arrived in the post out of the blue, and the dentist wasn’t in the loop. I asked, but just got fobbed off.
 
mandryka said:
In part, probably you’re right. I saw some poor quality NHS service in July this year, in an A and E in St Hellier Hospital in Sutton. My feeling was that it was institutional partly - that’s to say a de facto policy of ignoring distressed patients who were crying for information and reassurance - to the extent of rushing past while not even giving them eye contact. The nurses working at night were middle aged, one close to retirement she said, and I think there was a fair amount of disillusion and cynicism on their part too. I heard them hand over to the day staff and you could tell the night staff felt unsupported, abandoned to a thankless task. I felt so angry about it all that I made a complaint, only to receive a standard fobbing off letter.

And another example of institutional incompetence last year. I was referred to Guys dental hospital, they rejected the referral, and didn’t tell me or my dentist until I chased it. The dentist made a second referral to another dental hospital (St Helier again, but nothing to do with the above) who accepted it immediately - and then out of the blue Guys just gave me an appointment! So I had two appointments in different NHS hospitals. I was totally confused about how Guys could have changed their minds without offering any explanation, and indeed without any liaison with the referring dentist or me - a letter with a date and time arrived in the post out of the blue, and the dentist wasn’t in the loop. I asked, but just got fobbed off.
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Admin is the biggest problem.
My wife is a consultant in a two hospitals from the same Trust: one on Mondays and Wednesdays, another on Tuesdays. Twice last year they have booked appointments for both hospitals on a Tuesday. The same happened with one of her colleagues. They also often book when she's on annual leave and don't book when she's working...
I've had that happen when I took my youngest to an appointment at the JR hospital, on a day when the consultant was doing clinic from home.
 
AIUI, the NHS has the smallest (by proportion) number of administrative staff to medical staff.

This is because, (IMHO) when NHS admin staff numbers went up under New Labour, the Media had a collective fit of the vapours: "OMG! Think of the money spent on all of those office staff. You could buy nurses with that!" And that, made any increase in funding other than nurses and doctors politically unappetizing. Some daft, difficult to justify headline grabbing salaries didn't help either. Then, public opinion aside, as funding started to get throttled, funding for back-office staff took a hit to save money for doctors and nurses, further reducing costs.

IME senior management prefer salary and job numbers as metrics for savings / cost; they're easier to measure and understand than trying to work out the impact of losses due to a consultant or ward sister spending two hours every day sorting out their admin (well, they can just work longer / harder / smarter). Then there's the unmeasurable effect of excess admin making people leave because they joined to save lives, not paperwork.

Add to that some very archaic practices (paper letters are still king) and un-joined up IT systems between each care sector (or in some cases hospital departments) which ramp up the administrative burden and well.
 
Found friend on floor today , been there all night and not well . called ambulance and thankfully there in about 40 mins . Ironically it was same ambulance paremedic as last time . my word what a wonderful job they do . now in A&e but i wasnt allowed to accompany him
 
mandryka said:
In part, probably you’re right. I saw some poor quality NHS service in July this year, in an A and E in St Hellier Hospital in Sutton. My feeling was that it was institutional partly - that’s to say a de facto policy of ignoring distressed patients who were crying for information and reassurance - to the extent of rushing past while not even giving them eye contact. The nurses working at night were middle aged, one close to retirement she said, and I think there was a fair amount of disillusion and cynicism on their part too. I heard them hand over to the day staff and you could tell the night staff felt unsupported, abandoned to a thankless task. I felt so angry about it all that I made a complaint, only to receive a standard fobbing off letter.

And another example of institutional incompetence last year. I was referred to Guys dental hospital, they rejected the referral, and didn’t tell me or my dentist until I chased it. The dentist made a second referral to another dental hospital (St Helier again, but nothing to do with the above) who accepted it immediately - and then out of the blue Guys just gave me an appointment! So I had two appointments in different NHS hospitals. I was totally confused about how Guys could have changed their minds without offering any explanation, and indeed without any liaison with the referring dentist or me - a letter with a date and time arrived in the post out of the blue, and the dentist wasn’t in the loop. I asked, but just got fobbed off.
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ha funny should mention st helier !!! i used to work in St Helier A&E many years ago !!! quite an exciting time and not much different to today but we did NOT have ambulances backing up like today . they just came in and out quick as a flash !!

http://www.heliermemories.org.uk/
 
hifinutt said:
ha funny should mention st helier !!! i used to work in St Helier A&E many years ago !!! quite an exciting time and not much different to today but we did NOT have ambulances backing up like today . they just came in and out quick as a flash !!

http://www.heliermemories.org.uk/
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That was my local hospital as a kid - thankfully not too many trips there apart from when I slashed my hand open sharpening a carving knife. Was born at the Mayday in Croydon - what a name for a hospital!
 
wow ... maybe i helped look after you as a kid !! it was around 81 if i recall . did an agency shift at mayday once .. happy days
 
Seeker_UK said:
AIUI, the NHS has the smallest (by proportion) number of administrative staff to medical staff.

This is because, (IMHO) when NHS admin staff numbers went up under New Labour, the Media had a collective fit of the vapours: "OMG! Think of the money spent on all of those office staff. You could buy nurses with that!" And that, made any increase in funding other than nurses and doctors politically unappetizing. Some daft, difficult to justify headline grabbing salaries didn't help either. Then, public opinion aside, as funding started to get throttled, funding for back-office staff took a hit to save money for doctors and nurses, further reducing costs.

IME senior management prefer salary and job numbers as metrics for savings / cost; they're easier to measure and understand than trying to work out the impact of losses due to a consultant or ward sister spending two hours every day sorting out their admin (well, they can just work longer / harder / smarter). Then there's the unmeasurable effect of excess admin making people leave because they joined to save lives, not paperwork.

Add to that some very archaic practices (paper letters are still king) and un-joined up IT systems between each care sector (or in some cases hospital departments) which ramp up the administrative burden and well.
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A lot of the admin staff has been replaced by cheap overseas service providers and barely-fit-for-purpose software. It's the Tory's tax-payer's VFM cheap'n'cheerful mantra.
At the trust my wife works for the letters used to be dictated by consultants, typed in India, reviewed by consultants and sent by admin staff; now consultants use a software with voice-to-text that freezes and crashes on a regular basis...
 
tuga said:
A lot of the admin staff has been replaced by cheap overseas service providers and barely-fit-for-purpose software. It's the Tory's tax-payer's VFM cheap'n'cheerful mantra.
At the trust my wife works for the letters used to be dictated by consultants, typed in India, reviewed by consultants and sent by admin staff; now consultants use a software with voice-to-text that freezes and crashes on a regular basis...
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My hospital outsourced sending letters to a private contractor. Their had problems with their system that meant no one got any letters for six months...
 
Anyone slagging our health service off whether it's overworked or not should be refused treatment for whatever is wrong with them. Of course though they will still get the same treatment as everyone else.
I admit trying to see a GP is a nightmare and the waiting list for treatments is getting longer, but it's still got the most fantastic people working on the front line.
Cut the pay and thin out the top tier of overpaid staff and pump more money into the front line.
 
paulfromcamden said:
My hospital outsourced sending letters to a private contractor. Their had problems with their system that meant no one got any letters for six months...
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What the actual ****? How can such a situation exist? So for six months, no one did anything but go "Oh dear, they certainly do seem to have a problem?" While no necessary communication got done? No work around conceivable?

In an old comedy movie the plot revolved around there being Inspector Generals in 18th century Europe who could come to a place, inspect, and then have people shot if they thought it warranted. Stories like this make me view such arrangements as high institutional wisdom!
 
DonQuixote99 said:
What the actual ****? How can such a situation exist? So for six months, no one did anything but go "Oh dear, they certainly do seem to have a problem?" While no necessary communication got done? No work around conceivable?
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When I contacted the consultant about my test results she explained and emailed me a PDF of the letter. I guess in theory they could have emailed everyone - though they will have patients without email access - or printed them out themselves and mailed them, but I who knows if there's anyone in the hospital with time to do that or budget to hire in temps etc.

With hindsight it's easy to argue that something should been done sooner. But I suspect the contractor spent months promising them it would all be fixed next week...
 
Simon Vess said:
Your irony is closer to the mark than you may guess…..just prior to Christmas I was the victim of Evri who managed to lose several e- bay purchases
Luckily I received a full refund, however sellers received only a fraction of the selling price

Moral of this story: my strong advice: NEVER NEVER use Evri/Hermes…..

Surely someone will reply by saying that they have always had great service from them.

simon
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Evri have managed to lose a package that should have been delivered a week ago.
They say their driver could not get to my house.
I live on a housing estate, not the north face of the Eiger.
They are now “ looking into it”.
 
Spent most of day at a&e .ambulance came in 40 mins with lovely staff . Only 6 ambulances outside and straight in .ct scan fast and lovely staff but i dread to think what happened in covid with no relatives .had to help this guy pee 6 times which they would not have time to do
 
paulfromcamden said:
When I contacted the consultant about my test results she explained and emailed me a PDF of the letter. I guess in theory they could have emailed everyone - though they will have patients without email access - or printed them out themselves and mailed them, but I who knows if there's anyone in the hospital with time to do that or budget to hire in temps etc.

With hindsight it's easy to argue that something should been done sooner. But I suspect the contractor spent months promising them it would all be fixed next week...
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No one needs staff and budget but the contractor, who if he couldn't produce letters one way should have done it in another.

If the Inspector General had heard of this....
 
I think like all organisations there are brilliant NHS staff and there are poor NHS staff but some things I have observed in the past 12 months due to supporting a friend with cancer:

1. Nurses (many after doing a 4 year degree) can't prescribe so much as a paracetamol or put a dehydrated patient on an IV drip without sign off by a Doctor. This leads to long wait times for decisions from overworked Doctors. Well trained but junior staff should have more authority/empowerment. In my friend's case (a 50yr old woman with stage IV breast cancer being treated for a broken hip) the symptoms were - weakness, extremely low blood pressure (90/60), urine the colour of malt whisky in her bag and vomiting. I (with no medical training) repeatedly kept telling the nurses she was dehydrated and needed IV fluids). They (with 4 years medical training and years of experience on the wards) ignored me and said any decisions like that would be taken by the Doctor. In the meantime they kept trying to get my friend out of bed to walk around on her hip repair when she was too weak to stand! It took 2 days until she was seen by a Doctor who (yes you guessed it!!) prescribed an IV drip - my friend then recovered rapidly!

2. Desperately needed multi million pound cancer beam therapy machines like Cyberknife (of which I believe there are only 3 in the country - Bristol, London and I think Leeds) only operate between 9-5 MOn-Fri. meanwhile people wait too long for treatment with them... Now I work in the airlines and I can tell you that their multi million pound airline training simulators are in use literally 24 hours a day. Walk into the sim hall at 3am in the morning and those machines are in use - because companies don't like multi million pound machines lying around doing nothing!!

3. My local Doctors surgery were unable to send me a copy of my referral letter to a specialist by email and I had to drive in to collect a paper copy because they are "only allowed to email other NHS email addresses and nobody outside the NHS for security reasons". Now I ask you - in an age where companies conduct multi million pound trade deals over email and have been doing for probably 2 decades at least when is the NHS going to get with the program and develop working business processes that leverage the benefit of technology????

4. Oh and why is it that staff in the airlines fly 24/7, 7 days a week and yet Sat and Sunday there's barely a GP in the nation working, there's only a skeleton staff in hospitals and at night hospitals run on a bare minimum staff? People get sick or have accidents day and night 7 days a week and so I see no reason why the hospitals, Doctors surgeries, nurses and Doctors aren't working around the clock like airline crew (and many other businesses) do.

I'm the first to acknowledge that the Tories have royally ballsed up the system by underfunding it (below inflation) for the past 12 years. They have caused the Brexit shitstorm which has reduced the supply of skilled European Doctors and nurses who work here, they have cut funding at universities for training Doctors and nurses which means less have been trained and all of this has led to an over-reliance on (expensive) bank and agency staff. Labour funded the NHS at above inflation as a matter of policy and things got a lot better under them.

It's not just the NHS it's the entire fabric of Britain that is failing under the 'small state' mentality of the Conservatives. Never in living memory have the roads, transport, hospitals, ambulances, universities and other critical national infrastructure been in such a shocking state. I for one am sick and tired of them looking after the non-dom's, the offshore tax haven users and the large transnationals booking very little tax through the UK exchequer. I have a multi millionaire Brother in Law who would never have to pay a marginal rate of tax above 20% anyway (because he runs his own company and pays himself dividends attracting corporation tax at 20% ish) who now uses an offshore wealth management company in Jersey to reduce his tax liabilities further. God knows what percentage of his actual earnings he pays in tax but it must be the square root of bugger all.... Meanwhile muggins here earning about £55 000 with an airline has a marginal tax rate of 40% plus about 9% NI on every penny I earn above about £40k and nobody gives me a tax deductible on my car needed to get to work or my petrol expenses... In fact the inland revenue recently came after airline crews for taxation on their overseas allowances which are paid to enable us to eat or get a coffee or whatever in the Hilton in Berlin etc which as you can imagine isn't cheap but is totally necessary. Judging by Question Time last night I am not alone. The Conservatives are finished at the next election because they have become the party who look after the top 5% like my Brother in law and screw the other 95% - including both the middle classes (like me) and the working classes and poor. If Starmer decides to bring in proportional representation then the Tories will be finished for good and never again will this nation be led by a party of such incredibly narrow appeal. Last time they were elected into Government on a mere 43.6% of the vote with a massive majority and 365 seats due to the way the current boundaries and first past the post loads things in their favour. The Lib dems as an example won 11% of the vote (a quarter as many votes as the Tories) and got just 11 seats - it's not democracy, it's ridiculous!
 
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