Dingdongler

The NHS has been discussed here many times. It has been plagued with problems since I've been a medical student (and I'm sure long before) However this last year or so things seem to have got really bad.

I can't figure out what exactly has caused this and who is to blame. Whether it's the previous govt and their PFI schemes that have saddled Trusts with unaffordable 'mortgages' and their appalling reform of the GP contract.

Or if it's this govt with their own reforms.

Regardless, things are dire. My own Trust has ambulances queuing for hours before they can even get into A and E, those ambulances then can't get out to attend to other calls.

We've not had a major outbreak of any kind this year so we shouldn't be in this position. If we did, god help us all.

When I speak to colleagues around London they are all experiencing the same issues.

Something has to give....

andy97

iTrader: (1)

My father in law has spent nearly 2 months in Boston Pilgrim hospital. He has been moved 4 or 5 times. Doctors and nursing staff failed to take proper care of him. They don't pass accurate records from one ward to the next, so his daughter's have to relay all his medical history to the new ward doctors. Some of his medicines need to be taken at precise times, when questioned about timings his records were misplaced. His barium test results were not allowed to be seen for data protection reasons, but we're freely available in the private hospital. In the end his daughter's sent him to a private hospital at £400 a day. After 10 days he was home after completing MR I scans and correctly diagnosing his conditions and sorting his medicines out.

john banks

Things are dire in GP land too. Once we had a manageable workload with four doctors and a mostly very sensible group of patients. Demand and expectation are increasing, funding is worse than before the bungled 2004 contract, and soon I'll be the last remaining actually working of four permanent doctors in my practice due to simultaneous long term sickness and maternity leave of my colleagues. When I ring up the hospital to admit people, for example with a GI bleed, I seriously get asked if I can avoid the admission in some way. A new generation of patients is consulting more than ever before with things that are minor and self limiting because of a "can't be too careful" approach which is crowding out the really sick people that would previously have been hung onto longer by the struggling hospitals.


The system is in a hiatus between collapse and privatisation. I just wish there was some clarity. From my perspective, why should I have less time and budget dealing with a suspected cancer case than a garage would have to diagnose and replace a faulty MAF sensor?

I would like to leave, but the circumstances don't actually allow this option just now. If employed, I would have resigned last month.

zip106

From a front-line pov what do you think the issue is Ding?

Is it, as we've been led to believe this week via the media, just too many people using the service for totally the wrong reasons?
Is it mainly the A&E services that can't cope?

Only today I had cause to call 111 - had a problem with my eye - but I only wanted to know if I should trouble my GP or would an optician suffice.
This led to me having to talk to 3 different people - the original call handler, then a nurse and then a doctor.
They insisted I went to the out of hours surgery, where they took my BP (too high!) and told me to make an appointment tomorrow to see my GP and also get to an opticians for an in-depth eye test.

The surgery had an hours wait, so much better than A&E - I think too few people know about these places - surely pushing it out to the public in a massive advertising campaign, whilst costing a fair bit, would still be cheaper than the cost of A&E staff sorting non urgent problems.

Matteeboy

People going for no reason? NHS Direct buggering up?

I saw a GP last week (worst cough I've ever had, splitting headache non stop, totally wiped out, sweats, shivers) and felt incredibly guilty when I found out that while quite ill, it wasn't serious...(still not 100% two weeks later)!

The situation does seem odd and very worrying.

andy97

iTrader: (1)

This winter seems to be the winter of coughs/chest infections. Every third person I come across is coughing!

c_maguire

There was an A&E consultant on BBC news today being asked why A&E departments were struggling. His response was that the problem didn't rest with them, but with the fact that beds are being clogged up in the wards by people who should be back in the community thereby preventy A&E moving people on. Compounded by the GP contract that means GPs are not providing on-call or weekend care as before.

Seems completely plausible to me.

zip106

As per my post above - people need educating about the 111 service.

urban

iTrader: (1)

I think immigration has a big part to play.

Tidgy

population is increasing every year, funding for hospitals is not.

Dingdongler

It's always a combination of things. The population is indeed growing and the GP contract shambles in 2004 means that very few provide an out of hours service hence everybody pitches up to AE.

Poorly thought out PFI contracts mean some Trusts are saddled with huge debts and as a result cut beds to save money.

Then working conditions become really bad and people leave, retire early or go off sick which compounds the problem.

Things look quite bad.

Matteeboy

Sor of feels like it might all completely fail soon. That would be pretty bad news.

b3nmw

I've been done a & e a few times last year with the kids. Waiting times are ridiculous seriously 4 hours, I wish double that. Nhs needs better funding and how it is divided better

Dr Hu

^^THIS.... due to massive council cuts, the 'care in the community' aspect is all but dead and gone...

So the hospital need to get them out of the bed they are in as they are 'medically fixed', BUT there is no half decent 'care' packages for them to receive once at home.... so they have to keep them in - et voila - total flustercuck....

They cut too deep, too fast, not necessarily directly out of the NHS, but where they have cut elsewhere is now coming home to roost.... short termism at its best.

I'm all for cutting the deficit, but not 'at any cost' - I'm sure we can all think of quite a few things we could cut right away and not even notice....

ALi-B

iTrader: (1)

Sound like what I had over christmas - spent best part three day in bed, couln't breath and just didn't have any energy to do anything. I didn't see the docs on the basis that once bed-ridden it didn't seem to get worse...I'm one of those types that only seeks help when at death's door .

Still have the cough now. Pulled a intercostal muscle again last weekend which means it now hurts to cough.

If this bug has hit someone more frail, it'll quickly put the system under heavy strain. Not good.

Matteeboy

Yep, still coughing too but the headaches gone and energy is back. I only see the doc when almost dead but I was a bit worried it might be bronchitis or something else. It's a right pain; had similar but only for a week a month ago. Not doing exercise for so long does my head in big time. I've twanged a couple of ab muscles coughing too!

dpb

Hope it's not self inflicted dirty seawater, mate got some kind recurring something about 12 years back

Maz

iTrader: (34)

It pains me to say it but I think maybe start introducing fees for doctors appointments and some services. I'm not sure how the administration and implementation would work but it may reduce those with minor ailments from clogging the system. Plus boost finances.
Bottom line we need more doctors, nurses, hospitals.

Matteeboy

Loads of non surfers have had it too; the water is a lot cleaner than it was too; only farm run off is an issue.

hodgy0_2

it is a fairly standard modus operandi, under invest, promote a bloated management structure, move the (any) organisation/industry away from the initial vision, then relentlessly attack and denigrate it

then say its all gone wrong - and needs privatising

john banks

GP out of hours sees more than it ever did. The only change is that GPs opt in to do it. In some areas they don't so much, but in this area they do and always have. I do not do any but only did a few before as I found locums to do them for me. I did car tuning instead

urban

iTrader: (1)

They charge for this in the Republic of Ireland, but they will be seen/treated for free if they travel to Northern Ireland.

rossyboy

iTrader: (8)

There's something else that nobody has mentioned - too much internet information now that results in self diagnosis and anxiety/paranoia.

I was guilty of this last year - too much reading of symptoms led to me believing that I had an extremely rare disease. GP and then Consultant agreed it was possible.

Multiple blood tests, full Torso CT scan, small chunk of leg muscle removed for analysis and Muscle electromyography later, I was declared fine.

If I hadn't read anything, I would have slowly got better myself. A nice prescription for Citalopram is the result!

Dr Google is a bit of a nightmare for the NHS.

Matteeboy

Agree with this. A minor headache and everyone thinks they've got Meningitis.

john banks

Latest idea is to let the worried well refer themselves for cancer testing. This whilst I cannot get people seen quickly enough who have actually have cancer or who are very likely to have it. If some consultants think some GPs are unselective in who they refer, just wait until the general public refer themselves...

shytorque

A friends wife worked in admin at the local hospital ,Rochdale Infirmary.
They restructured about 18 months ago and she had like three different roles at the time.
She was not offered any of these roles she did single handedly but was going to be forced to do a role she did not want.
She took early retirement in the end and her role was then given to "two " people to do instead of one...!!!
I know she was involved in making sure deadlines were met for seeing patients on time and this has got drastically worse since the restructure.
This may be some part of what is wrong.
People at the top ,making ill informed decisions rather than the correct decision.
I personally do not visit my doctors or the hospital unless I am "dying" or have had a serious accident. Last visit would be at least 4 years ago from memory so it aint me clogging the system up ..!!1

Carnut

I have problems.....yes I know you know so as a result I have been in and out of hospital for the past 8 years or so and had a few good experiences before that. This has involved many operations from 1hr to 12hrs. I have also had the pleasure of staying in hospital (obviously) from just a few days up to a YEAR, and currently go no more than one month without having to visit either the hospital or my GP.
My experiences have also been across many sectors of the NHS and has been across the country even being included in studies across Europe.


I could sit here all night and tell stories about how **** the NHS is and how through THEIR mistakes I lost my business, my life style, and much much more.(they have cost me and my family more than I care to remember. And not just money)


But I won't......the simple truth is the NHS is fantastic and getting better and better. There are clearly problems as with any business and some things need to improve but generally it is getting better.


The pressure is mounting and as we all know people are living longer plus we are able to treat and diagnose much much more than before, hence the work load has increased 10 fold.
If we were to apply the same pressure to the NHS 10 years ago that we apply now THEN you would see what a **** storm looks like.


One further thing, the NHS is still full of last generation doctors and nurses. The NEW young nurses and doctors have a much better way of dealing with things and unfortunately we will have to wait until the old die out.

JackClark

I love the NHS, I'm not particularly sickly - just a bit old - but do manage to end up in A&E about once a year and have no complains just praise any time I've used them.

I do think there should be a charge at A&E and for seeing your GP, just enough to be an additional filter. I found out this year that my Doctor does telephone appointments, that's as step in the right direction.

Carnut

My local GP practice was bad with long waiting times quite a few years ago now but their new system works great. You need to be able to phone at 8 o'clock in the morning but assuming you can manage that it's very very rare that you can't get a appointment that day. (You usually can choose am or pm also)

Secondly, i hear people talking about long waiting times at A&E and certainly this is the case but I've been going to A&E for over 25 years for both my own problems and taking others (hardly gone more than a year with out a trip of some sort) and it's always been the case that you have to wait for hours on end, nothing new having to wait a long time.

urban

iTrader: (1)

In my local practice you will not get an appointment same day. Usually 5 - 7 days.