Last Nights BBC Programme The Hospital

[fallen-archie]

If you did not see it then I recommend you do so on the Iplayer. It was an interesting insight into the comings and goings at Paddington St Mary's Hospital, a real fly on the wall documentary that throws some light on to te problems faced by our NHS. It mirrors my own experience within the system which is truly heading towards breaking point. Despite this, staff continue to do their best while consultants turn up for operations that cannot take place due to a lack of intensive care beds, To see so many highly paid and highly skilled Consultants sitting around awaiting a bedspace is soul destroying. The amount of money spent on the NHS needs to be rechannelled into the areas of greatest need and we as the general public need to stop abusing the system simply because it is free. I am proud of our NHS but without change will it last into the 22nd century?

[theelench]

Prescriptions, just another example of the manic over administration that robs the NHS of money.

About ten years ago I had a minor heart attack and have been on a repeating prescription for four pills ever since.  Until last year I would get a three month supply.  This was then stopped and I can only get one month repeats now.  When I asked why I was told this was to stop stock-piling and cut down on waste if there was a mistake.  As I take one of each every day how can I be stock-piling?  Why would I want to do this?

Speaking to my customers, most of whom are elderly and on drugs that they need to avoid being admitted to hospital, they are terrified of being left without medication.  Mistakes happen on a regular basis.  As the repeat prescriptions will not be signed more than a week in advance any mistake is likely to leave them without any pills as it takes about ten days for the repeat to be processed.  Hence the stock-piling, to tide them over when mistakes occur.

Until this was brought in my GP employed one prescription administrator.  Their work load is now tripled so he employs two.  Despite this prescriptions are still wrong because they are both under pressure as are the pharmacies dealing with three times the number of prescriptions. 

[jd.linklater]

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@goldenwonders wrote:

We appear to cater for every foreign language on the planet in the UK - and leaflets and brochures are available to suit! How much does that cost? I have friends in France who are British and they will tell you - if you don't speak the language that's tough in France - they will try and help but they don't waste a fortune catering for non speaking Frenchman.

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Can't find current figures but the UK public sector as a whole spent £140m on translation services in 2014.

http://www.bbc.co.uk/news/uk-england-25933699

[evoman3957]

What most people say about the NHS is true and in a lot of cases, from personal observations and experiences; that just goes to show that the remedy is not so easy.  On the one hand, you've got people who want to throw money at it, like there's no tomorrow, just so the squandrels & incompetent wasters can get through it even quicker..........and on the other hand, the Trotskyites; who think anything to do with money is abhorrent and any business should be put in the hands of the masses. Hopefully there's somebody in between, with a brain cell, who can understand the complexities and can come up with an answer.

[littleme61_6]

Patients entitled to Medical exemption certificates are given these for an array of long-term illnesses!. Ie: Diabetes, Stoma supplies.. etc.

But a lot of money could be recouped by the NHS if those medical exemption certificates are only used for the sole purpose of those illness medical requirements. Yet cough mixture, creams, HRT.. infact anything else nonrelated to the illness are allowed to be free as well, due to the initial exemption. If anything not related was charged for, a lot of money would be saved by the NHS. 

[fallen-archie]

That's brilliant, we all have experiences of the NHS in action and at last we have some really good suggestions on ways of which savings could be made and therefore ploughed back into the system. This is exactly what we need to see those reponsible loking into and actually doing something instead of sitting on their backsides playing the blame game. I for one can empathise with the example given about drug returns, millions wasted each year because the pharmacy won't take them back, And equipment abandoned by the public because they wee not charged for it or the hospital refused to take it back. Then there is the amount of time wasted by the ambulance service who get the patient to Hospital only to hae to wait for hours in the A&E dept simply because there are no casualty beds. I honestly believe that between us we coud save millons and improve the service to those genuinely sick.

[goldenwonders]

We can all have good ideas - BUT there is no one who is even considering taking them on board!

The prescription issue has been bugging me for a long time - so who is going to do something about it?

I could add to this prescription farce, my father in law and brother both died in the last 5 years - in both cases there were more than a carrier bag full of medications that had not been used.

My friend told me only last week that his father was ordering everything on his prescription list because he put crosses in the boxes - thinking that would mean he did not want the item - he is 95! To add to that he was even getting Paracetamol on a prescription - I could not believe my ears!!!! That was probably costing £'s more than the 20p you can buy it for on the High Street.

No one has yet commented on my issue with cancelled appointments - I believe the reason for cancelling these are two fold. Firstly it's because appointments are made so far in advance (in our case 6-12 months) that they do not know if specific doctors are working on those days. OR Secondly it's because the doctors we are seeing are also working on a private basis and are otherwise engaged elsewhere. So who picks up the bill for re-issuing appointments - the NHS! Common sense would say the NHS must have these doctors under contracts - just like a teacher, - and they would not be able to have time off inside certain dates (the equivalent of a term time). That could stop the waste in those areas.

Another area of waste - I recently was diagnosed with prostate cancer - so underwent various tests at the hospital, when I visited my doctor he told me he had no details of the results (this is 2 months later) and so needed to do other tests to verify certain things. What a waste - so much for the computer on his desk, if the info is not entered you might as well have a notepad!

[evoman3957]

https://www.theguardian.com/society/2012/jul/03/prescription-medicine-unused

[evoman3957]

https://www.theguardian.com/society/2016/dec/18/nhs-doctors-locums-pay-finance-hospitals

https://www.theguardian.com/society/2016/feb/11/are-locum-doctors-and-nurses-really-bankrupting-the-...

One answer could be that, instead of getting locums from outside private agencies; each Hospital runs it's own staff bank.  Staff called in, are paid a reasonable overtime rate; time and a half or double time. If a Doctor was on £20 per hour ( and trust me they're not........unless they've been at it for quite a few years ) that would be a max. of £40 per hour..........NOT £100 per hour and there'd be no agency fees.

[littleme61_6]

With everything everyone has added here, and very interesting links too to learn more, it's about time that the powers that be, who could, and can make a huge difference by making huge money saving changes, don't start getting the wheels in motion to sort all this out once and for all. Where ever they start it will for sure save money. 

[goldenwonders]

So now Theresa May says the gp's are partly to blame - and they must provide a 7 day service 8-8pm.

I think it would be nice if they just gave people an opportunity to get to see them!

[joe_bloggs*]

Powerful and shocking commentary about desperate plight of our NHS on Newsnight, The Tories remain in denial

https://twitter.com/BBCNewsnight/status/820040913355345921

[upthecreekyetagain]

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@goldenwonders wrote:

So now Theresa May says the gp's are partly to blame - and they must provide a 7 day service 8-8pm.

I think it would be nice if they just gave people an opportunity to get to see them!

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The perfect way to solve the shortage of GPs and encourage more doctors into becoming GPs - cut funding and extend their working hours - are all politicians mad?

[theelench]

My GP is approaching retirement.  He already works 8 -6 Monday and Tuesday and  7 - 6 Wednesday to Friday seeing patients.

After that he is often at work until 9 - 10 at night doing paperwork.  Plus he often has to do more paperwork at weekends.

No wonder he is looking forward to retiring although he is a dedicated doctor.

[fallen-archie]

A little more light was shone on the desperate situation last night, Social care seems to be a major problem so perhaps it is time for that to be reviewed as currently the local authorities are struggling to cope. Not convinced this is just a funding issue, I reckon it is in part political.

[theelench]

And did they mention the amount of wasted time and money that part of the system generates, not to mention the distress it can cause to patients?

My mum (85) has memory loss, turning into Dementia.  She has been assessed by her GP, a Specialist Geriatric GP, the Geriatric Mental Care Psychiatrist at the local hospital, Social Services (twice) and a care providing company.  We were summoned to the GP surgery a year after her diagnosis for routine re-assessment (to keep their records up to date) and more recently had a letter from the hospital for the same reason. 

Eight assessments,  no therapy or medication possible, the only practical help from the care company for which we pay.  Why aren't all the NHS staff and social services sharing her notes,  they do the same tests, ask the same questions again and again.  What's the point of distressing my mother by forcing her to travel to various surgeries and clinics and confronting her with her deterioration on a regular basis.  All these assessors on good salaries and her carer gets about £8 an hour.   Too many useless bums on seats draining away the cash that should be providing care packages.

[cee-dee]

Again, I didn't watch it but.... all this "funding" lark is a bit of a contrived issue?

Shropshire hospitals can't afford to pay their sandwich suppliers and asked them if they could defer payment until the next financial year (April??). What a cheek? I don't suppose they asked those non-productive people at the top of the Health Board to defer their pay?

[theelench]

Or their expenses for site visits or their subsidised staff restaurants or even their private health care packages.

[goldenwonders]

The NHS has so many problems - bed blocking is a major issue agreed. It would make sense that they had a second line of care for those who need it between hospital and convalescence/going home, this would free the hospital beds and act as a safeguard to reduce elderly patients ending up back in hospital.

On Tuesday my 17 yr old daughter had an appointment arrive for her ongoing saga of obtaining treatment for a small growth on her arm. Yesterday (the next day) the appointment was cancelled and another re-issued! What a waste!!! She has so far had about 8 appointments, spread over about 6 months maybe more, on one occasion arriving at the hospital to be phoned on the doorstep to be told the appointment was cancelled (due to her age) - she has to date received no treatment at all !

Also Tuesday I finally got to see my hard working GP (who was on holiday when I tried to make the appointment Monday last week) - I had a 4.20 apptmt - sat from 4.05 to 4.35pm waiting - during which 3 other patients went in. The surgery was deserted, I then realised the other doctor at my practice was now on holiday - in post 8 I'd asked why on earth would my doctor would go on holiday in Winter their busiest time? Seems its more common than I thought.

I remember in the 70's when my 1 GP and 1 receptionist ran the surgery - no appointments, walk in, he did home visits, surgery always pretty full with what must have been upwards of 20 patients sitting there. In those days the doctor had to give me 2 injections a week for allergic asthma, went on for 12 weeks. I never remember it being a major issue for them to cope, I don't remember any talk of the system collapsing - and I know where he lived so he was well paid! What has gone wrong?????

[upthecreekyetagain]

20 patients in a waiting room for 1 doctor with an average of just 10 minutes each means a wait of more than 3 hours - similar to what you will see in an NHS drop in centre today.

The simple answer is that there aren't enough GPs - we can't carry on tempting doctors from overseas, we need to train our own and make the profession attractive enough to encourage more to train.

We won't solve the problem by restricting pay and conditions - nor by trying to force current doctors to work longer hours or restrict holiday times - that will simply make the situation worse!

[evoman3957]

A consultant ( last night ) said it all really. The job of a Hospital, it's Doctors & Staff, is to make sure that patients are treated & brought back to a condition of health; where they no longer require Hospital care. It is then the responsibility of other care organisations, to ensure that facilities ie. beds; are available, to accommodate those needing any degree of further care. However, as the consultant went on to say, because the second of those two care requirements are not functioning properly; it seems to be OK to blame the first ( ie. Hospitals ) for the problem, when they are suffering through no fault of their own. I was amazed at the man, who was brought in as an emergency, requiring an emergency, life saving operation........after the op. there was no bed on the ICU; so he remained in the operating theatre for over 8 hours, after the operation had finished, being cared for.  All further operations, in that theatre, then had to be cancelled for the entire rest of the day. I was also a little " miffed " at the Polish man ( of no fixed abode ) working ( supposedly as a mechanic ) and sleeping in customers cars overnight; who took a bed up for 3 WEEKS, because they had nowhere else to send him...........**bleep**..........enough said !!!