NHS winter 'crisis'

[Damien]

http://www.bbc.co.uk/news/health-42552267

Telegraph's alternative take

Discussion here.

My mum works in the library at a hospital in Merseyside and today an e-mail was sent around to everyone asking if any non-clinical staff who've previously had experience on the clinical end could help out on the wards comforting patients etc while the nurses who are on there can help with more urgent matters. She said that's not happened before in her time working there and she's been at that hospital since 2008.

Some tweets:

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[Mozza]

Tories

 

[FC Ronaldo]

It gets worse every year and yet it still happens. Nothing has changed and everyone saw it coming.

Labour wouldn’t have solved all of the problems but they’d have given more of a damn and more funding than the current government. Hopefully people remember this when they next visit the polling stations because telling Trusts to postpone operations and put back appointments is so negligent it should hold serious (criminal?) accountability.

 

[The Outsider]

If this is caused by flu, perhaps too many over indulged at Christmas & New year as strange so close to the booziest days of the year.

 

[rpitchfo]

I'm a general manager in a large acute trust. Believe me when I say this is the worst it's ever been. Although I agree that the NHS has been underfunded for the last 7 years it's a little more complicated than that. The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is. Most of this is down to the unbelievable cuts social care has had to endure. Health are picking up the pieces and are Ill equipped to do this ( hospitals are very dangerous places for older people). More money wouldn't help us in this situation...one we don't have the staff and we would just end up building bigger and bigger warehouses of older people with little hope of them getting home in a timely way. Just reinforcing the cycle.

Please be patient with us during this time though. It's true that at least for us this is the best we have ever prepared. But it was never going to be enough in a system that doesn't work for our frailest. It's relentless and unprecented but everyone is doing Thier best.

 

[Snowjoe]

The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is.

Most of the people I know who work in the NHS say the same thing. A lot of my great grandparents were dead before or soon after retirement. But my grandparents and a lot of others are now drawing pensions for 20 odd years needing to be looked after. That retirement age is gonna have to keep rising and rising.

 

[JustAFan]

If this is caused by flu, perhaps too many over indulged at Christmas & New year as strange so close to the booziest days of the year.

Or how odd would it be if a lot of people were getting the flu right in the middle of flu season?

Of course not really strange that there could an uptick in flu cases around a holiday that falls in the middle of flu season. Afterall, think about what we do during the holidays. More people crowding into shopping areas, more parties/gatherings, church attendance goes up, more travelling, all things that bring you into contact with more people which increases the chances of the flu spreading. Nothing really strange about it.]

It won't happen every holiday season, but if you get a flu going around during the holidays it can spread more quickly then say in February.

 

[rpitchfo]

Most of the people I know who work in the NHS say the same thing. A lot of my great grandparents were dead before or soon after retirement. But my grandparents and a lot of others are now drawing pensions for 20 odd years needing to be looked after. That retirement age is gonna have to keep rising and rising.

This isn't a case of lovely little older people needing some help either. The average age of older people in our elderly wards is 91. The vast majority have multiple comorbidites, dementia and disabilties. They deserve the best possible care. I can tell you that isn't a loud, busy acute ward for 3 months.

 

[George Owen]

Underfunding of the NHS it's a controlled plan to eventually kill it and for the private sector to take over. Nothing new.

Hopefully the people don't give up and will defend it with teeth and nails.

 

[Mozza]

I'm a general manager in a large acute trust. Believe me when I say this is the worst it's ever been. Although I agree that the NHS has been underfunded for the last 7 years it's a little more complicated than that. The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is. Most of this is down to the unbelievable cuts social care has had to endure. Health are picking up the pieces and are Ill equipped to do this ( hospitals are very dangerous places for older people). More money wouldn't help us in this situation...one we don't have the staff and we would just end up building bigger and bigger warehouses of older people with little hope of them getting home in a timely way. Just reinforcing the cycle.

Please be patient with us during this time though. It's true that at least for us this is the best we have ever prepared. But it was never going to be enough in a system that doesn't work for our frailest. It's relentless and unprecented but everyone is doing Thier best.

Tories again, social care is the remit of local givernment and local government funding has been cut to the bone

 

[Stanley Road]

We don't have those issues in nl despite an ageing population and a flu epidemic.

 

[FC Ronaldo]

I'm a general manager in a large acute trust. Believe me when I say this is the worst it's ever been. Although I agree that the NHS has been underfunded for the last 7 years it's a little more complicated than that. The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is. Most of this is down to the unbelievable cuts social care has had to endure. Health are picking up the pieces and are Ill equipped to do this ( hospitals are very dangerous places for older people). More money wouldn't help us in this situation...one we don't have the staff and we would just end up building bigger and bigger warehouses of older people with little hope of them getting home in a timely way. Just reinforcing the cycle.

Please be patient with us during this time though. It's true that at least for us this is the best we have ever prepared. But it was never going to be enough in a system that doesn't work for our frailest. It's relentless and unprecented but everyone is doing Thier best.

Echo those sentiments.

Cuts and the continued lack of funding across the board is the primary cause of this with particular focus on, but not exclusively to, non-Acute functions. The cost saving measures in these areas across the better part of the last decade have resulted in the Acute settings having to try and cover the gaps in these services and causing further issues in a system already overstrained.

Social care, district nurses, reablement staff, paramedics and so many more teams that treat patients in their homes and community facilities are so far beyond max capacity with their workloads and support that there is no where else for patients to turn but into their local Emergency Departments. Along with those that could be treated in Minor Injury Units that no longer function or equivalent facilities that are chronically under staffed too. Then there are those patients that are in Acute care and no longer have homes to be discharged into and effectively bed block as there is no capacity for Social services to house them.

And the whole sh*t storm in between their Acute stays.

The NHS is a wonderful system and the best privilege we have in this country but it needs support and to be the focal point of government policies once again to enable it to treat us all how it should be.

 

[Ekkie Thump]

I guess it ain't a priority but I had to take someone to a walk in centre yesterday - full to overflowing. Old folk standing, 2 - 3 hr waits, everyone stressed overworked and miserable. Patients grumpy, uptight, ill and collectively coughing at one another. Scene was straight out of a busy Lowry painting. I feel for the poor sods trying to work under such conditions.

 

[Simbo]

Is it really getting worse? Honestly I've been hearing the same thing since I developed the ability to remember hearing things.

 

[Massive Spanner]

I'm sure it'll be fine when it gets the extra £350m a week.

 

[golden_blunder]

I'm a general manager in a large acute trust. Believe me when I say this is the worst it's ever been. Although I agree that the NHS has been underfunded for the last 7 years it's a little more complicated than that. The biggest challenge is simply the vast amount of older people requiring help...and just how complex that is. Most of this is down to the unbelievable cuts social care has had to endure. Health are picking up the pieces and are Ill equipped to do this ( hospitals are very dangerous places for older people). More money wouldn't help us in this situation...one we don't have the staff and we would just end up building bigger and bigger warehouses of older people with little hope of them getting home in a timely way. Just reinforcing the cycle.

Please be patient with us during this time though. It's true that at least for us this is the best we have ever prepared. But it was never going to be enough in a system that doesn't work for our frailest. It's relentless and unprecented but everyone is doing Thier best.

It’s thanks to people like you and your colleagues that the whole thing hasn’t collapsed already. Thank you

 

[Ducklegs]

Is it really getting worse? Honestly I've been hearing the same thing since I developed the ability to remember hearing things.

I dont know, but i remember sitting in A&E pilgrim hospital in 1999 with my son who had half his face hanging off after being attacked by a dog and didnt see so much as a nurse for 2 hours.

We saw a doctor an hour later, and then the first nurse again near 2 hours after that to stich him up.

When i broke my shoulder in the early 90s I went in to the Edith Cavell in Peterborough and I was seen to straight away.

The number of people hospitals have to treat now is ridiculous, and the the type of stuff people go to A&E for is even worse.

 

[golden_blunder]

We don't have those issues in nl despite an ageing population and a flu epidemic.

You pay more taxes there as a stand rate though. I remember mine was standard 33%
I also think that NL people tend to be healthy for longer due to their outdoorsy lifestyle and regular cycling

 

[Mozza]

Is it really getting worse? Honestly I've been hearing the same thing since I developed the ability to remember hearing things.

Yes

 

[golden_blunder]

A&E should be really for emergencies but now it’s like gps encourage you to go there to get access to the system.

They should have more nhs drop in centres to cater for things that aren’t an emergency

 

[Ramshock]

The NHS is the only great thing you Brits ever did, you really ought to look after it better

 

[Mozza]

In 2010 satisfaction with the NHS was the highest it had ever been, then the Tories happened

 

[Ramshock]

A&E should be really for emergencies but now it’s like gps encourage you to go there to get access to the system.

They should have more nhs drop in centres to cater for things that aren’t an emergency

They should also charge £10 for every missed appointment. That would cut down waste a lot.

 

[Unlikely lad]

Wards are fecking mental around here. I've always thought, 2nd/3rd week of Jan is usually the worst, so just a bit worried.

Having Christmas/boxing day and New year's day all following a weekend hasn't helped though.

 

[Classical Mechanic]

Aren’t a very high percentage of A+E admissions over the season through drinking?

 

[golden_blunder]

They should also charge £10 for every missed appointment. That would cut down waste a lot.

Absolutely. I know in Derry the a&e can be full of drunks carrying on or even fighting. They should all be charged £100 for wasting resources

 

[Mozza]

They should also charge £10 for every missed appointment. That would cut down waste a lot.

People haven't got money

 

[hobbers]

Aren’t a very high percentage of A+E admissions over the season through drinking?

Something like 70-80% of A&E admissions from Friday through Sunday are alcohol related, and that isn't even seasonal.

If we were going to scrap one thing from NHS coverage that would be the very top of my list. Just invest in a fleet of drunk tanks and bar them from A&E.

 

[Ramshock]

People haven't got money

People can call up or in to make appointments but cant do the same to cancel them?

 

[Ramshock]

Absolutely. I know in Derry the a&e can be full of drunks carrying on or even fighting. They should all be charged £100 for wasting resources

Seriously it will cut the wait in half., The only issue I can see is people saying its a way in for the money men to start charging fees.

 

[Stanley Road]

You pay more taxes there as a stand rate though. I remember mine was standard 33%
I also think that NL people tend to be healthy for longer due to their outdoorsy lifestyle and regular cycling

40% average tax and 50% privatised. Privatisation is the only way forward I'm afraid. We also had years of cutbacks on tje govt contribution but privatisation is the saviour. The folks of the uk have yet to realise the difference between outsourcing and privatisation unfortumately. When they do and are willing to pay more tax then it will all come good. We also have the best road metwork in the world apparently and now a budget surplus of around 2bn. These arent coincidences.

 

[Stanley Road]

They should also charge £10 for every missed appointment. That would cut down waste a lot.

We get charged for them but more than 10 quid. We have to cancel at least 24hrs in advance, i cancelled one just today. We also get sms reminders for appts 48 hrs in advance.

 

[Ekkie Thump]

Something like 70-80% of A&E admissions from Friday through Sunday are alcohol related, and that isn't even seasonal.

If we were going to scrap one thing from NHS coverage that would be the very top of my list. Just invest in a fleet of drunk tanks and bar them from A&E.

There's definitely a problem with alcohol related A&E attendance but your figures are a bit misleading. Here's a 2016 report into it for instance. Alcohol related admissions never rose above 25% on any given day (23.9% on a Saturday being highest). The figures you are suggesting actually form the figures for the peak alcohol hours on weekends - see below quote:

although the peak time of general attendance at the ED was 12:00 to 13:00, alcohol related attendances peaked between 2:00 and 3:00 at 59.0%. Using the data for Fridays and Saturdays only, this percentage rose to a peak of 71.9% of attendances.

 

[Mozza]

People can call up or in to make appointments but cant do the same to cancel them?

People forget appointments

 

[Ramshock]

People forget appointments

if they are really sick they wouldnt, theres no excuse. It saves money and time. A debit card in the system is all thats needed.

 

[JustAFan]

People forget appointments

If they are grown adults without any sort of mental issues that affect their memory, then it really does fall under their own responsibility to remember such things.

 

[golden_blunder]

People forget appointments

When you’ve been waiting so long to get an appointment I don’t accept that as an excuse

 

[Mozza]

if they are really sick they wouldnt, theres no excuse. It saves money and time. A debit card in the system is all thats needed.

If you're sick you won't always be well enough to remember. I'll also repeat people don't have money

http://www.bbc.co.uk/news/business-37504449

 

[Mozza]

When you’ve been waiting so long to get an appointment I don’t accept that as an excuse

Have some empathy

 

[Mozza]

If they are grown adults without any sort of mental issues that affect their memory, then it really does fall under their own responsibility to remember such things.

People make mistakes, you going to pretend you've never made them?