Yeah, some people are dicks. But it's hard to create a system that distinguishes between dicks and non-dicks.
NHS winter 'crisis'
- Thread starter Damien
- Start date
The system wouldnt be needed if people cancelled appointments they no longer needed. It only takes a minute.
I agree with you that people should be more considerate. I just disagree with your method to fix it.
How would you fix it Silva? Nothing gets peoples priorities sorted quicker than money coming out of their wallets
When people are aware what the cost of a missed appointment is, they're less likely to miss it and more likely to cancel one they'll definitely miss. So, like most other things, educating people on the issue.
I'd limit it to those in work, those without chronic conditions and have a two strikes policy. I'd trial it for one year in selected boroughs to see if it broke even or made a profit and to see if anyone was adversely affected by it.
Is it really that hard to make a phone call? fecking hell people.
No it's not that hard. Nobody thinks these people are well cool and deserve high fives. Wtf is wrong with a trial?
Nothing is wrong with a trial, what is wrong with making a phone call or sending a text? Suggest you read the last few pages
This is like blind man's ping pong. Nothing is wrong with making a phone call or sending a text. I'm up for a penalty being imposed as long as it's practical and fit for purpose. My proviso is that it targets those who are both culpable and capable of paying and that those who need the service most are not adversely affected by it.
I think we all accept that missed appointments do not amount to a financial or efficiency panacea, but little things do add up (NHS England alone comprises a budget in excess of £100bn). Hundreds of millions, the low billions, such sums build hospitals. Nor were Labour and the Tories so very far apart at the 2010 and 2015 elections; even had Corbyn secured an overall majority in 2010, he would still have most of these challenges on his plate.
On the one hand, we can ease the bed blocking through central policy; on the other, worsening seasonal flu is a tougher nut to crack. I also saw a news report tonight in which they described the...seemingly frivolous cases attending A&E; did these people not hear the broadcasts stating surgeries would be open during the festive period?
Anecdotally. i believe that the NHS' preference for centralsiation is in error, yet i am open to the more informed opinion of doctors present here. Ambulances would appear to travel further, and there must presumably be less redundancy in the system.
On the one hand, we can ease the bed blocking through central policy; on the other, worsening seasonal flu is a tougher nut to crack. I also saw a news report tonight in which they described the...seemingly frivolous cases attending A&E; did these people not hear the broadcasts stating surgeries would be open during the festive period?
Anecdotally. i believe that the NHS' preference for centralsiation is in error, yet i am open to the more informed opinion of doctors present here. Ambulances would appear to travel further, and there must presumably be less redundancy in the system.
Mistakes happen
People are using food banks in your Tory Britain, sanctioned and without money for months, finding £10 is a task. What may not seem a life threatening condition may be a life threatening one, the person is not a Dr after all, but for want of £10 may leave it too late.
How would the truly destitute prove their status. Do they prove it to the clinic? The clinic need to keep records of those who are destitute, who pays for the record keeping?
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We don't live in a perfect world
No surprise that the thread has been hijacked by talk of missed appoinments. There really are some thick shites in here.
UK needs to change the way healthcare is run and funded. NHS is way too big and bloated to adequately manage. And with an ageing population, you simply have to commit more money to healthcare.
This crisis is not about missed appointments, its not about 'too many people, its a deliberately engineered problem.
7 years of cuts to social care mean that people are now not treated in their own homes, but those people do not just dissapear. Instead, they end up in the NHS taking up beds because there is nowhere to release them to where they can have adequate supervision. That means less beds in the NHS, because there are always more patients than there would normally be, a lot more. Then there is staffing, we have lost thousands of nurses and doctors, many of whom fecked off when after brexit when the abuse ramped up.
So before winter, we already had an NHS with not enough staff (The tories also cut nursing bursaries so now there are less trainees as many can't afford to do the course without them), and already too many patients. Then the winter comes and with it the predictable rush of patients.
That is what has happened, and its down to cameron and may. They chose policies that delivered this, its not an accident.
7 years of cuts to social care mean that people are now not treated in their own homes, but those people do not just dissapear. Instead, they end up in the NHS taking up beds because there is nowhere to release them to where they can have adequate supervision. That means less beds in the NHS, because there are always more patients than there would normally be, a lot more. Then there is staffing, we have lost thousands of nurses and doctors, many of whom fecked off when after brexit when the abuse ramped up.
So before winter, we already had an NHS with not enough staff (The tories also cut nursing bursaries so now there are less trainees as many can't afford to do the course without them), and already too many patients. Then the winter comes and with it the predictable rush of patients.
That is what has happened, and its down to cameron and may. They chose policies that delivered this, its not an accident.
This is already happening. I have issues with my hand and see a physio at my local hospital. I recieve this text message 48 hours before each appointment.
You are expected to attend an Outpatient Appointment at ___ Hospital on __/__/2018 at 12.00 pm. Not attending costs the NHS approx £160. If you are unable to attend please call ___ ___ ___to cancel or rearrange.
The demise of community hospitals years ago (they were just closed, basically) has caused a huge knock-on as far as the elderly with chronic conditions "cohort" goes. So many folk going by ambulance to A&E would be better-served staying at home with enhanced support or going directly to a community bed for nursing and rehabilitative care.
My mum-in-law has had a couple of short hospital admissions lately for acute exacerbation of chronic conditions. They can't cure her, she doesn't want to be there and she doesn't really require urgent care - she needs IV antibiotics and re-hydration. On both occasions, the A&E department was completely backed up with ambulance personnel having to wait to hand-over their stretcher patient, and many bays full of old folk who need TLC more than A&E.
We need a more up-stream approach. By the time you get to an acute hospital, you've already fallen in the water.
Why not just remove the 'in work' part, but allow the doctors surgery or hospital to use their discretion on whether to push for payment or not. If its just some lazy toerag who constantly books appointments and can't be arsed to turn up then they can push for payment after the missed strikes (and frankly if its a £10-20 fee then I have absolutely no sympathy if its just laziness and they've had several strikes already). That would also avoid them having to penalize people who have genuine issues that could cause them to miss appointments at short notice.
I think you're right and I think the whole concept of centres of excellence, and its alleged cost benefits is flawed for the majority of NHS users. The centres of excellence should be exactly that, places reserved for those needing the specialist technology and the specialist staff.
We can get annoyed with people going to A&E over minor issues but if it's that, or wait until Monday (and hope that you can get to see your GP) when you don't know what's wrong it's no wonder people go there. Plus, as you say, ambulances having to take people miles across towns for little more than a rehydration program, some food and a warm bed. Proximity and speed of access are underrated things. Catching one bus, or even taking a neighbour 10 minutes up the road to get help is nothing like the typical multi-bus or multi-hour round trip - it's no wonder the demand for ambulances becomes impossible.
The loss of local units, and the loss of local old people's homes and warden assisted council housing at a time when demand for simple care is growing, is bound to impact the acute health service. If people can't get the easy help, either their problems get worse or it becomes an issue where there really is no Plan A - just a Plan B that says get them to A&E and let the hospital work out how to send them home.
And they're all at it, Labour, Lib Dem and Tory. Has the restructuring been called for by the NHS leadership over the years, or dropped in their lap by politicians?
Locally to me, two of the A&E units that we used to have are now housing developments. The only remanining unit for the entire borough is on a site which has had chunks of it sold off to raise money.
Another case of which i have some knowledge, is Queen's Hospital in Essex. Built with PFI in the 2000s, they closed four nearby facilities to create this vast complex beset with debt and other issues.
Did they go too far in the name of 'modernisation'?
The 'superhospital' thing is fine but if not supported by appropriate care at home for the elderly it will never work.
I've got several members of my family working in the NHS including a couple of doctors and it's regularly running at capacity. A lot of it is down to lack of social care and breakdown of family life. My brother does ward rounds and he says the biggest challenge he faces is getting old people out of hospital beds. They'll be well enough to be sent home but they don't have anyone to look after them so the hospital is stuck babysitting people who are not seriously ill anymore, but not fit enough to be independent. No kids taking responsibility for thier parents and no social care to take them on even for a few weeks.
With all due respect, why are people talking about missed appointments and alcoholism?
These are undoubtedly problems within the NHS as a whole but have little to do with the current problems we're seeing.
The majority of the patients presenting currently are unwell. Unwell enough to need admission. This has nothing to do with some drunks on the weekend or people coming in for a cough (though these don't exactly help).
There's not enough capacity, difficult to discharge, the primary care system isn't functioning and there are shortages of both doctors as nurses as both leave the NHS.
Its genuinely terrible.
These are undoubtedly problems within the NHS as a whole but have little to do with the current problems we're seeing.
The majority of the patients presenting currently are unwell. Unwell enough to need admission. This has nothing to do with some drunks on the weekend or people coming in for a cough (though these don't exactly help).
There's not enough capacity, difficult to discharge, the primary care system isn't functioning and there are shortages of both doctors as nurses as both leave the NHS.
Its genuinely terrible.
Completely agree, our prevention needs to be a lot better.
Hope your mother in law is feeling better!
Thank you, she is better at the mo.
Was care in the community all that brilliant even prior to the 2010s?
Day hospitals or related units have made up some of the closures during the NHS' restructuring, and it will take time to reverse the strategy. Although I do also believe that @Zlatattack has a point about families stepping up to the plate. After my uncle had heart surgery he came and lived with us for a couple of weeks. Yes, there are people without such means of support, but many do have such. In that regard, a complimentary system of relatives supplemented by district nurses, is what i woudl favour i think (at least for short-term manageable care). What does it say about us that we so readily palm out loved ones off on strangers in any event?
Day hospitals or related units have made up some of the closures during the NHS' restructuring, and it will take time to reverse the strategy. Although I do also believe that @Zlatattack has a point about families stepping up to the plate. After my uncle had heart surgery he came and lived with us for a couple of weeks. Yes, there are people without such means of support, but many do have such. In that regard, a complimentary system of relatives supplemented by district nurses, is what i woudl favour i think (at least for short-term manageable care). What does it say about us that we so readily palm out loved ones off on strangers in any event?
I can't help thinking that all this talk about missed appointments is started by people who don't want to pay extra taxes for both the NHS and social care.
I'm bang average in terms of income and wealth, which means I generally have money left over to spend on stuff I don't really need, and do stuff that costs money just because I've got it. I'd be happy to pay more tax instead, and I'd feel a bit of a twat if I wasn't.
I'm bang average in terms of income and wealth, which means I generally have money left over to spend on stuff I don't really need, and do stuff that costs money just because I've got it. I'd be happy to pay more tax instead, and I'd feel a bit of a twat if I wasn't.
Is this kind of thing really a Tory or Labour issue? Why isn't anything ever blamed of the public? If people didn't drink, smoke and eat so badly, wouldn't the NHS be much better off?
Last year my cholesterol level was elevated, so I changed my diet significantly and now it's much better. It doesn't mean I wont have any health issues, but I'm sure you get the point. There seems to be so much venom aimed at political parties and never the public. I don't get why these threads always turn to blaming the Tories, instead of venting anger at the fat smokers. For example, I think I read about 80% of heart disease is avoidable through better life style.
Last year my cholesterol level was elevated, so I changed my diet significantly and now it's much better. It doesn't mean I wont have any health issues, but I'm sure you get the point. There seems to be so much venom aimed at political parties and never the public. I don't get why these threads always turn to blaming the Tories, instead of venting anger at the fat smokers. For example, I think I read about 80% of heart disease is avoidable through better life style.
I'm a bit over in average in terms of wealth and income, but I wouldn't be happy to pay more tax. I work hard and hate it. I lived with my in laws for a decade to save money. I don't do these things to pay for other people to have free stuff. I'm not saying I don't support the welfare state, but within reason. I'd rather target those that are an unnecessary burden on it, as in my opinion they are the ones who are stopping unfortunate people from getting the help they need.
I dunno, man. People are so binary about this shit. I live in a country where I pay a shit-load more tax than I did in the UK and our healthcare service is much worse than the NHS, despite a bigger per capita spend. Nothing wrong with trying to make the budget that is allocated to the NHS go a little bit further. And at least a small part of that is not letting people take the piss out of a service that doesn’t cost them a penny, because it doesn’t cost them a penny.
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Nice to hear the NHS is more efficient than at least one other country's anyway. And of course we should try and make it even more so, but that aside I vote higher taxes!
Yes, I get the point. Now you will get 75 before you get health problems instead of 70 and live to 85 instead of 80...
- that might save NHS costs but at the end you get pension for more years...Have some people still not sussed out how this game is played? The deductions for so-called free stuff would still be taken from you at some point, for whatever raison-du-jour governments invent...even in indirect ways (rising prices etc etc). The game is rigged.
It's easy to say sometimes. Many families have 2 parents working full time to get by. I personally consider that a failure of our economic model. Whilst we can't fix that long term, maybe the government could offer employers like a sick relative incentive, like in the same model as maternity pay.
Agreed with the philosophy of people need to be more responsible and call / text if they can’t make appointments etc.
Sadly, it’s the UK, so have frightening visions of a huge bureaucratic operation with thousands of humans manning the systems to make it work, ‘Yes Minister’ style paraody, and eventually costing the country even more!
Sadly, it’s the UK, so have frightening visions of a huge bureaucratic operation with thousands of humans manning the systems to make it work, ‘Yes Minister’ style paraody, and eventually costing the country even more!
I'd be well up for paying more tax.
I'm glad to hear that, I hope she stays that way! Especially at this time!!Thank you, she is better at the mo.