[Misc] How can the NHS survive in its current form ?

[Weststander]

My Dad, long-term NSC poster @Cadiz Seagull is currently on the Stroke ward at the Sussex County with a suspected stroke. The new building and the care he has received in it has been absolutely fantastic, I can’t fault it.

But A&E, my God. I cannot describe how awful it was. I counted 24 people on trolleys in the corridor on Monday, and those were the only ones I could see from my viewpoint, there were a lot more. He was in a cubicle with two other people on beds at one point. So three people to a cubicle, and probably 50+ people piled up on trolleys in the corridors, and a full waiting room. It was literally like a war zone, and when I say ‘literally’ I do genuinely mean ‘literally’. I just couldn’t get my head around how this is happening in Britain in 2023. There is absolutely no excuse for it whatsoever. I was looking at people passed out on the trolleys thinking if they die nobody will know for hours. It’s absolutely appalling that a country like ours has let its emergency healthcare get in that state. I’m still genuinely shocked by it.

I’ve been on one of those Royal Sussex A&E trollies in a packed corridor (blood infection from an op in London) and have been there with family.

Hot rooms, overflowing with folk, no dignity, incredibly long waits, a carousel of the new but more ill arrivals taking the curtained booths, Third World.

The good news is that a £48m was secured in March for a complete overhaul/reconfiguration. Staff said to us that the room for A&E patients will dramatically increase.

 

[Weststander]

Most if not all NHS staff have to pay parking.

Certainly, locally, that has been in the place for 30 years.

It’s been pay at the Royal Sussex for many decades … streets and and the awfully cramped multi-story designed for tiny cars. Thousands work there, only an idiot would suggest (free) parking for all.

I was referring to the other training costs met by paramedics.

 

[Weststander]

To be fair it’s been like it a long time, arguably from the 90s onwards, I used to do a lot of work in A&E.

In the last few years undoubtedly it has worsened, but that is basically because more people are coming through the front door, and not enough patients leaving to free up beds, due to a complete lack of adequate social care provision.

You then add more risk averse Doctors into the equation and you have the current shitshow.

Actually, when John Major’s Patient’s Charter was introduced, and there was more emphasis on trolley waits, things improved for a spell.

Stephen Barclay is the worse possible thing that could have happened to the NHS, has a little knowledge and is basically talking out his arse in the main.

A&E’s are now dealing with random and sundry minor ailments, with GP’s surgeries not used. Plus the mental health crisis.

 

[One Teddy Maybank]

A&E’s are now dealing with random and sundry minor ailments, with GP’s surgeries not used. Plus the mental health crisis.

But people are irresponsible and frankly a number of GP practices adopt lazy practices, encouraging people to go to hospital instead of correctly policing it.

As for Mental Health, yes agree, and COVID has only increased pressure, but is A&E the right entry point?

 

[One Teddy Maybank]

I’ve been on one of those Royal Sussex A&E trollies in a packed corridor (blood infection from an op in London) and have been there with family.

Hot rooms, overflowing with folk, no dignity, incredibly long waits, a carousel of the new but more ill arrivals taking the curtained booths, Third World.

The good news is that a £48m was secured in March for a complete overhaul/reconfiguration. Staff said to us that the room for A&E patients will dramatically increase.

They had money before that as well from the 3Ts project. They want to be a trauma centre, which is why neurosurgery was moved from Haywards Heath. I really wouldn’t hold your breath.

 

[Weststander]

They had money before that as well from the 3Ts project. They want to be a trauma centre, which is why neurosurgery was moved from Haywards Heath. I really wouldn’t hold your breath.

No fear of that, I don’t want to visit A&E.

 

[dsr-burnley]

A&E’s are now dealing with random and sundry minor ailments, with GP’s surgeries not used. Plus the mental health crisis.

Many A&E visits are for minor ailments, it's true. But how is the patient to know if it's minor? Not all patients are medical professionals.

I went to A&E 10 years ago for a "minor ailment", stomach ache, one of those things that they specifically tell you not to go to A&E for. Within an hour of arrival I was on a drip and I spent 9 days in hospital with jaundice and pancreatitis caused by gallstones. I didn't know whether it was serious or not; that's why I needed a medical professional. GPs are no use for that sort of thing.

Fortunately, although I am in East Lancashire area, I am close enough to Yorkshire to use Airedale hospital in a trust on its own. There is a vast difference. When researching East Lancashire trust record on operations, I found (this in 2013) that they had cancelled over 5,000 operations in 5 years. One gall bladder patient had his op 4 times, once getting as far as being anaesthetised before they realised that they had a surgeon, an anaesthetist, and a nurse, but no theatre. He developed complications and needed a different operation, cancelled three times; they got round to it eventually, but too late. He died. Airedale, meanwhile, had cancelled about 15 operations in 5 years when a flu epidemic coincided with a major road accident.

Why should one hospital be well up to scratch while the other is appalling? Things haven't changed in 10 years. East Lancashire is still appalling. A friend of mine had a heart attack, with classic symptoms, there was no doubt what it was. Not only did the ambulance service cancel his ambulance because others had priority, they didn't even ring back to tell him to make his own way to hospital. (They made damn sure they went to Airedale, not Burnley.)

 

[One Teddy Maybank]

Many A&E visits are for minor ailments, it's true. But how is the patient to know if it's minor? Not all patients are medical professionals.

I went to A&E 10 years ago for a "minor ailment", stomach ache, one of those things that they specifically tell you not to go to A&E for. Within an hour of arrival I was on a drip and I spent 9 days in hospital with jaundice and pancreatitis caused by gallstones. I didn't know whether it was serious or not; that's why I needed a medical professional. GPs are no use for that sort of thing.

Fortunately, although I am in East Lancashire area, I am close enough to Yorkshire to use Airedale hospital in a trust on its own. There is a vast difference. When researching East Lancashire trust record on operations, I found (this in 2013) that they had cancelled over 5,000 operations in 5 years. One gall bladder patient had his op 4 times, once getting as far as being anaesthetised before they realised that they had a surgeon, an anaesthetist, and a nurse, but no theatre. He developed complications and needed a different operation, cancelled three times; they got round to it eventually, but too late. He died. Airedale, meanwhile, had cancelled about 15 operations in 5 years when a flu epidemic coincided with a major road accident.

Why should one hospital be well up to scratch while the other is appalling? Things haven't changed in 10 years. East Lancashire is still appalling. A friend of mine had a heart attack, with classic symptoms, there was no doubt what it was. Not only did the ambulance service cancel his ambulance because others had priority, they didn't even ring back to tell him to make his own way to hospital. (They made damn sure they went to Airedale, not Burnley.)

What’s East Lanc CQC rating?

Usually, hospitals do not get away with sustained poor performance and poor outcomes.

In terms of patients knowing what is minor, a common cold is minor, a sore throat is minor, earache is minor. All of these complaints I have seen being triaged, before being sent away with paracetamol.

Ring 111 have a discussion, get advice. It really isn’t difficult and would reduce some pressure on the system.

 

[Weststander]

Many A&E visits are for minor ailments, it's true. But how is the patient to know if it's minor? Not all patients are medical professionals.

I went to A&E 10 years ago for a "minor ailment", stomach ache, one of those things that they specifically tell you not to go to A&E for. Within an hour of arrival I was on a drip and I spent 9 days in hospital with jaundice and pancreatitis caused by gallstones. I didn't know whether it was serious or not; that's why I needed a medical professional. GPs are no use for that sort of thing.

Fortunately, although I am in East Lancashire area, I am close enough to Yorkshire to use Airedale hospital in a trust on its own. There is a vast difference. When researching East Lancashire trust record on operations, I found (this in 2013) that they had cancelled over 5,000 operations in 5 years. One gall bladder patient had his op 4 times, once getting as far as being anaesthetised before they realised that they had a surgeon, an anaesthetist, and a nurse, but no theatre. He developed complications and needed a different operation, cancelled three times; they got round to it eventually, but too late. He died. Airedale, meanwhile, had cancelled about 15 operations in 5 years when a flu epidemic coincided with a major road accident.

Why should one hospital be well up to scratch while the other is appalling? Things haven't changed in 10 years. East Lancashire is still appalling. A friend of mine had a heart attack, with classic symptoms, there was no doubt what it was. Not only did the ambulance service cancel his ambulance because others had priority, they didn't even ring back to tell him to make his own way to hospital. (They made damn sure they went to Airedale, not Burnley.)

I didn’t mean incidents which could unknowingly be something serious. Instead the well documented current phenomena of people who failed to get a GP appointment on the day for non-acute intervention visiting A&E instead.

 

[Weststander]

What’s East Lanc CQC rating?

Usually, hospitals do not get away with sustained poor performance and poor outcomes.

In terms of patients knowing what is minor, a common cold is minor, a sore throat is minor, earache is minor. All of these complaints I have seen being triaged, before being sent away with paracetamol.

Ring 111 have a discussion, get advice. It really isn’t difficult and would reduce some pressure on the system.

In 2003/04 16m admitted themselves to A&E, in 2021/22 it had risen to 24.4m. This wasn’t due to Covid, in April 2023 alone 2m was the number.

A thin line of overworked staff nannying a huge increase in attendees, many of whom should not be using the resource.

 

[dsr-burnley]

What’s East Lanc CQC rating?

Usually, hospitals do not get away with sustained poor performance and poor outcomes.

In terms of patients knowing what is minor, a common cold is minor, a sore throat is minor, earache is minor. All of these complaints I have seen being triaged, before being sent away with paracetamol.

Ring 111 have a discussion, get advice. It really isn’t difficult and would reduce some pressure on the system.

I did ring 111 and their advice was to go to a chemist and get some stomach tablets. The chemist's advice was to wait till after the weekend and get a GP appointment. Sometimes, the best person to diagnose a medical problem, is a doctor.

As for the hospitals now, East Lancs is officially good, Airedale as Requires Improvement. (Though its downgrade from Good was entirely on the basis that Maternity was deemed not safe on the recent inspection, which seems like a relatively small part of a hospital's remit to trigger such a downgrade.)

But as you say, anecdotal evidence will be much slower to update than clinical evidence, so maybe East Lancs is improving. But anecdotally, I have known plenty of people who say they would always go to Airedale ahead of Burnley (this has been true for 20 years or more), and none who say the other way round. (Minor point being that Airedale is on a main bus route and Burnley isn't.)

 

[Flagship]

When I lived in Brighton I had no problems at all with any aspect of healthcare. The RSCH was brilliant. I now live in Shropshire and I'm happy to say that my experience has been nothing short of exemplary.

 

[RexCathedra]

As a Yank I would only add you have embraced our method of funding tertiary education, and turned your prime minister into a President.
May I suggest adopting our excellent system of medical care provision?

 

[Goldstone Guy]

To answer your question health professionals.

Really to have a functioning, publicly funded health system this is how it has to be in my opinion. Good luck trying to tell the British public that, who would be having none of it. No politician would ever try it and I don't blame them - it would be political suicide. I do blame politicians for a lot of other things though, including ramping up public expectation of what the health care system can provide, which is one reason for getting us into this mess.

 

[Gazwag]

I’ve always wondered the kind of people that work in the NHS away from the front line. The wages are generally a lot lower than equivalent roles in the private sector and with all the restrictions / red tape that goes with it. Always fascinated the kind of people they take these jobs

It's actually the other way around, private health sector salaries are lower than NHS salaries in pretty much all positions

 

[One Teddy Maybank]

In 2003/04 16m admitted themselves to A&E, in 2021/22 it had risen to 24.4m. This wasn’t due to Covid, in April 2023 alone 2m was the number.

A thin line of overworked staff nannying a huge increase in attendees, many of whom should not be using the resource.

So true.

Perhaps the public have become more stupid….. or just pathetic…..
It really is a thin line.

Don’t get me started on DNAs (did not attend) outpatient appointments. I really would start charging people who fail to show.

Booking Team.
Reception Team.
Outpatient Nurse.
Wasted diagnostic slot.
Consultant time.

It all adds up, and that’s before you take it back a step to when the patient went to the GP for a referral in the first place.

 

[One Teddy Maybank]

I did ring 111 and their advice was to go to a chemist and get some stomach tablets. The chemist's advice was to wait till after the weekend and get a GP appointment. Sometimes, the best person to diagnose a medical problem, is a doctor.

As for the hospitals now, East Lancs is officially good, Airedale as Requires Improvement. (Though its downgrade from Good was entirely on the basis that Maternity was deemed not safe on the recent inspection, which seems like a relatively small part of a hospital's remit to trigger such a downgrade.)

But as you say, anecdotal evidence will be much slower to update than clinical evidence, so maybe East Lancs is improving. But anecdotally, I have known plenty of people who say they would always go to Airedale ahead of Burnley (this has been true for 20 years or more), and none who say the other way round. (Minor point being that Airedale is on a main bus route and Burnley isn't.)

But the front line staff in A&E are often Junior Doctors, so you’ve actually achieved very little and normally would be better off waiting for a GP. In my experience the senior A&E nurse is usually the person with the best advice and can often support junior staff.

The A&E consultant will have oversight, but if it is a site specific issue an on-call teams will be called where necessary.

Re maternity, depends whether you’re a ‘Mum to be’ I would suggest. Fairly significant for me.

 

[Commander]

So true.

Perhaps the public have become more stupid….. or just pathetic…..
It really is a thin line.

Don’t get me started on DNAs (did not attend) outpatient appointments. I really would start charging people who fail to show.

Booking Team.
Reception Team.
Outpatient Nurse.
Wasted diagnostic slot.
Consultant time.

It all adds up, and that’s before you take it back a step to when the patient went to the GP for a referral in the first place.

This works both ways though, a lot of the admin in the NHS is absolutely shocking. They waste so much money through errors and complete incompetence. It is clearly under-funded, but I don’t see how throwing another few billion quid at it would necessarily solve that much, it would just give them a load more money to waste.

 

[One Teddy Maybank]

This works both ways though, a lot of the admin in the NHS is absolutely shocking. They waste so much money through errors and complete incompetence. It is clearly under-funded, but I don’t see how throwing another few billion quid at it would necessarily solve that much, it would just give them a load more money to waste.

Be interested to hear the examples, a lot of it is automated.

There are a lot of staff under significant pressure, that includes fairly junior administrative staff. ‘Absolutely shocking’ seems extreme.

Edit:
Not aimed at your post. @Commander but the whole ‘there are too many admin staff in the NHS’ is a myth, and studies undertaken by various bodies, actually highlight how lean it actually is.

 

[Herr Tubthumper]

Stephen Barclay is the worse possible thing that could have happened to the NHS, has a little knowledge and is basically talking out his arse in the main.

It’s shocking how someone with zero experience and knowledge of healthcare gets to be the health minister.

Compare this to Germany.

Federal Minister of Health Prof. Dr. Karl Lauterbach

Prof. Dr. Karl Lauterbach was sworn in as Federal Minister of Health on December 8, 2021.

www.bundesgesundheitsministerium.de