The NHS thread

[Napster]

Anyway, the NHS. A rather fleeting view, but the people who work in the NHS, all seem to think a major problem is too many desk jockeys & business consultants, who rake in 10 times what the average nurse is earning.

I wonder what the impact of Brexit will be on the nursing situation?

http://www.telegraph.co.uk/news/201...s-registering-work-britain-falls-90-per-cent/

oh.

ps is the solution increasing nurse pay? if so we need more money. Is the solution streamlining the management? If so, how are multi-disciplinary actions managed effectively?

it's not as simple as left v right with the NHS - it's about health economics, future planning and the cost of medicine. Stop giving pharma companies extensions on their medicines and open up to more generics.

 

[Mad Cyril]

As far as I'm aware not many babies work, nor do they abuse the NHS.

Those that arrive in an ambulance in grey tracksuits, stink of weed and were outside making a phone call having a fag etc whilst nurses search Southend Hospital because they has missed their turn at A&E are the people I'm referring to.

The same day I witnessed that my own mother had to wait way to long with head injuries at the foot of the stairs she had fallen down in Debenhams. Due to the numbers in A&E that Sunday afternoon the Nurse allowed me to use a cubical to clean up and examine my own Mother. Luckily my sister was on hand to get her undressed for her x-ray. As I say Nurses were busy searching toilet cubicles for missing, so called, patients some of whom couldn't be found.....Perhaps they had got bored and went home to watch X factor or finish off the family size pizza.

The point is that the NHS is there for everyone.

 

[GBJ]

I wonder what the impact of Brexit will be on the nursing situation?

http://www.telegraph.co.uk/news/201...s-registering-work-britain-falls-90-per-cent/

oh.

ps is the solution increasing nurse pay? if so we need more money. Is the solution streamlining the management? If so, how are multi-disciplinary actions managed effectively?

it's not as simple as left v right with the NHS - it's about health economics, future planning and the cost of medicine. Stop giving pharma companies extensions on their medicines and open up to more generics.

I don't think anyone can predict what will happen after Brexit, with any real sense of confidence. Everything is guesswork & presumption ATM.

I wouldnt say Nurse's pay is a problem, per se. I'd suggest their quality of work/life balance is the issue. Nurses being forced to work 12/14/16/18 hours per day, are the problem. Nurses being forced to work under extreme stress is the problem. These problems have seemingly become the norm within the NHS.

Its no secret that the NHS is held up by migrant workers, (who by the way, do an excellent job) because British people seemingly refuse to accept that wholey unfair treatment as the norm.

Im not an expert, and don't claim to have the answers, but I'd suggest that a complete overhaul of the NHS is what's needed. The practices, the protocol & management. Like Rigsby said, it's not operating to today's society, and has become outdated.

First thing I'd do is axe the overwhelming amount of overpaid desk jockeys & consultants, and use that wage bill to recruit, employ & train new, more efficient & relative staff.

*ANECDOTE KLAXON*

I know a woman, never done a days nursing in her life, but has worked for the council for 30-odd years. She's now a consultant for Basildon hospital. From her own mouth, she admits that over the 25 hours per week that she works, she does very little "consulting". Her wage for this? £150k a year. That one specific wage could recruit & train 4-5 nurses, on a full time contract. Thus allowing existing nurses to maybe reduce their current unpaid working hours

 

[GBJ]

The point is that the NHS is there for everyone.

And is unfortunately, abused by some, which is both costly & detrimental

 

[GBJ]

Varying reports state that painkillers such as paracetemol, cost the NHS anywhere between £70m & £90m per year.

Thats ****ing ridiculous. A pack of paracetemol costs 14p in a supermarket. Everyone can afford 14p

That money could be used to recruit at least 10 nurses per hospital, up and down the country

 

[Napster]

Varying reports state that painkillers such as paracetemol, cost the NHS anywhere between £70m & £90m per year.

Thats ****ing ridiculous. A pack of paracetemol costs 14p in a supermarket. Everyone can afford 14p

That money could be used to recruit at least 10 nurses per hospital, up and down the country

So, the NHS shouldn't prescribe it.

ps see my point about generics.

pps about your earlier point, we should in all honesty remove the requirement for a degree to be a nurse, as well as admit more qualified migrants into the system. I do hope Brexit won't have an impact but I bet it will.

Oh and about the consultants, you do need some layer of accountability between nurses/Drs etc and the top level management, much like you do in most corporations, but these can be reduced.

The future is in more of a carrot approach rather than a stick approach - reward patients for making sensible decisions (alcohol/drugs/obesity) rather than attacking those who use it

Oh, and more telemedicine and more NHS drop-in centres open 24/7 would be good.

 

[Tangled up in Blue]

I don't think anyone can predict what will happen after Brexit, with any real sense of confidence. Everything is guesswork & presumption ATM.

I wouldnt say Nurse's pay is a problem, per se. I'd suggest their quality of work/life balance is the issue. Nurses being forced to work 12/14/16/18 hours per day, are the problem. Nurses being forced to work under extreme stress is the problem. These problems have seemingly become the norm within the NHS.

Its no secret that the NHS is held up by migrant workers, (who by the way, do an excellent job) because British people seemingly refuse to accept that wholey unfair treatment as the norm.

Im not an expert, and don't claim to have the answers, but I'd suggest that a complete overhaul of the NHS is what's needed. The practices, the protocol & management. Like Rigsby said, it's not operating to today's society, and has become outdated.

First thing I'd do is axe the overwhelming amount of overpaid desk jockeys & consultants, and use that wage bill to recruit, employ & train new, more efficient & relative staff.

*ANECDOTE KLAXON*

I know a woman, never done a days nursing in her life, but has worked for the council for 30-odd years. She's now a consultant for Basildon hospital. From her own mouth, she admits that over the 25 hours per week that she works, she does very little "consulting". Her wage for this? £150k a year. That one specific wage could recruit & train 4-5 nurses, on a full time contract. Thus allowing existing nurses to maybe reduce their current unpaid working hours

I would suggest you have a look at the impact studies already available, such as the one I linked to on the EU thread this am.

My own anecdotal "evidence" (as I've said before from a Health Lecturer here at the UIC in SC) is that since the Brexit vote there has been a sharp decline in nurses/doctors here in Catalonia applying for NHS jobs.This would seem to be confirmed by the Torygraph article that Napster linked to.

 

[Member]

So, the NHS shouldn't prescribe it.

ps see my point about generics.

pps about your earlier point, we should in all honesty remove the requirement for a degree to be a nurse, as well as admit more qualified migrants into the system. I do hope Brexit won't have an impact but I bet it will.

Oh and about the consultants, you do need some layer of accountability between nurses/Drs etc and the top level management, much like you do in most corporations, but these can be reduced.

The future is in more of a carrot approach rather than a stick approach - reward patients for making sensible decisions (alcohol/drugs/obesity) rather than attacking those who use it

Oh, and more telemedicine and more NHS drop-in centres open 24/7 would be good.

There are systems now in place to alert the prescription of items that are available for low cost at the supermarket/over the counter. NHS England now has a policy to try and reduce this area of expenditure (they are continuously looking for ways to save money, while also meeting their health/outcomes requirements.) Just denying someone a prescription because you would rather they go and self-fund their medication isn't always the right approach clinically.

There are also systems in place to alert and recommend automatic generic substitution but that's a bit more complex. There are adherence reasons why you might maintain someone longer term on a brand even if a generic is now available.

 

[Tangled up in Blue]

The problem is what ever fancy name you wrap it in, its just more tax for those that work, for a service that is abused by those that contribute nothing.

The NHS has been a disaster for the nations health. The original theory was that we will save money in the long term because everyone will be healthier. Instead we have created a significant section of people who think it is someone else's financial responsibility for their own selfish stupidity.

For example how does the alcohol industry still get away with the mayhem they cause at weekends in every town, followed by the cost in hospitals and the courts. Well over 100 MP's from all parties on the pay roll is the reason.

P.S You have still not come up with one money saving idea......We await your insight[/QUOTE]

Actually,I never promised to "come up with a money saving idea" at all.Which reminds me,I notice you've swerved my question to you,asking what your own solution to the NHS funding crisis would be.

 

[londonblue]

So, the NHS shouldn't prescribe it.

ps see my point about generics.

pps about your earlier point, we should in all honesty remove the requirement for a degree to be a nurse, as well as admit more qualified migrants into the system. I do hope Brexit won't have an impact but I bet it will.

Oh and about the consultants, you do need some layer of accountability between nurses/Drs etc and the top level management, much like you do in most corporations, but these can be reduced.

The future is in more of a carrot approach rather than a stick approach - reward patients for making sensible decisions (alcohol/drugs/obesity) rather than attacking those who use it

Oh, and more telemedicine and more NHS drop-in centres open 24/7 would be good.

When talking about paracetamol, do we actually know what we're talking about? Don't forget it also comes in liquid form in big bags that are administered through a canular as pain relief after an operation. We're not necessarily talking about a few pills. After each one of my wife's back operations she's gone through bags of the stuff.

 

[Member]

When talking about paracetamol, do we actually know what we're talking about? Don't forget it also comes in liquid form in big bags that are administered through a canular as pain relief after an operation. We're not necessarily talking about a few pills. After one of my wife's back operations she's gone through bags of the stuff.

There is an issue of paracetamol being unnecessarily prescribed (it's hard to quantify exactly what level it is and the economic implications even harder). In general there is an issue with prescription wastage and adherence. You make a fair point that different formulations mean there is still a reason why it'll be prescribed (I make the point above that there will be reasons why a doctor may prescribe paracetomol rather than tell the patient to buy it themselves).

 

[Napster]

There are systems now in place to alert the prescription of items that are available for low cost at the supermarket/over the counter. NHS England now has a policy to try and reduce this area of expenditure (they are continuously looking for ways to save money, while also meeting their health/outcomes requirements.) Just denying someone a prescription because you would rather they go and self-fund their medication isn't always the right approach clinically.

There are also systems in place to alert and recommend automatic generic substitution but that's a bit more complex. There are adherence reasons why you might maintain someone longer term on a brand even if a generic is now available.

Yeah fair enough, although patient adherence to even diagnosed and prescribed medicine is still a sticky subject!

 

[GBJ]

So, the NHS shouldn't prescribe it.

Not unless it's an extreme case, which the recipient would have to meet certain criteria.

pps about your earlier point, we should in all honesty remove the requirement for a degree to be a nurse, as well as admit more qualified migrants into the system. I do hope Brexit won't have an impact but I bet it will.

I agree about scrapping the need for a degree. Although it goes without saying that a high standard of training & competence would still need to be achieved.

I think with regards to more migrant workers, it's a bit besides the point. Bringing more workers into a sector which is cash strapped & falling apart won't solve the underlying issues, which have created the current state of affairs.

Oh and about the consultants, you do need some layer of accountability between nurses/Drs etc and the top level management, much like you do in most corporations, but these can be reduced.

That's the key point. Reduce the numbers, and free up the astronomical wages for something more worthwhile.

 

[rigsby]

Actually,I never promised to "come up with a money saving idea" at all.Which reminds me,I notice you've swerved my question to you,asking what your own solution to the NHS funding crisis would be.[/QUOTE]

So if you cant save any money it has to go private because even old JC will bottle it when it comes to Tax.

Personally I have always thought the NHS should be private but owning and using a car should be paid for by the tax payer. It seems unfair to punish bad drivers with high insurance premiums and we should all own expensive gas guzzling cars. If you cant be bothered putting oil in the engine and it blows up, so what there is plenty of rich Tory voters out there who could buy me a new engine.

Yes we could bankrupt the country but after all you can't put a price on motoring

 

[GBJ]

I would suggest you have a look at the impact studies already available, such as the one I linked to on the EU thread this am.

Can we inject some reality & stop panicking about migrants not wanting to come here.

Lets say, hypothetically, that no new EU migrants want to come here & work in the NHS. The only option would be to deal with what we've already got. That's 60-odd million Brits & a couple of million immigrants.

So how do we make the job more appealing, especially to Brits, who don't want to work in he NHS these days. Well Firstly,
You'd have to address the expectations of NHS staff. The majority of them don't want to work 80+ hours per week. And they certainly don't want to do unpaid overtime. The mantra is Work to Live, not Live to work. It's seemingly more indicative though, that in the NHS, you're certainly living to work.

So how do we solve this issue? Not easily, granted. You'd have to cut excessive costs & free up much needed funds. Recruitment & training would have to be top priority. Not easy, but if done successfully, the NHS would flourish, and its reputation would be restored to what it once was.

 

[GBJ]

Just denying someone a prescription because you would rather they go and self-fund their medication isn't always the right approach clinically.

In what example would it not be clinically right to refuse someone paracetemol, that cost 14p in a shop?

If im not mistaken, Paracetemol is usually prescribed by a hospital, in the cases of sprains, bumps & bruises. Or in other words, the trivial things, which can easily be self-medicated.

 

[Member]

Weird how the solution to solving the NHS is to cut down on 'excessive costs' and not on 'increase the amount we spend on it'

The NHS is funded at rock-bottom levels compared to other countries.

Let's spend more on the NHS and look for innovation and ways to spend that money better, rather than ask a complex service to do more with less.

 

[Napster]

Weird how the solution to solving the NHS is to cut down on 'excessive costs' and not on 'increase the amount we spend on it'

The NHS is funded at rock-bottom levels compared to other countries.

Let's spend more on the NHS and look for innovation and ways to spend that money better, rather than ask a complex service to do more with less.

The PFI deals previous governments (Labour and Tory) have put in place have hampered investment. Innovation is necessary for a country that has ageing infrastructure and populace.

 

[GBJ]

Weird how the solution to solving the NHS is to cut down on 'excessive costs' and not on 'increase the amount we spend on it'

The NHS is funded at rock-bottom levels compared to other countries.

Let's spend more on the NHS and look for innovation and ways to spend that money better, rather than ask a complex service to do more with less.

Because the NHS has suffered systemic abuse from top to bottom. Throwing more money at it may cure some symptoms, but it won't eradicate the disease from within

 

[rigsby]

Weird how the solution to solving the NHS is to cut down on 'excessive costs' and not on 'increase the amount we spend on it'

The NHS is funded at rock-bottom levels compared to other countries.

Let's spend more on the NHS and look for innovation and ways to spend that money better, rather than ask a complex service to do more with less.

People aren't suggesting that.

What about not providing an Ambulance on over 1,000 occasions for the same person. How about the paramedics who attend a code one Red (may not be the correct term) to a baby not breathing only to find the father has flu and doesn't want to wait until Monday to see the doctor.