Over stretched NHS

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maz
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Re: Over stretched NHS

Post by maz » Sun Mar 05, 2017 12:00 pm

Well it does sound like they are trying there Jane. I guess though that this new Urgent Care Centre will need at least 2 new management positions to make sure it runs properly :? Oh and of course a third to overlook the first two :lol:
Marilyn

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Janey Dal
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Re: Over stretched NHS

Post by Janey Dal » Sun Mar 05, 2017 8:14 pm

Oh at the very least Marilyn :lol: :lol:

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paul.m
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Re: Over stretched NHS

Post by paul.m » Wed Mar 08, 2017 6:38 am

Maybe we should redesign towns and cities so you have Drs surgery - Undertakers - Hospital - crematorium may make people think do I really want to go to that part of town .Receptionists could hand out 25% off coupons for crem as they say Dr Shipman will see you now .
Paul

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maz
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Re: Over stretched NHS

Post by maz » Wed Mar 08, 2017 10:10 am

:shock: :lol: :lol:
Marilyn

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Janey Dal
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Re: Over stretched NHS

Post by Janey Dal » Sat Mar 11, 2017 10:59 am

You may laugh Paul but we have discovered that if we advertise NHS Health Checks (which we get paid for) and put the word Free in the advert we get a better response :shock: :shock: :roll: :roll: .

I remember sitting having a coffee break several years ago when I did my management degree at evening class. The students were from loads of different industries and we were comparing what perks we got from work.

I said that working in the NHS I got free operations :roll: :roll: . It took several minutes before daylight dawned and someone said 'Hey! We all get free operations".

To which I replied "The B*******s! They said it was a perk." :lol: :lol:

Hugs

Jane xx

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paul.m
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Re: Over stretched NHS

Post by paul.m » Mon Mar 20, 2017 6:09 am

If its free its a bargain and everyone likes a bargain .
Paul

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Janey Dal
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Re: Over stretched NHS

Post by Janey Dal » Sat Mar 25, 2017 11:01 am

Not sure if I've mentioned this previously but the latest 'buzz' from NHS England in Primary Care is about 'Hubs' of around 30,000 - 50,000 patients.

This means that groups of GP practices will be encouraged to work together to provide things like physiotherapy, minor ops, counsellors, diabetic clinics etc etc (aka a Hub).

It's all about economy of scale. Small practices can't afford to provide the diversity of services that larger practices can. So some number cruncher somewhere remote both geographically and mentally has come up with the magic formula :roll: :roll: .

It has some merit for practices like mine which is in a town centre with several other practices nearby, but will cause major problems for the smaller, more remote practices which I honestly believe will start to become rarer because they simply won't be able to attract the funding from central government.

Of course the remote decision makers forget that there ARE other places in the country outside of London.

However there is a mind-set that suggests that there are 3 cohorts of patients who should be treated very differently.

1 - patients who have multiple conditions which require proactive rather than reactive interventions
2 - patients with long term conditions which are stable
3 - everybody else (ie the healthy population who only require a GP on rare occasions)

Again it all makes sense on paper - but then you get into the reality...................

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Jane xx

unclemorris67
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Re: Over stretched NHS

Post by unclemorris67 » Sat Mar 25, 2017 11:27 am

My hospital Medway Maritime has come out of special measures.
Next annoucement it spend just under £500000 in 3 months to fund locum doctors, instead of paying the usual £76 per hour it paid nearer £700

The hospital has always worked with GP service, there has been medway doctors on call unit (meddoc) beside A&E for years. This is where i was sent to when I had my possible 1st AP was told it would be 6 hours for an appointment. Told them i would be dead as I didnt have a tummy ache but something worse, thankfully a nurse walked passed reception and kindly offered to examine me. The 2nd time when I went via ambulance, meddoc doc walked in came back with morphine, wheelchair and letter for surgeons. He was angry that A&E couldnt see a proper medical emergency.
Sharon

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stuart13
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Re: Over stretched NHS

Post by stuart13 » Sat Mar 25, 2017 11:36 am

There is a serious issue with 'locum' medics holding health services to 'ransome'.

Who do they think they are .............................professional footballers?

:evil:

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Janey Dal
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Re: Over stretched NHS

Post by Janey Dal » Sat Mar 25, 2017 11:41 am

Indeed Sharon! It is the hospitals that are causing most of the funding crisis.

Primary Care is, on the whole, pretty cost efficient. Secondary care is a nightmare of unnecessary bureaucracy and inefficiency.

I have always worked in Primary Care in some form or another so this is not just an opinion from my current job.

The hospitals are still run by the Consultants who think that if they say 'jump' everybody has to ask 'how high?'. This has never changed in my years of working.

Years ago when the NHS was trying to make the patient record shareable by everybody, Primary Care went for it. The GP practices embraced it.

The hospitals had different IT systems in every single department, none of which were compatible with each other, let alone any external systems. But none of the Consultants were prepared to compromise because they all believed 'their' system was the best.

And Stuart's point on locums holding the NHS to ransom is absolutely spot on! There is supposed to be a ceiling on fees charged by locums but it is regularly breeched. We have recently had to hire a locum GP at my surgery to cover maternity leave. They told us what they wanted from the contract. And in Secondary Care the fees are horrendous. I have heard of one locum who charged the hospital £6,000 per WEEK.

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Jane xx

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Janey Dal
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Re: Over stretched NHS

Post by Janey Dal » Sun Apr 30, 2017 11:41 am

Just an update on how damned inefficient the hospitals can be at times.

Alan went to orthopaedics to get his leg, arm and ribs checked out. When he got there they didn't have any notes about his leg (which has the most serious damage) so that was deferred to another day.

They then sent him for an X-ray on his ribs. He went back in to see the consultant who then sent him for another X-ray on his arm :roll: :roll: . They have discovered another chipped bone in his arm and he has to go back again for an appointment about his leg.

And to add insult to injury he has subsequently received a letter stating that his 'chest X-ray shows a fracture of the radial styloid' - so we looked it up. The radial styloid is apparently the bone in his wrist :shock: :shock: .

A pretty comprehensive chest X-ray then :lol: :lol: .

And yes I know he did the damage to himself and I know it's free but it is the inefficiency that is so hard to take. It worries me when the NHS is in such a massive funding crisis that secondary care can't get their processes slicker.

And no I don't want a privatised NHS AT ALL. But hospital consultants get paid the same salary whether they are efficient or not - so there is no incentive for them to improve their processes. If, like GPs, their income was what was left after all the outgoings have been deducted, they might try harder.

Hugs

Jane xx

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stuart13
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Re: Over stretched NHS

Post by stuart13 » Sun Apr 30, 2017 3:44 pm

So where in does the fault lie with the Xray fiasco?

Or with whom?

:roll: :)

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MikeyB
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Re: Over stretched NHS

Post by MikeyB » Sun Apr 30, 2017 3:56 pm

Fractures of the radial styloid were called Chauffeur's fractures. They used to be commonly caused by the engine firing when a crank handle was used. Stu will remember that.

Just a bit of useless medical history. :D

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stuart13
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Re: Over stretched NHS

Post by stuart13 » Sun Apr 30, 2017 4:44 pm

:wink:

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MikeyB
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Re: Over stretched NHS

Post by MikeyB » Mon May 01, 2017 1:25 am

I honestly don't know how any of you lot dare get sick in England, I really don't. It sounds terrible. Ludicrously, almost comically over managed, not underfunded. The funds are used to pay idiots in meetings, not clinical care. I am thankful every day that I live in Scotland.

If you look at my last post on the "multiple pathologies " thread, you will see why.

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