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Slightly jocular title but this is no joke. This comes via a friend who’s a nurse & it’s genuine. The general drift of it echoes what my Dr friends told me about our counties situation when we went for a beer last week.
It’s outrageous and actually quite scary.
Posted anonymously by an A&E doctor:
Im writing this because I’m angry. Actually more than that, I’m fu*king livid.
I’m an A&E reg with 9+ years experience in A&E both here and overseas. This morning was the first time EVER that I cried in my car after a shift.
I was on nights over this New Years period, but New Year was not the issue, every shift is like this now.
Where 5 years ago we had 50 patients in the department on handover at night, we now have 180. It used to be around 20 patients to see with a 1-2 hour wait for clinician, it’s now 60-70 with a 10 hour wait.
People used to lose their minds if patients were coming up to 4 hour breaches. Last night 60% of the patients in A&E had been there for more than 12 hours, some for more than 40. Many I saw the night before, still in the same place when I came on.
No triage or obs after 2 hours of arrival, no bloods or ECGs or gas for 4 hours. Regularly finding people in the waiting room after 4 hours with initial gases showing hyperkalamia or severe acidosis or hypoglycaemia.
87 year olds coming in after falls sitting on chairs for 18 hours. Other elderly patients lying in their own urine for hours because there’s no staff, or even room to change them into something dry. As the reg in charge of the shift, Ive had (on multiple occasions) to help the sole nurse in the area change patients by holding a sheet around the bed because we have to do it in the middle of a corridor. People lying on the floor because there’s no chairs left, trolleys parked literally wherever we can put them.
Things have been getting even worse for the last 3 months. 5 weeks I came home raging to my wife that people are sitting in their own piss for hours and it’s so inhumane. Now we’ve got to the point where people are actually dying. People who’ve been in A&E for 2-3 days,
The media and public might blame the A&E nurses and doctors for this, but honestly what the fu*k are we meant to do with 180 people in a department built for 50. With 8 nurses rather than the MINIMUM staffing of 12. 1 or 2 nurses per area, giving meds, doing obs, trying to provide basic cares to 25-30 people, an absolute impossibility. And there’s less nurses every week, because honestly why would you put yourself through this day after day?
Resus patients are quickly assessed and stepped down to make room for the next pre-alert, going to the area with those same poor nurses, already overstretched, now inheriting an severely unwell patient.
We need to accept the truth, the NHS isn’t breaking, it’s broken. And the same bastards who broke it are doing reality TV shows and writing books about how they saved the NHS whilst refusing to increase nursing pay. We try and shovel shit with spoons whilst they pour it in with dump trucks
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
The public have no idea, they don’t really know how dangerous this all is. When they come in they’re horrified, but most of the population don’t know how bad it is. This could be their mum on a trolley for 17 hours, or their wife or son or daughter.
I genuinely feel it’s now our responsibility to speak out. We don’t for fear that it will make our hospital look bad or harm our careers. But it’s not a hospital problem, it’s a national problem, and it’s a problem brought about by the politics of the people in power.
We need to shine a light on what they’ve done, make the public so angry that they demand a change. Massive recruitment of nurses through a proper wage/paid uni/free parking/free Nando’s if that’s what it takes would be a start.
If anyone has any idea how we could coordinate some kind of campaign to show the state of emergency departments in the UK right now please write a response, because I can’t work in this much longer, and more importantly I’m not sure the patients can survive it.
But don’t you know, the NHS is not in crisis and it is sufficiently funded. The PM told us earlier.
They've also been getting an extra £350m a week since Brexit 🙄
My daughter is a nurse in a regional centre and she can confirm it's totally shit. The other week she was supposed to be scrub nurse for two operations at the same time, obviously she couldn't be.
Was talking to a paramedic friend of mine the other day and she said they dread taking patients to A&E because it's pretty much guaranteed to be end of shift for them. Unable to discharge the patient into A&E as there isn't space, unable to attend any other incident, no idea of when they'll finally get home.
She said her longest wait to date was 6hrs before they could release the patient and drive back to their home base where they were 2.5hrs late. She said others have seen worse.
But yeah, it's been at the back of my mind on rides...
A couple of weeks ago local to me, an elderly lady fell on the ice and broke her hip. Residents helped her out, supplied duvets, hot water bottles etc, kept her company and kept the rain off but it was nearly 2hrs before the ambulance got there. Took 3 phone calls to 999 to escalate it. Even then it was "only" a rapid response vehicle, not something capable of conveying the woman to hospital. That took another 30 mins to get there.
I know a nurse on A&E who openly admits people have died due to the situation as it is now, the eare deaths that would not have occurred a couple of years ago
It is truly broken. 🙄
The ward situation is just as knackered also. Boarded Bays is the new one.
Bays designed for four patients now has a fifth bed slapped in the middle (must be mobile apperantly) with no access to an Oxygen point or a Nurse call bell.
If the worst comes to worst and crash trolley has to come in, fifth bed has to wheeled out to corridor!
People know exactly how bad it is and they aren't blaming the A&E staff.
Whether they actually understand what it really means, or how awful it is for the staff.
My parents are in their 80s and have caught the awful cold - trying to make sure they don't get worse, needing hospital may kill them
We know this, we knew this 4 years ago ) and earlier) yet somehow when it comes to a person on a booth alone, with a pencil and a ballot paper, it isn't what they think our care about. Htf is that?! Gawd help us.
It’s shocking and sad to hear.
I think there is a massive branding issue behind the strikes and situation. It’s like the unions or whoever is managing it need a decent PR co.
Public perception is that it is about pay rather than the situation being described here.
Even what is described here doesn’t get to the core of the problem.
You can increase pay by 50% and increase hiring but nothing is going to outpace the increase in use by a rapid aging population. Even without incompetence that alone breaks the system.
How can that be solved without increasing hospital count for n the UK by x%. At guess from sounds of it we will need 50% increase within the next 10 years. Anyone got any ideas?
At the large city centre NHS hospital my wife works at they now have a marquee in the car park as a triage/waiting area. A *ing tent. In 21st Century Britain, which is supposedly a first world country.
She's also just received a parking fine from the city council after they doubled the parking fee from £4 a day to £8 a day with no notification or signage or anything. She gets her ticket from a coin operated machine in the dark. She only has to do this because she was lied to in her job interview to return to this hospital after a few years in a community hospital whilst our kids were young. I.e. she would have a staff parking permit.
It is *ing bollocks. The ****s we call a government need running out of Downing Street at the sharp end of a pitchfork. That smug prick Sunak with his £750m in the bank and his gold-plated future telling people there is no crisis can **** right off. It is an outrage.
Well, no-one has said it yet, so I suppose I should.
**** the Tories, and **** you if you vote for them.
APF
For balance:
I parked for free at my local hospital today - as all staff and patients can.
I was seen on time (TBF, I was first of the day), by a friendly and professional nurse, who sorted my treatment and emailed the consultant while I was there.
I walked around to the pharmacy and picked up mrs_oab's drugs (worth as much as our car, picked up every quarter).
I bumped into an elderly neighbour at the main entrance, who I helped over the ice to thier daughters car. He had been in A&E at 7.30am, and was leaving the hospital at 9.30 am, with follow up clinic booked for tomorrow.
APF +1000!
I understand the chronic underfunding and funds not going to the right areas, but it's the huge increases in people using A&E that is a real shocker for me, i just don't understand why people are still running to A&E for things that a minor injuries could sort, or 111 or a pharmacist, it just seems to be straight to A&E which comes with the added annoyance that a lot of people who should be going to A&E are leaving it due to the press just now giving these horror stories.
Still can't see this government doing anything good in the time they have, they like to use the issues caused by Russia/Ukraine/Covid/etc, but when looking for excuses to not fund the NHS or pay those striking more they ignore the actual issues and go back to inflation, or the lack of unemployment as the basis to why it's prudent not to pay people more in these hard times.
Timely.... My wife's just rushed in to say her 92yo grandpa is in a side room in A&E with SATs of 40% as there are no beds available. ****
How can that be solved without increasing hospital count for n the UK by x%. At guess from sounds of it we will need 50% increase within the next 10 years. Anyone got any ideas?
the key issue is "bed blocking" by those needing support at home which cannot be arranged. Thats what creates the logjam. Home care is paid at below national minimum wage and is as a result of generally poor quality. Home care workers have either to work unpaid overime or leave needs unfufilled. Home care providers cannot recruit an councils cannot increase funding
Sort the home care situation out then folk can get moved out of A&E into the main hospital. Patients not entering thru A&E will not have appointments / operations cancelled for lack of beds. Reducing waiting lists takes the pressure of GPs as they are not having to look after such sick peiople at home and will not have to continually re refer
So the key is sort out social care
What has caused the huge increase in a&e demand? I'm not sure I've seen an explanation. Ageing population? Missed GP appointments? People avoiding care homes? All of the above perhaps.
Even with the Tories in government I never thought I'd see the NHS in the catastrophic state it's now in.
I'm terrified that if I needed to call an ambulance for my old mum now that going into hospital would be the end of her for sure.
I absolutely f*****g hate what the Tories have done to the NHS. They are vermin.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
I totally agree. I've had some experience as a member of the public as a user of A&E and taking my nan to A&E, in the last few years.
All i'll say is anyone who votes tory should be strung up to the nearest lampost.
Strikes and pay rises won't make any difference.
You can't tell me it hurts less when someone dies in an ambulance queue for a&e admission any less if you earn £14ph or £12ph. It will still rip a piece of your heart out.
I dont think most of the staff who work on the front end do so for the pay and benefits. They do it to help people when they need it the most.
Its to keep raising awareness that the system needs billions, that cant be allowed to be siphoned off by tories, adding to the pot.
So they can help more people, safely and efficiently.
Where we are now with covid , kamikaze budget and putin means finding the billions is not going to happen, the tories will privatise as soon as they can get all their ducks in a row to benefit themselves, and blame everyone else and we all will pay. Again.
That said, the number of chancers calling 999 and turning up at A&E's is also a joke.
I know you can't judge a book by its cover but i'm fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
What has caused the huge increase in a&e demand?
Part of it is down to the lack of GP appointments which in at least part is caused by the logjam meaning GPs spend more time with very sick people who need hospitals but cannot get a bed so have less appointments for others
Part of it is down to the lack of GP appointments which in at least part is caused by the logjam meaning GPs spend more time with very sick people who need hospitals but cannot get a bed so have less appointments for others
Also this.
The whole system has systematicaly run into the ground by the conservatives.
The NHS as we knew it is dead, and it breaks my heart, because it’s a beautiful system. It shouldn’t be like this, and those of us who have been around for longer than 5 years know it wasn’t always like this.
In June 2016 a pal of mine was 50/50 on leaving the EU, I patiently explained why I thought that leaving wasn't a good idea plus the kind of folk who were behind leaving weren't the kind of folk you'd want been involved in running the country. "What's the worse that could happen though" he said.
He was commenting on the state of the NHS today on FB, I reminded him of his words...
i just don’t understand why people are still running to A&E for things that a minor injuries could sort, or 111 or a pharmacist, it just seems to be straight to A&E
Because out of hours provision is also ****ed. We used to see a GP if there was a minor problem but since the GP contract change if someone needs a hands on assessment it's ring 111 who tell you to go to A&E. QED
For further balance. I’ve worked through out Christmas and midweek last week. It’s dire, not just in our area across the UK. I can see data for lots of areas when on duty and they all the same. I attended an incident at the weekend where they had waited hours for something they should never had. I couldn’t apologies enough to the family. I got back to my car, angry upset and disappointed in what has happened. Then had to get on with the next incident.
Its also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake - its deliberate
sillysilly
Full Member
It’s shocking and sad to hear.I think there is a massive branding issue behind the strikes and situation. It’s like the unions or whoever is managing it need a decent PR co.
Its not bad PR... it's a right wind press all too keen to blame all the failings on the NHS rather than government and then paint nurses etc as overpaid moaners! 😡
APF for PM.
Unfortunately there are too many people (about 2% too many according to the most recent poll) who regard rubber dinghies containing a handful of migrants as a greater threat to our way of life than a crooked government that embezzled billions during the most acute part of the pandemic. A government that is headed by an unelected billionaire who regards anyone with less money than him as a deserving lover.
Unfortunately the current state of things is also, partly, a reflection of the lumped stupidity of the electorate - who swallow any old crap so long as it says it is all someone else's fault.
Aaaaaargh.
111 also has its triage issues.. if there's any doubt about the health of a person it's basically a recommendation to call 999.
There's no easy way around that, a person on the end of the phone, who is not a doctor, or even a qualified nurse, can't realisticaly triage over the phone, so the script will lead to... call an ambulance.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
I don't think I've ever felt more in agreement with anything said, ever.
Have had horror stories from friends in the NHS for years but they really have become scarier over the last few weeks. One friend said they turned up for their shift on their ward and they were the only person available to look after 17 patients, it's meant to be a minimum of 4 patients to each nurse. They're really struggling with staffing levels especially as it's an expensive part of the country to live in (Cornwall) and that lots of their European colleagues have left.
I'm actively avoiding any undue risks right now as I don't want to be a burden on the system unnecessarily.
That said, the number of chancers calling 999 and turning up at A&E’s is also a joke.
I know you can’t judge a book by its cover but i’m fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
It isn't unknown for people to feign an injury so that they get an ambulance (usually on a Friday night after drinking a lot), get taken to hospital then leg it. Voila, free taxi home. One of my friends even had one patient in the back of his ambulance tell him to go to one hospital rathe than the one they were going to as it's easier for them to get home afterwards.
One of my cousins is a serial visitor, he's a drug addict and dealer so is there 3-4 times a week with issues or for being beaten up. There's a group of locals that essentially clog up the system as the local drug rehabilitation clinic was closed down and the next nearest help available is 20 miles away. The whole system is being ground down politically and financially despite the absolute efforts of the front line staff.
And in case anyone forgot to mention it:
**** the Tories and if you vote for them **** you too.
Its also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake – its deliberate
For sure, this is a diliberate and concerted effort by the Conservatives. They don't mind killing a bunch of people, as long as thier retirement funds and investment portfolios are looking good.
Steer clear of the really thick chains as they are very heavy and inflexible to thread through bikes without causing damage or inconvenience
Godda say I'm surprised it took to post 23 fir someone to point this out. I was thinking of starting a post about this very thing the other day.
As Tij says, it's completely deliberate. They're painting us into a corner. They know we're pretty much ****ed. They've ****ed the economy and they've ****ed the NHS. There is no way Labour can rescue this shitshow in one term. The scum party will be back in 6 years and be able to lay the blame on someone else. The peasants will believe them and they'll come to the rescue with the only available option, which is to sell-off great swathes of the NHS to the Merkans.
God I loathe the electorate.
Strikes and pay rises won’t make any difference.
You can’t tell me it hurts less when someone dies in an ambulance queue for a&e admission any less if you earn £14ph or £12ph. It will still rip a piece of your heart out.
I dont think most of the staff who work on the front end do so for the pay and benefits. They do it to help people when they need it the most.
The strikes are about conditions, work overload, lack of recruitment, cutbacks not just pay.
It’s also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake – its deliberate
This. Unfortunately. And now they know they will likely lose the next election they give even less of a shit about anything other than furthering their own interests.
Spent 12 hours (7pm-7am) in A&E a couple of Mondays before Christmas with chest pains.
Was an interesting cross section of walk-ins.
More than a few who simply couldn't get GP appointments.
I couldn't even get past the GP gatekeeper with chest pains, was offered a phone appointment.
The staff were great, one even came round got everyone hot drinks as the tea machine was broken.
It was a 4 hour wait between each time I was called in. 30mins before triage iirc.
Well, no-one has said it yet, so I suppose I should.
* the Tories, and * you if you vote for them.
First time I’ve ever agreed which a palace fan. Well said Alex (you’re still shit though) 😉
For additional balance, my orthopaedic surgeon friend had several operating lists cancelled over the last few weeks because management had commandeered all his recovery beds for A&E. Sure that’s only elective hip operations getting bumped but Apparently the managers were so desperate they had also tried to cancel some cancer related operating lists. In this instance they were shut down but it illustrates how bad things are.
Pay rises are part the answer. The nhs is haemorrhaging staff, losing far more than thy can recruit. A pay rise would help staff retention. Knowing that the government values you at the same level as Lidl values it’s shelf stacking staff doesn’t help you cope with the longer hours, the stress, the knock on effects on home and social life etc...
What I will praise is the people.. the off duty fireman who attended my nan as first responder, and the paramedics who turned up not long after.
These are the people who are propping up the whole health system, and I can't praise them enough, 100% professional and on the ball despite the circumstances.
These are the people in society we need to look after more, not less.
Politicians are either clueless (cannot think out of the box) or do not have the determination or lack the will.
May I suggest the followings: (yes, someone will come along to say that's unfair because we want that too etc, go work in NHS then)
1. Reduce drastically or abolish income tax for those working or pay by the NHS (can work out the details later if the earn beyond certain level), or a combination of pay rise and reduce income tax. Personally, I favour No income tax if they earn below say £45K as nurses, if they earn more you can decide or work out the rate etc.
2. Govt should create a rule that all those paid by NHS should receive low mortgage interest rate (if they intend to climb the property ladder) or very minimum mortgage interest rate, tell that to the financial institutions. If financial institutions do not like it then they can go.
3. Same goes to all public transports (trains and buses). NHS workers get massive discounts while travelling on them or even free etc.
My overall view is that there must be an incentive to attract people to join NHS. This can be done in many ways but as I say if there is a will there is a way.
Not sure if my suggestions make sense but as usually someone might disagree if they are working for Inland Revenue.
It’s always worth restating that this is not accident or incompetence, this is deliberate, planned Tory policy.
They’ve always hated the nhs, hated that a hugely successful and popular public service exists. It proves that the ‘only private industry works’ mantra is a lie. The Tories want peoples health expenses to go to private companies, as in USA, not because it’s a good system but because they and their friends will get fat on it.
i just don’t understand why people are still running to A&E for things that a minor injuries could sort,
Tried that recently?
I know you can’t judge a book by its cover but i’m fairly confident at least 60% of people presenting themselves in A&E are not emergencies.
You can't get GP appointments, so if you have something potentially serious - a nasty rash, recurring chest pains, a headache that won't go away etc etc you've got nowhere else to go. It's now called a 'walk-in centre' but it's still just the same A&E, here in Cardiff at least.
It’s always worth restating that this is not accident or incompetence, this is deliberate, planned Tory policy.
I wouldn't just blame one political party. This is an accumulation of political incompetence over decades.
Now it has reached the break point which needs sorting out, which is not a surprise because nothing will last forever.
This is an accumulation of political incompetence over decades.
True, but our point was that one specific party has had it as a formal goal for a while. Ie its not accidental/ incedental, it is the plan
You can’t get GP appointments, so if you have something potentially serious – a nasty rash, recurring chest pains, a headache that won’t go away etc etc you’ve got nowhere else to go. It’s now called a ‘walk-in centre’ but it’s still just the same A&E, here in Cardiff at least.
Yeah, I know and understand, really I do.. The whole System is FUBAR, so it comes back to political choices by the government.
My overall view is that there must be an incentive to attract people to join NHS.
Well free parking should be a given, lol!
But I don't belive that's the main issue with health care workers...
Have you ever been in a job thats mentally battered you senseless for ten or more hours straight?
Have you ever been in a job where people are dying and there's nothing you can do about it because you only have one pair of hands?
The mental toll on NHS people, probably most especially A&E people will take its toll, they will quit due to mental health, or simply due to burn-out.
A tired and exhusted nurse or paramedic or whatever, is not going to do the best job.
The GP thing is a factor. Bear in mind there’s been a recruitment crisis in general practice for years - GPS aging out, burning out, moving abroad, retiring early due to the stress. That’s worse in more rural areas where recruitment is difficult like Devon and Cornwall. Add in that these areas saw a big influx of population due to lockdown/ work from home and that they are often popular retirement areas with a demographic that skews older.
A good friend is a partner in a big local GP practice. They are currently so stretched that they cannot offer any non - emergency appointments as all their available clinical time is needed to deal with urgent cases. Rising Flu and Covid numbers are causing huge pressure in General practice too.
Same goes to all public transports (trains and buses). NHS workers get massive discounts while travelling on them or even free etc.
[strike Do we shite.[/strike]
Ooops! I have this chest bug thing so completely misread the context as I’m wrecked. Sorry.
Well free parking should be a given, lol!
As I said above I prefer NO income tax for NHS workers earning below £45k/pa, plus others discounts from public etc.
I can guarantee the number of people wanting to work in NHS will increase significantly.
Any political activist(s) on STW, if you can get my suggestion through you have a winner. Guarantee!
You can’t get GP appointments, so if you have something potentially serious – a nasty rash, recurring chest pains, a headache that won’t go away etc etc you’ve got nowhere else to go.
Yep, nobody wants to sit in A&E for 12 hours, I was told to, over the phone by a GP at 6pm after contacting the surgery first thing in the morning.
It wasn't an emergency as far as I was concerned but I did need medical attention.
I was well enough to drive there and pay for 12hrs parking.
Still can't believe staff have to pay.
What has caused the huge increase in a&e demand?
I'm not sure there's been that huge of an increase in A&E attendances.
https://www.statista.com/statistics/378338/total-accident-and-emergency-attendances-in-england/
6.5m in Q3 of 19/20 (Oct-Dec 2019 - pre covid).
Stats for December aren't out yet, but just under 2.2m in each of October and November 2022, pro-rata'd up for the whole quarter is 6.5m.
https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2022-23/
The problem, as TJ says is social care. Councils have had their funding cut. They can't afford to run social care properly. Patients are stuck in wards waiting for social care plans to allow them to be discharged. Wards are full so patients who need to be admitted from A&E can't be as there are no beds for them. The really sick patients are stuck in A&E in assessment rooms and taking up time of staff who should be assessing, patching up and discharging the less sick patients, which means if you turn up needing a few stitches you're not going to get seen for hours.
And if you need an ambulance, well that's going to take ages to get to you because the ambulance is parked up at A&E, with a critically ill patient in the back of it who can't be 'offloaded' as there is no space in A&E, because there is no space in the wards, because there is nobody to give social care, because David Cameron thought the 'big society' should be looking after people rather than actual professionals doing it.
Still can’t believe staff have to pay.
Only in England and at one PFI hospital in Scotland where the scots government have no control over the contract
Much of this comes down to the logjam created by the collapse of social care. Never lose sight of that.
Much of this comes down to the logjam created by the collapse of social care. Never lose sight of that.
I agree with that.
Correct me if I am wrong but haven't successive governments shut smaller A&E departments all over the country. Concentrating more patients through the larger hospitals, without increasing capacity to the same as what was lost to these centralisation/cost cutting measures.
The local hospital to me takes patients from the edges of two neighbouring counties that used to have their own A&E departments. Last time I was there (a few years back) I had to go to the reception to get help for lady who was sat in a puddle of piss in the waiting room, I was treated in a corridor! I know of two other children's hospitals in neighbouring Lancashire that were closed/reduced capacity with the patients sent to St Marys instead.
40 Hospitals eh...remember that!
I think there is a massive branding issue behind the strikes and situation. It’s like the unions or whoever is managing it need a decent PR co.
agreed in 2015 doctors went on strike due to their revised contract T&C’s and also because they saw the impending doom. Mrs FD worked in a major trauma centre that had unsafe staffing levels back then.
Its not just a Tory thing, all political parties have done their part, even the public didn’t help with voting Brexit.
Every part of health and social care is broken, working beyond efficient capacity which then makes you more inefficient and harder to get back to the ‘normal’
Patients that require A&E are getting more complex, but the main issue in an acute hospital is getting patients out. The numbers of acutely unwell patients isn’t dramatically changing.
Its relatively easy to treat someone easily at the front door who needs a plaster on their finger and send them on their way, it’s the more complex ones that need acute care and then social care after that in essence are bed blocking and creating the delays with ambulances
More step down beds are needed in the community to take patients when they are finished in an acute bed.
And yes the NHS requires more staff in all areas. I admire the request for no income tax on less than £45k, but doctors need looking after too. If you want people to get better you need competent trained doctors, and people simply are not being attracted to the profession at the minute due to poor doctor pay and conditions
Currently Mrs FD in an absolutely stupid situation. She treats cancer patients, and her Trust want her to work extra sessions to see more patients. 1. That’s great if they had the theatre capacity and staff 2. Every time she work’s extended hours, it actually costs her money so there is zero incentive to do more hours. This is effecting many doctors !
I’m not sure there’s been that huge of an increase in A&E attendances.
Oh there has. Early figures are around 300% more than normal for this time of the year, our call records alone have been exceptional.
Correct me if I am wrong but haven’t successive governments shut smaller A&E departments all over the country.
yes - for good clinical reasons. Large A&E depts in large general hospitals are much better for major trauma
Much of this comes down to the logjam created by the collapse of social care. Never lose sight of that.
Talking to my sister who’s a senior medical professional in the NHS bed blocking is the root cause of the issues facing the NHS right now. Beds are blocked by people who could go into care homes leading to staff not having enough beds and thus focusing on the very sick in A&E. As the population ages the problem becomes more acute.
As technology has improved it was assumed less beds would be needed as day surgery would reduce overnights and thus informed the level of nurses and doctors that would be needed. Although true the fact nursing homes are mainly private and run on wafer thin margins didn’t get factored in leading to bed blocking.
It won’t be popular on here but this policy of private care provision started before the current government.
yes – for good clinical reasons. Large A&E depts in large general hospitals are much better for major trauma
Sure. But funnelling more patients through facilities without increasing capacity sufficiently seems like gambling on things not going wrong!
And yes the NHS requires more staff in all areas. I admire the request for no income tax on less than £45k, but doctors need looking after too. If you want people to get better you need competent trained doctors, and people simply are not being attracted to the profession at the minute due to poor doctor pay and conditions
Yes, of course. Just need to work out the details.
Still can’t believe staff have to pay.
Only in England and at one PFI hospital in Scotland where the scots government have no control over the contract
I should have added, I've been in paying my contractor parking while a nurse was trying to sort her parking payments out.
As an aside parking charges paid by contractors will simply be added to the bill and probably doubled.
So the key is sort out social care
This is being mentioned and then glossed over a lot in reports.
On 5Live tonight a representative of the care home owners association or whatever its called said he has 25 spare beds waiting in his 5 care homes, but the councils don't have the central government funding to even pay the reduced cost to move patients into them.
Seem to recall a few reports from hospitals where the number of blocked beds is roughly the same as the number waiting in their A&E. I can't help but think the (partial/temporary) solution is not that hard to figure out if only we had the will
Oh there has. Early figures are around 300% more than normal for this time of the year, our call records alone have been exceptional.
Fair enough, there must be some regional variation, but I’ve sat through presentations given by A&E consultants saying they are happy with the number of RESUS bays they have and in fact the number of A&E bays they have (opened recently) but it’s the bed blocking and not so ill patients or those that could in fact be streamed directly to speciality but can’t be due to bed blocking that is causing the issues. A&E is just the dumping ground for everyone and anyone as it’s the one door that is not allowed to turn people away
Blocked beds is not mainly care home capacity related - its mainly home care. Mt last job was in a rehab ward. Some areas it was a 3 month wait for home care.
I also think the number of blocked beds far exceeds the number of folk waiting in A&E for beds. I've seen numbers up to 1/3 of all hospital beds are occupied by folk ready for discharge but with no care in place to be discharged to
Its also deliberate tory policy to create crisis in the NHS so they can say privatisation and insurance based services are the only cure. Make no mistake – its deliberate
This
From which the only conclusion is this…
* the Tories, and * you if you vote for them.
Just to stress the point, the government, or what nowadays passes for one in this Mickey Mouse country, had this to say this morning
https://twitter.com/stevebarclay/status/1609957311610556416?s=46&t=VQ0QwZ4s5TEeoaUgkaR4mA
Seriously… that’s what the health Secretary, who’s been invisible, has to say about the world this morning. It’s like an episode of Black Mirror
6 weeks ago the NHS saved my life... That might sound a little melodramatic maybe, but it actually happened. I had an infection flaring up post bowel cancer surgery, I was unaware just how bad it was until it was almost too late. Having had to call an ambulance months previously and it taking 14hrs to turn up (by which time the problem had abated), my GF didn't even bother and just drove me to A&E this time... Unable to sit (infection on my arse), barely able to stand (severely weakened immune system, Sepsis taking over my body), it was obvious to all around me I was in a bad way... After 4hrs, I eventually got triaged, by which point I'm beside myself with pain... 2hrs later, I get catheterised, yet no meds administered at this time... 1/2 an hour later 2 co-codamol pills arrive (why was I catheterised at that point?!?!) to relieve my pain slightly... I spend the next 6hrs drifting in and out of consciousness...
After a little over 12hrs, I finally get admitted to a ward... Well, I say a ward, I spent the next 3hrs in a bed in a corridor, still no real pain relief, everyone banging into the bed as they run past or try to get other beds past... Then finally get moved into a ward, whereupon 1/2 an hour later the on call doctor takes a quick look at me and says "antibiotics are going to do nothing to that, we need to get you into surgery ASAP before that gets any worse!"...
But of course it did get worse, I was still at the back of a queue of other people needing surgery, and it was another 12hrs later before I went into theatre, by which point my immune system has shut down most of my unnecessary functions to survival, I'm off my tits on morphine with the strongest possible dose they can give me yet am still writhing in pain, and then I go into surgery...
All of 15mins later I was out (apparently, I was out cold for hours under general anaesthetic), infection relieved, wound packed and dressed... I woke up the following morning like a new man!
Arguably I left going to A&E a little late, but didn't want to go unless it was absolutely necessary (was on strong painkillers and antibiotics at home anyway). The fact it was 27hrs from the point I was admitted to A&E to the point they operated on me to relieve the infection that was by that point, only a few hours from taking my life, absolutely blew my mind! But I fully understand and sympathise why the situation was so, and can see how people are needlessly dying under similar circumstances.
As for why we're there... Well it's been said many times in this thread already. Systematic defunding and re-resourcing of the NHS by an extreme right wing sect masquerading as a Tory government, with nothing to lose and everything to gain by destroying it.
The thing is though, they are relying on voter apathy. The UK has become one of, if not the most apathetic and politically unmotivated country in the world over decades and decade of the two main parties fighting over the same centre ground. Obviously, this all changed with the Brexit vote, and gave the Tories carte blanche to go hard right overnight, taking many years for much of the population to cotton on to their tactics...
The problem they have now is that even the most loyal of Tory voters are mostly absolutely disgusted by their actions to destroy the NHS right now, apathy is dwindling... The people will revolt sooner or later, and it won't be a handful of disgruntled voters and a few opportunist looters, there will be mass civil unrest!
The Tories should be mindful of pushing people past the point where they have nothing to lose. I'm not saying they need to be afraid of the odd loner with a victim complex... I'm saying they need to be very, very aware of pushing "normal" people like me to the point where they feel they have nothing left to lose any more... People who have nothing left to lose don't act rationally, and will often lash out in retaliation, taking their pound of flesh or more directly from those who have directly caused their pain and suffering... I feel ashamed to say it, but I am a lot closer to breaking point myself than I would like to admit. But at the same time, I bet you there's hundreds if not thousands of people out there that are already closer to breaking point than I am!
I'm sure a few dozen of Tory MP's fighting for their lives in an A&E department that is massively overrun and cannot cope with the demand, would get the govt to reassess their priorities... Be sure that at the rate the government is going right now, someone (or some people) fulfilling the goals of their own personal vendetta is becoming an increasing certainty rather than an outside chance... You want to play with fire, then expect to get burnt...
Blocked beds is not mainly care home capacity related – its mainly home care
unfortunately now though, many elderly who end up in A&E and eventually a ward are decompensating to such an extent that they are not capable of looking after themselves by the time they get out. I think COVID and not being able to visit has prevented this from really becoming public knowledge to date, but now family and friends will see it happening
My 76 year old Dad slipped and broke his femur on the Friday before Xmas. 10hrs later the ambulance finally turned up. My stepmum tried ringing 6 times during the wait, and was told he wasn't an emergency.
They've still not fixed his leg.
6 weeks ago the NHS saved my life… That might sound a little melodramatic maybe, but it actually happened.
You are NOT melodromatic at all. Your life is saved by NHS.
I still stand by my argument that either the NHS workers get tax free or very minimum tax together with the public incentive etc. This will reduce shortages because the sector will attract more people entering. Then the other details of social care etc can be looked into later.
First thing first, if there are shortages no matter what they do they cannot cope even if NHS workers get 100% pay rise.
Instead of pay rise, with no tax or very minimum tax, that pay rise can go to fund more people to work in NHS. Yes, someone still need to do the calculation but I am sure this is a better approach.
I still stand by my argument that either the NHS workers get tax free or very minimum tax together with the public incentive etc.
I fully agree with your sentiment about properly incentivising working for the NHS... Sadly I disagree with the means... Money isn't the largest driver for people in these critical jobs. Reducing their tax liability doesn't reduce the stress of the job, or the likelihood of patients needlessly dying on the job in situations that could be avoidable!
The solution is to fix the NHS, root and branch... Which of course needed to start at least 5 yrs ago, if not 10, for it to have any meaningful effect before the next 2 general elections have happened!
I am very very fearful we have witnessed the biggest crime of our lifetimes here... Sadly I think it's too late for the NHS, no amount of public outcry or even staunch Conservatives renouncing their membership and vowing never to vote Tory again, is likely to change it. It has gone too far I think! They have won, they will break it up and sell it off to the highest bidders in no time, then they'll slink off to spend their ill gotten gains whilst Labour are left to try and pick up any pieces!
This is an accumulation of political incompetence over decades.
under the labour government waiting times for treatment reduced from 18months to 18 weeks. there may have been other issues waiting in the background to manifest for sure, but these ****s have been in power for 10 years. this isn't a 'successive governments' issue, it's a tory issue. i'll echo the other sentiments regarding those who are tories or vote tory, but i've recently been warned for avoiding the sweary filters...
If this is just Tory then Labour are not exactly doing a good job stating that as fact, in addition to how they will solve the problem. Sounds like throwing all the money in the world not going to solve things for NHS unless they just give it to local councils to fund social care and avoid bed blocking.
Paying zero tax or increasing pay with both cost the same. I am for either.
Based on two weak ass parties that I can only see making everything worse does anyone know which countries have the strongest economic outlook with nice MTB trails, but without the aging population?
Reducing their tax liability doesn’t reduce the stress of the job, or the likelihood of patients needlessly dying on the job in situations that could be avoidable!
The first stage is to encourage or to provide incentive to attract more people into NHS. The pool of of NHS workers need to increase first.
Reducing their tax liability doesn’t reduce the stress of the job, or the likelihood of patients needlessly dying on the job in situations that could be avoidable!
Yes, that's because there is no enough NHS workers, hence the stress of keeping other alive. They need more people but if there is no incentive to join NHS, the problem remains. Therefore, the starting point is to increase the pool of NHS workers. In the immediate term, I do know the solution but if the Union is arguing for pay rise that will not solve the problem in the long run. NHS workers might be happy with the pay rise but how can they improve if they have limited capacity to deal with increased number of patients? Impossible.
The solution is to fix the NHS, root and branch… Which of course needed to start at least 5 yrs ago, if not 10, for it to have any meaningful effect before the next 2 general elections have happened!
How? If you have Not enough NHS workers how are you going to fix the branch? You cannot automate health care like a machine. Hence, my view is to increase the pool of NHS workers and this must start with the attractiveness of working for NHS ... may it be financial incentive in the form of No tax or minimum tax. If you wish you can also charge people £2 to £5 per visit if there is a need. All these will mean getting more fund for NHS or at least increase the pool of NHS workers. It is better to have more NHS workers (pool) than less. Then the details can be sorted out etc.
adly I think it’s too late for the NHS, no amount of public outcry or even staunch Conservatives renouncing their membership and vowing never to vote Tory again, is likely to change it. It has gone too far I think! They have won, they will break it up and sell it off to the highest bidders in no time, then they’ll slink off to spend their ill gotten gains whilst Labour are left to try and pick up any pieces!
Nothing is too late if there is a will. As I said, if any politician is serious they can consider my solutions. Never try never know. But I bet most politicians (all parties) are just simply too afraid to do things different especially if it impacts on the "revenue".
If NHS staff get tax free or minimum tax they are just going to spend the money and the money will eventually go back to the Inland Revenue etc or back in circulation, but not sure why they are so afraid.
Sounds like throwing all the money in the world not going to solve things for NHS unless they just give it to local councils to fund social care and avoid bed blocking.
There is NOT enough people attracted to the sector. No matter what you do will Not reduce the problem. If there are no people in the social care sector (assuming it is NHS), you can have all the beds you want but if you have one person taking care of say 60 people in care, how is that going to work? Problem remains.
does anyone know which countries have the strongest economic outlook with nice MTB trails, but without the aging population?
Well that would take you outside the west / first world. Chile?
these **** have been in power for 10 years. this isn’t a ‘successive governments’ issue, it’s a tory issue.
Coming up to 13 actually, and each successive PM has ratcheted up the nastiness!
If this is just Tory then Labour are not exactly doing a good job stating that as fact, in addition to how they will solve the problem.
For reasons beyond all fathomable comprehension, Keir Starmer seems hell bent on trying to make himself appeal to margin Tory voters from the last 2 General Elections... He's asleep at the ****ing wheel, when the country needs him to not only be taking charge of a unified Labour party, but providing real vision and clarity for their 5yr plan that sees them begin to undo the damage that has been done by the Tories in the last 13yrs... He's more concerned appealing to "Mondeo Man" who he thinks is still a hardline Brexiteer, despite all the shit that has gone on!
This is gross incompetence on an incomprehensible scale by Starmer! If the NHS collapses, it will make Brexit look like a kids ****ing tea party by comparison!
This is gross incompetence on an incomprehensible scale by Starmer!
NHS is a poison chalice for most politicians to be honest.
Rules are men made so I don't know why nobody even argues for different tax regime for NHS workers considering the importance of NHS to the nation. Absolutely crazy.
Not even a single politician ever mentioned about different tax regime for NHS workers (well, at least I have never heard of).
Please post this to a twitter or insta account so that I can forward it to people that think the problems of the NHS lie with health tourists and nursing strikes....
I'm leaving this (un) sacred isle next week because it's so freaking depressing seeing the change in the last 15 years ago and the amount of apathy and blame culture that currently pervades.
**** this Government, **** the apathy that exists.
To the op, if you give up or have had enough I can fully appreciate your decision. The NHS has been treated like shite for the past 10 years. Save yourself....!
This is a supposedly first world country battling with third world problems.....
And that's before I start ranting about the state of the roads... Playing slalom along the A12 or any other road in town if a freaking joke.... Seriously... I thought the roads in Poland were bad, but I'd swap those for those in the UK right now.