We all know that the NHS are excellent with acute and clever stuff, but when it comes to routine things it all seems incredibly wasteful, both on people and money, or is it where I live.
I decided to have an mot as I’ve never had one, I made a doctors appointment, she told me that I have to go to the local hospital for blood tests, I then need to make another appointment with the practice nurse to have my blood pressure taken, I then need to make another GP appointment for counselling prior to going back to the hospital for another blood test for prostate cancer, then another GP appointment to discuss any results.
So three GP appointments
One nurse appointment
Two blood tests
could be one blood test at GPs, GP could do blood pressure. all could be reduced to two GP appointments
And as far as I know I’m fit and healthy
Sometimes I've had blood tests at the GP by appointment with the nurse and other timers I've been told to go to a hospital for them. No idea why the difference. Never heard anything back or been mentioned in subsequent GP visits either so I assume all ok.
As you say, amazing with the complex but make the everyday painful.
Got a text from my Surgery yesterday morning telling me to make an appointment for my yearly checkup so Oct 21st booked with the tri age nurse will do blood test, blood pressure and if i remember correctly an ECG + i will take my sample with me ( told them i didn’t have a pot so they gave me one) and we will talk about my health in general and a tablet review.No need for a Hosp visit unless the tests turn out badly.
Is your practise a small one ? as it all seems overly complicated.
I FEEL LIKE I'M DIAGONALLY PARKED IN A PARALLEL UNIVERSE
It’s quite a big one, 8 doctors I think just outside HarlowOriginally Posted by mart broad
It is quite ironic, we make an ECG, O2 and blood pressure telehealth machine
There are a lot of people doing sterling and committed work in the NHS, but many for only 5 days a week it would seem. I wonder if the latest Tory pledge for more money will include honouring their previous election manifesto to make the service a true 7 day a week full service. It is still the case that to get ill at weekends is not a very good idea!
We are failing to make it work 5 days a week
There's no point trying to make it work 7 days a week.
Jeremy Hunt (who promised 7 days a week) was orbiting a different planet to the staff of the NHS. So obviously a politician meddling in an organisation he doesn't understand, from a position of power, many many miles away. We laugh at him, but then we frown.
In my hospital we are 183 nurses short
Think about that
We went to visit my BIL on Saturday afternoon big hospital in Sutton Coldfield, we had never been there before so we went to the main reception desk to ask directions. I was amazed that there were three ladies manning the desk. The place was deserted
Save yourself the time and bother, do a quick and dirty test at work.
When you get older .......
What can I say - nearly five years lost visiting care homes, hospitals and disabled care centres as an advocate for friends and relatives.
Some musings on what I have noticed something that they have in common
Policy speak so that they understand:
The triumvirate confluence of the pharmacological. bureaucratic and medical hubris imbued with condescension toward the patient produce inter disciplinary process disconnects that serve only to hinder the prospects of a satisfactory outcome to any given "pathway" treatment.
OR
Common sense language :
to put it another way ignoring the smell of piss and biscuits some medical professionals and administrators prefer the patient and family in a supine position so that they and their colleagues can walk over the patient's self respect whilst removing any semblance of meaning and control from their thinking and, of course, preventing the patient from self defence is the inevitable clash of silo bureaucracies that will tie the patient's or family's hands behind their backs by laughingly ignoring suggestions of joined up, cross departmental, common sense approaches to situations on the basis of "it just can't be done !"
Let's not forget also the awkward crews that seem to wander through the background and periphery of the organisation bleeding the financial resources with remarkable adeptness and skill by giving pay rises to the wrong people and overpaying suppliers by vast amounts.
They who design and build hospital sites without a thought for the reality of cars and transport issues just so that parking one's car or having it towed away can become another layer of stress which tightens that knot in the stomach just a little more.
Praise is also due to the excellent telephone "defence" systems design that prevent customers talking to anyone useful.
To the people that break the GP facility that's been in situ for generations so that an A&E waiting room on any given day is more like an anthropologist's lab than a modern health facility.
They that design the early morning "soup kitchen" queue approach to getting an appointment with a £100k per year demi god and "condemn" anyone who isn't online to lifetime of waiting because it doesn't suit "the system".
............and let's not forget the part that our political representatives have played over many years with their pendulum "reform"policies. Congratulations to them and their naive, political non systemic approach to screwing the whole thing up and raising costs to astronomical levels.
..................but
Do you know in spite of all that above the nurses, porters, cleaners, paramedics and ambulance crews all seem to insist in wanting to do a good job and with a smile in most cases.
B
Business partners wife is a Staff Nurse.
She was asked to go to London for a meeting.
A day return.
Train tickets were bought for her by her hospital admin team.....£167
Checked online, same tickets could have been bought for £53
Can't understand wastage like this tbh.
I waited 3 months for an xray of the lower spine and then a further 14 months for an MRI.
The outcome? Straightening of the lumber spine, Arthritis and a bulging disc @ 40 years old ffs!
The treatment? Here's some Naproxen, give us a shout when you run out... goodbye.
I know everyone is different, I'm going to save myself the indignity and suffering, can't be doing with the loss of control, never mind the emotional burden and cost to family and it's off to dignitas or similar, if/when it gets to the smell of wee and biscuits part.
Quite simple when you spend someone else’s money who cares and this thinking is rife within not only the NHS but Govt across the board.
I FEEL LIKE I'M DIAGONALLY PARKED IN A PARALLEL UNIVERSE
Quite honestly after 50 yrs in the Funeral business given some of what i have seen can only agree.
I FEEL LIKE I'M DIAGONALLY PARKED IN A PARALLEL UNIVERSE
They will probably use an agency for this, hence the additional costs - not justifying it in any way.
When you look long into an abyss, the abyss looks long into you.........
GP appointment for counselling prior to going back to the hospital for another blood test for prostate cancer
this is a biggy, you need to know stuff before you have one of theses tests !!so that's why its another test.
Friend of mine had his contract changed as part of the shift to 7-day working week.
Now does 2 days on, 12hr shift then 4 days off.
As a recent singleton without kids he absolutely loves it, particularly given as his stuff is relatively routine so he doesn't get many appointments for weekend shifts.
Combine this with keeping his holiday allowance as days he's absolutely laughing. Takes 2 days off & gets 10 days off.
Are you serious?
Basically it's broken, too many people using it who have no right to use it, ( but that's a different discussion ), too many people spending other peoples money, or should I say, wasting other peoples money.
The point mentioned above about the cost of the train ticket is just one in many millions of pounds that is absolutely wasted.
I remember some years ago the hospital where someone wanted a blind fitting at a window, they got fed up with waiting, and the cost, ( I think it was many hundreds of pounds ), that they went out and bought one themselves for a tenner or so and fitted it.
It's a fantastic system when working properly, but it's just been abused by so many people.
If my GP practice was a business, they would have gone bust a while ago. A lot of disinterested time servers.
The only job where you can get paid over £100,000 a year and basically be totally disinterested in your "customers". A very large minority of NHS staff rely on credit actually due to the very small minority who do sterling work.
Your GP practice is quite likely to be a small business.
Can only agree OP I am still waiting for a minor op on my lower back its been 4 months ! They buggered the first attempt but never mind heh ! you can always come back for another go.
The amount of money this has cost, with a visit twice a week to the local doctors surgery to monitor and dress the wound . Even the nurses cant believe how long its taking . I had my pre op back in mid July and was told this only lasts for 3 months ,not much longer left before that runs out then i suppose I will have to start again!
By the way Im also in Essex , so this maybe something to do with our health authority.
The NHS is no different to any other organisation who has to make cuts. The top brass protect their own interests/jobs and the cuts hit where it matter mosts - front line services.
it needs a rank and file restructure from top to bottom but there’s too many vested interests these days for it to happen.
My wife is a hospital matron and has to work rota weekends so not five days a week, her trust also has 600 nursing vacancies due to the awful working conditions I wouldn't want to do it and due to all the brexit shit
nearly all of their European nurses have gone home and they are now having to try to recruit from Africa and India.
I can't see boris or any other of the brexit clowns having to wait 2 years for hip surgery and other important operation like us mere mortals
OK we have had a multitude of slagging off the NHS procedures but not once have we given any reason why they do it or even the remotest suggestion of an alternative MO.
Criticism is easy to to and cheap. It is akin to making the corny old moan of "the country is going to the dogs" and leaving it at that.
My son was once on the Board of Trustees of a local hospital and the two main problems were lack of funding from central government. They increased the funding by 1% pa but the aging population increased the running costs by 4% pa and perpetuated the bed blocking problem which spread to other departments by soaking up staff and resources.
Yes the NHS can do with improvement but at least make the criticism constructive.
To be fair, you could probably buy the same ticket three times in a row, and pay a different price each time.
What was the other problem?
Criticism is often deserved and as valid as the cry to 'give more money to the NHS' we are always hearing from politicians and the populist press.
From the examples given it isn't lack of funding but bureaucracy and poor management. Throwing extra money at it isn't always the solution.
Indeed, what I meant was a business in a competitive market where I could take "my money" and go somewhere better.
If you have ever seen the "Behind Closed Doors" reality TV show about a GP surgery (currently one in Bradford), the doctors and practice nurses there are great. Now I can't believe they are just doing it for the cameras but the service they provide is excellent - the polar opposite of what I get.
The NHS is expensive and bureaucratic heavy but it’s completely free for use of service. Yes I understand income tax. Your subsidizing of medication means that many more people can take the drugs that keep them healthier compared to people not being able to afford them.
On the whole is NHS does what it should. Try living in most of the US without private insurance and tell me how rubbish the NHS is then.
Living in Canada our health care is free as well but prescriptions are not (most medium to large employers provide health insurance). I know of many families and individuals who go without their prescriptions because they are simply too costly. When I left the UK prescription were something like 7.50 or thereabout.
I've always thought this - ours is nothing like that. No way do our doctors get up to welcome and open doors to see us out (same goes at my elderly Mother's surgery).
Also they seem to know all of their patients. I'm lucky to see a doctor I've ever seen before.
Not sure if it’s a regional thing then but the vast majority of non British nurses in my local hospital are Filipino.
Having read the previous comments in this thread I can say that GP's practices seem to vary a great deal in their delivery of patient care.
Yesterday I had an ECG and blood taken by a practice nurse and then an asthma consultation with a specialist. Both of these were arranged for the same morning for my convenience, albeit with a 20 minute wait between them. The practice nurse recommended an appointment with a GP and made one for an hour later (this was subsequently deemed unnecessary and cancelled as a result of my subsequent meeting with the specialist). FWIW, I am always greeted by my doctor (or nurse) in the waiting room, escorted by them to their consultation rooms and usually having the door opened to see me out.
Should I need to make a GP appointment I can usually get one with my own GP within a week, or if I'm prepared to see one of the other doctors I can get one on the same day if I phone shortly after 8am. The practice has an in-house pharmacy and any prescriptions made in a GP appointment can be obtained from the pharmacy straight afterwards. My wife is with a different practice in our area and her experiences are broadly in line with all the above.
Given that patient funding is the same amount per patient at GP practices (AFAIK) it does raise the question why the experiences of us all varies so much?
R
Ignorance breeds Fear. Fear breeds Hatred. Hatred breeds Ignorance. Break the chain.
When we married my wife chose to stay with the small village practice she was with, her experiences are pretty much in line with yours, my doctors are in a small town, it is interesting that if payments are standardised how come the process is not. Another thing I find odd is the number of times we hear that A&E does not have enough capacity, yet it is a very common story when people go to their GP and are told "if you don't feel better by X go to A&E"
I have used the NHS a lot recently, ok it's not perfect by a long way but before slagging it off some could do well to try being ill without it.
So we can't criticise it then? Will only get worse.
In 2009 I was extremely ill, Bupa worked fine. my comments though were aimed at my GP and the unbelievably inefficient and wasteful process they use for something extremely routine.
Another thing that I don't understand is the farce of having to go to your GP to get a referral if you have health insurance, why waste their valuable time, "my toe hurts, I have insurance, can I have a referral"
I was interested to discuss with a young GP-trainee how the system works (In England at least)
The Practice receives ever-decreasing sums per patient on their Register - from Central Government. From this - they have to balance their books, but additionally - any referrals to hospital for specialist investigation/treatment comes out of the practice funds. He explained that was the reason that being a Practice Partner - was a poisoned chalice and that GPs now simply want to work FOR a practice, rather than have the burden of ownership.
A practice in Hampshire, with circa 7,000 patients - not financially viable, so closed..... with the patients being transferred to several other practices - with subsequent dilution in service.
There is massive waste/profiteering from the NHS - that is for sure.
My own local area is great, however.......
Phone up the practice at 08:00 any weekday, and you will see a practice nurse (or Dr if warranted) - that very morning. The nurse will consult with a doctor if required during the appointment.
Phoned them 08:00 Friday - saw the nurse at 10:30, who gave me a ‘voucher’ for an x-ray at the hospital, and made an appointment for me to return to the practice on Monday for a blood sample.
I went to the local hospital at 08:15 Monday (You simply turn up with the voucher, and if it is a quite time- straight in. If busy - you join a queue). It takes away one level of administration - works well. Had the blood taken Monday afternoon.
Friday 08:00 to Monday 13:00...... One consultation, one x-ray, one blood sample. Beat that!
If you throw more money at a school the first thing it gets allocated to (by the head) is the head's salary. "Having to drive the school through difficult financial times don't you know", tough job. Dunno if the NHS is the same but I bet there's some nice cars in the "executive" car park.
I live in a town of about 27000 people. The GP practice I was with for 30-plus years closed because the managing partner couldn't find anyone to take over when she wanted to retire (not even a senior partner, who had been with the practice for twenty-odd years). The local Health Board ran the practice for a few months with locums & trainees before shutting the doors.
The practice had about 6000 patients who were distributed to three other, already very busy, practices in the town.
Currently, at the practice I've been assigned to, the wait for a doctor's appointment is a minimum of three weeks & to see a nurse slightly less. There seems to be no time or provision for 'clinics' at the new practice: for example, no 'Well Man' annual appointment. Last winter, I enquired about a flu jab, having had one for several years due to an ongoing medical condition. I was told I didn't qualify! Test results take an age to be seen & commented on by a doctor & then you're back to waiting weeks for an appointment to progress them.
Frankly, I now consider going to the GP as a last resort. It shouldn't be thus, though, should it?
______
Jim.
Frankly I find that astonishing. What a massive disincentive for Doctors to err on the side of caution.
My wife spent 18mths working in Admin for a local practice. The pressure and abuse she had to deal with every day were relentless, she was the front line of an underfunded system and continually put in a position of trying to defend the system or placate angry patients. Something needs to change and as the OP pointed out there are inefficiencys that could bring potentially significant savings.
A family member is an NHS employee, above a staff nurse's pay scale. Work-related travel is bought and paid for upfront by the travelling employee, and has to be claimed back in retrospect via a claim form, with receipts. There are limits in terms of pence per mile for all rail or car journeys.
Tickets are never bought for employees by the hospital admin team in the way you have described.
Administering the NHS' internal market costs an estimated £10 billion per year. No evidence of any benefit compared with NHS Scotland, which never introduced this Thatcherite baloney.
This is one of the simple and quickest fixes. The internal financial market was designed to save money but ends up costing a fortune. It could be removed tomorrow with no noticeable effect, and the cost reinvested to redesign care delivery.
PFI cost is the main burden, but that is with us to stay.Sent from my SM-G950F using TZ-UK mobile app
Around 12yrs ago, I was sitting opposite a male and female who were travelling up to Aberdeen (train - first class area) from Edinburgh. From listening to their conversation between each other and the girl’s phone conversation to Grampian Health Trust - I ascertained the following:
The company they worked for were billing out at £750/day for each of them.
They were to be in Aberdeen all week.
They were both statisticians.
So - £7,500 +VAT for dayrate alone, plus hotels, taxis, meals etc........... without treating anyone!
I related the tale to someone in NHS who was sure they were manipulating the statistics to meet all the government-enforced targets, and to make sure that they were carrying out their quota of clicky-hip operations etc.
And don’t start me on the continual name-changes/‘re-branding’ of these NHS districts and the attendant costs!!!!!! They could call themselves “Grampian Country Chickens - Human Division” and as long as they provide the required standard of service - who cares???
Too many tiers of management in NHS, and snouts in the trough. A demoralised workforce who witness it all. (Much like the police, fire service, etc)
A few years ago I knew someone who worked in finance for the NHS he somehow got made redundant at £30k, three months later to the day he went back to the same job as a contractor at £105k
Unfortunately this sort of thing doesn’t surprise me (or many others I’m sure).
Fas est ab hoste doceri
I must say, from personal experience, that our local NHS has been brilliant.
I went to A & E at Coventry last year with an eyesight problem. Although I had to wait a couple of hours, when I was seen it was quickly diagnosed as a detached retina. The Dr phoned one of her colleagues at Birmingham Eye Hospital as they had no eye surgeon that weekend and basically called in a favour.
I was operated on the following morning (Sunday) and have no doubt that this speedy service saved my sight in that eye. Two months later the same symptoms showed in the other eye. I went to Cov Hospital eye clinic, examined and was told to come back the following day for that sight saving operation. I asked the surgeon how many patients he had had to deal with that day for the same op.. I was the tenth. Follow up care was exemplary.
Two months prior I did the usual bowel cancer test which proved positive. My operation for that was undertaken less than a month later. Again follow up care has been fantastic.
Although our local GP Surgery does not do blood tests I can book one online and have an appt next day at our local hospital without the hassle of waiting.
Went for six monthly diabetic check up last week at GP, when booking in at arrivalsI enquired about annual flu jab and was booked in immediately after my consultation re diabetic review.
I’m not saying that there isn’t room for improvement generally but the care I have received has been brilliant and I’m very grateful for that service and dedication.
Cannot praise our local NHS enough.
Last edited by JeremyO; 4th October 2019 at 17:35.
its already been said - to many snouts in the trough and wastage on a massive scale .
i saw this first hand a number of times as i used to sit on 2 of the top local PCT boards and saw the finances every quarter
the biggest con of all being the massive payouts the commissioners received when the system was changed from a PCT to a CCG - only for them to walk directly into the same job the next day as the government had not taken into account the fact that doctors know next to nothing about commissioning services and dont have the time to do it anyway.
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