At 15:55 yesterday, I had to call an ambulance for Mum as she was in extreme pain - she was unable to communicate clearly because of the pain, laboured breathing and more.
The paramedics arrived at 16:50. At 17:25 Taken straight to hospital (paramedics stated that they can't leave someone in that much pain).
At A&E she was first seen at 09:17 this morning. Spent the night howling in pain with no relief offered.
Where the feck is the money going!?
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Missed the edit - It's only fair to say that the paramedics were excellent!
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She would have been triaged at A&E between 17:25 and 09:17
Last edited by: Zero on Sun 7 Aug 22 at 14:24
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She was, less than a minute spent with a very overworked nurse who couldn't give her any pain relief because she didn't know what the doctors would be doing next.
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I need to correct the above - I was clearly sleep deprived when I typed it - she wasn't seen by a doctor until 09:17 this morning.
She wasn't the only one who waited so long and others who were there before her were still waiting when I took her home.
There just weren't enough staff.
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I've spent a lot of time sat around in my local A&Es over the years both officially and with my late Mother.
I've made a few observations not in any real order. I'm certainly no expert but this is just an observation:
It was generally always busy.
A high percentage of patients were elderly and in trolleys and wheelchairs.
Staffing seemed for the most part reasonable.
A lot of staff appeared to be rushing about but achieving little.
A lot of staff spent a lot of time at their stations looking at computer monitors.
Protocol appears to be that every patient is seen by a Doctor.
There doesn't seem to be any form of 'fast track' with minor stuff.
Patients are probably kept a while for monitoring purposes. If someone is discharged too quickly and then takes a turn then they are immediately accountable.
If a major trauma comes in staff are immediately depleted so waiting patients are put on the back burner.
I know there are simplistic observations and I certainly dont want to devalue their work but something doesn't appear quite right.
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>> I know there are simplistic observations and I certainly dont want to devalue their work
>> but something doesn't appear quite right.
the problem is outside the main A&E, meaning they have too much to handle.
People cant get doctors appointments, there used to be minor injury units and local and cottage hospitals. I had 4 within 5 miles of where I live, now I have 1 but you need to know how to exploit it because its more or less kept quiet.
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A&E is increasingly used as the entry point for all patients - the rest of the hospital is full so the A&E teams are doing more of the general medical work that would have been done once the patient was in a ward.
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The staff in A&E were fine.
Mother has been in chronic pain since a fall last year and is getting very little NHS support. One example - a recent pain injection - she got to the hospital in good time for her appointment at great expense (nearly £50 each way for a taxi able to take her wheelchair) and the appointments were running behind schedule. The X-Ray chap who was doing the injections wrapped up at 18:00 and said he was going home - no more patients were to be seen and appointments were rescheduled for 3 months hence.
Yesterday is the first time that she has not been able to communicate clearly because the level of pain increased dramatically.
The pressure put of father is starting to show.
I think it is time she went to a care-home where they can monitor her pain 24/7 but she doesn't want to lose what little independence that she still has.
Save for trips to hospital, she hasn't been able to leave the house for over a year and of course lockdown before that (with father having to shield) meant that even shopping trips were very limited.
I am now very worried about both their health.
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>> I am now very worried about both their health.
Well you need to be engaging with social services with the aid of your GP.
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>> >> I am now very worried about both their health.
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>> Well you need to be engaging with social services with the aid of your GP.
>>
>>
I have been trying that with very little effect so far.
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The keyword is "Vulnerable"
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Free at the point of use is a system that inherently will always create a system where demand exceeds supply. The only way that you will get supply and demand in balance is by the application of market forces.
That is the reason you can get an appointment for your dog at the vet’s the next day but you need to wait a month for a doctor’s appointment.
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>> That is the reason you can get an appointment for your dog at the vet’s
>> the next day
You tried that lately? Shortage of vets. Nothing to do with Brexit of course.
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Actually I have. Actually for a cat. Rang 5pm Friday. Was told they closed at 5.30 but but she would hang on for 10 minutes. Diagnosed likely thyroid problem
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Don’t worry, when Truss gets in she is promising to cut tax for everyone so that will solve the NHS….. right????
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>> Don’t worry, when Truss gets in she is promising to cut tax for everyone so
>> that will solve the NHS….. right?
I'm no economist but Truss is economically illiterate.
We have inflation at crisis levels.
The tax cut promise is now £30,000,000,000 (which she we will borrow).
The BoE has an inflation target 10 points below forecast levels, and has control of interest rates. It is already raising rates to control inflation, putting up interest cost on the £30bn. and also on the £2,000,000,000,000 existing public debt as that rolls over.
The £30bn. tax cuts will be inflationary.
The BoE will have to push interest rates even higher to control that extra inflation, further increasing interest costs for the taxpayer and for mortgage borrowers.
She is an idiot, or very very cynical and self-serving.
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She is promising the earth, anything and everything will do no matter how stupid and undeliverable. She knows she's got no chance in a GA, so she might as well turn the country into a basket case now and leave them the mess to sort out, hoping they cant and have a shot at the GA afterwards.
Politicians? Scum. No wonder they get abused
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Truss worked for, and supported to the end, a boss who was a master of telling people what they want to hear. She doesn't have his talent for presentation, but is not stupid - blind ambition trumps honesty?
Economically fatuous and not credible - reducing tax creating growth needs people to do the jobs - but there are not enough unemployed to fill vacancies today.
How this helps the NHS is unclear. Is the problem is lack of money (£350m per week on the Brexit battle bus), lack of staff (from overseas?), or poor management incapable of initiating change.
Honesty and clarity is in short supply. Quality of A&E service seems poor - but much better to get the processes right (staffing, number of beds, GP services, social care integration etc etc) before simply writing out bigger cheques.
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I wonder if we'll wish we kept Boris?
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Perhaps thats the master plan.
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The more you give the more it will take so perhaps it is in its interest to keep apparently failing. Thing is the money does not actually seem to hit the point of delivery.
My daughters boyfriend has just graduated and completed his first week. He's already talking about how much he can earn doing Locum shifts. Another has graduated a year ago. Hes already had enough and is looking towards the Army.
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>>Locum shifts
I would be very surprised if a trust offered locum shifts to a new F1 unless they were really really under pressure.
Where Miss Z earned a shedload was doing cremation reports with regular cheques from undertakers contributing a significant amount to the deposit for her flat.
Last edited by: zippy on Sun 7 Aug 22 at 20:38
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Missed the edit...
Miss Z is currently without a proper job as her contract has just ended and she does not start her new one until October.
She knows she will get some locum shifts but she has booked in several "girls" trips (holidays and weekends away) throughout August and September including one week abroad with Mrs Z (Turkey apparently) and a wedding in Spain.
She has already been offered some locum shifts but they will have to fit in around the "aways"!
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In our theatres we are running at about 40% locums, some bank but mostly agency staff, our staffing has improved as the managers went on a job-seeking 'holiday' to India and recruited 20-30 nurses, many of these don't have theatre experience so they will need training. Recently the agencies (there are two main ones) that supply the trusts in my area of SW London wanted a pay rise for their staff, the staff said that they would not come to their booked shifts unless the requests for an increase in their hourly rate was met.... the trusts gave in.... I now work alongside agency staff taking home £35 to £45 PER HOUR!
That's where the money's going.
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Isn’t the answer for you to become an agency worker then?
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>> I now work alongside agency staff
>> taking home £35 to £45 PER HOUR!
>>
Blimey, Miss Z got £650 for a 10 hour shift last week as a registrar. For nurses that's exceptional! If they can get it then that's what they must be worth or the trust would recruit to fill the gap.
Last edited by: zippy on Sun 7 Aug 22 at 22:44
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"That's where the money's going."
So what sort of % of a Trusts annual budget is going on staff costs? If I recall 85% of the Police budget here I am went on staff costs.
So an environment has developed whereby staff of all ranks is not available at times of peak demand or there is not enough staff?
I often wonder how Consultants manage o do their 'Private' work again during times of what should be peak demand. I am feeling that a lot of restrictive practices are alive and kicking in the NHS.
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>> I often wonder how Consultants manage o do their 'Private' work again during times of
>> what should be peak demand. I am feeling that a lot of restrictive practices are
>> alive and kicking in the NHS.
>>
I know Miss Z has helped out on a small number of private operations. It was made very clear and she followed the rules to the letter; there had to be sufficient staffing on the ward and she had to "stamp out" or what ever the phrase is, but basically come of shift so she wasn't paid twice. Seems totally reasonable to me.
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So she may only be getting 2% rise (see elsewhere) , as was agreed by her union last year, but on the whole she has the opportunity to do a helluva lot better by doing a bit of overtime.
Overtime was the way I made ends meet during part of my working life but not at that kind of rate. One part of me feels that complaining over a 2% rise is a bit churlish. Another part of me is thinking no wonder the NHS is absorbing so much money. And another is thinking no wonder some medical staff only want to be in NHS employment for part of a normal working week, leaving themselves with freedom to not work, or to earn large amounts in the other part of the week.
Last edited by: smokie on Mon 8 Aug 22 at 10:41
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The NHS has long been, quite simply, a monolithic organisation that is almost completely out of control and with no end in sight.
If politicians try to impose some form of order, then the majority of the general public and Labour politicians insist that no form of efficiency measures or cut backs will be tolerated.
Yet until something on those lines is undertaken, the NHS, amazing though it is, will become an ever increasing financial millstone around our necks; just throwing money at it will never solve the problems, just mask them.
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The system needs fixing - made difficult by selective information presented as fact.
The ~£40 per hour paid for agency staff seems high but does it include employers NI, holiday pay, pension contributions, sick pay, etc.
Is the NHS failing to sell the benefits of working there - job security, in service training, career progression etc.
Should the NHS encourage newly qualified to stay by writing off, student loans etc over a period of years post qualification. At present ~60% of student debt never gets repaid anyway.
A 25-30 year old may place a much higher value on immediate income than more experienced staff (eg: saving for house deposit). Can employment conditions be flexed to better meet their needs - eg: maternity pay, child care, more flexible shift patterns.
How much is down to government policy (eg: Brexit freedom of movement), poor hospital management (eg: lack of training, lack of local flexibility), or both (eg: failure to integrate social care, GPs, hospitals etc).
These are not excuses for poor performance but there is little chance of real improvement until issues are honestly addressed.
To add - perhaps I have been fortunate but the quality of care personally received from the NHS has been consistently very high. However basing wider conclusions on personal anecdotal experience is fundamentally flawed.
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There is a solution. For the NHS, social services and social security.
Means testing.
With the death of the cash economy, its very easy to track the income of most people and bill them pro rata for services using proper integrated IT.
It will also require mandatory ID cards.
Expect to see this in Truss's manifesto in about 40 minutes.
Followed by clarification from an acolyte in about 12 hours.
And a denial in 24 hours. (depending on what the Bournemouth mafia think of it)
Last edited by: Zero on Mon 8 Aug 22 at 11:42
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Do keep up Zero... :-)
www.bbc.co.uk/news/business-62437819
"People turning back to cash as prices rise"
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>..using proper integrated IT.
Fail at step 1.
It's Public Sector.
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A major problem for the NHS is the lack of social care availabe for the elderly leading to bed blocking.
That care is of course already means tested.
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I briefy worked for the NHS until 2019 as a delivery driver. The job itself was fine, easy and enjoyable to be honest. What I couldn't hack was the culture within the non medical staff. Lots of "jobsworths" in my depot and in the local General Hospital especially with one "little monkey" as my manager referred to him, he worked very hard at being as idle as possible. On one day, and on purpose, dropped clinic notes. at the wrong location. He held a clinic up until I found where he'd left them. He was a classic barrack room lawyer as well. A 25 litre container of windscreen washer fluid deivered to our depot instead of to an adjacent ambulance station so taken home by a staff member, another driver going to the gym on his route and promoted to a supervisor. A few of dozens of examples of bad behaviour......
Last edited by: R.P. on Tue 9 Aug 22 at 20:03
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It's about time we stopped treating the NHS as a religion, looked at how countries with a better system ran theirs and learn from it.
But of course it won't happen, Labour and the Lib Dems would start screaming about "The Tories want to privatise our precious NHS, envy of the world (Really?) etc". They are both quite happy to live with the great unwashed having to put up with waiting all day for an ambulance and years for surgery because it is politically useful.
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>>looked at how countries with a better system ran theirs and learn from it.
We spend less than comparable economies - that is a good starting point?
www.oecd-ilibrary.org/sites/910674f2-en/index.html?itemId=/content/component/910674f2-en
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Unfortunately the public sector can be a good place for these type of people to stay below the radar, And when they do get challenged they start screaming bullying and harassment.
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>>I briefy worked for the NHS until 2019 as a delivery driver.
I had a similar job with local government. I ended up thinking everyone was on the fiddle. What annoyed me more than anything else, was I was dealing with lower intelligent beings, who seemed to assume I knew everything they knew. Very difficult when you need instructions.
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Shocking NHS - zippy
