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NHS Getting Better
Former Member
Posts: 1,876,323 The Mix Honorary Guru
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MOK, this is all just numbers to me, (they haven't taught us to think yet
Prove it. Prove that waiting times haven't come down, and that more people are being treated in Day Surgery Units and I will listen.
BTW You may have noticed that the story has some criticism in it. Spin, or more a case of a whole story?
Be interesting to see how the Tablids play this story.
Firstly it means that you will wait shorter time for surgery, also in A&E departments...
But this money isn't just about reducing waits and increasing "activity" levels, it's also about improving quality, providing more information for patients so that they can pay a bigger role in their own treatment...
As for the actual rise, it isn't as much as is being portrayed, remember the employers NI contributions increase and this affects the NHS too, our contributions are higher now...
These figures mean absolutely nothing, they are spin, they are targets that they knew they could meet and then deliver to the press.
Pual Burstow sums it up better than me to be honest:
"Getting the NHS to judge its own success is like getting school children to mark their own exam papers."
Do you actually know anything about change? You don't set yourself goals which are unattainable, that would be foolish.
Which is really my point, if you don't know what you are talking about, you just make yourself look stupid.
You have absolutely nothing to back up your arguement.
Actually I think you'll find that the Audit Commission and CHI judge us.
If the NHS could walk on water the right-wing media would say it's because it can't swim. Their ultimate goal is the abolition of free health and the introduction of health insurance- so the very rich would save a few quid a year in tax, and if millions don't have access to health so what eh?
So the right-wing media will continue to paint the bleakest of pictures about the NHS, and Tory sympathisers who should know fucking better will continue to believe all the spin from the Thatcherite press.
Some things never change.
Although having said that my sisters a nurse and she says there have been improvements around her neck of the woods and my small experience with A&E was actualy pretty good.
Personally, from experience, I'd say that we could do better. There are some areas where money is being thrown at problems, rather than long term solutions being found. That is not good.
I work in a hospital where 99% of all patients wait less than 4 hours in A&E... and we are talking about thousands of patients per month.
We carried out 20,000 operations this year. No-one waited more than the target - some had to be operated on in the private sector and this I have problems with. Not because of any political belief, more a question of how we can sustain a change if we have to buy in the extra capacity from outside.
And yes, Aladdin, it's worth noting the minimal coverage which the talbloids have given to this when compared with the coverage given when a single patient has a problem. This is a good story for ALL patients...
Although when I went in for myself it was about 7am and there was no one there so I had the whole place to myself and I got 5 star treatment. Shame I wasnt really in a fit state to enjoy the attention.
Im not going to say I know squat, because I dont, but the popular preception, one I happen to think has truth in it, is that the targets are fudged- if you have to see someone in A&E within a set time, theyll rush people to be seen then just bump the queue further down the corridor.
But thats more an issue with targets themselves- it does not promote genuine imporovement, only improvement against set parameters. And as the Government set the parameters, improvement is only going to be measured in the areas where there are quick fixes- the poor areas simply wont get measured officially.
Its still good news, but as always I take it with a pinch of salt. After all, which Government is going to say that they have got worse?
Nope, this doesn't count. The four hours applies to disharge or admission. Basically you must either have been treated or admitted to a ward within four hours of arrival.
Or as one person put it, provided you admitted, treated or die within four hours, you count! (Sorry NHS Humour is a little black)
They shouldn't do so because then you end up in a vicious circle. Let me give you an example.
In order to reach the 4 hour target a hospital admits everyone who is near this target time. Thus they achieve the 4 hour wait. But hang on, what happens then is that the beds are filled with patients who don't need to be there and because you bed is filled you cannot admit the next patient and so you fail on thier target time.
Also you run the risk of not being able to admit anyone waiting for surgery. This has a negative effect on surgery waiting times plus means that each of these patients who you have cancelled at the last minute must have their operation within 28 days. So you create another target you must achieve, just because you didn't do the right thing at first.
They key to the whole thing is to only admit the people who actually need to be there. So sort out the A&E so that decisions can be made quickly, and sort out the discharge so that people leave the minute that they become fit and you will be able to manage your beds.
In my Trust we have 99% of patients admitted/treated within 4 hours in A&E and we rarely (if ever) cancelled a surgery case because we don't have a bed for them.
I used to think that, but I don't any more.
There is a target which says that anyone suspected of having cancer must be seen withing two weeks. In order to do this we have had to take a drastic look at how people are referred by GPs, how they get into clinic, what we do in clinic.
Once diagnosed we have to operate within three weeks. Thus we have had to look at how people get "llisted" for surgey, how we make sure that theatre time is available, and how we get them to leave as soon as is appropriate.
So from a single target we have reviewed and changed the entire system.
The quick fixes are hit first, I agree, but the bigger problems are being worked on at the same time.
And you have no idea of how much we measure on a daily basis. God knows I wish we didn't... so time consuming.
I honestlly have never looked into it but if more money was used into research then wouldn't a lot more money be saved because you wouldnt be treating ill people . Or putting money into research things like cot death and then money could be saved because of mental issues following things like this ?
Couldn't give you an exact figure, but I know that millions are spent on health promotions etc - such as smoking cessation.
That people don't take any notice of them (me included
Possibly the best way to save money though, would be for the public (the users of the system) to stop wasting NHS time - such as calling an ambulance for a cut finger... yes it happens!
Someone seriously injured in a life/death situation could be saved if an ambulance hadn't been sent to someone who didnt need it but at the other end of town there was a R.T.A. who needed urgent medical assistance.
It is.
I don't know why the law isn't enforced though.
That's even better than DSU. If the GP can do it, then there is no need for the patient to travel to a hospital. There is a huge number of "minor" ailments which can be treated by the GP - mole removal etc...
One I've heard was that they coulnd't find their TV remote control...
God only knowns what kind of moron thinks that this is something which the Ambulance Service can sort for them :rolleyes:
I've been to A&E a few times myself and I was shocked at the kinds of things people were doing, shouting, screaming, pushing and shoving nurses. I dont know how they put up with it.
MOK, have you any ideas about how to deal with this? Harshly seems to be my thought, but, well, as with a lot of things like this the people doing it are at the bottom of the pile already.
We have a "no tolerance" policy at this Trust - provided that the member of staff reports it, which they are encouraged to do.
Abuse our staff and we will prosecute.
It doesn't matter how upset someone is, some actions are just not acceptable.
There was for example a homeless woman in A&E when I was there, shouting, pushing people, etc. and the woman looking after her was just basicaly asking the doctors to give her drugs so she would go away. How do you deal with some one like that? If they have nothing to loose there is nothing you can threaten them with.
Agree and if they have nothing to lose, by definition, there is no deterrent anyway.
Usually though, being escorted from the premises by Police and put in a cell is enough to calm most people down.
My sister used to work on a childrens serious trauma unit and she'd get loads of parents yelling at her and that.
I mean obviously telling someone their kid is about to die does put quite a bit of strain on them, but thats not really an excuse.
MOK, are you part of the admin team or do you actualy deal with patients, and if so how are they to you?
You make it sound like the two are mutually exclusive
I have had little problem with patients, but then I don't work in the A&E pressure cauldron. I've never been hit by a patient but I have had plenty of verbal abuse. Personally though, I have been able to deal with them and I don't put myself into a position where I am in danger.
For example, I will take the "shouter" away from other patients, usually into a side office. I encourage them to sit in a chair and I will stand betwen them and the door. Firstly, by standing whilst they sit I have taken a "Phsychological" position of power. Secondly, with them sitting it is harder for them to be aggressive and thirdly they cannot block my escape route.
Probably the most important part though is that I don't rise to the abuse. I keep myself calm and the tone of my voice calm but I make it very clear what I will and won't tolerate.
It's not easy, but having been a Poll Tax collector (which is why I had to learn this approach!), I can think of worse jobs and situations...
Huh, I wish. Then I could be an obstructive, arrogant cumudgeon with little respect for anything other than my own opinion and agenda [/bilous attack]
Nah, I just a grey suit who works very closely with the people I have just insulted. I have to have an understanding of medical practice so that I can make informed decisions and I have got that by working my way through the system and by listening to what people have told me.
I may not know how to remove a gall bladder, but I know how long it takes, what equipment is needed, how long the patients will stay (day case, if I can swing it
This comes from having to look at what we do, understand what we do, so that we can improve what we do. I am a moderniser. If you belied the tabloids then you would think that I spend all my life doing nothing but make up statistics...
You know my views on outsourcing - damn have I replied to that thread...?