Home Politics & Debate
If you need urgent support, call 999 or go to your nearest A&E. To contact our Crisis Messenger (open 24/7) text THEMIX to 85258.

Less beds, Better Care...

Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
Story here

Opinions?

Comments

  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It's a good news story really.

    I was a bit bemused by the statement that "ambulance crews are treating people on site rather than bringing them into hospital ". More like telling time wasters to go forth and multiply rather than bringing everyone in, but there you go. I can't think of many conditions serious enough to require an emergency ambulance but not require at least a trip to A&E (?ED, whatever they call it).

    It's obvious that better treatments will lead to shorter stays in hospital, and there can be little doubt that healthcare has improved over the past 20 years.

    Shame it's being sold down the river in the name of "choice" but this is the future.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Seems plausible. If I was ill and had the opporunity of recovering at home or in a disease-infested hospital, I think I'd pick home.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    I can't think of many conditions serious enough to require an emergency ambulance but not require at least a trip to A&E (?ED, whatever they call it).

    I think that the problem is that in some cases the don't know until they get there, but they are able to treat some conditions on the spot these days whereas they use to take them straight to A&E.

    Funnily enough this includes a number of cardiac episodes...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    "Cardiac" in the musuloskeletal chest pain meaning of the word?

    I'm sure they don't bring everyone in, but that doesn't mean they "treat" them at home. They clearly didn't need the ambulance.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It's partly why they don't always send an ambulance but sometimes send a paramedic/alternative.

    Have you read the blog "Random Acts of Reality"? He's much better at telling you the front line for the ambulance services than I am. But then it's his job!

    And no, I mean cardiac episodes. Usually related to stable angina and chest pain following exercise...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I must look up that blog. Don't get me wrong, paramedics are usually very highly trained and certainly do a lot more than they ever have, including thrombolysis in STEMIs. But at the end of the day, they do not exist to treat people but to bring acutely ill patients swiftly to hospital. Stable angina doesn't require an ambulance, but angina pain at rest does require hospital investigations, specifically a 12 lead ECG, which are not carried on ambulances.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Sounds like some kind of sick joke to me. Less beds, better care? Try telling that to the next person who contracts MRSA in our dirty, filthy hospitals.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    stargalaxy wrote:
    Sounds like some kind of sick joke to me. Less beds, better care? Try telling that to the next person who contracts MRSA in our dirty, filthy hospitals.

    or the next person with a higher life expectancy?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    It's obvious that better treatments will lead to shorter stays in hospital, and there can be little doubt that healthcare has improved over the past 20 years.

    :yes:

    Agreed also that it's a good news story and finally some positive reportage about the NHS, though obviously not everyone will see it that way. Those who can be treated and convalesce at home would more often than not be bloody happy to do so, and of course that takes away some of the pressure on the hospitals in which they'd otherwise be patients. Better management of long-term conditions is definitely a key factor in this shift, and the growth in day surgeries that can be carried out -- as well as the short shrift being given to time-wasters in terms of demands made on the emergency services and ambulances.

    Of course there's still a long way to go, but at least it's a step in the right direction... for once.
  • Teh_GerbilTeh_Gerbil Posts: 13,332 Born on Earth, Raised by The Mix
    It's true.

    But, let's be honest. Once hte NHS is reasonably sorted out, we SHOULD have more beds. Also, they should never have takne away our local hospitals. That was an arse move.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    stargalaxy wrote:
    Sounds like some kind of sick joke to me. Less beds, better care? Try telling that to the next person who contracts MRSA in our dirty, filthy hospitals.


    MRSA is completly unrealted to 'cleanliness'

    most MRSA would be stopped if you stopped all visitors to hospitals


    every other developed country has an MRSA problem, from over-prescription for anti-biotics......

    my local hospitals pretty good these days compared to what it used to be imo despite being built too small for my area as a whole
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Teh_Gerbil wrote:
    Also, they should never have takne away our local hospitals. That was an arse move.

    That depends, do you want junior doctors to be trained properly?

    If you do then you need centres where they will get exposed to as many problems as possible, in light of the very changes in treatment which the story highlights. You cannot do that in multiple small sites.

    Having said that, there are many things which could be done in small community based hospitals and it's certainly something which my area is keen to retain.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    But at the end of the day, they do not exist to treat people but to bring acutely ill patients swiftly to hospital.

    That's the theory certainly.

    However, short of refusing to send someone there is little the ambulance services can do. I think that they have it right, attend when they can and treat people on site if they have the skills...
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    stargalaxy wrote:
    Sounds like some kind of sick joke to me. Less beds, better care? Try telling that to the next person who contracts MRSA in our dirty, filthy hospitals.

    A fairly jaded tabloid style answer, IMHO.

    MRSA isn't there because there are less beds, it's there because cleaning isn't a good as it should be. That is not a beds issue but a "lowest bidder" one.

    Perhaps one of the questions you should ask, is should that person be in the bed at all. So many times the answer would be "no"
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    That depends, do you want junior doctors to be trained properly?
    Hmmm, I'm not convinced the government really cares about that to be honest. It's been tackling staff shortages threefold - by reducing the work doctors must do, increasing pay for current doctors to increase retention, and training a whole lot more, but also training specialist and consultant nurses to do the jobs that trainees were carrying out not so long ago. That is what will prevent junior doctors being trained properly. As will physician's assistants (or whatever they end up calling them), which will do bread and butter operations and clinics but will take away training opportunities for surgeons and GPs. I'd argue that cottage hospitals allow greater exposure to medicine for trainees than specialist referral centres do.
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    Hmmm, I'm not convinced the government really cares about that to be honest.

    It isn't a Govt agenda. It's been forced on managers by the Royal Colleges. It certainly is part of the cause for the reconfiguration which happened in east kent.
    training specialist and consultant nurses to do the jobs that trainees were carrying out not so long ago. That is what will prevent junior doctors being trained properly.

    thta really worries me too, and I've voiced it on many occasions, especially at GPwSI schemes pick up. There's no sustainability in them.

    I heard a consultant surgeon say that she couldn't offer clinical governance cover for GP surgeons because she hadn't carried out those minor procedures for years now, and she never saw her juniors do it anymore either...
    I'd argue that cottage hospitals allow greater exposure to medicine for trainees than specialist referral centres do.

    I think that there is a role for juniors to move across the primary/secondary care barrier to a greater degree than they do now, that's for sure. Question is, when will the Colleges wake up to the fact that the NHS has changed and therefpre training needs to change too?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Their hands are tied. The government wants consultants within a maximum 10 years of qualification. (Without any increase in training numbers or posts, of course).

    If every F2 is expected to do a 4 month primary care rotation, who's going to be working on the wards?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kentish wrote:
    who's going to be working on the wards?

    Who does the community wards now? GPs. Why can't junior work under them instead of consultants?
  • Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Because generalists cannot guarantee (and cannot be expected to guarantee) suitable training for specialist trainees.
Sign In or Register to comment.