Has care in the NHS and in social care improved over the last year? The Department of Health wants your views: £50 to be won

Judging by the fragmented and inconsistent care given to my 101 year old mother in law I would say that the promised joining up of health and social care has not happened. The GP wont work with the District Nurse who would like to deliver daily care but cant because that lies with , Social Services who have farmed out her daily care to an agency who can't or wont deliver, the housing complex where she lives calls an ambulance every time she 'feels funny' - her words and she is carted of to A & E numerous times to be told there is nothing wrong.

I think the biggest challenge to improving care is the morale of staff.
I know of no-one who actually likes working for the NHS, even when they wholeheartedly subscribe to its ideals.
I hear of nurses and junior doctors being bullied and harassed, of people's jobs being downgraded, of one group of healthcare professionals beng obstructive towards another, of impossible targets having to be met, of changes being implemented before the last lot have been assimilated.
The constant pressure to deliver more with fewer resources, compromising professionalism.

How to improve it? Listen to the staff.

I just wish this question wasn't limited to the last 12 months.

Had it not, I would have had personal experience and said a big fat 'yes' my local hospital has improved.

It was after all, not so long ago, in the top 10 of the worst hospitals in England.

No, my local hospital has not improved, and neither has care for my mother in law.
It has taken me weeks to get a face to face appointment with a GP, so that has become worse.
A friend's father has just died in the local hospital. This friend has said that they just do not seem interested in keeping older people alive any more. Lack of care, lack of help with feeding, etc.

DJ

Goodness what a difference between counties, towns and villages.

I think our doctors surgery and those in the area would be mortified to think they gave that level of 'non care'. Weeks to see your GP! Weeks.!

Our family uses a reasonably new on-line appointment system and never, ever has there been more than a 2 day wait and if you ring the surgery the lovely receptionist will 'always' get you an emergency appointment, if genuinely required.

My dad had a pacemaker fitted last year and he was 94, sadly after good care he died of Sepsis but I don't blame the hospital for that. At no time did I feel or think the hospital was looking at his age as a consideration to offer poor care nor medical action.

Had he been not suitable for the operation due to his health, which is not necccessarily age related is it, then I have no doubt there may have been decisions to be made but certainly age obviously did not relate to trying to prolong his life. In all honesty common sense and reality would have been accepted by both my father and the family if his age and related health had meant his chances were diminished and the hospital advised differently.

Extremes in the NHS are nothing new whether it is hospital food, waiting times etc. but to wait weeks to even see a doctor astounds me. Do you or mother live so remotely that you only have one surgery near to you DJ hence you cannot move to another doctors? Is it rude to ask which is your local hospital?

It's difficult to know how valid my experience is as I am lucky enough not to have to use the NHS frequently. But I have in the past commented on how efficient our local GP surgery was and how lucky we were always to be offered an appointment the same day or the next, when friends registered elsewhere would have to wait up to a week. However, I rang for an appointment on a Monday a couple of months ago and was told there was nothing available with any of the six doctors until a week on Thursday. What worried me is that the receptionist didn't ask about the reason for my call and whether I needed to see someone urgently. I didn't, but I can imagine someone with serious symptoms and lacking in confidence just waiting 10 days, and suffering for it.

The hospital I am talking about is Durham. I live in quite a large village halfway between Durham and Consett, so not in a backwater, but it is in the North East which seems to get forgotten about except when the government wants to dump on us.

I agree with you POGS, that this should not just be about the last year. This government has been in charge for over four years.
Do they think we have forgotten what was promised at the last election, no top down reorganisation?
I felt quite sickened when Cameron used their experiences again of what happened with his son. That was under the Labour government, I believe, the way they were treated.
Janea lives in the North East, too, and I presume she is talking about up here. My GP has just stopped being the chair of the CCG, having retired from being a GP, too. I did not think she looked old enough to retire. She insisted she was, but she's probably still in her 50s, judging by when she qualified.

I live in NW London and on average it takes 4 weeks for an appointment with the GP of my choice. If it is a same day appointment I have to drive there because the phone is permanently engaged and I cannot cannot get through.

It is a superb GP surgery but there is a high level of missed appointments each month which does not help.

Thank you for replying DJ

Charleygirl made a point that made me think. Is the fact it has taken weeks to speak to a doctor because you have asked for a specific doctor or is that just a matter of course at your surgery.

Also I had to go our 'larger surgery' not so long ago and I was amazed at the information board that runs on a loop stating how many missed appointments there had been the month before. I don't remember the exact number but it was over 200.

DJ I am genuinely shocked a surgery takes weeks to give an appointment.

This was posted on Facebook today by a GP in his late 30s:

"I'm quitting. After the 11 hour day with no time for a loo break (not that it matters as also no time to eat or drink!) and dealing with patients for a solid 9 hours before I even looked at the paperwork, I've had to listen to most of them moan about how long it took to get through on the phone/get an appointment with me and most of them expected me to fix lifestyle issues rather than actual medical problems. The actual sick ones were, as is often the case, the most pleasant but in the minority. I'm sick of breaking my neck trying to do this job well at the expense of my own health. I'm too exhausted and emotionally drained when I get home. I have nothing left to give. This job has changed beyond all recognition in the last 5 years and I don't see a way back from the enforced crap we have to do, to the media fed and demanding worried well, disorganised management and chronic underfunding. I'm approaching 40 and have many working years ahead of me, I used to love my job and it's demands were part of that but the very essence of general practice has been eroded in the uk. I feel utterly despondent now when I think about what it used to be even a decade ago. :-( "

I don't think this is untypical about how some young doctors feel about general practice.
jen some of the examples I gave were people I know in the northeast, some weren't.

It takes over 2 weeks for me to get an appointment because apparently the schedule doesn't come up on the screen so I'm told. Why blame the computer?

My GS was taken to A&E because according to the X-ray he had cracked his toe. As a result he was plastered up and given crutches. It took around 4 hours. On his return a couple of day later he had an appointment which meant missing school and he was passed from pillar to post because noon knew who was responsible for changing his crutches to longer ones! Also there was a query as to the damage. So another day of missed school ensued and a further 4 hours of hanging around to find he'd not broken or cracked his toe after all and the plaster was removed. So because of the hours of waiting in spite of being given an appointment and the distance from school he'd missed 2 days of education.

It seems to me that the right hand doesn't know what the left is doing and throwing money at it is not the answer.

I've noticed a change in a mole and got a doctors appointment (not my usual GP because I was seen with a few days - good) . He was unsure and wanted to give me a referral. I asked how long I could expect to wait and was told 6-8 weeks - bad. I'm lucky to have health insurance and I'm seeing a dermatologist within 2 weeks and feel guilty about it because my friend who has had a melanoma already is still waiting for her NHS appointment to check out another mole.

The fiasco over my eye appointments is another saga but that is not within the year.

The whole health scenario has become, in my view, scary and becoming more so as we get older. Too many chief and not enough Indians

Twelve months is certainly not long enough to note any improvement in my opinion,you are not going to be able to change the mindset of employees with NHS within that time specially the ones who have been with the NHS for many years,it is going to take years to change and get out of the practice of always blaming someone else or lack of funds.
We have a splendid GP Surgery with receptionists who do go that extra mile if appointments are urgent and many add on services but the waiting list for specialist treatment is long and oversubscribed at the best of times.
I do think more on the job training for ward staff in hospitals could be a good way to start, get back to basic's and forget that nursing and caring does not have to come via University but from people who have genuine empathy for their patients.

The reason it takes so long, POGS, is because when you ring up, there is a triage system. Someone, doctor or nurse rings back in a two hour window, either that day or the next. They then decide that I need to see a nurse, who seems to be the only one who has any appointments. Then she decided I needed to have the doctor ring me. Then the GP says I need to see my named GP who is the only one who knows all about me.
In the practice there are only two partners now when there used to be three, and the rest are locums. They have decided, and I agree, that I ought to see my own GP about my medication because last year I had an aortic dissection, and I have a lot of medication for it.
This happens every time I have to have an appointment because they need to keep a close eye on me just in case. Fortunately I no longer have to fit hospital appointments into the system!

I do not suppose the Department of Health has asked the NHA what they think, so here it is.

nhap.org/%e2%80%8bdavid-cameron-youre-champion-nhs/

Anyone who wants a proper debate about the NHS could always sign this petition.

epetitions.direct.gov.uk/petitions/64908

I've been surprised by the number of missed appointments, too. It occurs to me, reading through these posts, that if you have to wait two to four weeks for a non-urgent appointment the symptom that worried you might have gone away. Or you've decided you can live with it. Or you didn't put it in your diary straightaway and it has slipped your mind. Or it should have been an urgent appointment and you are now in hospital.

I'm lucky to have health insurance

That is the advice I have given to my children and GDs (get health insurance whilst you are still young and the premiums will be relatively low) - there was a time when serious ailments went to the head of the queue but that seems not to be so much the case anymore.

That's a bit complacent, HollyDaze. Not all of us can afford to pay the premiums for health insurance. Some do have it as a perk in their employment contracts. However, insurance is probably the route the Government is hoping to send everyone down. Meanwhile, urgent cases are still dealt with quickly. A friend went for a cardiology outpatients appointment and was immediately sent up to the ward and told not to move. Within a few days she had a valve replacement.

I agree with glammanana that we should revert to on the job training. I also think we should revert to 'proper' matrons who cared about the patients and expected their staff to do the same - or else. The different levels of nursing eg SRN and SEN were good ones and allowed more freedom to be part of the nursing team. Perhaps I'm old fashioned but I don't like this first name malarkey either. Calling a nurse or doctor by their first name I think is too familiar and them calling me Golden is not appropriate either.

That's a bit complacent, HollyDaze. Not all of us can afford to pay the premiums for health insurance.

I can't afford it either annodomini and, like most other people, I have to hope that the NHS can deal with things; it doesn't follow that I want the same for my family. If the NHS was like it used to be, it wouldn't occur to me to even think of alternatives but, sadly, it isn't like it used to be so if people can afford it, why would they risk their health if they are unfortunate enough to live in an area where care is less than satisfactory?

A friend went for a cardiology outpatients appointment and was immediately sent up to the ward and told not to move. Within a few days she had a valve replacement.

Then your friend is very lucky. I went on Wednesday to have x-rays of a lump in my neck (I know what it is) - the surgeon sent me straight for scans and blood tests, marking them urgent so that they would be done the same day (which they were). She then requested a fine needle aspiration to be carried out on the lump - the chap who was to do it said he was too busy; it turns out I will have to wait 3 weeks for the procedure. Would I go private and have it done quicker if I could afford it? You can bet your bottom dollar I would. As I have said, we are not all lucky to live in areas where healthcare is good.

Holly, the valve replacement is not luck. That would not be done in a private hospital. It's too dangerous.

As far as NHS care goes I feel that maybe we have been lucky the standard of care my mother,who is 92, has received has been consistently high. I have noticed that her GP has been very wiling lately to visit her at home but thought this was due to her age and increasing frailty-but maybe not.
To everyone experiencing poor care from their GP can I suggest that you ask if the practice has a Patients Participation Group and if they have, raise the matter with them and maybe volunteer to be on it: if they haven't have a meeting with the practice to discuss starting one.
You can also get involved with your local hospital and CCG by volunteering if you really want to change things. It is our NHS and it is far too precious to be entrusted only to politicians and over paid managers.

Overpaid managers?
I have just discovered that the chair of the CCG was paid £180,000, the chief operating officer £150,000 and 3 or 4 others between £90 and £150 thousand pounds.
That's where NHS money goes. This is to people who are GPs as well as their CCG duties, so that explains why they are hard to get appointments with.

It has taken 11 weeks from a hospital appointment when I was told I could come off beta blockers, to actually stopping them. Only four of those weeks were actually reducing the dosage; the first seven were getting a face-to-face appointment with a GP.
Since flu vaccinations became available, I have had two appointments with a GP and two with a nurse. I have another with a GP and another with a nurse lined up over the next two weeks. However, I have to make a separate appointment to have the flu vaccination. This seems to me a waste of time on both my part and the NHS.
Last year and previous years, if you had an appointment at the surgery, you were asked if you had had your vaccination, if you wanted it, and were then given it. Why is this year different? Is it just my surgery?