A and E admissions

Ask the Doctors and they will tell you that a fully comprehensive and integrated service is the only thing that will work and not the segregated service that the Tories are forcing on the NHS.
Totally agree whitewave, but been talked about for about 10 years with no progress so far as I can see.

See the A&E targets are going south, well what a surprise. This nonsense of the binge drinkers. What is the explanation then for this sudden enormous rise in binge drinking. Some people have always drunk in excess, this is simply an excuse to mask what is really happening and what is really needed

Ask the Doctors and they will tell you that a fully comprehensive and integrated service is the only thing that will work and not the segregated service that the Tories are forcing on the NHS.

I think you're absolutely right, MamaCaz. And a lot of people saw this happening when they changed the law. And it's why the licensing laws were introduced in the first place

I genuinely don't see why licensing laws haven't been revised. I haven't checked any figures to verify this, but I'm fairly certain that the problems of drunkenness, disorder and the knock-on effect on our hospitals have got far worse since they were relaxed.

Surely going back to limiting pub/club opening hours (and the times at which alcohol can be sold in shops too) would be a sensible first step towards reducing the problems. Or is our Government (I don't just mean the current one here) afraid of losing too revenue much in duty / VAT on alcohol?

I don't imaging for one moment that going back to more restricted licensing laws would totally eliminate the problems, but you have to start somewhere, don't you, and as excessive drinking is such a huge and obvious problem, it seems to me to be a very good place to begin!

Am I missing some obvious reason why they won't do this?

Mishap at my nearest A&E you're met by a triage nurse in the lobby, but the ambulance crew stay with you until you're wheeled into cubicles. Sometimes the paramedic is sat around twiddling his thumbs waiting for the ambulance to arrive, too. The whole system backs up all the way down the line.

My first time was the longest wait because they were busy with a local pop festival:

10.35 doctor calls ambulance,
11.26 paramedic arrives,
11.36 calls ambulance,
12.11 control ask if ambulance is still required, then offer an upgrade to Red1,
12.27 ambulance arrives,
12.49 ambulance departs,
13.18 arrive A&E,
13.40 into cubicles (& crew depart),
13.55 into Resus.

Total time, 999 - Resus: 3h20

Ah, I can see the flaws now.
Someone I know was a bedblocker for literally months. Now I can see how that could happen.

soon, when managing Intermediate Care we would comprehensively assess people and, with the patient and family, agree NH placement was best option only to have lengthy delays whilst NH came and reassessed- and they would often cherry pick patients putting the whole caboodle back to stage 1 for those they declined (usually the most dependent people) , who could spend weeks in hospital, slowly declining, awful situation for everyone. Particularly happened if SC funded as paid less to NH.

With H and SC supposedly 'co-working' that's meant to stop....but I suspect whilst budgets remain with respective agencies little will change in reality.
SC would never trust H with 'their' £££!

" it's as bonkers as when Social Services were fined for delayed transfers of care aka bedblockers by hospitals but given the money to pay the fines, instead of looking at the root causes."

I think the root cause is having the NHS and care homes managed by two separate bean counters, each with their own budget to protect. Care homes, and the budget to pay for them should be given to the NHS. If the whole shooting match comes out of one budget they'll soon decide whether it's cheaper to have people blocking hospital beds or not. (A disadvantage might be that people get shunted into care homes when they ought to be in hospital, though.)

Does it cause people in the appropriate jobs to look at the root causes though?
I am merely asking questions. I am only an outsider looking in.

Mishap it's as bonkers as when Social Services were fined for delayed transfers of care aka bedblockers by hospitals but given the money to pay the fines, instead of looking at the root causes. All it achieved was a blame culture and acrimonious falling out between Heath and Social Care.
Not to mention that older people have paid in to the Health Service all their working life and now living longer and subsequently needing those services.
All that the fines are doing is creating rifts between different elements.

Do you think that the ideas are good for the majority? But that there isnt a one size fits all system?

I think that 4 hours is a plenty long time time to wait.

Charleygirl. I think the reality is what you say though about older people. Though we could do without the constant repetition.

The whole system is bonkers - A&E departments are fined (yes - really!) if the ambulance crew has to stay with a patient whilst awaiting a doctor seeing them. Hospitals employ "corridor nurses" to oversee patients waiting on trolleys in order to avoid this fine.

Some of this stuff beggars belief!

I thought that Jeremy Hunt was the guy who spoke at length at the end of the piece. Perhaps I'll listen again online later.

I am also sick to death hearing that our age group is clogging up A&E because we have chronic conditions and are living longer! This was on the news yet again today.

We are not binge drinking on a weekly basis, falling in the street and having to be taken to A&E, totally blotto.

I heard that, too crun. The first speaker is actually trying to run a hospital and the second, the waffler, was the Health Minister. Not enough doctors and nurses? The Minister says there are, so the man running the hospital must be mistaken. 'They always want more' according to the Minister.

On R4 Today programme this morning, somebody was saying that the way the government funds the NHS means that hospitals make a profit from planned admissions, and a loss on A&E, so there's no incentive to invest in A&E.

John Humphries then turned to someone else and asked if that was correct, and got a very long waffle which avoided the question, and the gist of which was 'we just can't get the staff'.

That flies in the face of the reports just before xmas saying that there are ten applicants for each vacancy.

Ha! Thanks for doing that FarNorth.

Google tells me that MSW is the website provider.

www.mysurgerywebsite.co.uk/live/default.aspx

How many here know who owns their surgery?

Yes, I do.
Owned by Kintra, built under New Labour as a PFI.

I did look mine up. It has call 111, nhs choices and MSW at the bottom of mine.
No idea what MSW is.

"How many here know who owns their surgery?"

I would have just assumed that the surgery belongs to the doctor(s). I'd heard that the doctors are self-employed, as a sop offered at the time the NHS was set up because of objections to becoming NHS 'employees'.

https://www.opendemocracy.net/ournhs/steve-sweeney/ae-crisis-mounts-as-east-of-england-wastes-money-on-privatisation

I was only going to quote a bit of this article, but I could not decide where to stop.
Is there anyone who lives in the East of England area who would care to comment on any of it?

www.nhsforsale.info/privatisation-list/contract-alert/contract-alert-report-april-april.html

This is over a year, not the 4.5 years this government has been in power.
I have just found out last month that my GP surgery is now owned by Virgin/Assura.
How many here know who owns their surgery? You probably all think they are owned by the NHS. Many of them are not. It is difficult to find out because of confidentiality clauses how much of the NHS is now run by private companies. All we know is what they want us to know.

I thought 5% of the NHS was privatised under Labour and it is 6% to date??????