NHS winter crisis looms

I doubt if universities can afford the loss of overseas students' fees without increasing domestic fees.

The fees for an overseas medical student at Cambridge are currently £40,200pa, compared with £9,250pa for British students.

durhamjen said
They don't want to,{work??? } firecracker, and certainly not in mental health, which is Theresa May's big idea
fullfact.org/health/fewer-doctors-and-nurses-working-mental-health/
My Brackets
"Dont want to what?" DJ

Once again DJ coupled with her favourite link to a left wing website, puts her own spin on the facts.

There are fewer doctors working in mental health yes, that much is true, but is this caused by :

Lack of money allocated to create the jobs in mental health?
Answer : Yes!

Lack of sufficient trained doctors to take the roles, because there is a general doctor shortage which enables doctors to, even now, pick and choose what to specialise in and mental health isnt one of the most sought after specialities (such as ENT, pediatrics, or opthamology).
Answer: Yes

British doctors are refusing to go in for mental health and leaving the profession to work in something else or going abroad to complete their specialist training in somthing else.
Answer: No

The reluctance of many doctors to enter the less glamorous and in some ways less emotionally rewarding branches of medicine underlines how badly we need to train more. Doctors on entering their career should realise that they might not get the exact speciality they want, just as lawyers know if they want some interesting niche like charity law, or media law, or public international law, its going to be very competitive to get what they want. At the moment doctors are scarce enough that most do get to choose their speciality.

Foreign doctors who come here to work in unpopular areas (geriatrics is another one) haven't necessarily chosen it because they 'love it' either, but for pragmatic reasons, they know it will help them get a job anywhere in the world. Our own doctor numbers need to be increased so that they too are forced to adopt an attitude of pragmatic realism! Train enough doctors and theyll be glad to just get a job!

fullfact.org/about/impartiality

You should know by now that some people aren't impressed by facts and will peddle myths because they suit their own agendas. Some people don't even quote sources.

I can rarely be bothered to contradict them any more, even though they're wrong and ill informed.

How pompous some posters are. Pompous and condescending.

So called Full Facts

www.ukcolumn.org/article/faux-facts-disturbing-truth-about-fullfactorg

"this interesting little non-profit company, headed by Tory Party donor and AnneFreud Centre Chairman Michael Samuel"

truepublica.org.uk/united-kingdom/unbiased-full-fact-comes-brexit/

"Some of the sponsors of Full Fact are well known REMAIN campaigners. The Labour party and a number of its affiliations for one. The hugely powerful, wealthy and influential City of London Corporation, largely representitheeng the banks publicly backs membership."
"Diageo is the worlds largest drinks distributor, is another financial sponsor of Full Fact and a huge supporter of EU membership as is Roll Royce the BMW owned manufacturer who have admitted to sending letters to thousands of employees warning of the consequences of Brexit in a clear campaign (that they ended up apologising for) to garner more favourable pro-EU votes"

"Then to add a little more weight to the debate as another sponsor of ‘Full Fact’ there is the equally influential Cambridge University who’s Vice Chancellor has said ‘I cannot identify a single persuasive reason to recommend leaving Europe’"

Hmmm. This website may not have an obvious party political bias, but much like the BBC it is absolutely an establishment organisation.

People who trust it for their information are, I suggest, colored by the same biases.

Not impressed by the integrity of Michael Samuel either:

www.scotsman.com/news/uk/tory-tycoon-offers-fine-to-escape-speeding-ban-1-2829383

A MILLIONAIRE businessman caught speeding offered to pay a much bigger fine to a court – if he was allowed to keep his driving licence.

Former Conservative Party donor the Hon Michael Samuel offered to pay a “large” fine in return for being allowed to escape a ban for driving at 104mph

The wealthy businessman even asked the Crown to change the speed on the charge against him to a lower figure than he was clocked at.

WOW! He should have been gaoled IMO for trying to bribe the court like that!

The Telgraph exposes more of the duplicity of so called "Full Facts":

www.telegraph.co.uk/news/uknews/leveson-inquiry/9976733/How-Leveson-was-denied-the-full-facts.html

There is little more dangerous than sources which claim to be 'unbiased'

Full Fact specialises in what it calls “promoting the facts for their own sake, without an ulterior motive” and exposing journalists who it says are “playing tricks with the truth”.
It says that the media’s “inaccuracy” proves that the press must “be subject to additional constraints”.
It conducts frequent “fact-checks” of suspect newspaper items and regularly complains to the Press Complaints Commission (PCC) about stories it dislikes, saying that some newspapers are like “a water company putting poison in the water supply”.

Ah so another pro EU organisation trying to restrict free speech.

www.gov.uk/government/publications/full-fact

Exactly its an establishment organisation telling you what they want you to believe.

fullfact.org/about/funding

ukcolumn and Brian Gerrish:

www.charliefoulkes.co.uk/truth/brian-gerrish-disinformation-agent.html

truepublica and Charles Jacoby (otherwise known as a wiki-woo site)

www.brianhaw.de/index.php/index/4160-unsolicited-emails-it-is-a-matter-of-fact-global-research-true-publica-are-disinformation-who-knowingly-publicly-lie-to-maliciously-cause-identifiable-harm-to-living-people-04-12-2016

The above kind of fruitloop sites are why Full Fact is needed more than ever these days. I know whom I'm inclined to believe.

The BBC is apparently setting up its own fact-checking unit to check out 'facts' on social media sites, which is good news.

www.theguardian.com/media/2017/jan/12/bbc-sets-up-team-to-debunk-fake-news

How amazing that an 'establishment' site should have to agree to closer accountability to be approved by the Charities Commission. Methinks some people can't make up their mind .

Very generous of the establishment to approve a site which is forever showing how economical the establishment is with the truth.

fullfact.org/about/frequently-asked-questions

How about getting this down to a mundane level again?
M DH has had this winter's guest virus for nearly 3 weeks. Bad cough and now pink eyes that are a bit sticky. He hates going to the GP and is convinced that the cough is a tiny bit better so I told him to go and ask the pharmacist about his eyes. He was given antibiotic eye drops and was surprised that these could be dispensed without a prescription. Result! No swopping viruses in the waiting room and an appointment freed up for someone else. I know that you can get hydrocortisone creams from the pharmacist as well. And thrush medication. Anyone else been using the pharmacist rather than doctors and nurses to ease the burden on services and avoid virus filled waiting rooms?

That's new!

When my daughter was little, she was especially prone to eye infections, which always seemed to develop on a Friday evening (gggrrr!) I went to the pharmacist so many times for little ampoules of sterile water, who always told me to get a GP appointment as quickly as possible for antibiotic drops, which he couldn't prescribe.

Only for yourself DD so the pharmacist can see how bad it is - too serious and its off to the GP. Not sure they can sell thm for kids either.

And that Jess is exactly how it should work.

In the small village where I used to live the pharmacist was always the first port of call as there was no GP practice there. I was saddened to learn he had died from a heart attack after self diagnosing indigestion and refusing his wife's suggestion he seek help.

anya that's worrying.

My daughter forwarded an information sheet on Facebook that outlined different medical problems and your first port of call. It is common sense, but it seems that there isn't a lot of that around. But maybe that's unfair on my part, maybe the difficulty getting appointments with your doctor who is herself under severe pressure, drives people in a panic or worry to A&E?

It was upsetting as he was a very good diagnostician normally WW

Re unnecessary visits to A&E I thought I heard of one hospital who had a system for sending away those who were neither an accident or an emergency, someone very qualified to decide.

Did anyone else catch that on the news (? I think)

Yes Exeter - a consultant stands at the door apparently. Not sure what happened to their triage system, perhaps it needs beefing up? Seems a waste of good consultancy.

It might WW but if it's effective in reducing large percentage who don't need A&E then that's a positive. And word gets around.

It would have to be an A&E consultant I suppose to know exactly who needs treating. Anyone less qualified could put lives at risk. It is an effective filtering system for sure.

Thought some of you might be interested in this


pbs.twimg.com/media/C2FBWKDWEAMtpDz.jpg

Link to a King's Fund publication about A & E admissions:

www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters#somewhere

An extract:

Is the pressure on A&E mainly a result of people going to A&E when they should go somewhere else?

Around 13 per cent of people who attend A&E are discharged without requiring treatment, and a further 35 per cent receive guidance or advice only (HSCIC 2016). This does not mean that all these people are attending A&E unnecessarily or could be cared for elsewhere. For example, someone who leaves A&E without being admitted may well have attended appropriately because they required treatment or assessment that only A&E could provide.

Estimates vary but a survey of 3,000 people in 12 A&E units conducted for the Royal College of Emergency Medicine found that 15 per cent could have been treated in the community; again this is not to say that they all went to A&E 'inappropriately'.

Two of the claims put forward for why people go to A&E unnecessarily are examined below.
Lack of access to GP appointments

It has been suggested that more people are attending A&E because they can’t get appointments with their GP. It is difficult to pin down accurately how many people this might apply to.

However, the latest results from the GP Patient Survey show that 85 per cent of people were able to get an appointment to see or speak to someone at their GP practice, down from 88 per cent in 2011. From the latest figures, of those who couldn’t get an appointment or were offered an inconvenient appointment (11 per cent), around 4 per cent reported going to A&E instead. We know that being able to obtain timely appointments is a key concern for people accessing GP services. However, data from the GP Patient Survey suggests that while there has been a slight reduction in people’s ability to access their GP, there has not been a significant deterioration.
Confusion about the system, including about how to access to out-of-hours care

It has been suggested that removing responsibility for out-of-hours care from GPs (as part of contractual changes in 2004) led to an increase in A&E attendances. However, there is no evidence to support this.

Most people go to A&E during working hours, and these hourly patterns in attendances have remained largely unchanged in recent years. However, people are clearly uncertain about how to access out-of-hours care – results from the GP Patient Survey in July 2015 found that only around 56 per cent of people said they knew who to contact out-of-hours. While this is higher than 2014, it is actually lower than in previous years.

Access to other types of care out of hours (for example, district nursing care) is also important in keeping people out of hospital. We know that the number of district nurses employed by the NHS has decreased by about 36 per cent in the past five years.

The Parliamentary Health Select Committee, the NHS Confederation and many others have expressed concerns that the fragmented provision of urgent and emergency care makes the system confusing for the public. In response to these concerns, the NHS five year forward view commits to doing ‘far better at organising and simplifying the system, with the aim of helping patients to ‘get the right care, at the right time, in the right place’ by making more appropriate use of primary care, community mental health teams, ambulance services and community pharmacies. To support this, NHS England has been undertaking a review of urgent and emergency care, and has launched 'vanguards' in eight areas of the country to pioneer new approaches to delivering urgent and emergency care services.

--
The publication also points out that attendances are higher in Summer (so we haven't seen the worst yet), but admissions are higher in Winter. One of the factors increasing time in A & E is not being able to find beds for those who need to be admitted.

This is very worrying. It's probably what the government wants, though.

www.theguardian.com/society/2017/jan/14/mays-scapegoat-attempt-could-spark-mass-resignation-says-top-gp-nhs-crisis

By the way, the government wants to reduce the number of pharmacies, while telling us we should use them instead of going to A&E!