The NHS is a service not a shrine,” Mr Streeting said. “It is judged by how well it serves the public.”

Are you so sure MaizieD? Robotic surgery is all the rage.
If you look at countries with apparently brilliant healthcare - I don’t think politicians capitalise in the same way as here . I wonder if the best performing healthcare stands separately from politicians and where there’s plenty of money from oil revenue eg Qatar? Or just plenty of money?

growstuff

Personally, I thought the red books were a waste of time. My children's books have hardly anything in them. Nevertheless, I've still got them and looking at them brings back memories of their births, which wouldn't be the same if they were online. If my children had ever needed serious medical care, I doubt if the red books would have been used.

My child was in and out of hospital and his red book weren't with him and was regularly referred to until his notes arrived. They also used it when we went abroad and he had an asthma incident.

MaizieD

^Why are people so frightened of reform and bringing the NHS into the 21st century?^

GG13, would you like to explain what you mean by 'reform' and 'bringing the NHS into the 21stC'? The statement is delightfully vague and could mean anything at all.

I agree it’s vague, I am not employed by the NHS nor am I a clinician.

If something is working to the best of its ability and not broken its best to leave well alone however, this is a discussion about fixing the NHS ergo it must be broken.

The advances in medicine have been enormous in recent years and the NHS now has the ability to manage most ailments if not cure them in entirety.

The NHS is kept in limbo, its funding and direction dependent on whoever wins the next (or any election)

In my opinion it would be far better to have a cross party commitment with continuity of members to oversee it. This could save it from the yo-yoing between ideas of the two main parties.

It needs to concentrate on efficiency of all staff, sorting out social care which should ease so called bed blocking .

GP’s should be more accessible (we are fortunate our surgery is open 8am - 8pm Mon - Fri and 9am - 5pm Sat) which should in theory lessen the need to go to A & E for minor problems due to being unable to get a GP appointment.

Despite knowing this would be extremely unpopular, if you fail to turn up for any health appointment then you should incur a fine, this might just focus minds on how fortunate we are to have the NHS. (There would have to be some leeway for those with diminishing health/responsibility)

Staff retention, training and recruitment in all sectors, use only in house staff banks as opposed to private ones who are making £££’s and this money could and should be directed into HR within the NHS.

If I think of anything else I will come back

icanhandthemback

growstuff

Personally, I thought the red books were a waste of time. My children's books have hardly anything in them. Nevertheless, I've still got them and looking at them brings back memories of their births, which wouldn't be the same if they were online. If my children had ever needed serious medical care, I doubt if the red books would have been used.

My child was in and out of hospital and his red book weren't with him and was regularly referred to until his notes arrived. They also used it when we went abroad and he had an asthma incident.

In that case, I stand corrected. I guess it was fortunate that my two never needed any medical care as children. In fact, my daughter is now in her 30s and I don't think has ever had a hospital appointment.

MaizieD

Nothing is ever fully independent of politics, ronib because people are political. The only way that could be achieved would be to have it run by robots.

What a sad view of people. Do you really believe that there are no altruistic people around who would rin the NHS for the good of the people.

GrannyGravy13

Casdon

The NHS cannot be governed by cross party consensus, that’s an absolute non starter, because there isn’t any. The Tories want to move towards a privatised, American system. Apart from Reform, no other party else does, and that can’t be reconciled.

So what do you suggest?

If we keep to the same old modus operandi veering from one cohort to the next then it’s pretty much guaranteed that the NHS as it was at its conception will cease to exist.

Why are people so frightened of reform and bringing the NHS into the 21st century?

I’m not frightened of reform at all GrannyGravy13, I’ve thrived through a number of huge reorganisations during my NHS career, I just know that cross party consensus on the NHS is a non starter because the ideologies are diametrically opposed.
In my experience all restructuring does is change the order of the ducks. What is most needed is accountability. The NHS is an extremely complex organisation with huge vested interests, and bringing in top level management from outside has never worked (anybody remember Griffiths?).
If I were the next government I’d start by being very clear what the next year will see in terms of training and investment in capital and revenue terms, and what is expected. I’d prioritise putting more acute beds into the system, both in general and mental health. Not a thousand targets micro-managed as it is now, people need to be freed up to deliver and management support needs to be freed up from number crunching to systems redesign. About five or six very clear targets should be set, and very closely monitored. That’s what I’d do, but probably not at all what any government would do. Nothing will be changed until April 2025 though, because the current year’s targets have already been set.

kittylester

MaizieD

Nothing is ever fully independent of politics, ronib because people are political. The only way that could be achieved would be to have it run by robots.

What a sad view of people. Do you really believe that there are no altruistic people around who would rin the NHS for the good of the people.

I don't.

Casdon my only experience of working in the NHS was a very long time ago, we needed some extra cash so I got a temp job in HR at the local hospital. I was paid three times what the girls were paid who were contracted to the NHS. I wasn’t really needed, lots of tea drinking, toilet breaks and gossip one of the most inefficient offices I have ever been it.

I like to think that times have changed, but who knows?

GrannyGravy13

Casdon my only experience of working in the NHS was a very long time ago, we needed some extra cash so I got a temp job in HR at the local hospital. I was paid three times what the girls were paid who were contracted to the NHS. I wasn’t really needed, lots of tea drinking, toilet breaks and gossip one of the most inefficient offices I have ever been it.

I like to think that times have changed, but who knows?

I can’t speak for the whole of the NHS, but where I worked there were no non clinical Agency staff, and the level of scrutiny of requests for Agency clinical staff was beyond, requiring a huge amount of managerial time going through rotas, calling staff to see if they wanted extra hours, trying to find bank staff, moving people from other areas to cover - it was an industry in itself, and achieved nothing.

Apparently the NHS is the largest employer in U.K. and Europe and with 1.3 + million employees one of the biggest in the world.

Yes, and I believe it is also the employer with the most different diverse employment groups. It’s extremely complex.

I returned home from a few days away yesterday and there were FIVE letters all from the NHS . When I opened them they were each giving me a time and date of a hospital appointment and then immediately cancelled in another letter . As there were no dates when they were written I have no idea which came first or even if I have an appointment at all! I have been waiting since last November for this “urgent” appointment . This has cost at least £20 with postage and administration, and I am probably one of many for that clinic. I have tried phoning several times but no one answers , so I’m visiting the hospital tomorrow, clutching my many letters to try and sort it out. Interestingly the letter stated that they had over 200 people fail to attend appointments in February- I wonder why ?

I always receive a letter from the NHS telling me that I will shortly be receiving a bowel cancer screening kit. Why? The kit will come anyway, with all the info required. What a waste of time and money.

I’m currently reading a very interesting book - ‘The Patient Paradox’. I think it was a GNetter who mentioned it and I subsequently bought it. It’s written by an experienced GP. Her view is that the NHS is spending too much time and shed loads of money on unnecessary testing and procedures on people who are well, and do not actually require these interventions. The NHS is turning well people into patients, possibly at the expense of those who are ill. She puts forward a compelling case. I don’t yet know whether I fully agree or not - but it’s certainly food for thought.

NHS app was a good start but my GP service still can’t update information properly. Some information gets included but other letters, tests etc. don’t. They should ask patients if they are happy to be emailed or use NHS app. Posting letters is a lottery these days. Sometimes I get an email, update on NHS app and a posted letter. Surely a waste of resources. All in favour of using technology. Only way forward. Hope Labour can begin to make improvements but so much to do. NHS is great when it works but can be awful too.

I still receive texts on my mobile phone despite telling my surgery countless times that there’s no signal here. They pop up if I happen to take my phone to an area where there’s a signal and turn it on. It’s a common problem in this area but they just don’t get it and stick to ‘usual procedures’. Where’s that head-banging emoji?

These last few posts are all related to service redesign.

LizzieDrip

I’m currently reading a very interesting book - ‘The Patient Paradox’. I think it was a GNetter who mentioned it and I subsequently bought it. It’s written by an experienced GP. Her view is that the NHS is spending too much time and shed loads of money on unnecessary testing and procedures on people who are well, and do not actually require these interventions. The NHS is turning well people into patients, possibly at the expense of those who are ill. She puts forward a compelling case. I don’t yet know whether I fully agree or not - but it’s certainly food for thought.

Well, I'm extremely grateful for breast screening. I had lobular breast cancer, which rarely forms lumps. Although I suspected something was wrong, the GP couldn't feel a lump and didn't refer me to the two-week pathway, which she should have done. The screening service wouldn't give me a mammogram because the GP didn't make a strong enough case - she didn't believe there was anything wrong with me and it seems she thought I was one of the "worried well". Fortunately, I was due for my three yearly mammogram a few months later and a cancerous lesion was detected. In fact, I had two, but mammograms aren't sensitive enough to detect small lumps.

If I hadn't have had that routine mammogram, I would probably still have the cancers growing in my breast until they became untreatable.

Germanshepherdsmum

I always receive a letter from the NHS telling me that I will shortly be receiving a bowel cancer screening kit. Why? The kit will come anyway, with all the info required. What a waste of time and money.

Possibly because there are silly patients like me who thought the package I received from the NHS was a box of Covid tests and put it to one side because I had no immediate use for tests.

PS. The reason I thought they were Covid tests was because I'm vulnerable and requested some a few months ago, but hadn't received anything.

Casdon

These last few posts are all related to service redesign.

Exactly! During my entire cancer treatment, I didn't receive any physical letters. Everything was done via the hospital's app, which also has copies of letters and test results and allows me to message a member of the breast care team. I usually received a response within 24 hours.

Some hospitals can do it, but it's a postcode lottery.

LizzieDrip

I’m currently reading a very interesting book - ‘The Patient Paradox’. I think it was a GNetter who mentioned it and I subsequently bought it. It’s written by an experienced GP. Her view is that the NHS is spending too much time and shed loads of money on unnecessary testing and procedures on people who are well, and do not actually require these interventions. The NHS is turning well people into patients, possibly at the expense of those who are ill. She puts forward a compelling case. I don’t yet know whether I fully agree or not - but it’s certainly food for thought.

It is not just that well people are having unnecessary tests. NICE is also setting lists of preliminary treatments that must be tried before something like an operation takes place. These steps are mandatory even when the clinician is quite clear that they will not work and the patient should be cleared for surgery.

I had carpal tunnel syndrome for 30 years before over a few months it became extremely painful and dsiabling. I went to see my GP. She examined my hand and wrist and found clear signs of damage to my wrist that meant surgery was required - and as soon as possible BUT first, she told me I had to put a support on my wrist and take pain killers for a month.

This was something I had been doing for sometime and it wasn't working, but, no. I had to do itfor a month after seeing my GP for it to qualify. I did this and then my GP told me that I now had to have a steroid jab and wait a month. She was quite clear that this was highly unlikely to work either because of the extent of the exiting damage to my wrist. It didn't, but I was finally referred to a surgeon.

The surgeon examined my wrist, like my GP he too said that the only answer to my problem was an operation, but before he did it, I had to undergo another battery of tests to prove it was needed. Then finally I got the op. Day surgery with local anaesthetic and a bit of sedation.

I am not sure how much was spent on all the tests I had, probably a sum in excess of he cost of the operation. I can see that with mild cases these other treatments may be efficacious. But the NHS really should have enough confidence in the skill of their staff to be able to say that in circumstances where a clinician was clear and firm that a specific treatment was needed and a consultant agreed, then the treatment should go ahead without multiple attempts to try less effective treatments.