Junior Doctors strike

I was in A&E after a fall and a head injury - after 5 hours, I saw the maxilo facial folks who pinned my teeth, and even though not their job steristripped my lip and eyebrow and cleaned me up. I then spent another 4 hours sat in a draughty dark corridor while waiting for a doctor, alongside a frail elderly lady in a wheelchair who had been there for 8 hours with nothing to eat or drink (my DH got her a cuppa, and had a go at an auxiliary nurse to chase up her wait, a very grumpy doc arrived about 3/4 hour later complaining about having been called out) By this time DH was getting poorly as he had nothing to eat (diabetic) so we went home, where he ate and sat up all night to make sure I was OK, then called the GP out in the morning. And that was a fast track. Chap sitting next to us had been waiting 10 hours for just a stitch in a deep hand cut, so he could drive 100 miles home. You can imagine what he thought of our A&E

It’s more fantasy land than reality though isn’t it, that’s the problem with blue sky thinking. Chronic underfunding has left a huge backlog, and there are few options left in the short to medium term I fear.

No. We need more actual hospitals as well as treatment centres for more clear cut conditions. It's called blue sky thinking. Try thinking much bigger.

Aveline, it isn’t and can’t be as straightforward as that. Routine operations can be done in treatment centres provided staff and facilities are available. By no means all operations are in that category, particularly in general and specialist surgery specialties as opposed to some orthopaedics, and cataracts. Treatment centres are not set up with the very specialist equipment that some surgeries require either, they are there to do high volume, routine operations. They also don’t cater for emergency operations resulting in the cancellation of other complex cases which were booked to take place, and that happens all too often. More capacity is needed in general hospitals, including ITU and High dependency, to solve the waiting list problem.

Actually it is as straightforward as that. There needs to be more actual hospitals. Treatment centres for orthopaedics and ophthalmics and maybe Obs and Gynae. There needs to be therefore, an exponential increase in relevant staffing and requisite training. I'm thinking big here and trying to see what might actually help. I'm not constraining my thinking to current provision.

I don think it’s quite that straightforward Aveline. There is a problem with lack of operating theatre capacity and staffing, and not all procedures by any means are suitable for treatment centres, which don’t offer post operative intensive or high dependency care, which some patients need, or need to be in a hospital where it is available as they have risk factors.

That's very poor. I'm just thinking about it. The number of patients referred and the availability of appointments for treatment don't match. Therefore what is required is actually more hospitals/treatment centres which would in their turn required more staff this offering more job and training opportunities for doctors. Currently it seems they're trying to pour a gallon of patients into a pint pot of hospital appointments.
Only thing missing is the money and/ or the will!

Big variation in time to see consultant Cancer is very quick, other investigations can take a very long time, often 6 months between diagnosis and treatment.

Currently 15 months between diagnosis and treatment.

Here there is a delay between GP and Hospital information, it does get through but is out of date, which can make follow up difficult.
Big variation in time to see consultant Cancer is very quick, other investigations can take a very long time, often 6 months between diagnosis and treatment.

I agree. There needs to be much more localised organisation and with the appropriate funding for that population following it. Some overarching body but only with the lightest touch. No more endless meetings and quangos each with their own governance and standards.

Aveline

The 'integrated care boards' are clearly not working! Rearranging the deckchairs on the Titanic springs to mind.

How do you suggest the whole NHS is organised? It's too big to be managed as one unit from the centre. It has to be divided into some kind of regional board system.

My own feeling is that the problem is the internal market, which means that GPs have to use many different providers, who don't communicate well. The main stake holder (the patient) gets lost in the process.

The 'integrated care boards' are clearly not working! Rearranging the deckchairs on the Titanic springs to mind.

Aveline

I know it shouldn't happen but it does. It's just a suggestion.
The NHS needs a comprehensive reorganise and for it to be funded and managed out with the usual three to five years of a government. The BMA has a role to play too though.

I'm not sure whether you know, but it's just had yet another comprehensive reorganisation, as the boundaries of the Integrated Care Boards have been changed - again.

What do you suggest needs reorganisation and how do you think that would impact on and improve patient care?

Been at hospital again today with Son for a procedure and happy to report things are running almost normally again after the Drs strike. Just a fire alarm going off and staff telling people to evacuate the building and nobody taking any notice.

Cumbrianmale56

I find it far more obscene when a foreign footballer signs for a top English club for 500k a week and then demands 600 k the following season, which the club will pay. This is someone who has no talent beyond kicking a ball and deciding his pay each season. Yet we pay people with rral skills like doctors and nurses a fraction of this, in particular nurses.

This thread is about junior/resident doctors striking though.

I find it far more obscene when a foreign footballer signs for a top English club for 500k a week and then demands 600 k the following season, which the club will pay. This is someone who has no talent beyond kicking a ball and deciding his pay each season. Yet we pay people with rral skills like doctors and nurses a fraction of this, in particular nurses.

Aside from all the upset and disappointment these strikes cause to very ill patients and their families and extra work for other NHS staff, these resident doctors strikes have cost the NHS £3billion in recent years.

I know it shouldn't happen but it does. It's just a suggestion.
The NHS needs a comprehensive reorganise and for it to be funded and managed out with the usual three to five years of a government. The BMA has a role to play too though.

She has my sympathy, it’s not right at all to be put in that position.

That’s applying a sticking plaster, though. She shouldn’t have to rely on UPF’s. She’d just like 30mins in which to eat the lunch she prepares for herself.

She should bring bottles of Huel. You can get them online or from Boots. It's good stuff and is meant for people like her that are too busy to eat.

She uses exercises that the military use to prevent them from fainting on parade and carries various snacks in her pocket, Casdon. She’s got it finally tuned - if she’s just seeing bright lights, she knows she’s X amount of time to remedy the situation, if she’s seeing stars, she’s got less time, blackness means rapid action.

That can only work if there are more consultants, Luckygirl and that’s not likely to happen. Dd was telling me about the NQ doctors. When she qualified in 2020 she was assigned to departments and allocated to different experienced medics to learn on the job. It was generally about five trainees per dept. Very often now, because there are many more trainees coming through, they have to find their own mentors and there just aren’t enough places. Departments are now trying to manage ten or twelve trainees at a time which means they’re not getting enough experience. Also, whilst many patients are happy to accommodate trainees, no one wants half a dozen young men/women peering at them when they feel vulnerable.

Your poor daughter SueDonim, she will become ill herself if she carries on working like that without breaks. Even if she just had a pre mixed protein shake carton when she can grab two minutes it would help her avoid fainting attacks.

It’s harder to support this strike when it means your treatment has been delayed again.
Waiting at the bus stop, the drop in public sympathy near us was evident when most cars drove silently past the “hoot if you support us” placards outside our local hospital. DGS who has digs close by mentioned how much quieter it was this time too.
He’s not training to be a doctor, but if he gets a job as a teacher it will take him till he’s 40 to pay off his student loans.