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

janeainsworth - did you not read the link? Yes, our GPs do both and seem to manage very well. Did you fail to take in the comments I had made regarding GPs and how they used to work? They did normal surgery hours plus weekends and call-outs - they also did all the blood tests (no practice nurses to take over for them or local hospitals agreeing to do routine bloods for them). They also did mundane things like weighing you, measuring height, blood pressure - in fact, pretty much everything that is now carried out by practice nurses or local facilities on their behalf.

As for the comments regarding the 9 hour days - do you think that doctors are the only profession that work long hours? I can think of many that involve equally stressful work (I believe air traffic control being one of them previously hit the number one spot for stress). As for no loo break, no time to eat or drink and working 11 straight hours is stretching the boundaries of belief (one might even be forgiven for thinking some exaggeration is taking place) - either that or the doctors I've seen taking a break, drinking coffee (during an appointment), at the hospital canteen where I've seen them (both here sitting and having a meal or a coffee have been nothing but a figment of my imagination (and those who served them apparently). The paperwork you are referring to, you would need to elaborate before I comment.

Whilst I would agree that successive governments have done little to help the NHS (realistically), my comments were not aimed at that but more of the attitude from doctors towards their patients.

If I am failing to understand, maybe that's because you weren't quite patronising enough towards me in your post ...

I have to say that I'm not able to answer the original question, not being a regular user of the NHS. However, when I have had occasion to visit my doctor she has been excellent. When I had surgery 15 months ago it was obvious that the ward was understaffed and doctors and nurses were stretched to the limit. HCAs were kind, but not very skilled.

janeainswirth's comments about doctors could apply equally to those in education or social work. The enthusiasm, idealism and dedication have been rubbished by micro management continual reorganisation and constant briefing against the public sector.

Of course there are failures and inconsistencies which need to be addressed where they occur but the way successive governments have dealt with any failures is guarranteed to destroy morale and produce defensiveness.

An openness to listen and address anything less than optimum service is what all professional people wish they could do. Systems set up by overpaid suits at the expense of those in the wards, the classrooms and the homes of the disadvantages will not achieve this.

Hollydaze Has it not occurred to you that the doctors doing the on-call might not be the same ones who work in the practices during the week?

Does your imagination not stretch far enough for you to have any sympathy for a young doctor who works an '11 hour day with no time for a loo break.....and no time to eat or drink' and who 'deals with patients for a solid 9 hours before he even looks at the paperwork'
and who feels 'I'm too exhausted and emotionally drained when I get home. I have nothing left to give'.

How would you feel if it was your son or daughter working like that?
Would you feel that's what they deserved for being greedy, money-orientated people - or might you just possibly feel that the NHS is an exploitative employer which has sucked the idealism out of young people who have sacrificed years of their lives to train within the NHS?

janeainsworth - I had already highlighted that the quotes came from page one so I'm not sure why you are reiterating that - almost as if I'd tried to hide it.

Of course I'm quoting selectively - I'm quoting that bits that resonated with me, so how could I quote otherwise?

Whilst I would agree that government demands will have an effect, it won't have an effect on the way that GPs view their patients - I have met (and, indeed, had) GPs who treated their patients equally and took patient concerns seriously.

I'll give you the other side of the coin: on the Island, our GPs said the same as the GPs in the UK - they wanted more family time and that they didn't want to work weekends, evenings or around the clock at all. They got what they demanded and then they suggested that the Manx government set up an out of hours service that GPs could volunteer to man. At a rate of £180 ph, there were no shortages of takers for that role but try getting them to visit overnight - they would rather sit and pick up a telephone and deal with you over that. I believe you have the same problem in the UK: www.telegraph.co.uk/health/nhs/11188613/GPs-paid-100000-to-work-only-weekends.html It would seem that for some, they are quite happy to sacrifice that family/social life if the pay is high enough; I suppose everyone has their price but they really shouldn't complain about it.

It's not surprising that the government is scrabbling for money to pay doctors if those amounts are what are being paid out for a few hours work. GPs will have to also look to their own lifestyle choices when it comes to fixing the NHS and not be quite as greedy and money driven.

Hollydaze You are not being fair to quote so selectively from the Facebook posting which I quoted in its entirety.

Anyone who wants to read the whole thing, see my posting on page 1, of Wed 1st October 18:06:33, where you will see that the remarks that Hollydaze has picked out were made in the context of a young GP facing burnout before the age of 40. He is far from being the only one.

This is the result of the Government's obsession with targets and squeezing 'value for money' out of professionals (not just doctors) who work in the public sector.

What is wrong with the NHS, as highlighted in the Mid-Staffs enquiry, is that the idealism and professionalism that used to be the hallmarks of the NHS have been suffocated by the demands of self-serving politicians and managers.

the Department of Health would like to know what you think about whether there has been a real improvement in the care provided by the NHS and social care providers as a result.

"When we receive care, whether that is in the NHS, social care or in our own homes, we expect, and have the right, to be treated with dignity, respect and compassion."

So Lucy - have the responses given here been forwarded?

I think one problem was highlighted on page one:

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

Why does the GP use the word 'moan' instead of 'complain' - does that GP feel that patients don't have the right to be concerned/annoyed about the waiting times? Aren't GPs paid to fix all aspects of illness - not just the ones they approve of?

This job has changed beyond all recognition in the last 5 years

I think many patients would agree: the role of the GP certainly has changed beyond all recognition but it started to happen much longer than just 5 years ago. Many of us remember GPs being on call overnight, if called out they turned up to reassure and take control of situations - and most did it pleasantly and efficiently - even if said emergecy had been caused by 'lifestyle issues' (I don't recall GPs being quite so judgemental back then). Then again, I think GPs saw treating the whole person as their job and not just the bits that fell neatly into problems that could be dealt with by writing a prescription or a referral - GPs actually did a lot of the work themselves - or deciding that their disapproval of the cause of the a patient's condition was more important than the person that was sitting in front of them. I feel a whole new level of admiration for the kind of GPs I had in my 20s and 30s - they haven't all disappeared but they are a dying breed. I also remember GPs making housecalls during the day if a patient was too ill to get to the surgery - now it seems that you have to make your way there regardless of how ill you feel. I also remember during times of bereavement, GPs would visit the family home to enable their patients a degree of dignity by them not having to sit in, and then walk out through, a waiting room and make their way home after crying - not so anymore; it seems the sheep have been well and truly trained to make their way to the pen regardless of all else. How on earth did GPs cope with all that in times gone by?

The upshot is that GPs have been given a considerable pay rise for a considerable lessening of their workload - and still some of them complain. Not surprising that patients no longer hold them in high esteem as they once did and that is such a shame.

My neighbours are from Iraq and one of the ladies is around 58, has type 2 diabetes, severe learning difficulties, is deaf and unable to speak. She loves her dolls. She was admitted as an emergency for surgery which terrified her and she did not know what was going on. Her uncle is a practising doctor and her mother who used to be a doctor in Iraq were not allowed to stay overnight and had to abide by the visiting rules. Her care for want of a better word was appalling- she was neglected and could not tell anybody.

My view is that this should not be happening.

"Reliance on agencies – at a cost of up to £1,800 per day per nurse – comes as the number of nurse training places in England has been cut. In the last year of the Labour government, 20,829 nurse training positions were filled in England. That fell to 17,741 in 2011-12 and to 17,219 in 2012-13, rising to 18,009 in 2013-14.

According to the latest figures, there were 7,000 fewer qualified nurses in August 2013 compared with May 2010, excluding health visitors, school nurses and midwives. Ministers were accused on Saturday of “truly incompetent planning” by the Royal College of Nurses."

Taken from the Observer today.

Ethel, I have just had a letter asking me to go for another blood test as "the previous sample was unsuitable."
I've never had unsuitable blood before. Has anyone else?

"The result: intensifying pressure on the remaining hospital services - now taking the form of huge, under-funded demand on A&E, lengthening waiting times, and more delays in discharging patients from hospital for lack of suitable support in the community. A recent report in the Times shows the decline since 2010:

· The number of people waiting for operations has gone up by one million to 3.3million people.

· People are now waiting on average 10% longer for treatment.

· The numbers waiting over 18 weeks and over 26 weeks for outpatient appointments and treatment have gone up by 25%.

· Cancer treatment targets have been missed for two successive quarters.

· For well over a year A&E departments have been failing to hit targets for treatment within 4 hours.

· Trolley waits for a bed have almost trebled in the last three years.

· Last minute cancellation of operations last year hit the highest level for nine years.

· Delayed discharge of patients fit enough to leave hospital have hit a new record level.

· 60% of patients have to wait more than 48 hours to see a GP."

This is a quotation from Opendemocracy, quoting a Times article.
How can the Department of Health ask about improvements when this has been happening?

The waste of time and money is unbelievable, I had a yearly blood test which came back with the need to see a doctor, I got a letter and a phone call the same day, I rang the next day and was told I didn't need to see a gp just to have the tests repeated, when I went back the nurse said it was cancelled, I went the following day and was told I should have to see a gp. I have made an appointment ( 3 weeks wait ), I have since had several phone calls asking me to make an appointment. I had 7 texts reminding me of the first appointment and several more letters asking me to go to see a gp and the nurse.

What a waste of money for all the calls, texts and letters. The staff don't seem to be able to check the appointment system. It would have only taken a few minutes to check that I had an appointment and would have saved a lot of their time.
a relative of mine has had similar problems with a nearby practice too.

If everyone has these problems the money wasted will be a huge amount.

This what has happened according to Kailash Chand in the last two years..

https://www.opendemocracy.net/ournhs/kailash-chand/%E2%80%9Cnhs-reforms-our-worst-mistake-coming-from-tories-this-is-too-little-too-late

Considering that even Cameron is trying to make excuses for not knowing what Lansley and Hunt have done, the NHS has a nerve asking us about what has improved.

The improvements I have noticed are because I have moved from a densely populated area in the South East to the South West. My cancer treatment in the SE was superb, thank goodness, but getting appointments etc for routine things were difficult and frustrating.

Here, we have a wonderful GP surgery, where blood tests can be done, for example, and a cottage hospital next door where one can opt to have x rays done and to see the appropriate consultant, without travelling to the main hospital.

I have nothing but praise for North Devon hospital - I have had two operations there and about to have two more. Everyone, from the bookings team to the physios, nurses and doctors, have done all they could to ease the way.

So - post codes again?

The Guardian has a website where they want to know experiences of the NHS over the last four years, not just this one. I have just reread the OP and realised that the government just wants to know about improvements. They might have a problem reading this thread.

https://witness.theguardian.com/assignment/543564a6e4b09ceaddbcacc0

Galen you're a doctor. If you have problems what hope have the rest of us?

My experience when I dislocated my shoulder earlier this year was appalling! On trying to complain all I got were reiterations of the fact that there was no record of my continuous vomiting and that I was mobilised on the ward. I was also told that I could have been admitted if I wished which is the opposite of what I was told at the time. They are either lying or facts were not properly recorded at the time. I suspect the latter as the nurses seemed to spend all the time talking in their glassed off room rather coming out and interacting with us!
I have given up trying to complain which is probably the outcome that they wished for.

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?

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.

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.

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

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.

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. 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'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.