The Nhs Crap/not Crap?

[phoebejo]

I think it depends what area you live in and what section of the NHS is treating you. Geriatric care in my experience is shocking, pediatric care is very good.

 

I'd agree with that. The way my grandparents were treated was shocking, but the times I've been to A&E with the kids the staff and way we were treated have been faultless. The day my grandad died I saw him in hospital and I knew he was close to death, yet later that evening he was discharged back to his nursing home where he died in the early hours of the morning. The staff at the home admitted he was probably sent there to free up a bed and so that his death didn't become a hospital statistic The elderly deserve so much better care but too much money is spent on the pen pushers wallpaper instead of extra nursing.

[fee4]

OK

let me put my hand up-i am one of those NHS managers so many people have criticised.

i am also a psychiatric nurse

 

i think over all the NHS is NOT badly managed as far as we on the ground go-let me explain.

 

i am accountable to the NHS/social services/users/carers/NICE/local Government/unions/non statuatory organisations etc etc.

i have over 15 thousand targets to meet....as documented nationally-im not including stand alone local ones such as the reduction of alcohol induced violence in bexleyheath....

cleanliness?

user surveys

every document translated into every accepted language?

budgets

staff sickness

delayed discharges?

advocacy?

access to IT?

equality training?

PDRs?

recycling?

staff who use public transport?

 

you name it we have a sodding gate to get through....i did a DMS recentlywith the OU-the others from Nno NHS places couldnt believe the amount of targets we work under.

The Govt-wants to prove to you the general public that we do a gd job, within our finances-well that takes a lot of time, energy & resources to create-i spend Hours of my day trying to organise it to protect some of my junior staff from the stress of having to do this.

if we cant prove our efficiency-we get our budget cut-so thats why the bloody paperwork is so important...even if it doesnt directly affect the patient in front of you

i have to prove & explain every penny & every decision.

i made the decision today to leave a chronically mentally ill woman without a nurse from the home she is in as i cant afford the extra shifts-i can only send someone 9-5-even there im not sure what i will need to reduce to make sure the budget remains OK.

a lot of the private sector want a foothold-but pay staff crap wages & care even less-their standards are often even worse-i have just tendered 2 of my services against the private sector-oh we dont use qualified staff-we use trained staff-yeah right-a cetificate done internally not worth the paper its written on in the real world.

we won that one-but im sure we will be tendered out again....

 

we are so lucky to have the NHS-talk to any American & they will tell you the reality of most people not affording health care-as for the private stuff-check what they do cover-not the serious long term stuff-and not emergency unless you pay with very very serious cash.

 

i stil believe that health care should be free at the point of delivery-and i never want to return to the life of my grandparents where sickness meant poverty for the whole family.

 

fee

 

er sorry for what appears to have been a bit of a rant

Edited January 3, 2007 by Melp

[Melp]

Fee I've edited one word, hope you don't mind. Changed fee to free here

 

"i stil believe that health care should be free at the point of delivery"

 

No need to apologise either, not a rant at all

[Sheplover]

I am very proud and thankful that we have the NHS, yes it does need improvement, but it's better than the alternative.

 

I was worried when I visited my grandparents who were both terminally ill, at the amount of staff such as nurses who appeared to really dislike their job and the patients, why do something you hate?

[Richard (The Sane)]

Fee, you are most definitly not the sort of manager I critisised - sorry if I gave that impression.

 

I still maintain that the NHS is badly managed, but this is high level management strategy I am referring to. You talk about targets - to be honest the service is over-targetted.

 

Let me move away from the NHS for a moment but what I describe may strike a similarity. The company I work for was, 18 months ago, the bottom of the league table in the industry when it came to customer service - based on the number of customer complaints to an independent body. We had targets coming out of our ears and to meet them often was detremental to providing good service. We had a change of high level management - a total and complete change (Unusual for a huge company, but necessary).

The first thing the new management team did was strip out most of the targets and leave just a few really high level ones for upper management only.

Result? Staff morale went up instantly as everyone could get on with their jobs. Customer service has improved over 100% and is still rising - customer complaints is less than 25% of the number we saw this time last year.

Last month all outsourced operations were closed, so everything is back 'in house' - we expect more improvement there.

 

All the above was brought about by a different management strategy. That is how I mean the NHS is badly managed. Often it is not the individual managers such as yourself, but the overall strategy derermined by whatever board does that.

 

Sorry for the waffle, the only way I could really clarify what I mean was through my own experience

[Delfin]

My 84 year old Dad is currently in the OAP ward, with heart failure. His care is wonderful and the nurses could not be kinder. Even over christmas and new year they were cheery and looked after him very well, even though he is getting very grumpy.

 

Saying that I could not do their job EVER. My Dad is just poorly but quiet. There are others on the ward that would test the patience of a saint. One man keeps taking off his clothes (all of them) and running around the mixed ward. Another lady screams that people are trying to kill her for at least 14 hours a day in a very high pitched voice. The others are just plain very hard work. These nurses are wonderful, they look after the older people knowing that their care in the end probably will not help save a life, which must be a thankless task. I guess reading other posts that I am lucky my Dad is in the hospital he is.

 

After visiting my head is spinning with the other patients, and I don't have any responsibility for them.

 

Having said that the nurses work non stop, there are a lot of other workers on the ward in normal clothes that seem to do not a lot I think our nurses our wonderful, but with everything else going wrong with the NHS, I would rather be treated at my Vets

[Maria]

I think we should be very proud that we have a national health service, 'free'(relatively) at the point if use, and open to all citizens -although I do feel it can be taken advantage of by overseas health 'tourists'.

But, there are some issues I have with the system (not individuals).....

1) As an accountant, a few years back (maybe early 90's), the NHS was a growth industry for my profession. There were loads of jobs advertised, because the internal market had been created, and people were needed to cross charge (and work out the charges). There were also regular revaluations of assets I believe, and all this work needed accounting staff. Virtually every course I went on at the time had loads of NHS accountants,encouraging everyone else to apply for jobs, and discussing things like the best way to cost an ingrowing toenail versus a brain surgery op (actual labour used or perceived market value of skill required?). To me then, and now ,this was a load of nonsense - all these jobs just added to the cost of the service, and brought no external income into it. People would be sitting at desks invoicing each other.

At the time I also worked in the public sector, and eventually ran the finance team. I refused to introduce inter departmental charging for the reasons above - ie, all it does is add cost and not value. In my view there are far better ways to manage budgets than to recruit people to create charging rates which are then used by other staff to charge other parts of the same organisation. Fair enough if you're billing a third (external) party, because then you are bringing in new money,but otherwise you are just reducing the available resources for the core purpose.

2) Targets - far too many in my view. Again it just adds to the overhead and not core purpose, and if not chosen very carefully they can backfire.People tend to do what is needed to meet the targets regardless of the potential impact elsewhere ( eg we had target of paying suppliers within 30 days. Very laudable, but what actually happened was that people signed off invoices for payment even if there was a genuine reason for not paying, like double deliveries, incomplete orders, or faulty goods. Some suppliers started to over deliver a lot because they knew they would be paid regardless! The invoices were signed off for payment so that departments would meet the 30 day 'rule', but meeting that target often cost us a lot more......)

A few, carefully chosen targets, which taken together measure the purpose of the organisation can be effective.

3) On to service delivery - I do wonder whether the way nurses are trained now has lead to any improvements. As someone else said, I have come across some who do not seem to like what they are doing. When I was younger nursing was considered a vocation, and I believe most training was undertaken on the wards? This would give you an early insight as to whether you were suited to the role. Does the graduate training route allow for early contact with wards /patients, so that you could change your mind at an early stage?

Edited January 3, 2007 by Maria

[owl]

The NHS varies immensely from one place to another. The management at one hospital here in Wales was so atrocious that the consultants went on strike in protest against them and marched outside with placards!

 

Geriatric care tends to be the Cinderella, and when I was doing domiciliary care we found ourselves dealing with severe bedsores, scabies and weight loss incurred by patients while in hospital. We had clients who were mildly incontinent when they went in, coming home with no control at all because they had been told to pee in their inco pads rather than ask for help on to a commode. We have had 2 people discharged from hospital with active MRSA, which we were not informed about until their notes reached the district nurse a week or more later.

 

Much of this is due to understaffing. If there is no friend or family member available to feed those who cannot manage to feed themselves, people can go without food because it is placed in front of them and then taken away. This particular job should not be left to the nurses anyway in my view, but to meals assistants.

 

As for the doctors, again a huge variety in standards. What scares me is the way they close ranks and eject whistleblowers from their fraternity, which is why people like the notorious gynaecologist who endangered Laura's life get away with incompetence for so long. It is as if they can't admit any doctor is fallible, and in fact we would all feel a lot more faith in them if they did admit it instead of covering things up. A doctor at a diabetic clinic my OH went to asked him if he had had his foot amputated yet, and when he said no, there was nothing wrong with his feet, she replied that he had been scheduled for amputation. We said no way, and then she realised she had the wrong patient. A simple "sorry" would have been nice, but she just got cross and said that his feet were probably bad and in need of urgent treatment. When she could not find anything wrong with them she was even crosser.

 

I come from a medical family and know how hard this work is. I also know that doctors and nurses vary from the brilliant to the appalling.

 

About the psychiatric services, the less said by me the better. Nurses mostly good, but most of the consultants and psychologists seem to live on another planet.

[LyndaTaylor]

Recent treatment at Scunthorpe NHS when I broke my wrist was fantastic, staff were great though obviously very busy, seen on time, very little waiting for x-ray or to get the cast put on or off. Can't praise them enough.

 

I just hope they're not seen as one of the smaller ones they want to close to make way for centralised centres

 

Lynda

[scotslass]

Interesting!

I'm 100% an NHS supporter. The nurses are most definately underpaid and under appreciated!

 

How many of us know what nurses earn, I wonder? I had a look at this site - http://www.nhscareers.nhs.uk/details/Default.aspx?Id=4 and was surprised, to say the least. Click the link at the bottom of the page for actual salaries.

 

Are those poor salaries? Compared to whose? We can't compare nurses' salaries to those of doctors - the qualifications and training are completely different. If nurses feel they should earn as much as doctors, why don't they do a medical degree?

 

I am not going to be popular for this, but I believe one of the problems is that some nurses feel they are too good for the job they are supposed to be doing. I know they are burdened by paperwork - that is the modern world, and it's the same for everyone. I also feel it's sad that NHS employees feel they have to close ranks and become defensive when shortcomings are highlighted - good staff should be happy to support any move to improve the service, with the emphasis on that last word.

 

I have always supported the NHS. I believe that in the past it was something that Britain could be proud of. Now, like most people, I just hope against hope that I don't have to use its services too often.

 

Liz.

[Pendlewitch]

OH has had a heart attack, a hip replacement and is now waiting for a spinal stenosis to be corrected. At all times his medical treatment has been excellent, he had a bit of a long wait for the hip but after I made a total pest of myself with the doctor he got priority as he was only 53 and trying to stay at work and in great pain.

 

My complaint would be towards the attitudes of the specialists/surgeons he has seen over the years, I know OH can be nattery and repeat himself over and over again and totally misunderstand a question but it's down to nerves, he's no wimp but hates hospitals and occasionally becomes more than a little unhinged and stressed. I can be quite rude to him at times but I will not allow anyone else to belittle him, talk down to him or as happened in one case, two registrars nudging each other and laughing! They will not do that again after the dressing down I gave them and the report to their superior! I have had more than once had to say 'I beg your pardon' to a bolshy, probably overworked and tired specialist who has been distinctly rude to the OH, but this is their choice of job and they are being paid to do it, they are not superior beings and although they have the right to be treated with respect so has the patient! Being ill does not remove anyone's rights or brain.

 

I think nurses should be doing the skilled nursing work and the bed making, food delivery etc etc should be done by auxilliary staff.

[border collie]

How many of us know what nurses earn, I wonder?

Liz.

 

thanks for that link, they earn a lot less than I previously thought. Terrible wages.

[scotslass]

thanks for that link, they earn a lot less than I previously thought. Terrible wages.

 

I am genuinely surprised at that response.

 

I was comparing them to teachers' salaries, for example. I'll go back and have another look - it makes me wonder what an average salary is; I am obviously very out of touch!

 

Liz.

[alexis]

Newly qualified nurses earn approx £19200 . That is for usually a 37.5 hour week and they get around 7 weeks holiday a year.

A newly qualified doctors salary who also does only 37.5 hours a week would be £20741. This is often higher as a banding system is applied depending on the number of hours and amount of anti social hours worked. I am 2 years qualified and in my 1st year I worked on average 56 hours a week ( this varied and is worked out as an average over 6 months and when I did nights it was, and still is, a 90 hour week). Most 1st year qualified docs now earn around £30000 but when you actually work out hourly salaries it comes to around £12 an hour and we get 5 weeks holiday a year. Nurses get paid extra for working weekends and bank holidays, for us we don't as weekends are factored in the banding supplement, but do get days off in lieu for bank hols.

A newly qualified nurse starts on £9.80 per hour.

 

Nurses pay has improved quite a bit and I don't think it compares too badly with a lot of other salaries and many nurses earn higher salaries than the basic. All the ones I know are fantastic.

 

http://www.bma.org.uk/ap.nsf/Content/ddrbfactcard0607

 

I think the NHS has far too much bureaucracy and ridiculous targets that look good but don't actually achieve anything and often get fiddled!This new payment by results by which the amount of money a hospital gets seems to me a complete farce. The more investigations that get done the more money the hospital gets, nothing to do with results at all!

Edited January 4, 2007 by alexis

[khanu]

If newly qualified nurses get 19k that is about what I earned 6 years ago as a new engineering grad. (16k 6 years ago) Now with 6 yrs experience, extra quals and chartered status I still earn less than 30k. Definately chose the wrong career.