NHS wastage

[Jean-F]

i recently underwent a procedure on my eye, as a day case in hospital.
On leaving, a nurse gave me a bunch of eye drops, saying, “This one twice per day for three days, this one four times per day for two weeks, this one four times per day for a week, and keep those ones refrigerated, these painkillers for whenever you feel that you might need them.”
I said, “Hold on, twice a day for three days equals six tablets, the box you gave me holds twenty four tablets, likewise the four times per day for a week one equals twenty eight tablets, you’ve given me four boxes each containing twenty tablets.”
He said, “What you don’t need, throw away.”
I said, “Might it not be better if you gave me just the amount I need?”
He said, “I just give out what I’m told pal, if you don’t like it, contact the Department of Health.”
It’s no surprise that the NHS keeps needing more £ if this is normal.

 

[Lysander]

We waste an insane amount of stuff at our site. Medication. IT equipment. PPE overstock. It's crazy.

 

[SupraWez]

crazy isn’t it, same with things like crutches, they don’t want them back.

 

[Lysander]

crazy isn’t, same with things like crutches, they don’t want them back.

Well, they do, they have to go to the right place. You can't just walk into an NHS site and give them your old crutches. They have to go back to where you got them. It's generally the same with sharps [I emphasise "generally", since some GPs will take them].

What I find interesting is the one-use surgical instruments which then have to be disposed of and melted down. The costs involved in that plus the re-ordering and manufacture + incineration must be interesting. I'm not saying this is wastage as such, just intriguing economically.

 

[Ahleckz]

Why are you putting tablets in your eye? I suspect you’ll be back sooner rather than later…

But you’re right, we don’t need more money spent on the NHS (well, we may but that’s beside the point). We need to waste less of the money spent.

 

[Trifid]

24 tablets might be the minimum amount sold per box. Or if there is a smaller one, someone decided it was not worth the extra storage space stocking 2 options. To be honest I thought this was about the confusing instructions as I was lost with what you were meant to be doing... I don't think I'd do well being old and drug dependant to survive with the speed they go through a complex amount of instructions.

 

[Deleted member 651465]

You want to see the number of medical records staff they employ to push trollies of paperwork around a hospital, because they haven't quite gone digital yet.

Or the tiny list of approved contractors that charge the Estates department £lol to knock down a wall, because they can't get comparative quotes.

The number of Band 7 managers banking £40k whilst they've not got the autonomy or authority to actually make things happen without their manager, is also comical.

 

[cheesefest]

Another overspend that NHS do - have the heating on in areas where it’s not needed! When we had that warm weather earlier this month, I had an outpatient appointment. It was boiling hot in the waiting area (lower ground) and put hand on radiator and it was red hot! This along with wearing a mask made feel lightheaded. Good job I had a bottle of water with me!

I couldn’t wait to get out of the building! Normally this dept you see consultant an hour later than appt time. It was just ten mins.

OP, it was the same with me with post surgery eye drops. I was given drops for the first 3 days, then week, then 2 weeks. The drops for the 2 weeks, I only went into 2 vials on the 3rd box.

Yet when I was prescribed with 20 tablets from my GP (forgot what they were) and the pharmacy gave me a sheet of 15 and 5 from another.

 

[cheesefest]

You want to see the number of medical records staff they employ to push trollies of paperwork around a hospital, because they haven't quite gone digital yet.

Or the tiny list of approved contractors that charge the Estates department £lol to knock down a wall, because they can't get comparative quotes.

The number of Band 7 managers banking £40k whilst they've not got the autonomy or authority to actually make things happen without their manager, is also comical.

The medical records staff use the hopper bus that goes between the hospitals using a supermarket trolley which was dumped nearby. It was very windy when I walked past and about 30 bits of paperwork blew everywhere. I helped to pick them up. Didn’t study closely but I saw at least three names on the paperwork I picked up. I wouldn’t be happy if my records blew away.


My dad had his records gone missing. Found 20 months later trapped between drawers in a filing cabinet!

 

[lookitsjonno]

I'd hate to see how much IT consultancies make from the NHS

 

[Lysander]

The medical records staff use the hopper bus that goes between the hospitals using a supermarket trolley which was dumped nearby. It was very windy when I walked past and about 30 bits of paperwork blew everywhere. I helped to pick them up. Didn’t study closely but I saw at least three names on the paperwork I picked up. I wouldn’t be happy if my records blew away.


My dad had his records gone missing. Found 20 months later trapped between drawers in a filing cabinet!

Last week a member of the public found a bag on the street full of patient records and medication left somewhere by a staff member. Great!

 

[Jean-F]

Why are you putting tablets in your eye? I suspect you’ll be back sooner rather than later…

But you’re right, we don’t need more money spent on the NHS (well, we may but that’s beside the point). We need to waste less of the money spent.

You’re right, I put tablets when I meant drops, perhaps I should have said units, my bad.

24 tablets might be the minimum amount sold per box. Or if there is a smaller one, someone decided it was not worth the extra storage space stocking 2 options. To be honest I thought this was about the confusing instructions as I was lost with what you were meant to be doing... I don't think I'd do well being old and drug dependant to survive with the speed they go through a complex amount of instructions.

I was confused when he was telling me, but I was given a printed page giving details of which med and how often.
I suggested that as the boxes were all sealed, could I take the unused, seals still intact stuff to a local pharmacy, I was told that a pharmacy would only scrap them anyway, once they’d been issued to a patient, that was it, no returns.

 

[thegreysquirrel]

The boxes hold a certain amount and are sealed. Once they are taken off site, you could be lacing them with all sorts, so they won't take them back and give them to anyone else. They must also be issued with the instructions/warnings/side effects/etc leaflet. It's not worth their time to take out sleeves of tablets that they then don't have a box/leaflets for.

 

[BowdonUK]

I seem to remember a few news articles a couple of years ago about how the NHS pays way to much for products that just cost a couple of pounds at a shop.

At some point I hope the NHS has an audit, so everything can be streamlined and they know what they are over spending on.

 

[Josh]

A Jean-F post without mentioning a family member, friend in America or road name?

Something is amiss!

 

[Werewolf]

i recently underwent a procedure on my eye, as a day case in hospital.
On leaving, a nurse gave me a bunch of eye drops, saying, “This one twice per day for three days, this one four times per day for two weeks, this one four times per day for a week, and keep those ones refrigerated, these painkillers for whenever you feel that you might need them.”
I said, “Hold on, twice a day for three days equals six tablets, the box you gave me holds twenty four tablets, likewise the four times per day for a week one equals twenty eight tablets, you’ve given me four boxes each containing twenty tablets.”
He said, “What you don’t need, throw away.”
I said, “Might it not be better if you gave me just the amount I need?”
He said, “I just give out what I’m told pal, if you don’t like it, contact the Department of Health.”
It’s no surprise that the NHS keeps needing more £ if this is normal.

The tablets might simply be they don't have the staff/time/materials to separate them into smaller packages and only have one standard set.

One thing to note is that for some medications the cost of actually splitting them up can be higher than the cost of simply giving you a standard package as IIRC if they split them they have to be fully labelled and checked by a pharmacist in the correct packaging.

They also tend to like to give you spares for the simple reason that it's better to give you some extras of something they consider necessary than have you potentially run out. For example my dad had an eye op a few weeks ago and he had some temporary eye drops that he needed to take, he had to use them for ~3 days but the package had 6 "one day" vials which seems wasteful until you realise that some people will struggle to get the drops in their eyes (I had to do them for my dad and h'es been doing eye drops for ~40 years) so by giving the extras that cost the NHS virtually nothing, it ensures there is enough to cover for people who might need two or three attempts each time.

There is often a very good reason for how and why they do these things, and it's often down to things like making sure they do it properly and reducing the chances of error or someone having to go back as an emergency to ask for more.

 

[Trig]

The NHS is a mess, trusts having different colour uniforms from the next, each ordering their own stuff, should all be centralised and standardised so it can be bought in bulk at a discounted price, the whole thing is a mess, yes the cuts arent helping, but if it was managed properly then they wouldn't need as much in the first place..

 

[cheesefest]

Do GPs prescribe items such as suppositories anymore? You can get a pack for £2.50. Yet how much money is it costing the NHS for prescribing this?

 

[Werewolf]

I seem to remember a few news articles a couple of years ago about how the NHS pays way to much for products that just cost a couple of pounds at a shop.

At some point I hope the NHS has an audit, so everything can be streamlined and they know what they are over spending on.

One reason you might "spend more" is to guarantee you've actually got it and that it meets the correct standard.

You really don't want to send staff down to the local shop in the hope the shop has something that is vital in stock in enough quantity when you need it, instead you have a contract with a supplier who will deliver a specified amount on a schedule and should be able to do so even if the local shops are out.

The NHS like any organisation can overspend on things compared to buying local at times, but that is pretty much always going to be the way if you need a guaranteed supply at a set price over a long period, you're also not exactly doing "like for like" if you compare what you spend on something retail to what you pay to have it delivered (as you aren't taking into account how much it might cost you to go to all the shops needed to get say 5,000 bottles of disinfectant or 10,000 rolls of toilet paper).

One of my friend's works at a major Uni and was telling me of one of the things that happened there over the last year, apparently one department suddenly had a bill for a routine item that went from being insignificant to more than pretty much it's entire normal budget.
It turned out they'd got a "must have" order in with the supplier for an item that usually cost a couple of pounds a box, but because of Covid that item was now extremely hard to get hold of and the cost wholesale to guarantee you got it had gone up something like 10-50x.

On a related not it used to be cheaper for some restaurants to do things like go to the local Tesco/Morrisons/Aldi and buy several hundred tins of beans or a load of veg than it was for them to go to the wholsaler, until the retailers really started to get strict about it as apparently the retailers don't like a business or organisation to clear their shelves.
I remember one time being in my local supermarket when the cashier was refusing to serve someone, when I looked over it turned out that the person had basically cleared the the Baked Beans out because the store's price per tin as something like 10p, which meant it was well under the price (per 100g) of even the cheapest bulk catering tins.

 

[Werewolf]

Do GPs prescribe items such as suppositories anymore? You can get a pack for £2.50. Yet how much money is it costing the NHS for prescribing this?

I'd imagine it depends.

My mum at one point was on a variety of pain killers of different types, IIRC it included Morphine, Ibuprofen and Paracetamol, she was prescribed all three (she had basically a completely failed hip that was at times causing massive amounts of pain and she was at best on two crutches and a mobility scooter, getting to the chemist every couple of days was not an option).
It might have cost the GP's practice something like 10x what it would to buy it, but you can't buy paracetamol more than IIRC 32 at a time at the Chemist (and less anywhere else), which means she would have had to be buying it every few days, so she would get a large box on prescription then every time she, or one of us went anywhere that sold it we'd buy additional packets (to save the GP having to do additional prescriptions)*.

There is more than just an element of "is it cheaper to have the patient buy it" when prescribing, there is also going to be an element of is the patient able to buy something in sufficient quantities, or the correct dosage to cover their needs.
Due to laws on how and when certain items are sold it can make sense for the patient to get things in the prescription that might be cheaper for the NHS to not supply.


*this buying them herself actually raised an eyebrow at a DLA tribunal (which took something like 2 years to reach because the DWP couldn't read their own doctors report, and never bothered to look at any evidence**), where one of the panel queried why she was buying in addition to the prescription, the GP understood instantly as he was able to do the maths on how long her prescribed amount would last vs what was was told to take, and the cost if she'd got a prescription every time (vs the compromise of basically getting 2 weeks supply on prescription and filling the gap saved the NHS at least the cost in time and money of one prescription a month, but getting some of it on prescription saved her multiple trips specifically to buy it).


**Their own doctor stated she couldn't walk. From what I've read that sort of thing was not uncommon and I hate to think how much dealing with that nonsense cost the government.