NHS Fail

[Xordium]

Defeated - jesus is that the way your mind works.
Let's take all your stupid points one at a time then:

The argument of under funding may be valid but the simple fact is in any business with cash flow problems is they cut their cloth accordingly and find ways to adapt and get better.

No, lot's of businesses go bust. The NHS can't afford to do that. How do you suggest we cut the cloth? Stop treating who exactly (oh I see you've had some stupid ideas on that below) and get better - how can they get better without the required number of staff or the required equipment to do the job ...

From the outside looking in (and with anecdotal evidence from friends/family who work in the service) there seems to just be no willing to improve, the solution seems to be keep demanding more. That isn't reality, even if it was met halfway and improvements were made alongside funding increases it might help but there is nothing (again from the outside looking in)

So you admit you've not got a real clue here. Thanks that makes it easier so I don't have to point out the obvious about an increasingly elderly population and increasingly more expensive treatments costing more money and all that obvious stuff ...

One thing they could do instantly is remove all plastic surgery & weight loss stuff, I don't know what the spending is on these services but I don't understand why they are offered free of charge.

You mean like for the craniofacial patients who are frightened to leave house because of the way they look? Or the burns victims? That plastic surgery - yer ok.

Weight loss programs you mean like in preventative medicine that shown time and time again to give massive cost savings, improve the quality of life and lighten the workload on a stretched system.

my wife was in hospital for a few nights on the menu she had a choice of about 8 meals, simplify the menu to cut costs (you can bulk buy to reduce expenditure)

Yes, I am sure all the people will love that! Diabetic - meh - different culture - meh - paediatric patient - meh - PKU - meh, sod em all eh they can eat gruel!

Why not stop using agency staff? I know they do vital jobs but if you give them a choice of a full time job or not a penny into their bank they would probably fold.

Yes, totally lets take the most expensive part of the NHS (the nursing budget) and double it overnight - that is change management in action! Because every ward has the same number of patients with the same dependency day in day out throughout the year!

I'm not in the NHS and that took 2 seconds thought so I'm certain if there was a real, in depth review they could sort it out. I do change management and I know without seeing a single thing inside the NHS I could save huge amount of money with very little effort. You can do that in any business that hasn't been heavily leaned and I would hazard there is only one type of leaning the NHS know about (**** joke, sorry )

Yer, like I said it was obvious you took 2 seconds - btw the NHS has primarily run on lean principles for over 10 years most hospital were using Toyota's and Ford's implementations of them before the word lean had even been thrown around.

 

[No1newts]

Not just the elderly but mainly.
We could also take them to care homes but families say no.

Perhaps free bed for X time then charges after this point?

But like over running your car park space

 

[d_brennen]

The NHS has non-medical management staff. If a trust overruns it budget, sack them, and the next mug who takes the job. Why on earth fining a struggling organisation is a good idea, I do not know

 

[SexyGreyFox]

I hate to think how much DNAs cost (Did Not Attends) which are different to Cancelled.
The vast majority of patients I look at who have Outpatient appointments have at least 5 DNAs to their name which means they have done 5 other patients out of an appointment..
I haven't got a figure for DNAs every day in the hospital but last week I was at the GPs and there was a sign saying 'This month we had 135 people who didn't turn up for appointments'.
If this is typical of every outpatient department the cost must be phenomenal.
The NHS would be brilliant without patients, they get in the way.

 

[No1newts]

Snip

Are you purposefully being ironic? If not stop for a moment, can you see the irony in what you are saying in answering my points?

If you can let me know, or ask nicely and I'll explain.

 

[Deleted member 66701]

Sorry, I've been told today on here that anecdotal evidence counts for bugger all I'm afraid. I'd like to believe you and change my opinion!

Fair enough.

 

[Xordium]

Are you purposefully being ironic? If not stop for a moment, can you see the irony in what you are saying in answering my points?

If you can let me know, or ask nicely and I'll explain.

So you've started this thread, you've come up with some stupid ideas, and now you've been called out on them you can't respond to any of the points raised.

 

[Dis86]

Fair enough.

Believe me I would!

 

[Deleted member 651465]

THIS IS WORTH READING

Anyway here's a few little facts about our hospital.
Our A&E is capable of dealing with 250 patients a day but for some reason we get 400+ a day.
We opened up a walking wounded A&E called Ambulatory Emergency Care to deal with the A&E overspill to look at 30 patients a day - there are now over 100 a day.
I personally know two people who turned up at A&E this week - one with stress and the other with a runny eye.
Every day we need to admit 150 patients into wards however we have 200 patients a day who are Ready For Discharge, in other words they can go home.
Why can't/don't they go home? - because families won't collect them until the weekend and we can't take them home because the families won't let us.

Standard practice. Just this week I met with one of the consultants to do a risk assessment for triaging patients from the back of an ambulance, in the car park!

 

[No1newts]

So you've started this thread, you've come up with some stupid ideas, and now you've been called out on them you can't respond to any of the points raised.

Ok you don't understand, I'll spell it out.

I clearly stated I didn't know any NHS specifics, I clearly stated they quick spitballed ideas, I clearly stated I had no inside knowledge or expertise.

Note the above? That is what you have used as your criticism of the arguments (that were not even put forth as substantial points for discussion in the first place but let's not even bother going there) hence the irony in what you are saying. If you want an argument you'll have to go elsewhere.

You're welcome for the explanation, you could have just asked.

Can we get back on topic now?

 

[Jas1975]

But if there is no punishment for point 1 where is the motivation to cost cut and reform?

We have been at both your point 1 & 2 for a decade now and nothing has really changed when there has been accountability, when you remove it why would it suddenly then get better?

From the other side of the coin (answering from the NHS point of view) ...

It won't. I don't understand why you would see it as a fix?

I also don't know why are you seemingly outraged at the inevitable results of economics? No money - no services. Again fairly simple to comprehend. If it were a private business it would be insolvent and wound up. But the NHS hasn't that option, it has to continue. If you see corporate / exec mismanagement being the cause of the issues then I welcome you to spend a day with us. If your issue is with under funding from successive governments then at least we agree on something, but I suspect from your posts that this isn't a government rant.

The link you provided offers the commodity of time. It gives the chance to implement changes without having further penalties applied to budgets that across the UK have been blown out of the water.

I'll put it into perspective.

An average trust has a budget of £350 million pounds a year. IT investment for a privately run business would normally run at 3-5% of that figure. Currently within the NHS, IT investment will probably be approved at 0.1% to maintain IT services. Estates are the same. Heating, lighting, cooling, buildings maintenance - everything that isn't patient care has been stripped down to the very bone, there is minimum wastage.. There is nothing left to cut. Option 1 is the only route left.

Something needs to change, but the public won't like what it is....

Having someone believe they are entitled to tens of thousands of pounds worth of services based on the assumption that they have paid their £50 per month in National Insurance doesn't work anymore. It hasn't for years - so what is left to do? Do we cause outrage by taking away what has now become expected?

Circle Health failed to run Hitchingbrooke as a profitable franchise. That case has been well documented. But personally I believe elements of the NHS could and should be privatised. That would alleviate the pressure. We cancel non-essential surgery, you want it - you pay for it. Charge relatives who see the NHS as a free care home a daily rate.

The NHS has to evolve if it is to survive - by suspending the penalties gives time to come up with new ways of doing things. The government otherwise would be fining and cutting the budgets of 99% of the hospital trusts in the UK.

 

[andshrew]

You say this...

I do change management and I know without seeing a single thing inside the NHS I could save huge amount of money with very little effort.

and go on to suggest some of the most short-sighted cost saving measures and then get upset when Xordium calls you out on them. OK.

 

[Danthus]

The fact that different trusts pay different prices for items is a rather obvious place to start to be fair.

 

[No1newts]

You say this...



and go on to suggest some of the most short-sighted cost saving measures and then get upset when Xordium calls you out on them. OK.

Bad wording there fair point, the very little effort part is what I meant. I missed that I had said "without seeing anything" my apologies, by that I mean with any business who isn't far down the lean path there are clear savings generally easiest in processes around purchasing and similar departments. My bad wording though.

 

[Silly Goose On The Loose]

Something about EU migrants.

 

[V F]

Hey guys, I have a great idea... Why don't we privatise the NHS and make it profit driven lolz

All the best

David Cameron

I thought it had been for a long long time...

 

[No1newts]

I think it has been driven to cut its operating costs and run more sensibly, turning profit from that beast is an impossible dream

 

[Tefal]

So your defence is effectively.


"Hey guys i have a stupid idea!!!"


"That idea is stupid"


"Omg you can't criticise it for being stupid i said it was stupid, THE IORNING!!!111!!!"

 

[No1newts]

So your defence is effectively.


"Hey guys i have a stupid idea!!!"


"That idea is stupid"


"Omg you can't criticise it for being stupid i said it was stupid, THE IORNING!!!111!!!"

When I hadn't realised I had made a mistake then yes it was.

Whenever you do an PACS workshop on something new (or fixing something broken) best way to start is to throw out ideas that come in to your head to get things going no matter how crazy/stupid or whatever else they may be considered.

Always like the saying "when you eliminate the impossible whatever remains no matter how improbable, must be the truth" ok it's a slightly warped usage but you can consider everything no matter how stupid the basic idea sounds as it leads to further thinking perhaps reaching a solution no one would even considered in the first place without the initial daft idea.

 

[treacle]

terrible news.