Do people realise how bad the Ambulance service is right now?

[GGizmo]

I've sadly had to go in to A&E multiple times on emergency.

I don't actually know why they take so long to assess people. I know there is delays if they admit you to find a spare bed in the hospital.

But if its just doing blood tests and ECG's then I dont understand why it takes a few hours.

 

[flibbage0]

The situation is dire, I work for the NHS as a pharmacist and have friends that are paramedics, doctors etc and there is a severe shortage of staff. For instance the same job has gone out on 3 separate occasions and on two occasions nobody applied and on the 3rd occasion someone applied but when I interviewed them they were not suitable for the role at all.

Paramedics, pharmacists and nurses are now finding work in GP surgeries as they get a desk to themselves instead of running around the wards all day. Normal 9 to 5/6 and protected learning time. I don't blame them for doing it.

I hate to be political but it does come down to Government funding.

 

[Minstadave]

I've sadly had to go in to A&E multiple times on emergency.

I don't actually know why they take so long to assess people. I know there is delays if they admit you to find a spare bed in the hospital.

But if its just doing blood tests and ECG's then I dont understand why it takes a few hours.

Your typical ED team is pretty small compared to the number of patients and emergency can easily soak up most of your staff. The vast majority of ED patients never see resus so don't see the emergency care having to provided whilst the masses sit around in Majors/Minors.

 

[throwaway4372]

there's meant to be census 2021 results soon afaik

 

[McBain]

NHS is a joke, it’s been a joke for a very long time. Don’t worry we will get taxed more with zero improvement.

 

[ColdAsIce]

I doubt many, including those of us who work in Ambulance Services, really understand the issues at play but I have a few observations:

1: Demand has increased, though I suspect that staffing numbers have increased too. I don't think it's fair to blame users of the service for the problems. At least not exclusively.
2: Ambulance Services are under greater pressure than ever to treat at scene. When I started over 11 years ago the main focus was on safely transporting patients to hospital. If you were a diabetic having a hypo you quite possibly went to hospital. Now you'll quite likely be treated at home. This is usually great for those patients, and should be recognised as good patient care but it does mean crews spend longer on scene than they used to and may mean that additional staff attend to facilitate treatment the first crew on scene recognise is likely to allow the patient to be left at home but can't administer themselves, thus reducing the nu!bet of available resources.
3: As mentioned turn around times at A/E are longer than they have been. If there are no beds in A/E for patients arriving by ambulance and they're too unwell or vulnerable to wait in the waiting room crews can't free up. There's no space in A/E because there's no beds for the patients in A/E to be moved into and those beds aren't free, in part, because social care is a mess and those requiring it spend longer than clinically necessary in hospitals while it is arranged.
4: Demand and (at least perceived) disinterest and unacceptable delays accessing primary health care either from NHS111/NHS24 or GPs is 'forcing' some to call 999 for things they perhaps wouldn't otherwise call for. This could also be said for social problems too. While these calls don't always generate an ambulance response they do take up service time and resources regardless. This is partly down to a lack of GPS and other primary health care practitioners.
5: A higher percentage of patients are more ill than they perhaps need to be. Whether that's because chronic condition management and routine testing stopped during the early Covid pandemic and therefore problems went unnoticed until they became emergencies or for other reasons I don't know.
6: Staff sickness and retention is a problem. I make roughly the living wage and I have delivered babies, I have talked people through CPR more times than I can count, including on babies and children and in a variety of horrific circumstances. Working overnight at Tesco stacking shelves would be a lot less responsibility and stress for not really that much less money. I know of many people in my service who have left or are actively looking to leave. Vocation or not, there comes a point when enough is enough. I
7: Poverty with its associated poor mental, substance misuse, crime, poor diet and low exercise levels, is also a factor I think. Poor people are really struggling and that affects their health.

I'm not sure how you fix things. Addressing some of these things, or all of them would help I think. It takes money but it also takes a longer term, joined up approach - something government's are poor at. You can't look at any one part of our social matrix in isolation. You can't fix the ambulance service with improving social care, without improving social equality, without improving education etc. It's all connected

It’s terrible that your skills and care are worth just enough to get by. Like you say nightshift in Tesco stacking shelves with no responsibility and a podcast on and you wouldn’t lose much overall. This cannot continue.

 

[Worthy]

I've cleaned this thread up and reopened it. Sorry if I've had to delete a few posts that maybe only borderline warranted it, but I had to ditch the whole conversation after it started going down a certain route.

To the rest of you, you know who you are. I'm not in the mood today, any more of your knuckle-dragging nonsense dragging yet another thread into an argument, and it's hammertime. A week minimum - we'll go up from there.

 

[GGizmo]

I wonder how much of it is a backlog from GP's directing people to other places?

I'm not sure if people can walk in to my GP surgery without an appointment.

I'd imagine if an A&E unit is bombarded with low risk people then unless they want to start removing people from beds I'd have thought it would eventually have an impact on people coming in with Ambulances?

Is the backlog with Ambulances caused by them having to wait at the A&E?

I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?

 

[ColdAsIce]

I wonder how much of it is a backlog from GP's directing people to other places?

I'm not sure if people can walk in to my GP surgery without an appointment.

I'd imagine if an A&E unit is bombarded with low risk people then unless they want to start removing people from beds I'd have thought it would eventually have an impact on people coming in with Ambulances?

Is the backlog with Ambulances caused by them having to wait at the A&E?

I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?

Yes GPs are adding to the additional load. If they won't even see you then what option do you have? Might as well take yourself to A&E and wait it out.

 

[Puzzled]

I've heard the main issue with bed numbers isn't the physical beds available, but how many people are supposed to cover a number of beds. Can't the government temporary change the law to allow for it to be more beds per nurse than it currently is to free up more beds available?

Problem we have at the moment is staff (particularly nurses) leaving due to being overworked and stressed so giving them even more patients to look after won't go down well.

The NHS needs more staff, recruitment from abroad is still attracting applicants but we need to do more to support people here who want to become a nurse, doctor etc.

Nearly half of the new nurses and midwives registered to work in the UK in the past year have come from abroad.
The total - more than 23,000 - is a record high and comes as the UK has struggled to increase the number of home-grown nurses joining the register.
Nurse leaders questioned whether international recruitment on this scale was sustainable.
The Nursing and Midwifery Council data for 2021-22 also showed the numbers leaving the profession had risen.
More than 27,000 left the register last year, up 13% on the year before and reversing a downward trend in leavers over recent years.
In many ways this was always expected as significant numbers of staff put off retirement to help out in the emergency phase of the pandemic.
And retirement was certainly the main factor - more than four in 10 cited this - although nearly one in five also blamed too much pressure.

• Call for long-term plan to help 'burnt-out' nurses
• Nursing shortage warning as winter looms

Overall the numbers on the register, which also includes a small number of nursing associates, rose by nearly 26,500 to more than 758,000, the highest number ever. One in five are from abroad.
Nearly all of the international recruits that have arrived in the past year were trained in countries from outside Europe - before Brexit Europe supplied more than the rest of the world. India and the Philippines are the countries which are supplying the most.

Half of new nurses and midwives come from abroad

International recruitment hits record high with nurse leaders warning about sustainability of trend.

www.bbc.co.uk

 

[Jono8]

The economy and society is likely going to implode soon.

The greed of the rich will be to blame.

 

[Chris Wilson]

Hihe economy and society is likely going to implode soon.

The greed of the rich will be to blame.

The impractical aspirations that the poor have been given, especially the poor younger generations is also blameworthy. It has left at least two generations disgruntled with their lots

 

[Jono8]

The impractical aspirations that the poor have been given, especially the poor younger generations is also blameworthy. It has left at least two generations disgruntled with their lots

There is an element of truth to this, yes.

"You can do anything/be anything if you put your mind to it" is one of the the biggest and most dangerous lies ever told.

 

[Chris Wilson]

A damning verdict on a local, large hospital trust who were already the subject of horrendous lack of care charges.

Shrewsbury and Telford NHS Trust admits failures after two patients die​

A hospital trust has been fined more than £1.3m after admitting failures in care that contributed to the deaths of two patients.
One of the charges related to the death of patient Mohammed Ismael Zaman in 2019 at the Royal Shrewsbury Hospital.
The 31-year-old died of severe blood loss while undergoing dialysis, Telford Magistrates' Court heard.
Max Dingle, in his 80s, died after his head became trapped between a mattress and bed rail during hospital treatment.
Shrewsbury and Telford Hospital NHS Trust (SaTH) admitted three counts of failing to provide treatment and care in a safe way, resulting in harm or loss, between October 2019 and May 2020.
Charges were brought against the trust by the Care Quality Commission (CQC) under the Health and Social Care Act 2008.

Shrewsbury and Telford Hospital NHS Trust has also faced intense criticism over maternity failings
Representing the CQC, Ryan Donoghue said the failures in Mr Zaman's care "were the legal cause of his death, for which the trust is responsible".
He said Mr Dingle, who had been admitted with chronic lung disease, died from a cardiac arrest after he was freed.
"The basis [of the guilty plea] is that the failures exposed him to a significant risk of avoidable harm," Mr Donoghue said.
As well as the two deaths, the CQC accused the trust of exposing other patients to significant risk of avoidable harm.

'Devil and deep blue sea'​

In court, SaTH accepted it would take considerable time to rebuild trust with the local community after entering guilty pleas.
The trust is currently £60m in debt and during the hearing the judge acknowledged every pound he fined the trust would be "a pound that doesn't go on patient care".
"It's a devil and deep blue sea exercise," the judge said. "In the end, fines make patients suffer."
The trust was recently subject of a damning review into its maternity services.
The Ockenden review, published in March, found "repeated errors in care" at the trust contributed to the deaths of 201 babies between 2000-2019.

These cases were neither funding nor staffing issues, but pure unadulterated negligence and incompetence in my opinion.

 

[inferno]

The impractical aspirations that the poor have been given, especially the poor younger generations is also blameworthy. It has left at least two generations disgruntled with their lots

Social media and the internet too. Everyone knows just by looking at their phone how much they are getting screwed on a daily basis.

 

[Roar87]

There is an element of truth to this, yes.

"You can do anything/be anything if you put your mind to it" is one of the the biggest and most dangerous lies ever told.

I mean, it isn't, it's actually an incredibly good thing to say to people since it encourages them to aim for goals they might otherwise think are out of their reach. Surely they're going to be in a better position simply by having strong aspirations than if they were told not to bother trying? How is it dangerous?

 

[Blackjack Davy]

Yes we're aware. The NHS is usually pushed to the limit over winter only to level out over the summer months. Except the last couple of years the NHS has become the Covid Treatment Service and coupled with the total unwillingness to do anything to limit infections and hence hospitalisations we're where we are now. We also have one of the lowest number of spare capacity in beds in europe to boot. So add it all up and we're where we are now.