Just how can the NHS save money?

A quick google shows you can buy NHS crutches retail for under 15 quid. That's so cheap they might as well be disposable. As already said, collecting, sterilizing and testing they are still usable would cost considerably more.
 
Werewolf said:
Quite possibly.

To reissue the crutches they would need to:
Book them in.
Give them an inventory/tracking number (so the following could be done properly)
Check/replace rubbers (that can be "fun", they are usually extremely tightly fitted).
Check the various rivets are in good shape (there are several that wear/work loose).
Check the arm ring and handle grips are good (the grips have a tendency to shift/work loose).
Clean them (may require dismantling).
Store them.
Document all of the above as having been done by someone with suitable training (and likely done off site as I doubt the NHS has the room/facilities at most hospitals, so that's added costs).

You can buy better crutches than the NHS typically supply for under £30 retail if you know where to go (I used to have to do it for my mum*), and for the NHS to reissue them and be covered for insurance liababilities it would probably cost more than writing them off after one use of several weeks/months.

Wheelchairs tend to be far better constructed than crutches and typically far far more expensive :) (we were lucky to find a local retailer that did them for only about £250, after one scheme** that issued my mum with one via a voucher ended up costing us about £300 on top of a £300 or £500 voucher).

In my experience crutches only tend to last about 12-18 months of use anyway (that was with my mother using an electric scooter for any movement around outside), so any savings would likely be minimal allowing for the cost of the refurb/reissue.


*She was on crutches continuously for about 20-30 years, and it would take months to get replacements via the NHS vs about 15 minutes online, or a 30 minute drive.
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Half of those processes on your list would apply to new crutches too:

Book them in
Give them an inventory/tracking number (so the following could be done properly)
Inspection checks
Store them.
Document all of the above

In a day and age when we talk about Re usability and minimising the costs , this isn't setting a great example.


ci_newman said:
Keep them in the family for next time someone needs them :)
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Or for getting a seat on the train
 
Mass reform...small changes across the entire system would hopefully add up to big savings. For instance...change the way prescriptions work for those diagnosed with lifelong illnesses so that prescription meds are only free if they're related to the illness in question; change the entitlements for NHS sight test and vouchers (should everyone over 60 be entitled to a free sight test?). I'm sure that those who work in the NHS will have hundreds of cost cutting ideas...it's just implementing them in a way that doesn't cost more than the potential savings.
 
Family friend is going through physio at the moment and they've loaned him ~£2,500 worth of kit consisting of an indoor walker/outdoor walker, some kind of memory foam mattress topper and a toilet seat riser(apparantly they're given back to manufacturer to be recycled afterwards). I understand there's a lot of paperwork involved but £2,500 for 4 items seems extortionate. I can't imagine they get much, if anything back from the manufacturer.

The physio claimed to see around 10 patients a day. That's a hell of a lot of money assuming even half of them have similar kit loans.

I'm certainly not suggesting stopping the loans but there must be cheaper options.

He said the physio assistant pulled up in a new BMW M3 they're all from a contracting company so there's most likely a fair bit of overcharging going on there assuming the assistant wasn't sidelining as something else.
 
fatiain said:
I was talking to an ex-paramedic the other day, he said that the packet of plasters you can get in the Pound Shop costs the NHS tens of pounds because of preferred suppliers and contractual obligation.

Yes, £20-£30 for a packet of ******* sticking plasters, because contracts. :mad:
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Ambulances in my region don't carry plasters. This always seems to surprise people, but it makes sense if you actually consider what an ambulance is for.
 
x-st said:
Mass reform...small changes across the entire system would hopefully add up to big savings. For instance...change the way prescriptions work for those diagnosed with lifelong illnesses so that prescription meds are only free if they're related to the illness in question; change the entitlements for NHS sight test and vouchers (should everyone over 60 be entitled to a free sight test?). I'm sure that those who work in the NHS will have hundreds of cost cutting ideas...it's just implementing them in a way that doesn't cost more than the potential savings.
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The issue on free prescriptions for those on lifelong has always intrigued me and I cannot understand why the current system is in place.
I take levothyroxine and will do for the rest of my life. Because I've been prescribed this, all of my medication is free. I have a medical exception certificate and anything I need is covered. This makes no sense.
Anybody who is prescribed levothyroxine is entitled to receive that drug for free. So why isn't that item simply dispensed for free to anybody who requests it? Make the item free rather than giving everyone who is prescribed it an exemption certificate?
I also take anti-rejection drugs for my kidney transplant. Again, make this drug free to all that are prescribed it, don't just give them a certificate.

Although I'd be happy to see everyone's NI contributions increase by £100/year and all prescriptions free.
 
Luke said:
Ambulances in my region don't carry plasters. This always seems to surprise people, but it makes sense if you actually consider what an ambulance is for.
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It's the same with Paracetamol (and presumably most other OTC drugs). 4 packs in the Pound Shop, for a quid, again, tens of pounds because contracts.
 
area51_for_psx said:
I am NHS IT. And we are not well paid. And are on a shoestring budget most of the time. So I doubt what you are saying is true. Am NI NHS if that makes a difference
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NHS IT for the northeast of England covers a massive area. The HQ is located at the southern end. A friend had to drive 90 miles each way to berwick to plug in a mouse for a GP that refused to do it because 'it's not his job'. 2 hours each way. 10 minutes on site. Mileage.
There's then the administration behind that.
Whereas your pay may not be great you don't just cost what you're paid. For a site visit from me my client gets charged 1200 a day. I don't get paid anywhere near that.
 
fatiain said:
It's the same with Paracetamol (and presumably most other OTC drugs). 4 packs in the Pound Shop, for a quid, again, tens of pounds because contracts.
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No, paracetamol costs the NHS the same as Poundland. The overall cost comes down to the GP/prescribing doctor's time, pharmacist time & fees
 
I order admin supplies for my department and I get that type of stuff cheaper than I could at Partners so they've got that side of it right.

When the new GDPR rules come in every Trust is about to lose more money.
People will now be able to request their hospital records free of charge where it did cost £50, our Trust can deal with 6000 requests a year so that is a big loss.
 
even if it was cheaper to clean and restore them(not sure they would, depends how much they pay for them) , it requires a chunk of up front cash to set it up, which they cant find. this is a problem with most of the public sector. there's so much they could do to save money but there's zero amount in the budget for relatively small changes like that. only big budgets for new massive projects.
should be a pot of gold from the government to implement decent changes.

also needs money to switch from reactionary health care to proactive. could start with newborns and follow them.

also I think nhs should be able to sell far more data to research, ai projects etc as long as personally identifiable things are removed.

and seems to be a lack of integration for outside info, 23andme are similar are growing. Yet when I talked to GP about it they weren't interested, even though it suggests some drugs I should avoid. More importantly it wont be many more years till its cheap enough for large numbers of people to get their entire genome sequenced. For others they may be genetically predisposed to a higher risk of certain diseases that if GP knew could tailor yearly or however long monitoring. Often cheaper that way than catching it years after its developed.
 
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My auntie has worked there her whole life (and still does) and paraphrasing her long rant "you used to have a sister running a ward and a doctor in charge, now you have a sister, a manager who is ****, a consultant at twice the cost to help him out, a senior manager who's worse than the one below with two consultants holding his hand and then another sister and a doctor wasting their time telling the management **** heads what to do so they don't **** everything up." :p

Essentially she says they've replaced experts (NHS professionals) with professional managers who know nothing about the NHS and from there the beauracracy has spawned and bloated further to support the management.

She's been in getting on to 40 years so I would assume she knows her stuff.

Ps. I may be getting matron and sister confused before some pedant pulls me :p
 
fatiain said:
I was talking to an ex-paramedic the other day, he said that the packet of plasters you can get in the Pound Shop costs the NHS tens of pounds because of preferred suppliers and contractual obligation.

Yes, £20-£30 for a packet of ******* sticking plasters, because contracts. :mad:
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A quick google search for "NHS drug tariff" could have dispelled that nonsense. Nowhere in the NHS is anyone paying £20+ for a pack of band-aids.
 
No1newts said:
My auntie has worked there her whole life (and still does) and paraphrasing her long rant "you used to have a sister running a ward and a doctor in charge, now you have a sister, a manager who is ****, a consultant at twice the cost to help him out, a senior manager who's worse than the one below with two consultants holding his hand and then another sister and a doctor wasting their time telling the management **** heads what to do so they don't **** everything up." :p
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heard similar from old time nurses, moved from matrons that had real power and kept it ship tight to new systems that not only cost more but have poorer results.
can't comment on how true it is, but I know from my previous jobs things like this is quite common, companies try new things and they don't work and rather than admitting it and reversing it. They keep trying to tweak it to work and/or ignore it so senior management are protected, even if they do stuff up really badly, they are pushed rather than fired with a nice payout and the next manager comes in and tries there big thing to stick on a cv, it's irritating.

currently, some big wig is trying to change ourshifts which no one wants not even lower management and it's obvious it's going to fail, yet they're pushing ahead with it.
 
The ONLY way the NHS will ever save money is by changing our society and culture. You can chuck increasing amounts at it, but the root cause still exists - the way we live, the things we do, the ever worsening standard of personal health that is deemed acceptable, the feelings of entitlement that so many have.
So what if this is the 20th time I've been admitted due to self inflicted alcohol/drug related incidents? I'll be back doing the same next week! So what if this is the 2nd cardiac arrest I've had and 10th admission for lung disease, i'll still smoke and! It is so disheartening to hear a patient demand immediate surgery, or admission, or medication, because their taxes pay for my wages. **** off, you've never worked a day in your life and have cost the country more in health & police resources than 99% of the country.

The whole upper/middle/lower management is a pain, but pales into comparison with the other issues (IMHO).

Still, even as stretched and pressured as this health service it, it is still astoundingly good. Mainly due to the staff.
 
In my previous role, I worked at a trust that had resources cut so badly that they basically had to outsource basic maintenance tasks.

Think about this... a works and estates department that previously would be able to accommodate most typical maintenance tasks and some minor works (like moving a shower room around or putting up stud walls) has to result in getting contractors in. Those contractors are on ££££ as they’re on the approved list... I think they had one electrician, a chippy and a plumber on the W&E team out of a trust of 14,000 staff.

Now, the kicker is that with the current arrangement if a ward wants a shower room moved around they get a quote from the minor works department (a sub department within W&E) who outsource to the approved contractor. This approved contractor gives minor works a price who then add their own 30% markup, so that the ward itself pays well over the odds for the most basic jobs.

I was responsible for the H&S planning for new hospital builds and have seen costs as high as £6000 to take down a plasterboard wall and move some basic services like water and power. I dread to think how much moving oxygen and suction would add to the cost.

It’s depressing because it means if you’re an approved contractor you can screw the trust and still get paid because of no viable alternatives.
 
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