How to solve the NHS funding crisis

molerat

vivatifosi wrote: »

For example, I heard some commentary this week that if we invested in more district nurses, and they visited the elderly chronically ill in their home once a week in addition to the healthcare assistants, then more of the issues would be picked up on before they necessitated a hospital stay.

Our local surgery has a "virtual ward" where the nurses go out. They have a case briefing each morning just like a real ward. It keeps people in their homes and had saved around hospital 200 bed days in the trial period.

antrobus

caronoel wrote: »

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It works in well funded healthcare systems like the Nordics. It could work here

Can you please state what specific 'Nordic' healthcare system you are referring to, and what exact charges they levy.

ukcarper

Red-Squirrel wrote: »

I'd say that 'poor' means anybody for whom £10 (or whatever the charge may be) represents enough money that it might make them delay going to the doctors about, for example, a slightly iffy mole, or worsening depression, or painful sex, or a possible STI, or an infection that probably needs antibiotics but isn't causing them too much bother just at the moment.

I’d say that’s a very loose description of poor, not all people spend thier money wisely and two people with same income and essential o/g could act differently.

Graham_Devon

Red-Squirrel wrote: »

I'd say that 'poor' means anybody for whom £10 (or whatever the charge may be) represents enough money that it might make them delay going to the doctors about, for example, a slightly iffy mole, or worsening depression, or painful sex, or a possible STI, or an infection that probably needs antibiotics but isn't causing them too much bother just at the moment.

There are plenty of systems out there which we can take the "best" from but keep it so that people don't suffer.

Something needs to happen though, as people are being delayed now due to the huge number of people using the system for everything.

Unfortunately the only thing that will make people think is having to pay for it, somehow.

All those things you mention could be dealt with in pharmacy with the pharmacist. All it would need is the pharmacist to direct you from there if they feel you need further investigations / treatment they cannot provide. The list you presented doesn't need a GP at first call - that's the problem we currently have.

kinger101

Thrugelmir wrote: »

Down to everybody to use the service responsibly. Not expect instant treatment and be cured at the slightest feeling of being unwell. Such as suffering a cold or running a temperature. Or expecting dietary advice to cure being overweight or suffering dietabetes. When as individuals we control what we eat and how much we exercise.

Self diagnosis on the internet is most unhelpfull too.

Our local hospital suffers from a 20% non attendance rate for appointments. Time is valuable. That resource is lost. Never to be recovered.

A recent thing I heard on BBC Radio 4's More of Less indicated that although missed appointments are not without cost, it's a relatively trivial amount. The NHS (just like airlines) tends to overbook as they know they'll be no-shows. So it's not like the healthcare professionals sit doing nothing if Fred Blogs doesn't show up. The costs lost are probably only administrative.

zagubov

kinger101 wrote: »

A recent thing I heard on BBC Radio 4's More of Less indicated that although missed appointments are not without cost, it's a relatively trivial amount. The NHS (just like airlines) tends to overbook as they know they'll be no-shows. So it's not like the healthcare professionals sit doing nothing if Fred Blogs doesn't show up. The costs lost are probably only administrative.

I'd still be tempted to only offer free treatment to those that turn up. More precisely, I'd charge no-shows as private patients. Remind them that free-at point-of-delivery have a high value. And that treating it otherwise isn't an option.

borkid

Graham_Devon wrote: »

There are plenty of systems out there which we can take the "best" from but keep it so that people don't suffer.

Something needs to happen though, as people are being delayed now due to the huge number of people using the system for everything.

Unfortunately the only thing that will make people think is having to pay for it, somehow.

All those things you mention could be dealt with in pharmacy with the pharmacist. All it would need is the pharmacist to direct you from there if they feel you need further investigations / treatment they cannot provide. The list you presented doesn't need a GP at first call - that's the problem we currently have.

That depends very much on the medical history of the person involved. First sign of an 'iffy' mole I'd be to my GP, past history of malignant melanoma. Similarly I'd get my OH to the GP for some as he hardly ever complains. He worked for 3 days with chest pains before he asked 'could I try and get a GPs appointment'. As my GP used to say if you never see someone for years and they turn up there is something wrong!

Thrugelmir

kinger101 wrote: »

So it's not like the healthcare professionals sit doing nothing if Fred Blogs doesn't show up.

Wasted time is one reason behind the low productivity in the UK. My dentist now strikes patients off who fail to turn up. Impossible to fill a void with only 10 minutes notice.

At work I don't attend meetings unless an agenda and/or notes are circulated beforehand. Little point being unprepared for the discussion. As more often or not the time spent isn't fully constructive. Better things to do with my time. Yet many people do fill their diaries with meetings to justify their existance.

Herzlos

Stop paying way over the odds for goods and services.
Refuse supplier deals that prevent shopping around.
Hire more staff rather than using agencies.
In-house things like maintenance and catering.

That could easily being their expenditure down by a quarter whilst improving service.

kinger101

Thrugelmir wrote: »

My dentist now strikes patients off who fail to turn up. Impossible to fill a void with only 10 minutes notice.

At work I don't attend meetings unless an agenda and/or notes are circulated beforehand. Little point being unprepared for the discussion. As more often or not the time spent isn't fully constructive. Better things to do with my time. Yet many people do fill their diaries with meetings to justify their existance.

With NHS dentists, even if you're the first in, the appointments starts 10 minutes late in my experience. By afternoons, it was 1 hour late. There's no void. The next patient is simply called.

My mother routinely received chemotherapy 2 hours after the appointment time.