Physio Appointment via phone call!

Nebulous2

The NHS has been hollowed out for years - with the insidious 3% efficiency savings and the rise in management being primarily to blame. 

When I started in 1980 the hospital I worked at had the matron, a psychiatrist, an administrator who did the finances and a secretary who provided admin support to all of the above. Then there were concerns raised about the cost of the NHS and the fact they couldn't track and didn't know where all the money was going. Within 15 years there were six nurse managers, three general managers,  two HR staff, six admin staff and five finance staff. 

By this point they had a fairly good handle on where the money was being spent,  but the cost in getting there was out of all proportion to any possible savings, with close to 30% of the budget having been diverted to pay this increased infrastructure. 

The efficiency savings likewise started off as quite good fun. There was a small awards scheme with people getting £20-50 for a money saving idea that worked. Some of these ideas really worked, others were slightly cynical  but made a point: "If they let us turn down the heating instead of having to open the windows to cool the place down it would save a lot of money in fuel."  Very quickly however the low-hanging fruit had gone and the 3% turned to desperation.

Running a ward short of staff, while watching the new desks and offices appear in the admin block was dispiriting enough, but then being told that if one of your nurses left there was a six month moratorium on recruitment, where you had to run short for six months before you could recruit a replacement to meet the efficiency standards, was painful. 

I've never been convinced that the arguments about pay for the NHS are the main issue, as it tends not to focus on the poor, appalling even, working conditions. A lack of infrastructure, difficulty getting food and drink during long shifts, inability to get breaks because there aren't enough staff to cover takes a toll on people's own health, both physical and emotional.  I met a nurse who got kidney failure, ironically while working on a renal ward, because of lack of fluids. 

We generally worked eight hour days with a three shift system, five days a week, but now they have almost all moved to three twelve hour days, with a two shift system. While three days a week sounds good, I've been surprised  on dipping my toe back into the NHS, to discover many of them are regularly working five long days. They have become used to doing it to top up their pay, and the NHS has become used to depending on them doing it because they can't recruit. 

Yet the NHS has stepped up during the pandemic, dug deep, done what was asked of them. Some of the choices may not have been the best ones with hindsight, but they appeared the only ones available at the time. There have been no, or very few new resources, some high profile expenditure on nightingale hospitals, that then couldn't be staffed, and ventilators, but nothing on core resources. 

Where did people think the effort to deal with the pandemic came from? People, buildings, resources were to use the current jargon 'repurposed.' 

briskbeats

Very true 
The eye consultant that my father and I have, was on high dependency wards during the peak times of hospital admissions for Covid, plus did emergency operations such as torn retinas caused by DIY etc