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Plan For Two-Tier A&e

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Why do people go to A&E?

Because -

they can't see a GP during the day.

they can't see their own GP during the evening.

the pharmacist can't prescribe the right stuff

they have no idea whether the expensively built walk in centre is actually open anymore

they have no idea a walk in centre is available

they get depressed trying to ring their GPs out of hours service.

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Plan for two-tier A&E as part of radical shake-up

http://www.bbc.co.uk/news/health-24914385

NHS medical director Prof Sir Bruce Keogh, who led the review, said: "A&E is creaking at the seams. It is not broken, but it is struggling.

Nothing to do with the fast growing population then.?

The solution is quite simple..............

Sack all Management and admin staff and employ a matron

sack and ban ALL agency staff and actually employ nurses

stop these stupid form filling time wasting rubbish

Stop ALL the frivolous compensation claims - the human body will never be understood, so sometimes "fixing your illness" goes wrong - Tough!

If they did ALL that the cost of the NHS would halve

(spoken as an ex and very frustrated NHS employee)

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snip

Stop ALL the frivolous compensation claims - the human body will never be understood, so sometimes "fixing your illness" goes wrong - Tough!

snip

frivolous claims need not be responded to or defended.

Actual negligence needs to be weeded out, and sacking doesnt seem to be an option unless you murder 50 old ladies.

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frivolous claims need not be responded to or defended.

Actual negligence needs to be weeded out, and sacking doesnt seem to be an option unless you murder 50 old ladies.

Indeed. A big difference between acceptable risk of treatment and harm caused by human or system error/inaction (which is all too rife, unfortunately. That being said, people struggling to do more with less, system creaking at the seams etc)

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The solution is quite simple..............

Sack all Management and admin staff and employ a matron

sack and ban ALL agency staff and actually employ nurses

stop these stupid form filling time wasting rubbish

Stop ALL the frivolous compensation claims - the human body will never be understood, so sometimes "fixing your illness" goes wrong - Tough!

If they did ALL that the cost of the NHS would halve

(spoken as an ex and very frustrated NHS employee)

Somewhere, hidden in this post, is a hint of why the NHS causes about 30,000 avoidable deaths a year... <_<

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Somewhere, hidden in this post, is a hint of why the NHS causes about 30,000 avoidable deaths a year... <_<

Would this be......

most wards are staffed with "care worker" type staff with very little training, they are usually not even employed directly by the NHS, they are on rock bottom minimum wage and cannot wait to clock off

because severe staff shortages result in agency staff (that cost a hell of a lot more than employing nurse would cost)

those same agency staff do not fully understand the systems or patients on a ward they only arrived on this morning

those same agency staff don't really care much

or would it be a department managed by an accountant who doesn't really care how many heart attacks were admitted last night - only about how much over budget they went and why were the "stats" forms not completed correctly

avoidable deaths are difficult to define, but almost all deaths occur due to lack of qualified staff who can actually treat someone, Oh but they are busy in the office filling in the stat forms...... :angry:

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Why do people go to A&E?

Because -

they can't see a GP during the day.

they can't see their own GP during the evening.

the pharmacist can't prescribe the right stuff

they have no idea whether the expensively built walk in centre is actually open anymore

they have no idea a walk in centre is available

they get depressed trying to ring their GPs out of hours service.

Yes all of those......and why would they want to go and pay for very expensive medications at a pharmacist when they can get it all for free at the hospital? ;)

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I think its a bit of a postcode lottery. My current local surgery is very good. Been in a half dozen times last couple of years and always good and always get an appointment that day. However, past surgeries have been crap and some of families treatment with the NHS has been crap too.

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The NHS Pincer death:

A massive burden of boomers retiring en-mass on one side along with the neo-baby boom massing on the other.

Three phrases I am sick of

1 "Baby Boomers"...albeit shortened to Boomers.

2 "Keep calm" and do whatever.

3 Kicking that freakin can somewhere down some freakin road.

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The solution is quite simple..............

Sack all Management and admin staff and employ a matron

And who deals with HR? Recruitment? Account management? Who deals with complaints? Or libel matters?

stop these stupid form filling time wasting rubbish

Citation needed. What forms?

Stop ALL the frivolous compensation claims - the human body will never be understood, so sometimes "fixing your illness" goes wrong - Tough!

And then were is the motivation for a member of staff to do their job properly if there is no risk? Libel protects the consumer and holds the NHS to account.

If they did ALL that the cost of the NHS would halve

No it wouldn't.

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avoidable deaths are difficult to define, but almost all deaths occur due to lack of qualified staff who can actually treat someone, Oh but they are busy in the office filling in the stat forms...... :angry:

What forms are these?

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Yes all of those......and why would they want to go and pay for very expensive medications at a pharmacist when they can get it all for free at the hospital? ;)

Ah you think people are so tight they won't spend a few quid at the chemist on a prescription (There's something call Pharmacy first - which allows a pharmacict to prescribe certain bits of stuff but I don't think it covers good painkillers or antibiotics..it might though.. never really found any info on it that was useful)

and would rather sit in A&E for 3+ hours?

They could almost do a vending machine for the stuff they dispense.

Our GPs had a BP machine in the foyer until they realise it was actually very stressful sitting in public having the world and his wife watching you.

And a very small number of people pay for prescriptions don't they?

http://www.politics.co.uk/reference/nhs-prescription-charges

However, many people are exempt from paying this fee; indeed according to the Government, 88% of prescription items are dispensed free of charge.

http://www.nhs.uk/NHSEngland/Healthcosts/Pages/Prescriptioncosts.aspx

You can get free NHS prescriptions if, at the time the prescription is dispensed, you:

are 60 or over

are under 16

are 16-18 and in full-time education

are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)

have a specified medical condition and have a valid medical exemption certificate (MedEx)

have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx

hold a valid war pension exemption certificate and the prescription is for your accepted disability

are an NHS inpatient

You are also entitled to free prescriptions if you or your partner (including civil partners) are named on, or are entitled to, an NHS tax credit exemption certificate or a valid HC2 certificate (full help with health costs), or you receive either:

Income Support

Income-based Jobseeker’s Allowance

Income-related Employment and Support Allowance, or

Pension Credit Guarantee Credit

Universal Credit

Find out more about the NHS Low Income Scheme (LIS).

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And who deals with HR? Recruitment? Account management? Who deals with complaints? Or libel matters?

In my experience (I've worked in NHS IT for about 20 years, initially within but now for an outside supplier, and my wife is a full-time nursing sister, although she took several years off to raise our kids), the big shift came about in the 90s under the tories with the introduction of the nhs market, etc. Basically, this required another level of admin and management. IT too now plays a bigger role, so that's another layer there.

However, the biggest change, in my wife's opinion, is indeed the amount of form-filling now required. The concurrent change is that new nurses can be remarkably poor in their ability to place patient welfare first. The unintended consequence of targets has been that staff now target the target, rather than actually giving the kind of care that would allow those targets to be meant naturally. Well, what did anyone expect?

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Ah you think people are so tight they won't spend a few quid at the chemist on a prescription (There's something call Pharmacy first - which allows a pharmacict to prescribe certain bits of stuff but I don't think it covers good painkillers or antibiotics..it might though.. never really found any info on it that was useful)

and would rather sit in A&E for 3+ hours?

A friend of mine is a paramedic in London.

He spends a lot of time attending to people who have phoned an ambulance because they want some paracetamol.

He has managed to go for weeks on end without attending someone who needs medical attention, let alone emergency care.

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In my experience (I've worked in NHS IT for about 20 years, initially within but now for an outside supplier, and my wife is a full-time nursing sister, although she took several years off to raise our kids), the big shift came about in the 90s under the tories with the introduction of the nhs market, etc. Basically, this required another level of admin and management. IT too now plays a bigger role, so that's another layer there.

However, the biggest change, in my wife's opinion, is indeed the amount of form-filling now required. The concurrent change is that new nurses can be remarkably poor in their ability to place patient welfare first. The unintended consequence of targets has been that staff now target the target, rather than actually giving the kind of care that would allow those targets to be meant naturally. Well, what did anyone expect?

:D:D:D

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Class.

No wonder people just cut all this crap out and go directly to A&E

Unfortunately people don't realise they're quite likely to be seeing a doctor with 1 or 2 years experience, rather than the minimum of 5 for a GP.

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A&E apartheid. Camerdontcare?

Try again NHS chiefs, you must have totally forgot about politics (surely it is within your pay scale to have thunk about that?)

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Having worked in a hospital many years ago I was always told that the role of AE was to carry out triage and to stabilise the most serious cases before passing them on to specialist hospitals. The concept of specialist AE dealing with things like heart attacks and strokes (conditions that can anyway vary in severity) seems an oxymoron. Presumably the proposal is just cover for more cuts in patient care so that tax payer money can be spent on the important things like health managers bonuses etc.

Edited by stormymonday_2011

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