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30% pay rises for NHS workers.


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I never said that. If you can point me to my thread where I said that then, well I, apologise.

Otherwise you can.

 

On ‎22‎/‎03‎/‎2018 at 9:51 AM, spyguy said:

 

The number of mistake made due to missing andor wrong paitent information is shocking - there seems a race to see the hospital can cure more people than it kills. All down to what is trivial information.

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2 hours ago, Warwick-Watcher said:

Southern Health fined GBP 2 million. Where does that money go? To the Exchequer presumably? And where does SH funding come from - the Exchequer? They need to personally fine the management otherwise nothing changes (I accept it may become harder to find people to act as managers in this event).

Very good point. So the end result is - nothing actually happens aside from the Chief Exec finally making an apology on TV and that's that.

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5 hours ago, kzb said:

The term bed blocker I find demeaning.

There are only about 60% of the hospital beds now as there used to be.  In the same time period the population and particular the older population has increased significantly.

In that same period the NHS budget has almost tripled in real terms.

The reason they want you out of hospital is because Social Care is means-tested (and NHS care is not).

What you should be asking about is value for money.  Why is the budget tripled and we get less for it?  Economists measure "productivity" in the NHS falling by about 5% p.a. Others argue about this but it tells us something.

I gave you one of the answers to this upthread in that Spectator article.  There are of course many other reasons but I bet that is the most fundamental one.

I dont find bed blocker demeaning.

Having oap in an acute hospital longer than they should, or even when they should be is a scandal and should be called out.

LA and the oaps estate need billing 800/day for each oap.

Then theres the health risk. You want keep people away from hospital. The more people, the more risk. Look at norovirus shutting hospitals. Mainly caused by oaps.

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2 hours ago, PopGun said:

 

I said 'seems a race'.

The number of accidental deaths and injuries in yhe nhs is too high. Its mainly dumb stuff like wrong documentation.

A read of tge never events is eye raising. How can a process involving large number of people but still manage to perform the operation.

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4 hours ago, Warwick-Watcher said:

Southern Health fined GBP 2 million. Where does that money go? To the Exchequer presumably? And where does SH funding come from - the Exchequer? They need to personally fine the management otherwise nothing changes (I accept it may become harder to find people to act as managers in this event).

I guess the people paying the price are the next patients in the queue.  They'll have to wait longer for treatment.

Insane.

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3 hours ago, spyguy said:

I said 'seems a race'.

The number of accidental deaths and injuries in yhe nhs is too high. Its mainly dumb stuff like wrong documentation.

A read of tge never events is eye raising. How can a process involving large number of people but still manage to perform the operation.

Back tracking I see...

why don’t you share the safety and performance numbers of the hospitals run by circle and serco..

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2 hours ago, spyguy said:

I said 'seems a race'.

The number of accidental deaths and injuries in yhe nhs is too high. Its mainly dumb stuff like wrong documentation.

A read of tge never events is eye raising. How can a process involving large number of people but still manage to perform the operation.

 

There are many reasons behind this, but some is made a lot more difficult due to changes in the way of working. For example, junior doctors who do a lot of medical leg work and documentation increasingly work complex rotas where every day they see a different random selection of in-patients, so they have no knowledge of individual cases. 

For example, this means that if there is a dangerous test result, the contact details on the request form often turn out to be someone who's doing a totally different job on that particular day, and not the person that needs contacting. Equally, it can also mean incorrect documentation as the reason for test.

Then there is pressure of time. It would be nice to have time to double check things where possible. 10 years ago when I was training, if a doctor sent a request for a complicated test, like an MRI, there would be some time to check the notes before doing the scan, and double checking what questions need to be asked before scanning to ensure that the correct body part is scanned with appropriate scanner settings, etc. to give the best chance of answering the relevant question. This was fine if a department was doing 30 complex scans per day. Nowadays, it might be 200 scans with only 2x the medical staff. The first thing to go has been the double checking.

The problem is that the NHS has been notoriously bad at communication. Most hospitals are still using numeric pagers as the main mode of communication, which makes it impossible to tell if a call is urgent, requires access to a telephone, and assumes that no one else will try to call the paging party and block the line. When I was a junior in one job I used to get about 100 pages per shift, about 20% of those failed because by the time I could get to a phone which was not engaged, the other phone was engaged, or the calling party had been paged to something more urgent, so someone random picks up the phone and knows nothing. There are ways to mitigate this of varying complexity and technology, but getting buy-in is difficult. It also doesn't really help accurate, time-consuming and mentally intensive work when someone is getting interrupted on average every 5 minutes.

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20 hours ago, spyguy said:

I dont find bed blocker demeaning.

Having oap in an acute hospital longer than they should, or even when they should be is a scandal and should be called out.

LA and the oaps estate need billing 800/day for each oap.

Then theres the health risk. You want keep people away from hospital. The more people, the more risk. Look at norovirus shutting hospitals. Mainly caused by oaps.

I know you're trying to be provocative.

I know of a sick 90-year old turfed out of hospital at 4.00 a.m.  Dropped off outside his unheated empty home, ambulance drove off and left him to it.

I hope you're looking forward to this when you're that age.

The other thing you need to know is, if you're not compos mentis you don't stand a chance against the NHS.  Old people are not accustomed to the utter incompetence of modern management systems.  They have this faith that things will work for them, when of course nothing does.

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Just now, kzb said:

I know you're trying to be provocative.

I know of a sick 90-year old turfed out of hospital at 4.00 a.m.  Dropped off outside his unheated empty home, ambulance drove off and left him to it.

I hope you're looking forward to this when you're that age.

The other thing you need to know is, if you're not compos mentis you don't stand a chance against the NHS.  Old people are not accustomed to the utter incompetence of modern management systems.  They have this faith that things will work for them, when of course nothing does.

Thats wrong too.

Rather than handle it in a sane, balanced manner.

You suddenly get these cases where oal people are kicked out at stupid times.

Again, neither letting OAP hang around or kicking them out at stupid times of the time gives me much confidence in how the hospital is run.

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2 minutes ago, kzb said:

I know you're trying to be provocative.

I know of a sick 90-year old turfed out of hospital at 4.00 a.m.  Dropped off outside his unheated empty home, ambulance drove off and left him to it.

I hope you're looking forward to this when you're that age.

The other thing you need to know is, if you're not compos mentis you don't stand a chance against the NHS.  Old people are not accustomed to the utter incompetence of modern management systems.  They have this faith that things will work for them, when of course nothing does.

There's nothing provocative about avoiding putting people who are not sick into an acute hospital.

Acute hospitals are for the very sick, not the old, inform or confused.

Could the insane, NHS centric wy of thinking have resulted the UK in spending billions rather than than millions on an OAPs sheltered accomodation?

As far as 'Would you like ...' if Im 90 and have a cold or some minor ailment then I would not expect to be going to a hospital.

 

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14 minutes ago, spyguy said:

There's nothing provocative about avoiding putting people who are not sick into an acute hospital.

Acute hospitals are for the very sick, not the old, inform or confused.

Could the insane, NHS centric wy of thinking have resulted the UK in spending billions rather than than millions on an OAPs sheltered accomodation?

As far as 'Would you like ...' if Im 90 and have a cold or some minor ailment then I would not expect to be going to a hospital.

 

When there is this much pressure on beds these things are bound to happen.

We still do not know how the budget is tripled and we end up with half the number of beds.

We also have far fewer beds per head of population than other first world countries.

The number of beds has been cut far too much.

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52 minutes ago, kzb said:

When there is this much pressure on beds these things are bound to happen.

We still do not know how the budget is tripled and we end up with half the number of beds.

We also have far fewer beds per head of population than other first world countries.

The number of beds has been cut far too much.

Reeducation in beds is down to most procedures being outpatients. Tnats a good thing.

Well ... its gone on salaries. 80% of health spend is salaries.

Whether it should is not matter.

The cost of a bed in an acute hospital is about 5x more than a bed in sheltered accommodation. Having OAPs hang around i n hospital is a gross waste of money.

And, having a system thats encourages an OAP to lie baout for a few days is bad for the OAP. They lose muscle rapidly.

 

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1 hour ago, spyguy said:

Reeducation in beds is down to most procedures being outpatients. Tnats a good thing.

Well ... its gone on salaries. 80% of health spend is salaries.

Whether it should is not matter.

The cost of a bed in an acute hospital is about 5x more than a bed in sheltered accommodation. Having OAPs hang around i n hospital is a gross waste of money.

And, having a system thats encourages an OAP to lie baout for a few days is bad for the OAP. They lose muscle rapidly.

 

UK is 30th in the OECD in hospital beds/capita.  Germany is about 3X UK, France X2, even poor countries like Poland are over X2.

It's gone in salaries....yes no doubt !  But who's salaries?  Lawyers and business managers?

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1 hour ago, kzb said:

It's gone in salaries....yes no doubt !  But who's salaries?  Lawyers and business managers?

Since you ask, these are the current vacancies at one of my former employers:

http://www.jobs.nhs.uk/xi/search_vacancy/c9bb6fb0384cde3d0497d13dd19f6d89/?action=search&master_id=121075

and here are some a bit higher up the tree at NHS 'Improvement'

http://www.jobs.nhs.uk/xi/search_vacancy/a02937c7c0fa6c0bdd168c41b1e76488/?action=search&master_id=127594

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1 hour ago, kzb said:

Heaven help the rest of them !

That chart is amazing. The UK is top or near top in all categories, except for the one that matters - Health Care Outcomes, where the UK is near bottom. I presume what this is telling us is that the UK population is fundamentally pretty unfit and unhealthy, and their health doesn't reflect the NHS inputs. Or are there some other factors I don't understand?

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26 minutes ago, onlooker said:

That chart is amazing. The UK is top or near top in all categories, except for the one that matters - Health Care Outcomes, where the UK is near bottom. I presume what this is telling us is that the UK population is fundamentally pretty unfit and unhealthy, and their health doesn't reflect the NHS inputs. Or are there some other factors I don't understand?

Other countries throw more money at screening. I note Cancer Research says there should be a universal  Prostrate Cancer screening programme fir example, NHS says no. They are looking at stats that show screening makes no difference to outcomes. They overlook the fact that only sick men tend to request a screen.

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34 minutes ago, onlooker said:

That chart is amazing. The UK is top or near top in all categories, except for the one that matters - Health Care Outcomes, where the UK is near bottom. I presume what this is telling us is that the UK population is fundamentally pretty unfit and unhealthy, and their health doesn't reflect the NHS inputs. Or are there some other factors I don't understand?

I get annoyed with health comparisons that include metrics duch as 'access to heathcare' and 'equity'.

I could devise a system where you just got your owiey rubbed better. Avaialiable to everyone. It would have shit outcomes but score well on that chart.

Its is hard to come up with a good metric - average lifespan, cancer deaths/population?

Usa does spend the most per head. But its outcomes and lifespans are poor. I think it just shows no heathcare system can make up for poor diet and of exercise which, again, points to health out comes not being that affected by healthcare systems k.e the NHS is marginal to the UKs health.

 

 

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12 minutes ago, crashmonitor said:

Other countries throw more money at screening. I note Cancer Research says there should be a universal  Prostrate Cancer screening programme fir example, NHS says no. They are looking at stats that show screening makes no difference to outcomes. They overlook the fact that only sick men tend to request a screen.

Well that requires forward tjinking and organisation. Things that are lacking with the NHS which loves a crisis.

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56 minutes ago, crashmonitor said:

Other countries throw more money at screening. I note Cancer Research says there should be a universal  Prostrate Cancer screening programme fir example, NHS says no. They are looking at stats that show screening makes no difference to outcomes. They overlook the fact that only sick men tend to request a screen.

Prostate cancer screening using PSA is an interesting one because AIUI many doctors regard it as being so unreliable it causes more trouble than it is worth. I suffered from this effect some years back where the private practise surgeon was relishing the prospect of treating me for cancer, and was quite crestfallen when further investigation showed no cancer, and my PSA went right back down. But in general widespread screening must be a good idea.

The problem I have is that 10 years ago, I could get a GP appointment within a day or two, but now appointments can be a month away. That is appalling, and a terrible indictment of the NHS.

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2 hours ago, onlooker said:

That chart is amazing. The UK is top or near top in all categories, except for the one that matters - Health Care Outcomes, where the UK is near bottom. I presume what this is telling us is that the UK population is fundamentally pretty unfit and unhealthy, and their health doesn't reflect the NHS inputs. Or are there some other factors I don't understand?

We are #3 in access. How is that even possible. People get off the plane at Heathrow and jump in a taxi for treatment. We literally treat anyone. 

How do Germany and the Dutch beat that ? They must actually have TV adverts abroad saying come and get it. :lol:

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2 hours ago, onlooker said:

That chart is amazing. The UK is top or near top in all categories, except for the one that matters - Health Care Outcomes, where the UK is near bottom. I presume what this is telling us is that the UK population is fundamentally pretty unfit and unhealthy, and their health doesn't reflect the NHS inputs. Or are there some other factors I don't understand?

Nope you’re on the Money there I think. If my memory serves me correctly, Belgium and Switzerland struggle too for similar reasons. Which I was quite surprised at.

Too much Chocolate and Leffe obviously 

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1 hour ago, ccc said:

We are #3 in access. How is that even possible. People get off the plane at Heathrow and jump in a taxi for treatment. We literally treat anyone. 

How do Germany and the Dutch beat that ? They must actually have TV adverts abroad saying come and get it. :lol:

This is just ******** though isn't it?

Look at that case of the Jamaican guy that's in the press at the moment; as of 2015 (ish?) all the trusts are required to charge at the point of access for non emergency care for anyone who can't prove UK residency so now a guy who's been paying taxes here for 30 years has to fork out 54 grand to get cancer treatment. 

Of course technically you could jump on the Eurostar the minute you feel a heart attack coming on. 

You carry on believing in your Romanian health tourist bogeyman though if it makes you feel better. Do everyone else a favour though and don't vote. 

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