The madness of the NHS

Good - keep hammering them, Shadow.

Managers all over the NHS are under serious pressure at the moment and are very much on the defensive. Probably dreading someone from Government suggesting saving more money and get rid of a few managers.

Our Chief Executioner is hoist with his own petard now. He has only been in-post for 23 months and has lost the Trust 33 million. We were 8m in the black, we are now 25m in the red.

Management response to cutbacks is to replace good staff with indifferent, lower-paid staff. Standards will fall accordingly. We in Orthopaedics, however, are standing firm and refusing to be pushed out of our jobs. Now we know the game, we can play too!
 
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It's a pantomime setup, isn't it Redhead?

I've just fired off a scathing email reply to their fobbing off, telling them I'm not happy and asking whose definition of 'urgent' means a 15 week wait? (which was originally 17, if a cancellation hadn't come up) They're just a complete shower.

(all cc'd to my MP as well - they'll regret thinking I'll take it lying down)
 
redhead said:
Well done also for being so brave as to talk about your problems and let students learn from your case.
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I didn't, I told them all to fuck off (and was in my rights to do so aswell).:D

The psychiatrist couldn't learn much and didn't seem to keen on on trying either, other than the usual "you've got this etc and i'm going to prescribe you this" stuff, therefore I wouldn't give much hope to the students, bless em!

Students sitting in on meetings you have with your consultant every 3 months is only pro active if you have the patients consent, otherwise you just get people like me with bad views of them! I should say i wasn't asked if i wanted 8 in the room (they just were sitting there), I had to actually ask the consultant to get them to leave.
 
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A friend has recently been undergoing counselling cessions for severe depression along with two types of medication. At the beginning of the first cession they were asked to fill in a form; do you feel suicidal; do you feel you want to harm yourself: do you want to harm anyone else; do you feel your life is worthless etc.. Six cessions later, because that is all they are allowed on the NHS, fill in the same form; same answers, the counsellor asked 'what have you learnt and good luck!' The friend couldn't answer because couldn't believe the question and the 'dismissal'. They have decided to go keep going but at the privilege of £35 an hour. In the meantime, the doctor has not noticed that no repeat prescription has been requested. The friend is trying for the sake of others but wonders if any of the actual professionals care very much.
 
Counselling courses don't go on even half as long as they should, just long enough to open up a can of worms and never long enough to put the lid back on!

There are far too many unqualfied people being let loose on the public because they have "done a course" - often only consisting of 5 or 6 days.
 
Well, watch this spot to see if the Supernova Secretary has been sacked. :D

Have been rattling cages all around ... and they all thought that I was such a sweet, compliant little sheep ...:lol:
 
I'm going for the contrarian view here. I'm ready for the comeback though at present I am too busy doing to talk that often and this site is a bu$$er on the blackberry.

Is it too difficult to imagine that there are consultants( of the external sort), managers and student trainees who really believe in the NHS, who want it to deliver the best possible service to the general public.Who are prepared to take significantly less income to help correct what they believe in.
In my view there are capable ones as there are capable nurses and similarly with poor or incompetent examples.In the same way there are many moral and competent bankers.

If one believed, as I do, that the NHS is one of the best inventions to come from these Isles, what better contribution can one make to society than to get in there and do one's best to improve it. Can you do that as a nurse, yes of course, but the extent is limited. Worthwhile but limited.

As a student, ok you need to learn and strangely it is the most junior people you can learn most from. Then if you have the ability and the balls you set about improving the system. Empower some, sack some, change the rules yet enforce others. Have an open mind and an open door. Listen look and learn. As a manager you should know the budget limitations and be able to assess how best to allocate a finite resource, fight to increase that resource but beware of the self interest groups.

I know of two individuals who really wanted to, and I believe could have, make a major contribution to the NHS but were considered too aggressive. Both have made millions for the companies they now work for and £100k's
for themselves. They still still look back with disappointment.
 
This thread wasn't set up to knock capable managers, TS, so your views are far from contrary to my own. Unfortunately such people are few and far between (around here, anyway). The situation in my own department is a case in point and has gone from bad to shambolic over the past week.

I believe passionately in the NHS and agree that there are many others who really couldn't give a toss.

The gripe that started this thread is that many of the changes being implemented are seriously and directly detrimental to the care of patients, because the Trust has made so many errors of judgement that they are having to claw back a massive overspend.

I am going to get absolutely hammered next week because I have been so appalled at some of the proposals that I have spoken out (alone) from my lowly and insignificant position.

The changes made have already begun to affect the care that I am able to give to my Consultant's patients. I have spoken out in protest at this and directly challenged my (various) managers as to how they are able to justify the reduced quality and standards, whilst still evincing the Trust's values and having the temerity to remind me of them.

I was chatting to one of our Registrars yesterday, who encouraged me to keep my stance and was writing a letter to support me.

He is a deeply religious man (a Sikh) and he sees my anger and frustration at not being allowed to do my job properly as the "... ultimate aim of all good people - humanity."

I am honoured by his support.

That makes all the pounding that I am going to get next week worthwhile.
 
Cheers Colin.

I shall be going in to work on Monday to get everything up to date, 'cos I may not have a job on Wednesday and I want my successor to see what kind of act she's got to follow. :D
 
At prima facie Redhead, it doesn't sound to me as if you're in too much trouble. You certainly won't be the first person whose ever rocked the boat in a large organisation
 
I feel the same, Warbler. The problem is that my bloody temper may get the better of me! :D

I don't lose my temper very often and learned long ago that to say nothing is often the best way of resolving a situation (and keeping one's dignity), but this time saying nothing is not the right thing to do. Trouble is, there is a good head of steam building up and I don't think I can keep a lid on it.

Celtic temperaments are a bit prone to the grand gesture of defiance and I might not be able to resist sending the whole Department an e-mail saying "Stuff your job. I'm off. Byeeee." (See, I've even worked out the wording!) They would be in rather big trouble then, because I'm the only person they have who is capable of doing two jobs - and doing them well.

There again, having sussed that getting rid of secretaries of my grade is what the upper management actually wants, in a cooler moment I am more inclined to stay, just to annoy them - and believe me, I will.

When I go in tomorrow I shall make sure that my work is bang up to date, so that no one can say that my little campaign is making the patients suffer. Then I shall continue to rock the boat with a view to capsizing it (for one manager, anyway).
 
I can't see that the NHS employ anybody with any common sense as a suit, to be quite honest. So many stupid little things that are arse about face could be remedied quite simply.

The waiting is interminable. Nevermind the 18 weeks for treatment, I know people who are on waiting lists for six months. Complain about it and you only get fobbed off.

Then there is the waiting once you're in there - surely anyone with an ounce of common sense is capable of working out that it is not in the best interest of an arthritic patient, in pain and requiring walking aids, to have to sit in a plastic chair for nine hours whilst they are waiting to go down for surgery? Of course there may be the option after 7/8 hours of waiting to go up to a ward and wait, but that is entirely dependant on when beds become available and naturally, when you're told you're due in for surgery c.2pm, when you're offered the chance to go to a ward at 3pm, there seems little point in moving by that stage.

Then there is the availability of beds. Why are they not available until late afternoon? That'll be because the patient that was discharged in the morning [who is occupying that bed] has to wait around until late afternoon/early evening for pharmacy to despatch the meds they are to go home with, that were ordered in the morning. It surely isn't beyond the realms of possibility to have prescriptions written up and signed by doctors then sent to pharmacy the day before discharge? Everyone realises that pharmacy is busy but if the meds were pre-ordered there could be a smoother system operating in getting patients moved in and out.

You also have the case of understaffing - insistence by the suits that only 2 nurses and 1 health assistant (or whatever they're called) are on duty at any one time at the weekend - that really works in wards if 15+ patients, doesn't it? Who is it who gets it in the neck from the less insightful [and often downright rude] patients? It's the nurses - the ones who are doing their best to do what they can and who actually want to work these extra hours.

The nurses and to a lesser extent the doctors are the ones who receive all the stick, from both sides, and it's just wrong. These are the people working the hardest yet they are the ones subjected to so much stress and grief?

Virtually all the dealings I have with the NHS smack strongly of a complete lack of common sense throughout its administration structure.
 
redhead said:
Celtic temperaments are a bit prone to the grand gesture of defiance and I might not be able to resist sending the whole Department an e-mail saying "Stuff your job. I'm off. Byeeee." (See, I've even worked out the wording!)
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I can identify entirely with that sentiment, rh. I had a professional disagreement with my line manager in June and drafted a letter of resignation. Word got to my boss but she saw that I was in the right and told me not to dare hand the letter in. "You'd be wasting your time, mate," she said. "I'd just rip it up and throw it back in your face. You're too valuable for me to let you walk out like that."

Hope all works out right for you.
 
Cheers, DO.

Shadow, your suggestions are just too common "sensical" to even be considered, much less implemented.

Gloucester has developed a system for discharging patients quicker, thus freeing up beds more quickly for the next wave of patients. Guess what the next step is?

Close all the beds that we no longer need to (you've guessed it) save money!

How about treating more patients more quickly?

Nah.
 
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Desert Orchid said:
I can identify entirely with that sentiment, rh. I had a professional disagreement with my line manager in June and drafted a letter of resignation. Word got to my boss but she saw that I was in the right and told me not to dare hand the letter in. "You'd be wasting your time, mate," she said. "I'd just rip it up and throw it back in your face. You're too valuable for me to let you walk out like that."

Hope all works out right for you.
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What was the outcome of this event, DO?

Was your grievance resolved to your satisfaction, or did you merely withdraw the threat of resignation in the expectation that it would be, and bugger all happened?
 
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