I’m writing this, Monday afternoon, one eye on the test match. I doubt I’ll have long to wait for the denouement …
I’m also waiting to hear the upshot of BoJo’s machinations; how much he’s going to divvy-up to fix NHS waiting-lists. I hope to include the upshot towards the end of my 700 pearls!
I’m waiting… millions are waiting, for the NHS, so let’s have a conversation about waiting.
It’s dangerous to second-guess what the public want from the NHS, observers, relatives, carers and users. If it’s possible to encapsulate what they all want, in an epithet, I’d put my money on;
Peace of mind…
The peace of mind that comes from knowing the service is there when you need it, you’ll be safe and the people looking after you will be kind.
Of it all, ‘being there when you need it’, is probably the most important.
Waiting hours for an ambulance, queueing for A&E, waiting for a care package, traveling around the country for a MH bed and hobbling about, waiting for a hip… is an ugly fail.
If anything will break the love-affair the public has with the NHS, it is ‘waiting’.
The one key determinant, the man-in-the-street measure, the yardstick and family conversation… waiting.
By the way… England are all out, we’ve lost the Test Match, well played India, so you have my undivided attention!
From bunions to by-pass surgery, it all has a price tag. From a few quid to loadsa-money.
Let’s assume a fair average might be £1,500 for a procedure, and go with about 15m waiting, that means the cost might be £22.5bn, on top of the day-to-day running costs.
The money is easy. How to do it is the tricky bit. Do we have a plan? Dunno...
Many Trusts are running theatres hot. Three sessions a day. Squeezing in more sessions, or one more patient on a list? Possible but costs money.
Working overtime… costs a premium and we know we have staff shortages, rota gaps and vacancies..
Accelerated discharge arrangements… costs social services money they don’t have.
The private sector? They only have 700 operating theatres, mostly staffed by NHS anaesthetists and surgeons working evenings and weekends. Most don’t have ITU, for emergencies. Anyway, they are busy earning premium rates from patients fed up with waiting for the NHS.
Solutions?
Encourage part-time staff to do an extra +day a week (more money),
ask recently retired staff to come back and help, (more money),
appeal for volunteers (a-la-covid), there’s an overhead cost,
block-book hotel rooms, for recovery (more money),
pay GPs to maintain patients, pain or symptoms free (more money)
prepare people to be as fit as possible for their operations, to reduce stays, (more money),
bring staff from overseas, (more money) and the Home Office? Ugly.
My solution… overspend and turn the debts into public dividend capital (accounting trick, ask the Finance Director).
… there ain’t much wriggle room.
If we had a plan, something that must be part of it is to manage waiting.
Validate waiting lists, weekly
Develop a national-dashboard, identify capacity and cancellation slots
Review waiters and accelerate those with clinical priority
Recruit volunteers to become specialty-liaison workers, use them to;
Tell the waiters exactly where they are on the list
Communicate with them weekly, with good news, progress and how to get fit for an op
Set-up groups for waiters, for mutual support, WhatsApp and what not.
Keep people motivated, optimistic and hopeful
Spot Trusts reducing lists the quickest, go and find out how they’re doing it and share their stuff...
… and, just as I was typing the last full-stop and given up waiting...
>> I'm hearing - University Hospitals of Leicester Trust is still unable to post accounts for 2018-19, amid a black hole of £100m.
>> I'm hearing - Around 1,000 GP practices have been 'ordered' to provide face-to-face appointments. It's estimated 57% of GP appointments in July were in person. A lot of smaller practices struggle with social distancing. Where it's safe, appropriate and a patient preference, remote consultations leave headroom to offer face-to-face. What on earth is this row about?
>> I'm hearing - GP practices are having issues with some patients who have been vaccinated against Covid in different nations of the UK.
It seems that there is no way for Scotland and Wales jabs to link up their Covid vacs on the NHS app, or the NHS vaccination certificate service, to prove that they are fully vaccinated?
>> I'm hearing - GPs are scrambling to cancel clinics as flu vaccine deliveries delayed by 'up to two weeks'. DH say there's no shortage. Who do you believe!
