Are you prepared for the Recession?

lert

LE
B0ll0cks.

I cant not reveal the source but there are 220 (ish) NHS Trusts in NHS England and many Trusts have multiple hospitals. A request went out for data for the centre to analyse - specifically they wanted chest x-rays of Covid patients.

Care to guess how many of the NHS England hospitals responded - not Trusts (with multiple hospitals) - hospitals. Go on. Have a guess.










18. Fcuking 18 hospitals.

NHS my arrse. the hospitals are empty.

220 people made redundant last week in one of the Clinical Support Units. There are 136 Clinical Commissioning Groups in NHS England. A CCG is basically a collection of GP practices and the CSUs provide support services to them GP practices. The reason for the redundancies is because the GPs are not making any referrals to hospitals for operations, scans etc, so they have laid off the support team because the have fcuk all to do.

Do you know how the NHS economy works?

GPs get paid for referrals. The hospitals get paid by the DoH for carrying out the treatment/operations.

One of the largest suppliers to the NHS has seen a 70% collapse in revenues because there are no operations being performed. They are currently sat on $50m of inventory in their supply chain that has not moved for 6 months.

Come back when you know what you are talking about.

Just off to clap for the NHS and stick my flag up.

Enjoy the pay rise. I took a 30% pay cut and my mrs took 15%.
Yeah see I've been round this buoy professionally, so please bear with me.

I did something very similar in March/April time, albeit with a different dataset and at a slightly smaller scale so I do know something of the challenge. I won't say anymore than that as I'm bound by confidentiality.

The first thing is there is no 'centre' really with the NHS. Sure PHE or the DHSC can request any data they want of the clinical trusts but they are under no obligation to actually provide it. The nearest thing to a chain of command that could would be the NHS regions but chest x-rays may simply not be their priority.

But let's say the regions get on board with request and pass it on to the Trusts. This is where it gets really interesting. Firstly, there may be no mechanism for transferring the data that's been demanded. Do you want electronic files or physical images? Let's assume electronic, what format and what's your transfer mechanism? E-mail? Via a portal? FTP? Upload to a database?

Where do you send them? Who's collating them? How should files be labelled? What data retention policies are in place and do they align with the sending Trusts?

All of that's called Data Governance and every Trust has different policies in place. Equally they all have their own data management systems which usually don't talk to one another. So if you're the Trumpton NHS Trust it may be physically impossible to send clinical data to Camberwick Green next door. Let alone that there London.

Lastly, and this is from personal experience, there's what happens when a new request for which there is no process in place actually lands with the Trust. Usually it gets passed around a few different e-mail recipients before ending up in a Group Inbox in the ICU. That usually means it's with the senior nurse to deal with. Sure she could spend a shift finding out that she doesn't know any of the answers to the questions above but she's got patients to manage so it ends up in File 13. Whoever sent the request in the first place moves on and here we are.

The NHS is great at some things, less so at others.
 

Grumblegrunt

LE
Book Reviewer
Except it's not a fairy tail, it's my own experience.

Very, very few Nightingale beds were used for two reasons -

The surge capacity that was generated in existing hospitals turned out to be enough.

Trusts worked incredibly hard not to send patients there. Like I said, moving critical care patients is a last resort.

So maybe your cousin's experience is not reflective of the national one. Maybe the ICU consultant you were chatting too was ready to give some lowdown scoop to a random bloke. I don't know.

I do know that the NHS came very close to being overwhelmed. CV-19 is a properly nasty illness that even if it doesn't kill you can proper **** you up.

it is a covid that can keep your immune system busy enough for the Pneumonia baccilli infesting our not designed for cleanliness modern hospitals or some of the other nasties in there.

I never said it cannot be nasty, but then flu can be nasty due to the secondary infections that follow it.

flu rarely kills but the pneumonia infection it lets in does. same with covid, all the new symptoms they have been hyping up are exactly the same as a bad flu season.

they have some great practices set up now we are well out of the peak - years later than they were originaly recommended. I have a friend on the ambulances who fills me in on what is going on, a nurse I know in the village works on the local covid wards which never got to capacity despite this being where patient zero was located.

my cousins hospital had it bad ward wise but the ICU was all but closed and the patients were the usual seaside retired elderly with a myriad other conditions.

they can't even get their waves right - this is the first wave until it changes significantly but there is at least another year of this and globally another three until we have an idea of what it does.

all over the world we are getting scare stories debunked, claims of deaths from are proving to be deaths not from and not even with like that young nurse in florida.

oh and I hear we are getting the roll out of the health passport type things in september,
 
Yeah see I've been round this buoy professionally, so please bear with me.

I did something very similar in March/April time, albeit with a different dataset and at a slightly smaller scale so I do know something of the challenge. I won't say anymore than that as I'm bound by confidentiality.

The first thing is there is no 'centre' really with the NHS. Sure PHE or the DHSC can request any data they want of the clinical trusts but they are under no obligation to actually provide it. The nearest thing to a chain of command that could would be the NHS regions but chest x-rays may simply not be their priority.

But let's say the regions get on board with request and pass it on to the Trusts. This is where it gets really interesting. Firstly, there may be no mechanism for transferring the data that's been demanded. Do you want electronic files or physical images? Let's assume electronic, what format and what's your transfer mechanism? E-mail? Via a portal? FTP? Upload to a database?

Where do you send them? Who's collating them? How should files be labelled? What data retention policies are in place and do they align with the sending Trusts?

All of that's called Data Governance and every Trust has different policies in place. Equally they all have their own data management systems which usually don't talk to one another. So if you're the Trumpton NHS Trust it may be physically impossible to send clinical data to Camberwick Green next door. Let alone that there London.

Lastly, and this is from personal experience, there's what happens when a new request for which there is no process in place actually lands with the Trust. Usually it gets passed around a few different e-mail recipients before ending up in a Group Inbox in the ICU. That usually means it's with the senior nurse to deal with. Sure she could spend a shift finding out that she doesn't know any of the answers to the questions above but she's got patients to manage so it ends up in File 13. Whoever sent the request in the first place moves on and here we are.

The NHS is great at some things, less so at others.
im being deliberately vague when I say centre as I also do not want to breach confidentiality..

people think it’s functions like a well oil machine where as it’s a bit like macdonalds - it’s like a franchise operation. Everyone has NHS on the business card but they do their own thing.

Edited to add - and no one will share or give access to data........
 

lert

LE
it is a covid that can keep your immune system busy enough for the Pneumonia baccilli infesting our not designed for cleanliness modern hospitals or some of the other nasties in there.

I never said it cannot be nasty, but then flu can be nasty due to the secondary infections that follow it.

flu rarely kills but the pneumonia infection it lets in does. same with covid, all the new symptoms they have been hyping up are exactly the same as a bad flu season.

they have some great practices set up now we are well out of the peak - years later than they were originaly recommended. I have a friend on the ambulances who fills me in on what is going on, a nurse I know in the village works on the local covid wards which never got to capacity despite this being where patient zero was located.

my cousins hospital had it bad ward wise but the ICU was all but closed and the patients were the usual seaside retired elderly with a myriad other conditions.

they can't even get their waves right - this is the first wave until it changes significantly but there is at least another year of this and globally another three until we have an idea of what it does.

all over the world we are getting scare stories debunked, claims of deaths from are proving to be deaths not from and not even with like that young nurse in florida.

oh and I hear we are getting the roll out of the health passport type things in september,
I'm not a clinician. I neither know nor particularly care how the virus works or the theory of contagion. I do data modelling, statistics and software.

I know the NHS was uncomfortably close to being overwhelmed in late March and early April. It was the lockdown measures that were introduced that avoided that. I hope they're not needed again but the alternative will be much, much worse.
 

lert

LE
im being deliberately vague when I say centre as I also do not want to breach confidentiality..

people think it’s functions like a well oil machine where as it’s a bit like macdonalds - it’s like a franchise operation. Everyone has NHS on the business card but they do their own thing.

Edited to add - and no one will share or give access to data........
I don't disagree on the somewhat dysfunctional and Byzantine structure of the NHS. Put it this way, I wouldn't start from here....

Where it does function extraordinarily well though is at the point of care. I'm very much not some soppy-bollocked, One Show watching mouth breather. Nor do I wiah to be overly dramatic, but the effort that went in this Spring from the NHS matched, IMHO, anything the services have delivered in the last 70 odd years.
 
I don't disagree on the somewhat dysfunctional and Byzantine structure of the NHS. Put it this way, I wouldn't start from here....

Where it does function extraordinarily well though is at the point of care. I'm very much not some soppy-bollocked, One Show watching mouth breather. Nor do I wiah to be overly dramatic, but the effort that went in this Spring from the NHS matched, IMHO, anything the services have delivered in the last 70 odd years.
I wouldnt doubt that. I am sure the mobilisation was on a par with what we would have achieved had the nasty Russians crossed the borders and Lionheart was a reality......

Back to the plot. Everything that is non Covid19 related has ground to a halt. A&Es are empty. No operations are taking place etc etc apart from in @Dafty duck's hospital where everything is functioning perfectly and its business as usual as it was in February.................................

We'll have that teacher on in a bit who was trying to persuade me that the state schools were still functioning and teachers were really busy and they had not stopped working 18 hour days........... my arrse they had
 
We'll have that teacher on in a bit who was trying to persuade me that the state schools were still functioning and teachers were really busy and they had not stopped working 18 hour days........... my arrse they had
I think this is one of the worst aspects of lockdown. Particularly for working class kids.
 
I think this is one of the worst aspects of lockdown. Particularly for working class kids.
Shit sandwiches all round I’m afraid. Looks like the South of England is about to experience what I went through in sunny Sunderland in the very early 80s. Ship building, then onto steel and coal to cap it off. I didn’t know anyone with a job - from 16 to 60.
 
Shit sandwiches all round I’m afraid. Looks like the South of England is about to experience what I went through in sunny Sunderland in the very early 80s. Ship building, then onto steel and coal to cap it off. I didn’t know anyone with a job - from 16 to 60.
I'm from North Shields and grew up there in the 1980s. My dad (from the Ridges aka the infamous Meadowell Estate) was a shipbuilder (as well as being a marine engineer). My granddad was a sailor and ship yard labourer at Smith Docks.

My North Shields great-grandfather was also a sailor and shipbuilder too.

I'm heterosexual though, so I joined the army straight from school to escape the dole queue.
 

Grumblegrunt

LE
Book Reviewer
As someone who works for the NHS as a head of department and having been involved with COVID planning and support throughout the pandemic at one of the biggest hospitals in the country, I would just like to point out. You're talking shit.
I'd stay away from debating if I was you, your diane abbot school of reasoning is showing.

not a medic then. not discounting your job I'm sure you are as important as you are making yourself out to be.

fair enough, you'll be chuffed to bits that all your financial mishaps have been swept under the carpet.

so why was the NHS so bad at this from day one then despite your obviously fantastic input? if this had been a thing it would have been overwhelmed in days without having to fake the figures.

the NHS own report states that over 4 times the number of deaths will result because of c19 measures than c19 itself - although I am accounting for the deaths with rather than the deaths from. mind you the deaths with figure is inflated as admitted by the ONS months ago.

if you are short of beds now, then just out of interest how short of beds were you before this then? with a nationwide decline in bed numbers with an ever increasing population and density in some areas.
 

Dafty duck

On ROPS
On ROPs
I wouldnt doubt that. I am sure the mobilisation was on a par with what we would have achieved had the nasty Russians crossed the borders and Lionheart was a reality......

Back to the plot. Everything that is non Covid19 related has ground to a halt. A&Es are empty. No operations are taking place etc etc apart from in @Dafty duck's hospital where everything is functioning perfectly and its business as usual as it was in February.................................

We'll have that teacher on in a bit who was trying to persuade me that the state schools were still functioning and teachers were really busy and they had not stopped working 18 hour days........... my arrse they had
I really don't know where you're getting your information from. I don't just cover one hospital and I can assure you that most things are back up and running. A&E departments in our patch are seeing attendances >20% over predictions. There are actual numbers to back this up.
 
I wouldnt doubt that. I am sure the mobilisation was on a par with what we would have achieved had the nasty Russians crossed the borders and Lionheart was a reality......

Back to the plot. Everything that is non Covid19 related has ground to a halt. A&Es are empty. No operations are taking place etc etc apart from in @Dafty duck's hospital where everything is functioning perfectly and its business as usual as it was in February.................................

We'll have that teacher on in a bit who was trying to persuade me that the state schools were still functioning and teachers were really busy and they had not stopped working 18 hour days........... my arrse they had
Some teachers were, most Head teachers were. Again we do you get your figures from? Or is some sort of bias against teachers on a whole?
 
Some teachers were, most Head teachers were. Again we do you get your figures from? Or is some sort of bias against teachers on a whole?
look in the school car parks and read this press and try speaking to kids
 
I really don't know where you're getting your information from. I don't just cover one hospital and I can assure you that most things are back up and running. A&E departments in our patch are seeing attendances >20% over predictions. There are actual numbers to back this up.
I've just come off a video call with a senior bod in the NHS and said I was speaking to a bloke who tells me his 1000 bed hospital is at capacity and its business as usual - the bloke started laughing then we discussed what's going on in Birmingham at the minute and his chat with the Director of Strategy for one of the Trusts.

Do you live in work in 1976 and you are really Dr Who?
 

Dafty duck

On ROPS
On ROPs
I've had the numbers through again for this morning, we're still full.
 
Depends who and what you are, if your Joe Public you need job security, if your Joe Company you need to find new ways to make money and thus work with or adjust your business model, I've had to concentrate more on volume selling and increasing my overall customer satisfaction, guess what it's working and I'm lining my pockets more so than usual and fairly
 
The mrs went into the office in London on Wednesday for the first time since March. Tube in from Rickmansworth on the Met line, which is about 30 miles out of the centre of London for those who don’t know it. She got on a tube at 0800hrs

54CF9210-536A-4F34-8F32-2BD7DE24628E.jpeg

at that time of day from this station, it’s standing room only and sardines prior to March.

Farringdon station which is a major hub. Empty.

her office on the exec floor normally has 75 people in. 4 people including her.

london on the way home in rush hour. Same experience.

TFL can not survive and not can the buses as this continues. With people not returning to offices, it makes no sense to subsidise it all - they should reduce the services.

I asked her if it reminded her of a Sunday morning in town about 11 as the shops are opening. She said it was more like 0800hrs on a Sunday. An absolute ghost town.
 
Hmmmmmm....... NHS

had a bad fall in June, lacerations to elbow and shoulder.
nothing obviously broken, dail 111.

don't go to A&E, call your GP

call GP, don’t come near us, you’ll get a video call

a week later, the video call - oh, that needs looking at.

a week later, finally get to see GP.... it was like entering the hot zone at Porton Down

yes, that needs an x ray.

a week later, go to appointment at clinic, even stricter Porton down procedures.

a week later, e consult with GP - yes, ’significant’ mechanical damage to both joints.

ok, arthroscopy?

no, hospital will not take you in, not emergency

ok, steroid injections?

no, hospital won’t take you in, not emergency

ok, oral steroids?

no, suppress your immune system

End result?
Probably permanently damaged shoulder and elbow, no treatment bar DIY with voltarol gel and paracetamol.

meanwhile, my wife, care home nurse, has worked throughout, they’ve had no NHS support either.
 

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