Paying a 3% increase in NHS salaries... viable?

kandak01

Clanker
Within the bounds of PERSEC, something came up during an army medical in autumn 2019 which I was told by the army doctors to see my civi GP about. I couldn't get an appt over the winter as they were stretched due to the usual winter demands and it wasn't seen as urgent. Once Covid started they stopped taking advance bookings and now only operate one day at a time. Call at 08:00 to try and get a triage call. Call after 08:05 and they're all gone. Having managed to get a triage call on a number of occasions, each time i'm told it's not critical that I see a GP that particular day therefore they refuse any further contact or treatment. I've already made a formal complaint to the practice manager however I got a generic reply that they're very busy what with a global pandemic and everything and patients are triaged based on their immediate medical needs. I did speak to BUPA and could get 15min with a GP for £70 however the follow up tests to get a diagnosis would cost into the low thousands. I resent having to pay that when i'm already paying £20k a year in tax and NI however it may be the only way to save my career in the reserves. The army doctor who is doing my App9 is of the opinion that the condition is serious enough to have me medically discharged from the reserves if not treated in a reasonable timescale so we're not talking about an ingrowing toenail!

I understand GPs have been busier than ever but I just can't get to see one either FTF or on the phone. It's absolutely ridiculous, and I'd dispute the bold - if I can't see a GP at all the NHS is clearly failing to provide me with primary health care!
That's an odd story tbh.
Most GPs practices will book you a non urgent appointment a few weeks ahead, and won't use up all available slots for emergencies. You don't need to phone at 0800h to access those.
Perhaps they have no non emergency slots because they've run out of GPs? (as mentioned, the number of whole time equivalents-WTE for future reference if we have to keep discussing this- is dropping despite increasing demand, since T&C aren't good enough for retention...)
 
That's an odd story tbh.
Most GPs practices will book you a non urgent appointment a few weeks ahead, and won't use up all available slots for emergencies. You don't need to phone at 0800h to access those.
Perhaps they have no non emergency slots because they've run out of GPs? (as mentioned, the number of whole time equivalents-WTE for future reference if we have to keep discussing this- is dropping despite increasing demand, since T&C aren't good enough for retention...)
fair point, things are arranged differently around here.
a- (used to be queue outside the door at 08:00 & hope you were in the first (10? 20?) & get seen that day
b- phone at 09:00. wait on hold to make an appointment. Up to 4 weeks in the future, even if you were OK seeing a locum. Bit sh1t if it was just to repeat a prescription.
c- website that doesn't work very well.

but generally, better than paying £300/month insurance
 
They used a self-booking system until covid started where you could book your own appt but only out to 2 weeks ahead so didn't always work when demand was high but you could get a same-day emergency which obviously I wasn't.

The most infuriating thing is not being able to get through the triage gatekeepers as it's strictly urgent, emergency consultations only. I can't even get them to get a GP to call when it's convenient for them in the next few weeks. I've been led to believe it's a pretty standard diagnosis pathway but until the GP puts me on it i'm somewhat screwed.

At least with a functioning insurance system I could (in theory) hold them to account and if they can't provide the contracted service then go somewhere else. I don't have that choice with the NHS unless I pay for the treatment twice.
that does sound incompetent of them if you can't even book it a month in advance, say. Even by sending the Dr an email/paper diary (the triage team, not you)
 
Because the value to them of their skills is not the same as the value to the NHS or wider society.

Try recruiting and retaining the health professionals you need to cure your cancer or pin your broken bones together with promises of applause and then discuss with them how the definition of value is universally a financial one.
I tried making this point earlier on but it seems to have fallen on deaf ears.

Staff leaving the NHS in their droves will do far more damage than a fair size pay rise will. Why work here for a lot less than your counterparts in other countries and be called a greedy twat when you ask to get a pay bump.
 

green_slime

War Hero
I tried making this point earlier on but it seems to have fallen on deaf ears.

Staff leaving the NHS in their droves will do far more damage than a fair size pay rise will. Why work here for a lot less than your counterparts in other countries and be called a greedy twat when you ask to get a pay bump.
but what extra will you produce for said bump, other than just stay? Will you just demand more next year?

Not making a comment about pay levels, just business logic.
 

ACAB

LE
I saw a post in the Mirror calling for the NHS to be given a 30% (Yes, you read that right, thirty per cent) pay rise. The fact that this would immediately Bankrupt the country (given the size of the NHS) and was obviously lapped up, becoming the most upticked post.
 
D

Deleted 4482

Guest
My observations:

I've been a frequent flyer with the NHS for a few years now due to some ongoing issues that won't actually be getting better. During COVID - local healthcentre was mainly closed for appointments but- I've been using the e-consult modality thing and- it works quite well. In one case I logged an e-consult, doctore called me back in the afternoon and asked if Id be able to pop down so he could do some BP / other checks.

I did note though that on every occasion I went to the hospital for bloods - the hospital was absolutely dead - like a ghost town. Even all the warfarin OAPs who descend on there on certain days seemed to have gone elsewhere.

I also needed a spirometry test after other issues on MRI were seen in my lungs. The NHS wasn't doing them during COVID and I had to get it done private. £200 for an initial zoom consultation, then £450 (I think) to actually have the test done at the private hospital. The results were then sent back to the consultant who did the zoom thing. The same consultant at my local hospital I am under for other issues with my lungs!

I have also commented on here before about during all the NHS clap crap- and it turning mainly into virtue-signalling and social media led 'contests' to see which street was most appreciative. Ive also never seen so many nurses / HCAs cutting about supermarkets in their uniform. In one case I saw 2 nurses who had obviously decided to go on a joint shopping trip giggling to each other as they got out the car. As they entered the Co-op they put on their best distraught and tired looking faces and appeared to be looking around for acknowledgment. Then there was the frequent nurse tries for 15 mins of fame crying on YouTube stunts- that didnt do the organisation any favours.

Meanwhile - police and other emergency services were still cracking on, despite being massively undermanned due to Covid cases and isolations. I didnt see any ambulance crews making teary YouTube vids- despite probably most amb crews being on escalation levels most nights that are normally seen on NYE.

Who is the resident funeral director on here? Ive forgot but I asked a while back- has business increased since COVID. I cant remember the exact answer but it was along the lines of...not really- just a lot less dying of flu now and instead its covid.

* I'm not criticising the NHS - I'd be dead quite a while ago without them. I do think a bit better management of expectations is required from above though.
 
but what extra will you produce for said bump, other than just stay? Will you just demand more next year?

Not making a comment about pay levels, just business logic.
It's not a case of producing extra, staff already work hard and way over contacted hours. It's about retention.
 
fair point, things are arranged differently around here.
a- (used to be queue outside the door at 08:00 & hope you were in the first (10? 20?) & get seen that day
b- phone at 09:00. wait on hold to make an appointment. Up to 4 weeks in the future, even if you were OK seeing a locum. Bit sh1t if it was just to repeat a prescription.
c- website that doesn't work very well.

but generally, better than paying £300/month insurance

I was the practice manager at a group of doctors in Leicester for 14 years. 2 surgeries, 5 partners, 2 trainees and 2 locums.
Our policy was, for some years, to phone at any time of day and we would book you in.
Now, the gov policy of only registering a certain amount of patients per GP (about 2100, ISTR) went out the window with the Blair gov and now you got penalised if you didn't open your books.
So the number of patients we had rose from just over 10,000 to almost 20,000 in about 3 years (only the partners had registered patients) . It became impossible to offer an appointment with a named doctor, as we had been doing for many years. It changed to you'll have to see any doctor.

They all got busy and booked up quickly. One of the new partners we took on gave us the "Oh, in my last practice we'd only let them book by phone from 0800". We even got a new telephone system which, we were assured, would handle 1,024 calls before cutting anyone off.

Yep, cue the complaints that people had been on hold for over an hour and then got cut off. That meant there were 1,024 people phoning at 0800 plus each day. With only 3 receptionists at one site and 4 at the other, it was impossible to deal with all those calls.

Very few of those actually needed to see the doctor. They wanted their prescriptions redone ( something we would do with a GP appointment until a certain date had passed), a sick note, an insurance document, a driver licence renewal, an application to join the forces or whatever.

By the time I left, the practice population was over 30,000 (no limits) and, although I used to slag the GPs off for being overpaid and so on, they were working solid from 0800 to the midnight oil, seeing patients but filling in all the paperwork and so on. Yep, they suddenly got very good pay but the hours would probably have killed them before many years after retirement.

Talking to other practice managers (usually at events we were forced to attend like racial awareness or how to wash your hands properly) this was the same for all of them.

When each GP had a maximum number of patients we could offer appointments with their named GP quite easily. Once that changed, it became a madhouse and appointments with any doctor became rare, let alone with one who knew you.
I left in 2010. The crap started about 1998 or 99.
 

Slime

LE
My observations:

I've been a frequent flyer with the NHS for a few years now due to some ongoing issues that won't actually be getting better. During COVID - local healthcentre was mainly closed for appointments but- I've been using the e-consult modality thing and- it works quite well. In one case I logged an e-consult, doctore called me back in the afternoon and asked if Id be able to pop down so he could do some BP / other checks.

I did note though that on every occasion I went to the hospital for bloods - the hospital was absolutely dead - like a ghost town. Even all the warfarin OAPs who descend on there on certain days seemed to have gone elsewhere.

I also needed a spirometry test after other issues on MRI were seen in my lungs. The NHS wasn't doing them during COVID and I had to get it done private. £200 for an initial zoom consultation, then £450 (I think) to actually have the test done at the private hospital. The results were then sent back to the consultant who did the zoom thing. The same consultant at my local hospital I am under for other issues with my lungs!

I have also commented on here before about during all the NHS clap crap- and it turning mainly into virtue-signalling and social media led 'contests' to see which street was most appreciative. Ive also never seen so many nurses / HCAs cutting about supermarkets in their uniform. In one case I saw 2 nurses who had obviously decided to go on a joint shopping trip giggling to each other as they got out the car. As they entered the Co-op they put on their best distraught and tired looking faces and appeared to be looking around for acknowledgment. Then there was the frequent nurse tries for 15 mins of fame crying on YouTube stunts- that didnt do the organisation any favours.

Meanwhile - police and other emergency services were still cracking on, despite being massively undermanned due to Covid cases and isolations. I didnt see any ambulance crews making teary YouTube vids- despite probably most amb crews being on escalation levels most nights that are normally seen on NYE.

Who is the resident funeral director on here? Ive forgot but I asked a while back- has business increased since COVID. I cant remember the exact answer but it was along the lines of...not really- just a lot less dying of flu now and instead its covid.

* I'm not criticising the NHS - I'd be dead quite a while ago without them. I do think a bit better management of expectations is required from above though.

My local cemetery hasn’t had any more new graves than normal during covid, but what was unusual was that for several months no new graves were added, but then a large amount were added all at once.

So, no more per year than normal, just a suspension of burials at the start of the pandemic.
 

Mbongwe

Old-Salt
You could move to another GP, or, if it really is urgent, turn up at a hospital A&E.
I have found during this pandemic that it’s been quicker and easier than before to get both telephone consultations and face-to-face appointments with GPs, despite living in more than one of the UK’s most densely-populated boroughs.

I’ve seen a GP a few times during the last 18 months, for non-life-threatening matters. On each occasion I got a telephone consultation the same day I asked for it, followed by a next-day face-to-face appointment. I never got such rapid service pre-pandemic.

Why? I think the mandatory first stage of a telephone consultation enables GPs to filter out the usual timewasters who used to use GP surgeries as their local hang-out.

That leads me to worry that some people, especially those that may end up being diagnosed too late because they “didn’t want to make a fuss” to see a GP face-to-face, but I think that this is the way that primary healthcare is going.
 
D

Deleted 4482

Guest
My local cemetery hasn’t had any more new graves than normal during covid, but what was unusual was that for several months no new graves were added, but then a large amount were added all at once.

So, no more per year than normal, just a suspension of burials at the start of the pandemic.
Two months ago an old friend of mine died. She was 84. I phoned in advance and asked if I could see her. She had been dead 4 weeks already. I was told closed coffin etc..she'd turned black etc.

Turned up to just sit there and have a natter with her coffin there...at appointed time...my appointment had not been noted but..."just wait here and I'll be back in a few minutes".

Then led into a room that stank of rose perfume and a coffin there with a cardboard slip with her name on it.
I never lifted the lid but I nudge tested it. It was an empty coffin.

I can understand the logistical side of that sort of thing etc but.. I would have been ok if they'd just said "look- shes in a fridge in the next room but she's only a few metres away...".

Anyway- thread diversion, apols...back on track...
 

Mbongwe

Old-Salt
It became impossible to offer an appointment with a named doctor, as we had been doing for many years. It changed to you'll have to see any doctor.

Very few of those actually needed to see the doctor. They wanted their prescriptions redone ( something we would do with a GP appointment until a certain date had passed), a sick note, an insurance document, a driver licence renewal, an application to join the forces or whatever.

When each GP had a maximum number of patients we could offer appointments with their named GP quite easily. Once that changed, it became a madhouse and appointments with any doctor became rare, let alone with one who knew you.
Three of your paragraphs (in bold) summarise that people's expectations of the NHS needs to change.

Average life expectancy is generally increasing and the population is growing, therefore people will probably have to accept that they either have a medical query for which they need to see a GP (any GP, not specifically "that nice Dr Smith"), or they can go private if they've got a preference.

The same way as the concept of going in to see the manager of your high street bank for a general chat about your finances was replaced by the concept that you only got a face-to-face appointment to apply for a specific product, people need to accept that an NHS GP surgery is not a place to hang around to shoot the breeze and put the world to rights, it's a place to provide a first point of contact if you think you have a medical issue that needs attention.
 

ACAB

LE
Three of your paragraphs (in bold) summarise that people's expectations of the NHS needs to change.

Average life expectancy is generally increasing and the population is growing, therefore people will probably have to accept that they either have a medical query for which they need to see a GP (any GP, not specifically "that nice Dr Smith"), or they can go private if they've got a preference.

The same way as the concept of going in to see the manager of your high street bank for a general chat about your finances was replaced by the concept that you only got a face-to-face appointment to apply for a specific product, people need to accept that an NHS GP surgery is not a place to hang around to shoot the breeze and put the world to rights, it's a place to provide a first point of contact if you think you have a medical issue that needs attention.
Dementia is the growing problem amongst our old folks. They've found out how to make us live longer but at what cost?? Your average Dementia patient isn't compus mentis enough to realise that the state is ripping him off re treatment.

My Father in Law ended up costing us £5,000 a month - yep you've read that right, five grand a month - which would normally have paid for a Caribbean Holiday for a family of 4 for that length of time.

It's a government supported rip off.

Hopefully, it will soon change in favour of the family.
 

kandak01

Clanker
but what extra will you produce for said bump, other than just stay? Will you just demand more next year?

Not making a comment about pay levels, just business logic.
The business logic (to my mind) is that if you run a business that requires staff who take a long time to train up, who have uncommon skills, who are mission critical, and who aren't easily replaceable, you should have T&C sufficiently good to recruit and retain them.

It's madness for the UK to train insufficient doctors & nurses, and then annoy them so much that they leave the service earlier than you want. It's even worse to train them up and see them clear off to Australia etc. because your relative T&C are so much worse than readily available elsewhere. It's even madder to persist in actions that you're warned will clearly will detrimentally effect R&R. (pension debacle/sub-inflation pay rises/multiple professional jeopardies etc.) and pretend to be surprised when that's what happens.

TBH, I think relatively small improvements in general conditions would retain more people than better pay, and having leaders who aren't regarded with contempt would be a useful novelty too.
 

Joker62

ADC
Book Reviewer
Dementia is the growing problem amongst our old folks. They've found out how to make us live longer but at what cost?? Your average Dementia patient isn't compus mentis enough to realise that the state is ripping him off re treatment.

My Father in Law ended up costing us £5,000 a month - yep you've read that right, five grand a month - which would normally have paid for a Caribbean Holiday for a family of 4 for that length of time.

It's a government supported rip off.

Hopefully, it will soon change in favour of the family.
Don't bank on it!
 

kandak01

Clanker
How many have actually emigrated to wherever the grass is allegedly greener?
It varies depending on what staff group you look at.
Recently, not many (covid's stopped that).
A decade or so ago, about 20% or fewer very junior docs didn't progress to specialist training. Now, for some areas, it's >50%. Mostly, those are people leaving teh UK for greener pastures.

Currently, a lot of junior docs are in holding/temporary posts, and as soon as covid travel restrictions are lifted, they'll go overseas.
 

ACAB

LE
Don't bank on it!
No, I won't!!

Because the money boys have the ear of members of parliament, so I won't hold my breath. The thing is this was a private members bill a number of years ago until it got fillibustered out.

The sad thing is he's dead now and has been these past 2 years.
 

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