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An example of waste in the NHS
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JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.
You'd think so. But they'd probably spend the money on extra doctors and discover they need more nurses operating rooms etc. So the doctors would be sitting around doing nothing until extra funding arrived ten years later!JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.
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Doctors training is a minimum of five years which then requires another 8 - 10 years to become competent in a specialty. We are currently losing doctors because it’s better for them to take overseas jobs in terms of remuneration and conditions. The recent pay awards might start to stem the losses but we’re still in a desperate state. GP training is at present a completely unattractive proposition for new doctors. This is going to take years to resolve. Other para medical disciplines are mostly equally struggling. The financial rewards versus the responsibility and stresses are very unattractive to someone looking for a vocational degree. Until the NHS can offer competitive packages of salaries and conditions it will continue to struggle to attract staff. Until staffing is resolved it’s hard to see how the NHS can move forward from its dire situation.stevexreeve said:JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.
You'd think so. But they'd probably spend the money on extra doctors and discover they need more nurses operating rooms etc. So the doctors would be sitting around doing nothing until extra funding arrived ten years later!JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.3 -
Absolutely this. Wes Streeting has said as much about the funding model. They don't believe that is broken so it won't be changing. As for structural changes one of the major points on this in the Lord Darzi review was to paraphrase: "stop fucking around with it". The Andrew Lansley reforms of 2012 come off particularly badly for the desruption they caused to the whole system for multiple years whilst not brining enough in benefits. Yes there will be specific things that need changing to address issues in the system (I'm hoping GP practices as private businesses is top of the list) but it's clear there will not be wholesale structural or organisational change.Bournemouth Addick said:
Don't you? I guess time will tell but, so far, the government hasn't said they intend to change the funding mechanism nor undertake another wholesale restructuring. If that's your definition of reform I fear you're going to be disappointed as there is next to zero chance of this government moving to an insurance based funding system, for example. And I don't see there being much appetite for getting rid of the NHS internal market or shaking up the trust system either.PrincessFiona said:
I don't think he has a different meaning of 'reform'Bournemouth Addick said:
I'm not sure when Starmer says "reform" it means what you want it to mean. The recent announcement of the 10 year plan was around, "shifting the NHS from analogue to digital, putting more care in the community, and a focus on preventing people getting sick."PrincessFiona said:The NHS has had record funding. even Labour are saying vehemently, 'no extra funding without reform. And reform or die. It is NOT about additional funding but about reform and reducing astronomical waste
https://www.reuters.com/world/uk/uk-pm-starmer-promises-10-year-plan-fix-health-service-crisis-2024-09-11/
That's not the same as yet another restructure of the NHS or changing the funding model.
No details yet granted, but I can't see too much to object to in there and it clearly recognises some of the factors external to the NHS that myself and Canters mentioned above.
Out of interest are you in agreement or not that there are a lot of other factors outside the NHS control that also require urgent attention?
I've set out above their headline priorities for the next decade, they don't, currently anyway, include wholesale structural changes, more a shift in emphasis and a kick up the backside to roll out technology more urgently.
Did you have a view on the other aspects impacting on the NHS btw? From what I can see if those other issues are not resolved too, the NHS is still going to struggle, "reformed" or not.3 -
The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.0
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It happens now without the extra doctors !Mstevexreeve said:JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.
You'd think so. But they'd probably spend the money on extra doctors and discover they need more nurses operating rooms etc. So the doctors would be sitting around doing nothing until extra funding arrived ten years later!JaShea99 said:
Right. Surely part of it is there not being enough of them though. So how would more funding not solve that problem?Friend Or Defoe said:
Lions led by donkeys.JaShea99 said:
What?stevexreeve said:
Doesn't matter how you fund the NHS, it'll still be f***ing inefficient ! Lovely and competent people running around like headless chickens!ShootersHillGuru said:
The NHS does need reform and I worked in it for thirty years. The real problem is that it’s not just about reforming the management structures or even funding. That’s been tried by practically every government since year dot. The whole ethos of the NHS needs a rethink. Everyone wants an NHS but nobody wants to actually pay what’s required to make it function well. That’s not just about throwing money at it but fundamentally changing how we fund and view our healthcare. For me, I would suggest that all accessed services come at a small individual cost. Means tested certainly but if you need a blood test then it’s £10:00. A general x-Ray £20:00 and so on. You get the drift. People have to feel that they are invested in the service and their own health. I think this is even more important than collecting the fees. At present too many people treat their health and those that provide their health services as some sort of god given right. Pitch up and it all falls into place like magic. I can tell you there isn’t much magic. People are fully prepared to spend a lot on all sorts of things yet ask them to invest a small amount in their own health and they object. I know that’s not everyone but it’s a majority I feel. Health technology and pharmacology changes at a breathtaking pace and it’s bloody expensive. Nobody should be expected to or need to go into debt or struggle with medical bills but I think the time has come where big decisions need to be made. An insurance based system would be a disaster but asking people to pay a little towards and take some responsibility for their own health is I think the only way to keep the NHS in a form we would still recognise and want. It’s going to be a long haul because getting the staffing issues sorted is a mountain in itself.cantersaddick said:Agree with lots of whats been said but lets remember GP practices are private businesses and the contract that they operate under is outdated and in place long before most modern technology was in existence. As a result GP practices have far to much independence in how they operate a large number of things and the NHS cannot tell them how to operate even if it is better for the patient experience. GP practices also own their own data and can choose what and how much they share with the NHS which prevents analysis into how the system can be improved and how we can better target treatment and most importantly prevention.
Changing the GP model and phasing out the private GP practice model would be top of my list if I was in charge of reforming the NHS. It’s the most important factor in the Moving from hospital to community care - one of the 3 pillars of their 10 year plan for the NHS. It will be a difficult legal battle but we have a top lawyer for PM so if there is a time to tackle this it’s now. In my view this is the biggest blocker to the NHS performing well.0 -
Surely it depends how they are deployed ? To me they make sense as part of the triage process. Like most jobs, knowing what you don’t know is as important, if not more important, than what you know. My guess is that we will very soon all be using an AI tool at the start of our interactions with GPs.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.2 -
AI although not ready yet will no doubt eventually mean that the vast majority of Doctor / Patient initial contact will be done without the presence of a real doctor. It will be a sophisticated triage / screening process that frees up medics to deal with treatment of diagnosed patients. AI will change everything in every aspect of life and medicine is a perfect example of how it will make things more efficient. I was talking with a friend who visited us for the day, yesterday who is a recently retired consultant audiologist. We spoke about this particular aspect of NHS reform and he was fully enthused by it. A lot of a doctors time is taken up with consultations that eventually don’t need interventions or perhaps just need redirection to further investigations. AI when it’s with us will change everything.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.3 -
The nature of the AI beast means it will be with us quicker than you think, even in the NHS. AI is a learning engine so can be used in so many situations. The mammogram AI is a good example where the computer is given digitised images to assess. During the learning process it is simply told whether or not breast cancer is present. The AI knows nothing about photos or breast cancer. It merely looks at the series of pixels (at bit/byte level) and works out for itself how to decide if the mammogram shows signs of cancer. That’s the clever bit. It will be here very soon !ShootersHillGuru said:
AI although not ready yet will no doubt eventually mean that the vast majority of Doctor / Patient initial contact will be done without the presence of a real doctor. It will be a sophisticated triage / screening process that frees up medics to deal with treatment of diagnosed patients. AI will change everything in every aspect of life and medicine is a perfect example of how it will make things more efficient. I was talking with a friend who visited us for the day, yesterday who is a recently retired consultant audiologist. We spoke about this particular aspect of NHS reform and he was fully enthused by it. A lot of a doctors time is taken up with consultations that eventually don’t need interventions or perhaps just need redirection to further investigations. AI when it’s with us will change everything.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.
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I have family that won't use self check-outs as they don't trust 'them bloody machines' the technology is close, as I society I don't think we're even nearly ready to accept it.ShootersHillGuru said:
AI although not ready yet will no doubt eventually mean that the vast majority of Doctor / Patient initial contact will be done without the presence of a real doctor. It will be a sophisticated triage / screening process that frees up medics to deal with treatment of diagnosed patients. AI will change everything in every aspect of life and medicine is a perfect example of how it will make things more efficient. I was talking with a friend who visited us for the day, yesterday who is a recently retired consultant audiologist. We spoke about this particular aspect of NHS reform and he was fully enthused by it. A lot of a doctors time is taken up with consultations that eventually don’t need interventions or perhaps just need redirection to further investigations. AI when it’s with us will change everything.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.0 -
It won’t be a leaning curve. It will be a learning cliff but one that’s inevitable and opting out won’t be an option. It will have an effect on every job, ultimately making some completely redundant. One of the big questions will be just how we deal with the people whose jobs are gone. There will be very many.Stu_of_Kunming said:
I have family that won't use self check-outs as they don't trust 'them bloody machines' the technology is close, as I society I don't think we're even nearly ready to accept it.ShootersHillGuru said:
AI although not ready yet will no doubt eventually mean that the vast majority of Doctor / Patient initial contact will be done without the presence of a real doctor. It will be a sophisticated triage / screening process that frees up medics to deal with treatment of diagnosed patients. AI will change everything in every aspect of life and medicine is a perfect example of how it will make things more efficient. I was talking with a friend who visited us for the day, yesterday who is a recently retired consultant audiologist. We spoke about this particular aspect of NHS reform and he was fully enthused by it. A lot of a doctors time is taken up with consultations that eventually don’t need interventions or perhaps just need redirection to further investigations. AI when it’s with us will change everything.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.1 - Sponsored links:
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I agree but PA's have been used to cover doctors shifts and run departments which is a scandal waiting to happen imo. They aren't even that cheap as they actually get paid more than junior doctors (or did before this weeks pay agreement).Hex said:
Surely it depends how they are deployed ? To me they make sense as part of the triage process. Like most jobs, knowing what you don’t know is as important, if not more important, than what you know. My guess is that we will very soon all be using an AI tool at the start of our interactions with GPs.ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.1 -
As for AI consultations they cant come soon enough for me. Pretty much everyone I have spoken to about this has had the same experience as me where a GP has simply googled their symptoms in front of them. Its an embarrassment but also a symptom of the GP system where medicine is now both too broad and too in depth for someone to know enough about all illness to make that initial assessment.2
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I’ve been using AI tools in my business for a couple of years now, and they have transformed the way I work and massively improved the speed of output.cantersaddick said:As for AI consultations they cant come soon enough for me. Pretty much everyone I have spoken to about this has had the same experience as me where a GP has simply googled their symptoms in front of them. It’s an embarrassment but also a symptom of the GP system where medicine is now both too broad and too in depth for someone to know enough about all illness to make that initial assessment.Sooner it comes in the NHS, the better.2 -
A clear example of how things have got much worse over the last ten years and why anyone who thinks they will get better without further investment needs to re think.
https://www.bbc.co.uk/news/articles/cwy948p4j5wo
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Agreed. As does anyone who doesn't think it also needs reform. The two aren't mutually exclusive. I make Starmer right on this.ShootersHillGuru said:A clear example of how things have got much worse over the last ten years and why anyone who thinks they will get better without further investment needs to re think.
https://www.bbc.co.uk/news/articles/cwy948p4j5wo1 -
As is always the case, its easy to point in general terms but a lot harder to actually reform anything.
An example of real world not Daily Hail huge waste, or not.
Single use items are on the face of it, a huge cost until you understand the reasons why there is so much of it. As I tried to explain to my mother in law, "would you like a piece of equipment used again if it could save money." Of course she would. And put another way, "would you like a piece of equipment used again, on YOU, if there was the slightest chance of cross contamination"
Unfortunately, like most people, my mother in law does not know what is single use and why it exists. Likewise most people can see reform is needed but wouldn't have a scooby of what reform is other than convenient words.
I work for the NHS, (Medical Physics), not many would know what happens there, I'm certain there are some that would take their ignorance and want to reform my hugely expensive wasteful department.1 -
Within any large complex business the optimal strategic and policy decisions rely on an effective management structure to feed accurate and objective information to decision makers.
The NHS clearly struggles with this I suspect due to the complexity of the institution with services operating in discreet silos and discreet management with targets to meet, and new targets set, with unforeseen impacts on other departments.A TV series some years ago sent high profile successful businessmen into problem businesses to firefight a particular problem. The guy sent into the NHS to look at some specific inefficiences, identified a number of changes to address the problem. But it needed the co-operation of several different departments to achieve the procedural changes needed. They just couldn’t co-operate and wasted days in meaningless meetings discussing why they couldn’t do anything.
I guess politicians believe there is an internal culture issue which inhibits change
and why they are driven to impose change from without. The reality is they are the least able to manage anything and think bean counters can solve everything.0 -
Had a update on this, got a scan in 2 weeks and the op waiting list is anywhere from 12-45 weeks. Have to say, the pain has been exponential since the docs appointment so am glad I finally got it looked at.shine166 said:
Inguinal hernia, which isnt as bad as it could be. Having issues owning a 5 year old son with it though and still having to do all the parent stuff like picking up etc.Baldybonce said:
Where is the hernia?shine166 said:Managed to blag a appointment, hernia confirmed. Apparently there is quite the waiting for the OP, so if I want it done soon I was recommended to go private...5 -
I think it's good that we at last have a politician that recognises one of the main problem areas for the NHS.Dippenhall said:Within any large complex business the optimal strategic and policy decisions rely on an effective management structure to feed accurate and objective information to decision makers.
The NHS clearly struggles with this I suspect due to the complexity of the institution with services operating in discreet silos and discreet management with targets to meet, and new targets set, with unforeseen impacts on other departments.A TV series some years ago sent high profile successful businessmen into problem businesses to firefight a particular problem. The guy sent into the NHS to look at some specific inefficiences, identified a number of changes to address the problem. But it needed the co-operation of several different departments to achieve the procedural changes needed. They just couldn’t co-operate and wasted days in meaningless meetings discussing why they couldn’t do anything.
I guess politicians believe there is an internal culture issue which inhibits change
and why they are driven to impose change from without. The reality is they are the least able to manage anything and think bean counters can solve everything.
I would also like to put on record that I have yet to come across a bean counter who could solve anything !0 -
Dr Google is a much safer alternative!ME14addick said:The growing use of Physician Associates, who have only 2 years of training, instead of fully qualified doctors, is a worry. How can someone with so little training diagnose conditions to the same standard as someone who has gone through many years of training.0
