Angel of Death

[chapeau]

mdf290 has pretty much hit the nail on the head here.

 

[mdf290]

The problems started when the managers were brought in and promptly set about making "cut backs" sacking a load of experienced nurses, that caused a shortage which meant the agency staff had to then step in to fill the breach, not forgetting the agency taking their cut as well.
As i said why fix what wasn't broke??

What has changed now is that services can't get salaried staff.
I have advertised for full time employees in clinical positions accross the employment boards and via usual channels .
GPs will not take a salaried role even at 85k a year and their MDU insurance worth 8k paid.
Instead they register with locum agencies and work for £75 an hour.
Some GPs fully qualified are quite happy to work just two days a week as this will earn them 50k a year.

Nurses are the same.
They don't want a salaried role as that brings responsibilities or rotas they don't want to work instead they will select which days they want to work via offers provided by the locum agency . The health service then has to pay through the nose to get anyone to work weekends or late nights.

Here is a locum agency I have used in the past to get staff cover in the absence of being able to get employees to work a salaried position.
Look at the rates offered and notice how weekend rates pay more.


http://www.merco.co.uk//content/nurses/general-nursing

Remember these agency workers take NO responsibility. They can't be sacked and if they find work in a particular unit or service carries any responsibility they simply will not book themselves in their again and will look for 'work' elsewhere.

Look at the positions the locum workers fill everything from A&E to HDU wards.

Everyone within the clinical service KNOWS that using locum and bank staff leads to lack of continuity of care for patients.

There was a ridiculous scenario in primary care once where a patient had various problems relating to very high blood pressure.
I had a call from the partner of the patient unhappy about how the care was going.

When I looked into it she had arrived at our service with a fairly constant BP reading somewhere near where it needed to be .
What I found was a succession of Locum GPs had changed her medication everytime she had visited. Depending on which GP was in when she visited X Y or Z medication was prescribed.

The net result her partner said she did not know whether she was coming or going and to top it off her BP was appreciably worse than when she joined the service. Possibly stress related but also possibly because of the change of medication either way NOT an ideal scenario.

I wish I could be a government advisor on helping change the NHS landscape.

one of the very first issues I would tackle would be NEPOTISM.

As a service provider to an NHS contract one of the first jobs I had was to recruit new reception staff. When the interviewees arrived to fill the 6 posts I had to cover I was astounded to find three were genuine applicants but three were nepotistic 'shoe ins'.

One was the daughter of the PCT contracts manager who would be reviewing our performance against contract KPIs and SLAs.
One was my regional managers husband
One was my line managers daughter.
The PCT contract managers daughter became PREGNANT within weeks of starting the service leaving me eventually to look for temporary cover at extra costs to my already limited budget.


Money is being flushed away by the NHS due to ridiculous staffing budgets and abuse by clinicians.

The worst case I came accross was a GP locum I had put in place. He told me he was actually a partner with his own GP practice.
yet here he was working on the side for £85 an hour to see my patients when presumably patients at his own practice were being told by their receptionists they had to wait two weeks for an appointment or ;ring back tommorow' everything has gone today.
He was probably already drawing £100k from his own practice budget as salary and here he was working 'on the side'.
This is how GPs earn the reported 200k a year they get.

I wish I had never worked in that service as it has totally changed my view of the NHS and clinical staff in general.
It is grubby , money driven , inefficient and morally bankrupt.

You can bet the result of the govts investigations will be yet another round/tier of controls and policies attempted to be actioned by managers and yet again ignored/dodged by clinical staff.

What it really needs is the NHS to refuse to employ locum staff.
To only offer salaried jobs.
This will force the job hoppers to take a position
This will bring ACOUNTABILITY back into the system
This will HALVE the wage bill
It will bring CONTINUITY back to patient care
It will mean hospitals will be fully manned again at WEEKENDS

It will mean EVERYTHING to sorting out the sordid service we are paying through the nose for right now.

 

[Nige F]

mdf - irrespective of your age - which might preclude you from The Old Days - you are dead right My wife started nursing in the 60`s and watched he NHS decay over the decades - ask any retired nurse of that era

 

[Nige F]

[It is grubby , money driven , inefficient and morally bankrupt.

.

Just like Banking - and who reformed both the NHS and banks - back in the day

 

[chapeau]

If you are talking about Mrs T, then she did try to reform the NHS but got beaten back. She could dismantle the NUM but the BMA was unbeatable. It remains so to this day, a marvellous trade union (if you are a member....)

She won the occasional battle but the war was comprehensively lost. I had a ring side seat funnily enough, but that's a long story.....

Doctors are the smartest bunch of people you will ever get in a room and they don't like being managed by those who are considered less clever. Consultants hold all the cards in the NHS, less so in the private arena, but even there they dictate what happens.

 

[pred]

Am i missing something here?

The way i see it was; when they employed managers to run the NHS managers had a budget, to save money they sacked a few underpaid nurses, then when things get busy and the brown stuff hits the fan they have to call in emergency staff, the same nurses they have just thrown out and they expect them to come running, now if i was a nurse the first thing i would want to know is what is the rate of pay, why should they care about the patients welfare? The managers didn't seem to care when they started dismantling the NHS!!

 

[chapeau]

Am i missing something here?

Yep. You are way, way, way off the mark.

 

[mdf290]

There will have been a historical period where the NHS had too many nurses on their books.
This is the period when nurses were laid off generally with natural wastage and for a short time this would have worked.
Just bringing people in when needed would have been an elegant solution at that particular time.

Then things changed.
Money was thrown into the NHS as new treatments were made available to a far greater range of people. More and more people were being offered services and operations that years ago the NHS would have just told people to go private or put up with it.

Here we now had an imbalance the other way with suddenly not enough clinical staff.

The inevitable result was the empowerment of clinical staff who could then dictate terms.

and this is the same mess we are in now.
The BMA is a disgraceful organisation that uses coercion and threats and continually bleats how badly off its poor overworked doctors are when the reality is they can earn 200k a year or sit on their hands and still earn 50k..
Doctors sadly are so comfortable they did not even have the decency to act embarrased in front of me when I asked them to do some paperwork between patients having paid them up to £120 an hour. 'I dont do admin' was the response.
Summarising records by the way is not an admin job it requires someone clinical to make sure the important part of a patients medical history are properly recorded onto the patients computer record.

 

[mdf290]

Doctors are the smartest bunch of people you will ever get in a room and they don't like being managed by those who are considered less clever. .

The simple term for that is Arrogant.

I'm afraid I don't share your hero worship after my damaging experience with them.
The current QOF contract with primary care is simply a tool negotiated by doctors so that they get extra payments simply for doing the job they are SUPPOSED to be doing in the first place.
GPs would really love to have a load of patients on their books only turn up when they have an acute (immediate) health issue (cough , cold .. flu etc)
They are not interested in treating chronic (long term) ilnesses or preventing chronic ailments because that requires planning and patient monitoring.
So in 2004 they had the cheek to ask for payments ON TOP of their contractural payments per signed patient just for doing what they should have been doing in the first place.

Despite all their training and potential to do good most GPs like nothing more than handing out paracetamol for injuries or muskoskeletal issues or Amoxycillin for local bacterial infections.

All the managing done within primary care is down to monitoring consultations to ensure this sloppy work ethic does not impact on patient care.

The GPs might like to think they are the smartest people in the room but it takes the work of less qualified , less trained people to point them in the direction of their errors.

 

[chapeau]

Doctors are the smartest bunch of people you will ever get in a room and they don't like being managed by those who are considered less clever. .

The simple term for that is Arrogant.

I'm afraid I don't share your hero worship after my damaging experience with them.

I don't hero worship doctors, far from it, I am simply explaining how doctors think.

In General.....

The problem with GPs is that they are far far too smart to be doing that job, they are bored senseless most of the time, and they don't like most of their patients. I know that cos a lot of my mates are GPs and they tell me things they wouldn't tell you.

 

[gasbanni]

Perhaps Julie Bailey would have done a better job, had she called the cruel nurse by her correct name, instead of a character from a film's name. I'm bloody sure I wouldn't allow such a cruel nurse to hide behind nicknames.

Remember too , that up to now, no one has lost their job through this scandal.

The article states her mum gave her that nickname, the daughter should write a book and name names.

shocking article and worse comments on her from people who work in the nhs or did.

 

[gasbanni]

duplicated

 

[gasbanni]

Doctors are the smartest bunch of people you will ever get in a room and they don't like being managed by those who are considered less clever. .

The simple term for that is Arrogant.

I'm afraid I don't share your hero worship after my damaging experience with them.

I don't hero worship doctors, far from it, I am simply explaining how doctors think.

In General.....

The problem with GPs is that they are far far too smart to be doing that job, they are bored senseless most of the time, and they don't like most of their patients. I know that cos a lot of my mates are GPs and they tell me things they wouldn't tell you.

Well the money grabbing barrstard's shouldn't be in their jobs then.

 

[mdf290]

Had lots of bad experience with relatives etc in Hospital going back to 1990 but mention Nurses being crap back then and it was as if you had committed some kind of unspeakably evil deed.

Just like 'Global Warming' or 'Immigration' these Holy Cows like the NHS and Policing protect themselves by isolating their detractors and making them seem ignorant by pointing to all the good work they do.

Now of course the Emperors new clothes have been seen through and the image is naked and ugly.

 

[pred]

Had lots of bad experience with relatives etc in Hospital going back to 1990 but mention Nurses being crap back then and it was as if you had committed some kind of unspeakably evil deed.

Just like 'Global Warming' or 'Immigration' these Holy Cows like the NHS and Policing protect themselves by isolating their detractors and making them seem ignorant by pointing to all the good work they do.

Now of course the Emperors new clothes have been seen through and the image is naked and ugly.

YES!! I agree the nurses are crap!!......... However!! THEY ARE NOT IN CONTROL, I blame the management, you cant blame the monkey, it's the organ grinder at fault.

If i was doing an extension for you and the job was not up to scratch, you can't blame the labourers, to con a phrase "THE BUCK STOPS HERE"