Nurses, doctors and patients know the NHS inside out

YOU know the NHS is in a tight spot if you have been stuck on a surgery waiting list or called your GP at 8am on the dot and not nabbed an appointment.

Staff are as committed as ever — but after two years of Covid, things are tough.

4

4

Now, Health Secretary Sajid Javid is planning to prioritise “prevention and personalisation” to “put our health service on a stronger and more sustainable footing”.

He also aims to cut waiting lists — with patients still in need of care after 18 months able to go private for free.

Speaking at the Royal College of Physicians in London last week, he said: “We must choose between endlessly putting in more and more money, or reforming how we do healthcare. I choose reform.”

But what could reform look like if it was down to the people on the ground — patients, NHS staff and other healthcare specialists?

We asked the experts what would improve the NHS . . . 

THE NURSE

Make parking free for NHS staff

DENISE, a nurse from Plymouth, says: “Name me another industry that has to pay for the privilege of going to work. There are too many hospitals that charge staff to park.

“We don’t want to park away from hospitals, free, then walk into work because after a long, exhausting shift, you just want to go home — and it’s not safe to be wandering dark streets as a woman alone.

“I spend around £50 a month on parking. That’s more than £600 a year. It would make such a difference to every single NHS worker if it was free for us to park where we work.”

THE EX-DOCTOR

Retain and find new staff

ADAM KAY is the bestselling author of This Is Going To Hurt, a book based on his diaries from when he was an NHS junior doctor.

He says: “Every operation on the waiting list needs a couple of surgeons, an anaesthetist, two theatre nurses, an operating department practitioner, theatre support workers and healthcare assist-ants, cleaners and an admin team — not to mention staff in the recovery unit and on the ward for post-operative care.

“Where are they all coming from? Until we have an answer, I’m not sure we have an answer to the waiting list crisis.

“The NHS is short around 100,000 staff and more leave daily, burnt out after an unimaginably tough few years. There’s no point running a bath if the plug is missing.”

THE EX-HEALTH SECRETARY

Bring back family doctors

4

JEREMY HUNT, MP for South West Surrey and chair of the Commons Health and Social Care Select Committee, was Health Secretary from 2012 to 2018.

He says: “First, we need to give the exhausted workforce hope by sorting out staffing shortages once and for all, with independent, public forecasts of the numbers of doctors and nurses we should be training.

“Meanwhile, we need a massive recruitment drive, home and abroad, to get more doctors into local surgeries and hospitals.

“Once we have fixed the staffing problems, bring back family doctors. A study in Norway showed people who had the same doctor for many years were 30 per cent less likely to need out-of-hours care, 30 per cent less likely to go to hospital and 25 per cent less likely to die.”

THE GP

Proper social care packages

MATTHEW BOULTER is a GP Partner at the Atlantic Medical Group in Penzance, Cornwall.

He says: “Firstly, there is a massive block in a single part of the system which causes blockages everywhere else — and that’s getting patients out of hospital and back into the community.

“One of our local hospitals has well over 100 patients who are ready to be discharged and want to go home, but they can’t as there are no social care packages, or not enough social carers in the ­community, to keep them safe.

“If they were all able to go home, with the appropriate support packages, this would free up spaces on wards which would mean A&E could admit more patients, and ambulances would not be held up waiting to offload and could be freed up to respond to emergencies.

“Despite them being in the same government department, there is still a huge disconnect between health and social care, and carers are undervalued and poorly paid.

“If these two arms were joined up properly, feeding seamlessly into one another, we would reduce hospital stays massively and cut system pressures every-where.”

“Secondly, primary care is ­crippled by bureaucracy. GP surgery staff spend ridiculous amounts of time filling in paper-work for multiple organisations, much of it pointless.

“Finally, we all know about hospital waiting lists for surgery and procedures. 

“Eighteen month waits are now not unusual at all. 

“Managing and supporting patients on waiting lists is yet more additional work that all falls to primary care. 

“We see people daily in crippling pain, unable to work, losing their jobs and we witness the mental health consequences that follow. 

“We receive dozens of calls every day from patients asking how long they will be waiting but this is out of our control. 

“Patients feel abandoned and left in the dark. 

“I feel hospitals should more actively support those on their waiting lists. 

“An occasional reassuring phone call can go a long way and supportive advice could be offered. 

“If patients received a weekly automated text advising them of their queue position and the estimated wait, even if this is number 187 and 15 months, they would at least be able to see progress, even if it is much slower than we would all like. 

“This would cost very little and would make people feel slightly better about being in the tunnel even if they can’t yet see the light at the end.”

THE PARAMEDIC

Call ambulance only when you really need to

DEENA EVANS is a paramedic for West Midlands Ambulance Service and won The Sun’s Who Cares Wins 999 hero award last year after being stabbed on a job in July 2020.

She says: “We get a lot of calls where, when we arrive, we don’t really need to be there. Things like a high temperature — they haven’t had paracetamol to help reduce it. Instead they’ve wrapped themselves in blankets.

“Or a simple strain — an ambulance does not need to be called for that. You can get a lift or a taxi to access help. There needs to be more understanding of self-care — that if you have a temperature, take paracetamol, if you have a sprained ankle you put ice on and rest it.

“There are lots of services you can access before you call an ambulance or turn up at A&E. 

“There are mental health services, minor injury clinics. 

“Even pharmacists can help with many issues today. 

“We want to be available when called for those people who are seriously unwell and need urgent help.

“People are often scared if they’ve hurt themselves, especially since Covid, but don’t call an ambulance unless you need one.

“If in doubt, call NHS 111 and they will advise.”

THE PATIENT

Share information

Our reporter Clare O’Reilly’s dad, Michael, was treated for a stroke by the NHS last week, after two different hospital stays.

She says: “A lack of information- sharing from shift to shift really affected Dad’s care, resulting in him falling twice during his stay.

“We’d find ourselves repeating the medications he’s on for his epilepsy, reminding those caring for him about his dementia and Alzheimer’s, yet he was still left unaccompanied to go to the toilet despite not being able to use his right side properly.

“If patients don’t have someone vocal to advocate for them, follow up, chase information and keep reminding doctors and nurses, it’s easy to fall through the gaps and miss therapies or treatments or scans, or leave hospital without life- saving medication which Dad did.”

THE MENTAL HEALTH CAMPAIGNER

Brighten up mental health wards

4

BEN WEST, 21, from Staplehurst, Kent, has campaigned for better mental health services since his younger brother Sam took his own life aged just 15.

Ben says: “Speak to anyone who has been admitted to a mental health unit and they will often describe it as being ‘like prison’. They are dark places, with bare walls and are very cold. Often they are the worst place you can send someone feeling stressed and anxious.

“There are one or two pilot projects in the UK which aim to redesign these units to help patients feel less anxious.

“One has been designed to be sport and art-focused. Think coloured pillows, plants and artwork. It’s the same at many A&E departments where too many people with mental health conditions end up.

“Training GPs is also really important. 

“Although not every patient comes in to talk about mental health, they might come in with another issue, GPs should be trained to spot it and signpost them to the right place for help. 

“Loneliness in old people for example. 

“There should be a policy to help GPs best identify at-risk patients and get them to the right care as quickly as possible. 

“There are also people that don’t identify as high-risk. 

“How can a GP best help them before they do become high risk?

“Guidance should be put in place so they are referred to a charity or another service. 

“They shouldn’t be put on medication and sent out the door.”

EX-MIDWIFE

Improve NHS staff’s working conditions

EMMA GASKING, 27, from Milton Keynes, Bucks, quit her job as an NHS community midwife in 2018, saying that three years in the job had left her feeling completely burnt out.

She says: “Improving work conditions for staff has to come top of the priority list. When I worked in a hospital there would be times I would be so busy I wouldn’t eat, drink or use the loo for 13 hours. There is absolutely no reason why that should be seen as OK.

“We talk about wanting to increase staff levels, but that is almost impossible when the job is basically that you work 13-hour shifts, often without a break or a chance to eat or drink.

“You won’t be allowed to sleep on your break in your night shift in case you are called back — but you won’t be paid for that break. And you would be paid more in any other role of the same level of pressure and responsibility, while being treated better in all areas.

“If we want to improve the NHS it needs long-term thinking. It will initially cost more to improve working conditions and pay but ultimately it will save money — with fewer sick days, higher retention rates and fewer costly errors.”

THE GP RECEPTIONIST

Respect staff – and remember out-of-hours services

ONE surgery receptionist, who wished to remain anonymous, says: “Have more recognition and respect for staff — they’re only doing what is asked of them. We are made out to be the bad guys, but if we could, we would book everyone in — we don’t go in to be shouted at.

“It’s not us that controls how many GPs are working or how many appointments we can book each day.

“I think it’s hard to say how we can be recognised until changes happen, such as more GPs in, because if there isn’t it’s just the same loop: if we don’t have appointments, people aren’t gonna be happy, which is correct, I don’t blame them but just to realise it’s not us that controls how many GPS are working or how many appointments we can book in a day, but just to go, ‘Yeah, okay, I’ll try again tomorrow or take a pre bookable appointment’ – or go to a walk-in centre out of hours.

“And to also make use of out of hours doctors etc if they work whilst we’re open and unable to get in, because that’s what the out of hours or walk in centres are there for.”

“It’s also important for people to make use of out-of-hours doctors, if they’re unable to get booked in. That’s what the out-of-hours and walk-in centres are there for.”

THE ROYAL COLLEGE OF NURSING

Invest in nurses

PAT Cullen, Royal College of Nursing General Secretary and Chief Executive, says: “The reform patients want to see is about care standards above all else.

“The nursing workforce crisis is adding to waiting lists and treatment delays. Without addressing this basic issue, other ambitions risk never being realised.

“Ministers can make changes now which will help tackle this problem. Fixing social care is key to tackling the NHS backlog and social care must become a more attractive place to work, with salaries for care and nursing staff that at the very least match the NHS.

“Other things he must consider are scrapping tuition fees for nursing students and providing better maintenance grants.

“Too many nursing students, inspired to join our exciting profession, say financial pressures force them out along the way to becoming a registered nurse.”