Disruption?

[busby1971]

The NHS is broken and doesnt work, it does save some lives and sacrifices others, why anyone would think that a government delivered service would be half decent is beyond me.

Unfortunately you wont realise how bad and good (at the same time) the NHS is until you need it.

I think a shift to a European model is inevitable and until some stands up and tells the truth we’ll be stuck with the current service.

The people who deliver the service are generally good people, they deserve to work for a better organisation.

Whilst i might have BUPA at the moment, so I can think myself lucky, there will come a point in about 15 years where I won’t and will also be of an age where I become a frequent user.

Back on topic, people talk about a return to the 70s with all this strike action, I dont think it is, the vast majority of people arent union members these days, and polls are showing. 50/50 split in public support now, i think it will turn against the movement as people, just trying to get on, start to feel damaged by the protests.

And if the Tories manage to get the Labour party linked to the protests, then they could have a positive impact on their futures.

2 years to the next GE, which is an age in politics.

 

[muttywhitedog]

A start towards fixing the NHS would be to charge patients £25 to see their GP or hospital outpatients, with 100% of their payment refunded if they attended their appointment. The number of failed to attends in the NHS is shocking.

Hospital Outpatient Activity 2020-21 - NHS Digital

Hospital Outpatient Activity 2020-21

digital.nhs.uk

 

[Talk Wrench]

@Deltaitem

An American doctor is pointing out the benefits of the NHS, coming from a country that doesn't have one. Many in the US would love to see it happen over there, but the establishment won't wear it.

I couldn't care less about the American system.

You've shown me how it works? You haven't. You've expressed an opinion in text without backing it up.

Having worked in Europe for over 20 years and having paid into the health systems of five member states, I'm speaking from personal experience.

Where is your evidence that EU health systems are envied and successful, and is it really possible to lump 27 nations' healthcare systems into one generic response? That's kind of simplistic.

You may need to spend time reading some left wing forums. They'll tell you how bad the NHS is because of the evil Tories and how much better healthcare is in the EU.

Deductions from pay kind of already happens in the UK, it's called National Insurance.

There's your problem then... right there. National Insurance is just an illusion. It's a tax, nothing more, nothing less. There is no magic pot.

Health insurance has actually been shown to be very wasteful.

Don't get confused with compulsory public health insurance and private health insurance.

The second link above will give you a more balanced, less rabid view of the NHS, and even gets compared to other countries, including others from the evil EU.

By 2025, it's projected that the NHS will take 44p in every £1 of tax payers' money to fund it. Does that not indicate that something is wrong to you?

Performance related pay, you say? Well, that's partially there as well, see link below, and good luck making head nor tail from all of it. Personally, I'd put the doctors on AfC payscales, like the rest of the NHS, but that's another story.

Where did I mention PRP? I didn't. I said that doctors should be paid according to a regulated framework dependent upon what treatment they provide.

 

[Talk Wrench]

A start towards fixing the NHS would be to charge patients £25 to see their GP or hospital outpatients, with 100% of their payment refunded if they attended their appointment. The number of failed to attends in the NHS is shocking.

Hospital Outpatient Activity 2020-21 - NHS Digital

Hospital Outpatient Activity 2020-21

digital.nhs.uk

I think we are in agreement Mutty.

Wasted appointments are waste. Waste needs to be cut. Money saved can therefore be invested in personnel and pay and remove the need to strike.... except the above won't ever happen.

 

[4mastacker]

A start towards fixing the NHS would be to charge patients £25 to see their GP or hospital outpatients, with 100% of their payment refunded if they attended their appointment. The number of failed to attends in the NHS is shocking.

Hospital Outpatient Activity 2020-21 - NHS Digital

Hospital Outpatient Activity 2020-21

digital.nhs.uk

Do GPs get paid for each missed patient appointment?

The reason I ask is because I was at my GPs surgery a little while ago for an afternoon appointment and was sitting alone in the waiting area.

On the electronic message board, other patients were called in for their appointment, but there was nobody there to respond. Before I was called in, Mr Brown, Mr White, Miss Green and Mrs Black were called but all failed to show.

On the wall was a big sign showing how many appointments had been missed in the previous month and yet, I was left wondering whether or not the missing patients actually existed or was the GP having an extended lunch break and earning some easy money?

 

[Deltaitem]

I don't think they get paid for each appointment, missed or otherwise. With all this FOI stuff going on, it's probably a reasonable question to ask the practice manager.

 

[Tin basher]

Do GPs get paid for each missed patient appointment?

Apaprently not

"GP Payments - ​

NHS England is responsible for paying GP Practices for their services. GP practices are paid on the basis of the number of patients on their list. This is obtained from the registered patient list held by NHS Digital on behalf of NHS England."

From here https://www.england.nhs.uk/contact-...ractices are paid on,on behalf of NHS England.

Seems they are paid by the numbers they have on the books not the number who turn up for appointments. So seeing 10 a day or 20 makes no difference to the take home.

 

[muttywhitedog]

Apaprently not

"GP Payments - ​

NHS England is responsible for paying GP Practices for their services. GP practices are paid on the basis of the number of patients on their list. This is obtained from the registered patient list held by NHS Digital on behalf of NHS England."

From here https://www.england.nhs.uk/contact-us/privacy-notice/how-we-use-your-information/our-services/primary-care-commissioning/#:~:text=GP practices are paid on,on behalf of NHS England.

Seems they are paid by the numbers they have on the books not the number who turn up for appointments. So seeing 10 a day or 20 makes no difference to the take home.

It doesnt, but seeing 10 a day instead of 20 because 10 didnt bother to show up means that 10 sick people couldnt get seen today, so they go down to A&E instead. And with A&E clogged up with non-A&E cases, folk end up spending hours in ambulances. So, as a result of someone not bothering to cancel their GP appointment, a stroke victim is stuck in an ambulance for 6 hours.

In the CI world, its called Root Cause Analysis. Find the true reason and fix that, however unpalatable, instead of tinkering round the edges.

 

[busby1971]

It might be interesting to see if there are certain practices with more (a hem) missed appointments than others.

Ignoring any attempts to game the system I would assume that missed appointments are worked into the normal workload and if they expect 80% attendance then the 20% non attendance time is used to do routine admin, so not exactly wasted time.

 

[Deltaitem]

I doubt that. I suspect it's more likely that just like everywhere else in the NHS, appointments are squeezed in everywhere that they can, many staff will only leave on time if there actually are a few missed appointments, and due to decades of underfunding, compounded by a pandemic that turned the whole system on its head, many clinical staff actually do their documentation in their own time.

 

[muttywhitedog]

I doubt that. I suspect it's more likely that just like everywhere else in the NHS, appointments are squeezed in everywhere that they can, many staff will only leave on time if there actually are a few missed appointments, and due to decades of underfunding, compounded by a pandemic that turned the whole system on its head, many clinical staff actually do their documentation in their own time.

From my daughter's perspective, you are absolutely spot on. She is a radiographer for the NHS. Admin time is not factored in. Lunch is a hastiiy-scoffed sandwich between patients.