The BHF's Tipping Point report makes sobering reading for us all.
The BHF Tipping Point Report - British Heart Fou...
The BHF Tipping Point Report
MilkfairyHeart Star
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Milkfairy
Heart Star
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MichaelJHHeart Star
This is what I posted about referencing the Guardian. My friend's sister says you cannot believe anything you read in it. I tell her she reads biased nonsense!
I can find it but if I click on it the page is not found!
Excellent post.
Unfortunately these problems are so intractable that I fear they will persist for many years, and may well get worse before they get better.
I guess all we can do to safeguard ourselves is to live the healthiest lives that we can, eating sensibly, losing weight, quitting nicotine, exercising regularly, etc. Because relying on the NHS is becoming an increasingly dubious option.
It's also worrying for those of us living with long term heart conditions.
It's worrying for everyone, I just wish there were quick and practical solutions, But simply putting the training infrastructure in place to tackle staff shortages would take many years and a herculean political will, furthermore the population is getting ever older, so this dreadful situation is likely to become the new normal.
I don't understand why there is a cap of 7500 on undergraduate medicine university places.
Nurses, Midwives and Allied Health professionals have to pay for their university tuition fees.
They have reintroduced a small bursary, but it's not enough.
This is a world wide problem. Ontario in Canada is facing similar problems to the UK.
The net cost to the UK treasury for training each doctor is calculated at slightly over £250,000. I'm a little sceptical regarding some of the accounting, for example a trainee doctor during their first year in hospital is considered to be all cost and not to make any worthwhile contribution. However, setting aside quibbles like these the fact remains that training medical staff is expensive, and in the current climate I doubt the money will be found to address the problem at source by massively ramping up training.
I believe that now a little over 50% of all our medical staff are recruited abroad. There's supposed to be a moratorium on active recruitment in some of the very poorest countries, but no outright ban, so if a doctor from say Somalia actually applies to the NHS they'll still be accepted, thereby depriving that country of a resource that's even more needed there than here.
The whole thing is such a logistical and ethical mess, which is why I'm pretty pessimistic despite the politician's sunny words.
Ho hum!
☹️
I work at a University with a medical school. I and my team assess potential medical students to make sure they are fit to practice. The cap is complicated. There aren't enough medical schools these are increasing but it is costly to set up a medical school. Additionally existing schools have doubled capacity in recent years. But we struggle to find practice placements for them all. It is all very frustrating but there is a lot of work going on in the background re students. Also they take 5 years of study and 2 years on top to qualify.
I am aware of the challenges facing the expansion of medical school places. It is, however, good to see some new medical schools created, in the last few years, in places such as Lincoln etc
It's unfortunate that the long term planning for the future workforce for the NHS has not always had the attention it deserves.
Medical, nursing, midwifery and allied healthcare professionals all require clinical placements.
Yes I agree but think there is more work going on than the public are perhaps aware of from a student perspective. We are HYMS so we're very glad when Lincoln set up their medical school takes the pressure off us directly adjacent areas. Of course now we have physician associates which help. Additionally we have now a gateway course for MBBS programme which also helps. We have almost tripled our nursing intake all branches in last 15 years. Also nurse associates and apprentices. As you say all health care students require clinical placements and this puts more pressure on clinical staff. Unfortunately we are losing staff faster than we train students and have lost a lot of overseas staff. I can see both sides as a HOD and a clinician but sadly let down on many occasions as a patient. As you say a bit more workforce planning would help. I left the NHS to work at the university. I feel this is a really sad situation we find ourselves in no quick or easy solution and I am not optimistic of an improvement any time soon. My husband is also a nurse we spend a lot of time talking about this at home! We hear some awful stories from clients it is very very sad
Yes, so many Uk people seem to think expanding the number of medical schools/students will solve the problem shortage of drs., without realising that it is the long experience working with patients that makes the doctor rather than the theory. Yet because there are staff shortages within medical depts in hospital there is reduced capacity to take on either students or newly qualified Foundation 1-2 doctors. My son, still a junior dr., has had to work shifts with as little as one third of the recommended medical cover ( from consultant level down), and has refused , despite managerial(non clinical) pressure, to take on students as he is on his feet for 12 hours, without meal breaks, trying to treat patients. Covid has made things worse, and many young Uk trains drs. are looking abroad for better working conditions. Thus not easy to just train new drs, it would be at least 15 years till one noticed the difference!
Thank you Milkfairy. I'm afraid to say that this is probably another part of the iceberg. Root cause, in my opinion, the pandemic and brexit. I can't see a way back for the UK sadly. My partner and I are now actively processing a move to Cyprus where the care and lifestyle is far better than in this so called G7 country.
What has Brexit got to do with it?
Free movement of people 💁♂️
Could you enlarge on that? I thought Brexit was supposed to end the free movement of people, from the EU at least.
Mountwood, you are exactly correct. So a lot of labour left to return to their own country of origin. This is then exacerbated by it still being hard for people to come here. Personally, I welcome free movement, if people want to migrate here, even in small boats, let them come and let them work. It isn't their fault we choose to sustain people and refuse ro let them contribute to society.
But can't you see that free movement allowed large numbers of Europeans to travel to the UK to work. Stopping free movement effectively sent many Europeans back home. Is that what you want?
Healthcare workers departed en masse as a result of Brexit, in particular nurses. We in the UK seem to not want EU migrants in this country. Many from the EU feel unwanted in the UK. It's difficult to get settled status, whereas when we were in the EU there was indeed free movement of people.
It is very scary with us, 35 miles from the nearest emergency hospital and very few ambulances. They are relying on volunteers to attend cardiac arrests but this doesn't help patients with blockages or other heart conditions. Basically no out of hours care, the nearest on call doctor is 20 miles away and you need an appointment to see them through NHS24. We have a community hospital 200m from us but we are not allowed to use it as no out of hours doctor. No idea what their patients do in the middle of the night with no doctor cover. It seems the system is completely broken and more so for people living in rural communities.
That sounds grim.It's awful that people are being told rather than call an ambulance get yourself to hospital.
I had a heart related incident last Friday. My poor hubby panicked so much he rang 999. He thought I was having a HA. He was told that there was nothing they could do it was a 8 hour wait for an ambulance. My neighbour took me to our local A&E and i wasn't seen for hours by this time ECG was running fine. I live in Cardiff and the University hospital Wales is the biggest and most equipped yet all the ambulances sit queuing with patients on board for over 15 hours! Some paramedics go home after a 12 hours shift and when they come back are back with the same patient the night before.I feel this doesn't end well for us all.
That's appalling. When I had my HA just 4 years ago an ambulance was with me in under 10 minutes although when I got to A&E I was left on a corridor for 5 hours. What on earth has happened since then to make it get so bad? When I spoke to 111 last week,hey offered an ambulance but given that I was non urgent hey said the wait wasn't bad- only 4 hours. I Opted to get to Urgent Care myself and was in, seen and back home in 3 hours.
MichaelJHHeart Star
Here's my post. Maybe a Daily Mail reader reported little me?!
This is not sensationalism in the Fail but a report in the Guardian based on information from the BHF. Ambulance delays, inaccessible care and soaring waiting lists are blamed. The link for the article is:
theguardian.com/society/202...
This is getting very wierd MichaelJH your original reply has disappeared???
Here's the link again. I can't send the articles from the Daily Telegraph or The Times as they are subscription only to view
A bit deflating but let’s focus on gratitude. Many of us, self included, wouldn’t be here without the NHS, which, despite its various ills, is still one of the world’s best. Many countries have practically no health service or if they do it’s unaffordable to the masses. So I think we should focus on the positives and, as has been pointed out, take optimum care of ourselves in terms of lifestyle.
We’re still very fortunate and probably in the top 5% of the whole of humanity in terms of what’s available to us. Another way to look at it is if we take best care of ourselves we reduce the burden on the NHS. I for one am up for that.
I don’t feel people are ungrateful for the care they receive from the NHS. Are you suggesting people turn a blind eye to the acknowledged deterioration of the NHS?
Nobody asks to have a heart condition, some of us despite living a heart health life style, still end up living with long term complex heart diseases.
Please don’t misinterpret my words, I’m not saying what you suggest. I have long term heart disease myself soI know what I’m talking about.
In the grand scheme of things I think we are very fortunate, that’s all I am saying.
The NHS is doing its best and probably can’t do much better witits current level of resources.
Unfortunately the pandemic has exacerbated this and most of the staff are probably still exhausted but still doing their best. I think we should be grateful for that . And yes, I’m certain most of us are!
The care provided by the NHS has deteriorated.There are more excess deaths, in particular the stillbirth rate has risen.
ons.gov.uk/peoplepopulation....
I have been in hospital 15 times over 10 years. I am usually in hospital for a week or more.
I am grateful for the care I receive. I am not grateful for the deterioration of the NHS which is leading to an access of deaths, people waiting in pain for their operations or waiting anxiously their conditions becoming worse.
My brother recently died of bowel cancer. He didn't want to bother the GP about his symptoms. He died 8 weeks from seeing his GP. He went too late.
Nor I am grateful to witness staff, so demorailised that they are leaving or retiring early.
Milkfairy, there’s no doubt the NHS is underfunded, question is how do we fix that in these difficult times?
There is also great variation in personal experience. I visited my Aunt in Glasgow yesterday. She is currently being treated for lung cancer and says her treatment and care has been exemplary/world class so far, couldn’t be bettered . The hospital and staff have been wonderful. Fingers crossed She will hopefully get into remission and continue with her life thanks to amazing NHS. Lots of people across the country are probably having the same experience, others not so much.
Sincere condolences about your brother and I wish you well with your ongoing heart issues. As a fellow ‘heartie’ I do know it’s not easy to live with and it’s challenging at times.
I think we try to convince ourselves that OUR NHS is best, sadly this isn't true any more. Most of Europe has better healthcare than us. I have personal experience in Cyprus. My brother was telling a consultant friend of his about a holiday in France, he wasn't sure he should go due to his heath issues. The consultant told him to go, France is much better than UK. I kived in Germany years ago, better than UK even back then, Spain is better, in fact everywhere I have researched is better.
I think that a lot of services have changed over the last few years even before covid struck. with the NHS included.
It’s becoming more noticeable ( to me anyway) that more people are getting told that the ambulance won’t be there for their emergency straight away and they will attend asap when they can and that is worrying.? Sometimes as long as 30 minutes even when symptoms are serious.!!
I believe that things have changed and this is going to be the normal and we’ve got to get used to it unfortunately. 😢
The NHS care i have received has always been top notch and I've never had reason to complain. However I was scared out of my wits at the thought of waiting 8 hours for an ambulance with a heart related incident that could of taken a turn for the worse. Im 34 with a panicked hubby and 3 small children worried. Lots of people live with health conditions and rely on the NHS but what about when things suddenly go wrong such as HA, stroke, collisions etc. Who is there to help immediately? I was lucky my nneighbour happened to be outside and took me to hospital. What is going on in the NHS? I feel this is not just down to the pandemic but more deep rooted.
Last year when 111 decided I needed an ambulance several times I think the longest I waited was approx 35 mins. This year, the first time I cancelled the ambulance after just over 7 hours, the second time I cancelled after just under 4 hours. I cancelled as the red flag symptoms had gone, so I had no desire to add to the already over-burdened emergency services. I'm still waiting for my overdue appointment with cardiologist to discuss these symptoms. I recently rang 111 for advice, they wanted me to speak to a clinician "within half an hour." That took 3 hours, then they wanted me to speak to an out of hours doctor, supposed to be within an hour, but it took two. I'm not complaining, they have to prioritise and have huge workloads, but I refused the ambulance she wanted to send, telling me it was a cat 2 call and would be about 90 minutes.Before I'm chastised for not taking medical advice, I was only seeking an opinion about whether I was justified in pushing for an urgent GP appointment, and I have had these symptoms before.
I cannot imagine the stress on all the people working in the NHS, thank you to all of tgem.
Unfortunately what you have described is one of the ‘wonderful’ interventions brought about in the NHS to make it better. I have no idea how well qualified the people are on the end of the 111 line. It beggars the question that if they are very well qualified, would they not be better working on the ‘true’ frontline and not in a call centre? The follow up question has to be, if they are not well qualified, then why not? When someone phones 111 off course they are looking for expert advice. My heart condition often resolves on its own - it’s a matter of time. I am pretty experienced with it and know the red flags. What I never know however is, if it does not resolve within its time, I have already wasted up to 90 precious minutes. So, do I call an ambulance/get to hospital under my own steam? All the time thinking/worrying I am taking up some precious NHS resources that someone else could be needing more. My sense is that anyone working the 111 helpline will naturally err on the side of caution and send an ambulance anyway. Who would want to be in their shoes getting word back that someone had died on their watch? The system is actually set up to fail patients, staff and finances. There may be some small saving, somewhere, but really it’s a big cover up for lack of investment in staff and the NHS itself.
Yes, they will all err on the side of caution, and I feel the same way as you, given the delays how long should I wait? Or should I disturb my faithful lift-givers in the middle of the night? I wish they could create a finger prick test that would give troponin levels, then we'd have a better idea.
I am not so sure testing your troponin levels at home is the answer. Troponin levels cannot be intrepreted in isolation.
Troponin levels can be raised for other reasons not just heart attacks.
Troponin levels can be low during an episode of unstable angina only to rise later.
You could stay at home when you should be in hospital being assessed for possible acute coronary syndrome.
I know the BHF were conducting a clinical trial to get much quicker results for Troponin levels, I’m not sure if it concluded or was disrupted by the pandemic. I will research this and find out. I’ve been to A&E myself a couple of times and had to wait a while for the lab results. Unequivocally quicker/faster equals better for this test.
Myocin C(cMyC) is being studied at a team by Kings College London.One issues that needs resolving is whether sex and ethnicity may affect the levels.
bhf.org.uk/research-project...
Also a salvia test is being developed.
medscape.com/viewarticle/93...
I unfortunately have to go into hospital at least once or twice a year with unstable angina.
In 15 visits I have been admitted.
I think the nhs is a brilliant system and has served us well. But politically it become a porn in a broken political system. From my experience the testing and care I have had has been good, but when I was asked by my doctor go to a and e initially I had to make my own way is was a 4 hour wait for an ambulance even from a doctors surgery. The way I see it from around where I live, too many hospitals have been closed and too much responsibility is is placed on large Central hospitals which have to cover large areas of the county. We have lost small cottage hospitals which would have been used for converlesants. Major towns have lost hospitals and many towns have to now go to one hospital which can be up to 20 or 30 miles away or even further. I don't really know why the ambulance system has failed. Possibly lack of resources. But again everything becomes centralised. So because you have lost a hospital in a town you then loose its ambulances. If you had a cottage hospital in a small village it would have had one or two ambulances serving that hospital and that village and surrounding area. With any emergency time is the essence. We are still struggling to see a doctor face to face. The blasted virus we have all been through. Which from what I have read may have been about well before 2020. Has caused the excuse of telephone appointments first. I don't know what the answer is but I do know that all towns should have a hospital. Large enough to except the capacity of that town but towns are getting bigger.
Hi all, I don't know if I have been lucky, if you can call it that with a dicky ticker, I have found the NHS amazing in all departments I have been referred to, I was at dermatology due to high risk of skin cancer I told her about the GP saying I had athritis in my hands she arranged an x.ray there and then and now I have an appointment with the rheumatologist next week, I phoned my GP on Monday as I thought I might have a chest infection I got to see him 30 minutes later and got antibiotics, I also got a physio appointment without waiting too long. Fortunately I have never had to phone an ambulance so I don't know much about the waiting times. My mum who was born in 1929 has always spoke about when she was young if you needed a Dr the family wasn't able to eat as it was so costly, how horrendous to have to make that choice. I know the NHS has terrible failings especially when I read about the wait for an ambulance and there is far too much admin but the skills the surgeon's have is nothing short of brilliance and the care and dedication of a lot of nurses is wonderful. I thank them every day char
I must have been lucky too then because they have always been excellent with me. I cannot fault them one little bit and very grateful to them!!
Hi parrot I totally agree with your sentiment but there is wide variations in personal experience. It all comes down to funding, or lack thereof, and then we’re into the realms of politics \economics etc. For what it’s worth I personally would be happy to pay more tax if I was assured it was going to the NHS.
I'm not disagreeing with you at all. In fact, it was on the BBC News last Night about it again, saying how it is affecting ALL the Staff, mentally, emotionally, physically as they are ALL feeling the Strain. Yes, I would too because I feel really sorry for them!
Thanks for sharing. AE are stretched; and bed capacity is tight. Ambulances are held up at AE as they cannot "unload" their patients. One of the major issues is that we have patients are ready to be discharged but there is not social care. In one hospital they have in excess of 30 beds held up (sometimes referred to as "bed blocking"). Some hospitals have had to declare " an incidents" meaning they can do their work safely - this is serious". You had on top of that staff who are stressed close to break point. I do not wish to be alarmist, the above is first hand experience. Still, the staff are excellent and go well beyond the call of duty to care for patients.
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