Category Archives: Health

GPs complain of ‘malicious criticism’ over plan to increase face-to-face appointments

I  believe there is misinformation and lack of understanding on all sides, being doctors, Government and patients and no one is listening to the others.

For GPs to say patients are not wanting face to face is far from what I hear, as this is leading to many misdiagnosis leading to some deaths and much suffering on patients.

Some telephone appointments are better than face to face, but many patients are not even being given a choice. There is talk of some patients being given video links, but certainly not at my practice.

But the Government is not listening as they are totally blaming GPs which is not right for much of the problem is serious lack of funding by Governments over the years.

Then patients are not seeing the true picture as they can’t believe the information coming from GPs and certainly the Government.

So it is not just down to money for there is  a serious lack of trust from and by all parties, so trust has to be gained and then also have the required investment. For trust there has to be total transparency and this is down to Government and GPs, which I can’t see coming from either side.

But it is not all down to health funding, but also a greater need for substantial funding in Social Care, which could even be a greater issue than funding for health and even a greater need on Government to fully understand all the issues in Social Care, which they are totally unwilling to do currently. For even when the Government does mention Social Care, they only appear to believe this is for the elderly, when it is for all age areas from young children through all the years to the elderly.

By not dealing with Social Care issues the Government is putting much more pressures on health, which health could well do without.

So, on reflection the Government is the major cause of the problems, followed by GPs and then patients, but to solve all need to be on-board

 

 

Source: GPs complain of ‘malicious criticism’ over plan to increase face-to-face appointments

Government’s “rescue package” will prompt more GPs to quit, leaders warn | The BMJ

This may be correct to some extent, but is it the Government or the GPs who are out of touch, as I feel patients will largely welcome face to face, rather than the impersonal telephone appointments or video if you are lucky. In fact you are extremely lucky to get any form of appointment currently.

Currently my own health is not good so I am contacting my GP more often than I would normally have done and when I have managed to get through, after, more often than not, having been in a queue for going on 30 mins and sometimes a hour, only to be told all appointments have gone and never even offered any face to face, for those gone are only telephone appointments . My practice does not extend to video and telephone is the only form of communication as they have not joined the email age.

So are my practice offering face to face, who knows for the Receptionists are not forthcoming.

In the past, well before COVID, I have said that some face to face are not required, especially  if it is just to get results of tests, but then you were never offered telephone appointments, only face to face.

So it has gone from one extreme to another, when it should be a suitable mix.

I sometimes get the opinion that patients are just getting in the way and that no one in the practice cares anything for patients, this is, to some extent, also the way with hospital appointments, but not as grave as with GPs.

It is also one of the reasons why A&E visits are more in demand than previously, as people know when you get there you will be seen, even though the wait will be very lengthy. But not so with GPs for you are not allowed to enter a surgery unless you have a face to face appointment, when you can get one.

GPs could well be voting with their feet and yes they are under great pressure and well over worked, but so are very many of us.

But by not seeing patients many diagnosis are going unknown, for much of a diagnosis process is by observing patients, which can’t be done over a telephone and also not in some instances by video, if you can get them.

This is leading to many conditions not being diagnosed until it is too late, as many with, say, Cancer have found to their cost.

There is a shortage of GPs and if some are leaving this will make a serious situation very much worse, but there are shortages in many areas and in some of these health is also at stake, such as lack of social care, but the Government is virtually doing nothing on this.

I feel it is going to get much worse before there are any signs of any improvements.

Source: Government’s “rescue package” will prompt more GPs to quit, leaders warn | The BMJ

Covid response ‘one of UK’s worst ever public health failures’ | Health policy | The Guardian

Most of what is in this report, if not all, should have been known at the time and unfortunately is still occurring to some extent.

These were down to political mistakes and it is more than mistakes, it is complete disregard for various sectors of Society and today this is still occurring.

The only success was the COVID vaccination programme, but even though this was and still is successful, there are still areas were it is not.

While there were many areas where other actions should have been taken, much of what should have been done is to look at various sectors of Society.

One of the main areas is how persons with learning disabilities were viewed and here in the vaccination programme there was a considerable delay in including those persons in the priority groups. Then when they did it was mainly only one section, being those with Downs Syndrome when all should have been included.

But, even now many persons with Learning Disabilities (LD) are being excluded from the vaccination programme, while they are being offered the vaccine it is by injection only. But many persons within the UK are averse to needles and while persons without LD will, in the main have the capacity to understand what is occurring, many persons who are needle averse and also have LD do not have the capacity to understand how important it is to have the vaccination and to overcome their aversion.

With the flu vaccination programme adults with LD who are averse to needles are offered the nasal spray which is usually only given to children. So why are they not being offered a nasal spray in respect of COVID.

Well it is because, currently, there is not an effective nasal spray available, but research has been taking place. albeit, much later than the research for the injected vaccine. But, this research is not, I believe progressing very well as it is being found that the current COVID vaccines are proving difficult to changing into a form suitable for a nasal spray. If, as much effort was being put in as was for the original vaccines, then more than likely a suitable way to convert would be found. However, I believe that because the vaccination programme was and is currently a success there is no Government pressure being brought to find a suitable nasal spray, so it appears persons with LD who are needle averse are being abandoned, yet again by this Government.

So, will an enquiry prove this was again a mistake, maybe or maybe not for the inquiry needs to be allowed to look into this aspect, but will it and even then it will be too late for the persons with LD who are needle averse.

The Government needs to make no more mistakes and demand and provide the required recourses for a nasal spray to be found.

Currently, a COVID tablet is being put forward for authorisation to be used in America and this needs to be so in the UK as well.

But, the requirement for a nasal spray should not be abandoned.

 

 

Source: Covid response ‘one of UK’s worst ever public health failures’ | Health policy | The Guardian

Sheffield doctor and patient relationships now facing terrible strain | The Star

Everyone of us is under strain, due to 2 years of ongoing COVID, now is it COVID or is COVID now the one excuse quoted like the old favourite ‘the cheque is in the post’ who knows for no one is going to admit.

In General Practice it was once said that a majority of giving a diagnosis was by observations and only a small part by investigation, but now most, if not all appointments are by phone, that is if you can even get an appointment for by the time most people get through on the phone the appointments have gone. It is even notice that you can get to 1 in the queue and then you lose connection and if you have another hour to spare you ring again.

Most people do not have the time to wait in phone queues and are frustrated by the time  they get through and even more so if the wait is a waste of time because there are then no appointment or you are cut off.

So what is being missed by not having face to face appointments, I would say very much and this as still to filter through the system.

Yes, there are always systems, but we are individual people and not pawns to be juggled in an un controllable and so inflexible system. Then it is not just one system but many systems all working against each other.

These systems are very close to breaking as are the mentality of us all, so what is being stored in the name of the future. Is it purely COVID or is it a very serious lack of investment that many Governments, not just this one have ignored for , especially the ‘British Railways sandwhichmany years.

We saw all this in manufacturing, and many of the nationalised industries, which is why manufacturing was allowed to go to the wall to a large extent and why many if not all our previous nationalised industries were hardly ever properly invested in.

Take our railways, we invented the railways and to a large extent we then rested on our laurels and very little necessary investment was made to ensure our railways were the envy of the world, instead of becoming a laughing stock, especially the ‘British Railway sandwich’.

With the advent of privatisation the food was seen to improve as did much of the rolling stock and the speed of trains. But punctuality was always a main issue, but how much of this punctuality was down the the rail train operators and how much was down to the track and signals which currently is all but nationalised.

Investment is always the key, but one that is not acted upon in many instances as there are always assumed greater priorities occurring and investment is then put to one side never to be visited again, ‘kicked down a never-ending road’.

If investments were made when needed then many problems would not occur, but shortsightedness, is always the first port of call.

So it is investment, the lack of, which is the main factor in GP /patient relationships, leading to the creation of many problems still to surface.

 

Source: Sheffield doctor and patient relationships now facing terrible strain | The Star

Vulnerable patient’s death at private hospital is a ‘scandal’, says mother | Hospitals | The Guardian

Yet another scandal regarding to persons with learning Disabilities, so why are these situations allowed to happen and why are there no prosecutions on the persons who allowed the scandals to occur, where is the accountability.

Where is the public outcry?

Where is the Government action?

What are the Legal Authorities doing?

What are the authorities doing about the supervision and monitoring of all the various areas which are involved in the caring of persons with Learning Disabilities?

So many What’s and Where’s, but are any being answered, I fear not and if not why.

Is Learning Disability and/or Autism really at the forefront of Safeguarding and if not why not?

Is this Government doing all it can to safeguard persons with Learning Disabilities and/or Autism and as any previous Governments done so? On all counts I regret the answer is no.

In the UK there are approximately 1.5 million people with a Learning Disability (2019), with approximately 1% of the UK population has autism

More information regarding Learning Disability in Yorkshire and Humber (2012)

In 2020 the Population of the UK was around 67 million

There is a NHS Learning Disability Register, please if you have a learning Disability or you have a relative with a Learning disability please ensure you or they are recorded on the Register

In Sheffield there is a local Sheffield Learning Disability Register please ensure if you are in Sheffield with a Learning Disability you are also on this register, you can register by using this form.

 

Source: Vulnerable patient’s death at private hospital is a ‘scandal’, says mother | Hospitals | The Guardian

Boris Johnson has created a ‘social care plan’ without any plan for social care | Frances Ryan | The Guardian

A very good article which has looked at many of the issues around Social Care and a great pity that the Prime Minister, Boris Johnson, MP did not have the benefit of the points in the article. However, even, if he had he would have discounted many, if not all for in his supposed good plan he has gone down political lines, instead of non-political lines and put Social Care and those in need of Social care and those working in Social Care first, rather than thinking too much re political concerns.

But, give him some benefit of thought for at least he has done something, which none of his predecessors have done be they Labour or Conservative, even though it is way insufficient. National Insurance (NI) has to be one avenue, but also does Capital Gains Tax and possibly Income Tax and Business Rates  or some other venture.

In  NI some consideration should have been give to increasing the paltry 2% for earnings above £150000 say to 14%.

In Business Rates look at bringing Multi-National Companies into line and cut back on the loopholes where they can reduce their entitlement to pay on their revised profits.

In Income Tax and Capital Gains Tax rates should be looked at to increase by 1% or 2%, with also the tax free allowances being substantially increased to offset any increased taxation on those on low incomes.

Also consideration should be considered to bring Social Care into line with the NHS Health Services as it too should be free at the point of delivery to counter the discrimination between the two.

Prescription Charges, together with Dental and Optician charges should also be abolished, as should the costs of some medications and also equipment required in health and social care settings.

Only when all of the above together with a minimum salary rate of £14 per hour for all care workers and austerity cuts be reversed to all Local Authorities.

Lets for once in the UK have a financial outlook for both health and Social Services which delivers what should be and not governed by political outlooks of any party, but to benefit those who have to rely on both Health and Social Care Services which we are all proud of.

 

Source: Boris Johnson has created a ‘social care plan’ without any plan for social care | Frances Ryan | The Guardian

Rise in national insurance could fund post-Covid boost for NHS | Coronavirus | The Guardian

Source suggests government will expedite manifesto-busting 1p rise before party conference season


£10 billion seems a lot, but not only will it not be sufficient for both the NHS and Social Care, it is not even sufficient for Social Care, as it will only bring the funding back to the 2010 level, which in itself was wholly insufficient.

Source: Rise in national insurance could fund post-Covid boost for NHS | Coronavirus | The Guardian

National Insurance: Minister refuses to deny reports of tax hike for social care – BBC News

The justice secretary says social care must be properly funded but declines to “speculate” on plans.


I completely agree that Social care should be properly funded and I would say, totally funded, but there is a problems, one of many.

Currently, is there sufficient funding to be funding back to 2010 levels which is around £10 billion, I fear not.

Then, it was not sufficient to provide all the Social Care required, as directed by the Assessments of Needs done in 2010 and funding has dropped considerably so many in need of Social Care or receiving no care or a bare, insufficient minimum.

But the problem is even deeper than that, as for many years Assessments of Need have not been sufficiently completed, as not all reasonable needs have been recorded, only those that the assessor felt would be funded. So, in affect, there is no written record of the total care needs that are required, even from 2010 and since then many more have not been recorded.

In fact, many in need of care have not been coming forward, until the situations reached a safeguarding situation and not even then, which has results in many persons suffering when they should not have been and for some the ultimate was the outcome, being deaths.

Any none covering of needs, will eventually cause even more demands on the NHS, so the continuous ignoring of the problems in Social Care has had dire effects on the NHS and will continue to do so for many years to come, even if sufficient funding is made immediately.

For Social Care can’t be looked on in isolation from health as they are so intermixed, lack of social care requiring more health involvement and with health continuing involvement as there is insufficient social care to allow discharges from health care. This causing many to be kept in hospital longer than should be or in some instances discharged before any social care has been organised, which in some respects could have caused some of the elderly discharges into Nursing Homes and the result being excess deaths from COVID-19.

To say this is now the 21st century, the complete lack of dealing with the Social Care crisis is in effect, bringing health and social care back to the 19th century or even earlier.

People in authority have to be brought to account, both currently and even more so, previously.

Funding is but one aspect, but there are many others, some being

a severe lack of people wishing to come to be employed in Social Care

Government interventions to severely restrict people wishing to come from outside the UK to work in Social Care

Abysmal rates of pay for the work undertaken and the responsibilities

Poor working conditions

In some instances the lack of dignity and respect by persons working in Social Care for the persons they are caring for

The lack of sufficient quality of care supervision by, not only, Care Providers but also the Statutory Authorities, which includes Local Authorities and CQC(Care Quality Commission) which has been shown in Winterbourne Scandal, and many more since.

Much needs to be done, but there is very little action being taken currently and this needs to change immediately, for it appears this Government are happy to see deaths to occur as this reduces the amount of persons needing to be looked after.

 

Source: National Insurance: Minister refuses to deny reports of tax hike for social care – BBC News

A ‘national shame’: MPs demand an end to some autistic people being detained for years | UK News | Sky News

I do not usually agree with MPS, but in this instance I agree wholeheartedly with them for hospitals ate supposed to be there to cure persons with illnesses and autism and learning disabilities (LD) are not illnesses, but conditions and there is no cure. To give the impression there is should be made illegal and not, as currently incorporated into Law. Hospitals are not supposed to be prisons for you always have a right to leave an hospital, even if it is not recommended, unless it is deemed you do not have the capacity to do so. In which case, a ‘Best Interest Advisor is appointed, under the terms of DoLS (Deprivation of Liberty Safeguards) in the Mental Health Act 1983 as amended in Mental Capacity Act 2005.

It is totally wrong to place persons with autism and also learning disabilities in any form of captivity as not only is this restricting their freedom, but the whole act of restriction makes their condition worse, and it is this worsening, which is usually used to justify their continued admission.

They are not being helped, but are in effect being kept out of Society by misguided intentions and making them have a worsening quality of life, so I agree the Institutions need to be closed.

But by the reliance on these institutions nothing is being done to create much more suitable accommodations, where their freedoms are respected with appropriate care being offered.

This will require a whole new process, much more funding and employment and training of staff. Also a re-education of many Health, Justice, Social Care and Legal staff and organisations. In fact, in reality the Care and Treatment facilities and not that much different to the Mental health institutions they were meant to replace. In these many of the persons with Mental health issues have been discharged into the community but not that many LD and autism have.

It is a disgrace and should be illegal that the required funding for improvements are not being funded. But, to some extent this is all connected with the complete in ability to fund Social Care and not fully fund health and mental health, due to political motives.

All these areas of health and care have to be fully funded, completely sufficient training be made available and for staffing levels to be filled 100%, if not we can’t say the UK is provided first class care to everyone.

If a realignment of capital spending is required then so be it for only then could we say the UK is working to provide good quality life for all of its population and not just a stated few.

: A ‘national shame’: MPs demand an end to some autistic people being detained for years | UK News | Sky News

NHS facing ‘unforgivable’ workforce crisis as number of doctors stands 25 years behind similar EU nations | Yorkshire Post

This is disgraceful, but it is what occurs when Governments are responsible for financing organisations, for the finance given is only what each Governments feels is sufficient, not whether it is sufficient or not.

It is the same with pay rises, which is of course a matter of concern currently, as only a derisory 1% has been put forward so far. But even when a pay uplift is authorised, it is usual for no additional funding to be given, but just taken from the funding already in place, so thereby making an insufficient funding even more insufficient.

Is this the way for any organisation to be funded, well the answer is no and especially an organisation, such as the NHS, which is a very essential service.

But, at least they are receiving some increased funding, which can’t be said for social care, for if the NHS is in crisis, the crisis in Social Care is even more so. When considering the close relationship between the NHS and Social Care is even more worrying news, for any crisis in Social Care will cause even more demands on the NHS, causing even more demands on the insufficient funding on the NHS.

So, what is the answer, well the answer is that both the NHS and Social Care need to be sufficiently fund, not tomorrow, but immediately, for any delays will only increase the extent of the crisis in both the NHS and Social Care.

This is why I support the petition, Solve the crisis in Social Care,

https://you.38degrees.org.uk/petitions/solve-the-crisis-in-social-care

So if you care for either the NHS or Social Care or both, then you need to be considering supporting this petition.

 

: NHS facing ‘unforgivable’ workforce crisis as number of doctors stands 25 years behind similar EU nations | Yorkshire Post