The NHS Thread

[Demitri_C]

Surprised we don't have one. But this change is being implemented 

Quote

 

GPs to start capping appointments in work-to-rule

1 August 2024, 01:46 BST

 

GPs across England will start capping the number of patients they are willing to see, after the British Medical Association (BMA) announced an immediate work-to-rule action.

The BMA has told its members they can limit appointments to 25 a day – some GPs see more than 40 at times - in a dispute over funding levels.

In a ballot, 98% of GP members backed taking action, with the union saying a lack of funding is putting practices at risk.

NHS England has warned the action could cause significant disruption beyond just GP services.

In a letter to senior NHS managers last month it said this could include increasing pressure and waits in A&E, slowing down the discharge of patients to hospital, and disrupting referrals into hospital for planned treatments, like hip and knee operations.

It warned that, as with other disputes, “maintaining services for patients with urgent needs, such as deteriorating conditions” was key.

But NHS England national director for primary care Dr Amanda Doyle said if a patient needs to see a GP they should "continue to come forward for care as practices will remain open".

 

Click

 

Not sure how this is going to help with alot of people already finding it difficult to get GP appointments, if a GP  lets say currently is booking 35 a day and now you are capping at 25. That's 50 appointments less a week. that is just going to add more pressure to hospitals and even more longer waiting times. A real worry to me. 

[Chindie]

It's not meant to help. It's meant to highlight their members are important and getting shafted, and the government needs to do something about it. Aka, spend some **** money.

[markavfc40]

Just one of the many legacy's the last government has left for the new one to try to sort out. The previous government only increased budgets by 1.9% in 2024/25 which will mean many surgeries will struggle to stay financially viable.

Part of industrial action and seeing 25 patients a day is only one headline grabbing option. 

The new government has already stated they will immediately recruit an extra 1000 GP's (and yes there were remarkably that many and far more looking for work under the last government) which will be a start but like most of what has been left behind by the Tories it will take years to completely fix. 

The new health secretaries response to GP's is below:

 

[Chindie]

Unfortunately Streeting has a similar effect to appointing Basil Brush to the chairman of the board of Henhouse Safety.

 

[Demitri_C]

6 hours ago, markavfc40 said:

Just one of the many legacy's the last government has left for the new one to try to sort out. The previous government only increased budgets by 1.9% in 2024/25 which will mean many surgeries will struggle to stay financially viable.

Part of industrial action and seeing 25 patients a day is only one headline grabbing option. 

The new government has already stated they will immediately recruit an extra 1000 GP's (and yes there were remarkably that many and far more looking for work under the last government) which will be a start but like most of what has been left behind by the Tories it will take years to completely fix. 

The new health secretaries response to GP's is below:

 

Do you remember the old way under labour before the tories completely **** up the bpoking process?

I dont know if anyone elses does this- but before they would book slots 10-14 days in advance so you could generally get appointments. Then this shit way now call on day 8am on dot and you are 35th in queue then by time you get through all GP appointments are gone. Call back next day same again.

Its such a shit system and needs to revert back to old way. Also stop the bloody telephone appointments and start seeing more face to face appointments 

[choffer]

1 hour ago, Demitri_C said:

Do you remember the old way under labour before the tories completely **** up the bpoking process?

I dont know if anyone elses does this- but before they would book slots 10-14 days in advance so you could generally get appointments. Then this shit way now call on day 8am on dot and you are 35th in queue then by time you get through all GP appointments are gone. Call back next day same again.

Its such a shit system and needs to revert back to old way. Also stop the bloody telephone appointments and start seeing more face to face appointments 

That’s not the system my surgery use. For me, I log on, select which GP I want to see (I always choose the Sri Lankan fella because he’s awesome) and then I see what appointments he has available. I pick one that’s available and then I go see him then at the agreed date/time. 
If it’s an emergency appointment, I guess things are a bit different but I’ve never struggled to get an appointment when I’ve wanted one. 

[regular_john]

8 hours ago, Demitri_C said:

Do you remember the old way under labour before the tories completely **** up the bpoking process?

I dont know if anyone elses does this- but before they would book slots 10-14 days in advance so you could generally get appointments. Then this shit way now call on day 8am on dot and you are 35th in queue then by time you get through all GP appointments are gone. Call back next day same again.

Its such a shit system and needs to revert back to old way. Also stop the bloody telephone appointments and start seeing more face to face appointments 

Most practices offer a mix of appointment types.

Pre-bookable appointments can be more convenient for patients but often get wasted because people forget they've booked them, or the problem they booked in for has resolved, or something else gets in the way. The more pre-bookable appointments you have, the more appointments will go to waste. Guaranteed.

Same day appointments are more of a pain for patients but they (virtually) guarantee minimal waste, which is vital in a system as tightly squeezed as the NHS

[Demitri_C]

7 hours ago, choffer said:

That’s not the system my surgery use. For me, I log on, select which GP I want to see (I always choose the Sri Lankan fella because he’s awesome) and then I see what appointments he has available. I pick one that’s available and then I go see him then at the agreed date/time. 
If it’s an emergency appointment, I guess things are a bit different but I’ve never struggled to get an appointment when I’ve wanted one. 

I wish my GP had a system like this as thats what it use to be like and it is far superior.  So then really its the actual GPs choosing what system to use. Therefore they are equally at fault.

7 hours ago, regular_john said:

Most practices offer a mix of appointment types.

Pre-bookable appointments can be more convenient for patients but often get wasted because people forget they've booked them, or the problem they booked in for has resolved, or something else gets in the way. The more pre-bookable appointments you have, the more appointments will go to waste. Guaranteed.

Same day appointments are more of a pain for patients but they (virtually) guarantee minimal waste, which is vital in a system as tightly squeezed as the NHS

Im sorry but if you forgotten appointment within 7 days then as with a dentist you should be fined for that. As so many people need GP appointments and just wasting slots is costing NHS money. 

[foreveryoung]

All about reform, but it's a job no one wants. 

You could save a least a billion on senior management that are not needed and procurement which is a huge issue in the NHS.

[Demitri_C]

2 hours ago, foreveryoung said:

All about reform, but it's a job no one wants. 

You could save a least a billion on senior management that are not needed and procurement which is a huge issue in the NHS.

I dont understand how admin managers can make alot more money than doctors. Thats something that needs addressing.

With banding you have band 8s, A B C and the more seniors get a 9. In my view making admin managers at most a band 7 would save the nhs so much money. But as you say no one seems interested in doing it.

To be fair it is a huge job that would take a lot of time and money

[GarethRDR]

14 minutes ago, Demitri_C said:

With banding you have band 8s, A B C and the more seniors get a 9. In my view making admin managers at most a band 7 would save the nhs so much money. But as you say no one seems interested in doing it.

Define "Admin Manager"?  Front-line roles being woefully underpaid and managerial salaries not being competitive to equivalent private sector roles aren't mutually exclusive points.  You want to cap those salaries for roles with more readily transferable skills than clinical ones, you're staring down the barrel of a rapid skills-drain as all the useful people will be clearing off to other industries.

 

Edited August 2 by GarethRDR

[Demitri_C]

9 minutes ago, GarethRDR said:

Define "Admin Manager"?  Front-line roles being woefully underpaid and managerial salaries not being competitive to equivalent private sector roles aren't mutually exclusive points.  You want to cap those salaries for roles with more readily transferable skills than clinical ones, you're staring down the barrel of a rapid skills-drain as all the useful people will be clearing off to other industries.

 

Yes i want certain admin staff on a higher scales paid less so we can use the money saved on recruiting more consultants and nurses and pay them more .

I think admin staff should get no more than a band 7 salary as that frees up so much money to pay nurses and doctors more.

Edited August 2 by Demitri_C

[Demitri_C]

Just to add gareth a top scale band 7 adds up to 52k a year (without the pay increase coming)

 

Do You really need senior operation managers who earn up to 100k a year?

 

Edited August 2 by Demitri_C

[Mandy Lifeboats]

I can't understand the GPs taking this action now.  The new government is not even a month old.  There's been no time to make any significant changes. 

I find it a little ironic how my own GP surgery reacts to change and how hypocritical (no pun intended) they are.  

A few years ago nothing could be done over the phone.  I get repeated ear infections.  I know when I get one.  I know exactly the right drops because they were mandated by an ENT specialist and noted on my records.  But I always had to visit in person so that the GP could tell me what I already know and prescribe the drops noted on my records as being applicable.  The justification was that it was unsafe because there might be another symptom that I am not aware of. Last year my GP diagnosed a chest infection over the phone and insisted that it was safe to do so. 

 

Edited August 2 by Mandy Lifeboats
Spelling mishsteaks

[Davkaus]

I was listening to a BMA rep on LBC this morning and apparently their starting position is the GP funding needs to go from something like 6% of the overall NHS budget to 15%, which to me seemed like an astonishing ask on the face of it, but I can't find data on how that lines up to historical funding

[foreveryoung]

1 hour ago, Demitri_C said:

Just to add gareth a top scale band 7 adds up to 52k a year (without the pay increase coming)

 

Do You really need senior operation managers who earn up to 100k a year?

 

I think I've said before in here, but it just sticks in my head.

My moms friend earns £90k a year and works 4 days a week for the NHS. Even my mom has mentioned she's not actually sure what she does anymore, as everytime she calls her for coffee or lunch she's available. 

I'm sure she's not the only one either.

[markavfc40]

48 minutes ago, Davkaus said:

I was listening to a BMA rep on LBC this morning and apparently their starting position is the GP funding needs to go from something like 6% of the overall NHS budget to 15%, which to me seemed like an astonishing ask on the face of it, but I can't find data on how that lines up to historical funding

I have found the below from what looks like a report from around 2014. Seems GP funding peaked at around 11% of overall NHS budget in 2006.

 

 

https://www.jamesstreetsurgery.com/wp-content/uploads/2019/05/backgp.pdf

Edited August 2 by markavfc40

[GarethRDR]

1 hour ago, Demitri_C said:

Just to add gareth a top scale band 7 adds up to 52k a year (without the pay increase coming)

 

Do You really need senior operation managers who earn up to 100k a year?

 

I know full well what the bandings are, and what the proposal means.  I also know how difficult it is to even get to 5 years of experience at any level of banding, when you're constantly going through organisational restructures, delegation etc. which ultimately means your job has minimal long-term security, and you're effectively having to re-apply for it every 5 years or less.

I also don't know any "Senior Operations Manager" role I've ever seen advertised that sits at an 8D or 9 level, which is what you've described in your second sentence, as nebulous a job title as that is. 8Ds and 9s are programme directors, senior strategic leadership and so on.

This is to say absolutely nothing about the number of people who get asked to "act up" into roles without being compensated. with only the hope of a role further down the line.

Are their individuals drawing a salary above their competency?  I've known a couple, absolutely.  That goes for every industry I have ever worked in.

[Davkaus]

Indeed, most senior operations managers would be band 7s through to 8b. Maybe there are some a band or two higher pushing 6 figures, but they must have some very unusual responsibilities because it's certainly not the norm.

I'm not particularly confident that reducing bandings and capping pay much lower is a way to improve the efficiency of the NHS

[Demitri_C]

1 hour ago, GarethRDR said:

I know full well what the bandings are, and what the proposal means.  I also know how difficult it is to even get to 5 years of experience at any level of banding, when you're constantly going through organisational restructures, delegation etc. which ultimately means your job has minimal long-term security, and you're effectively having to re-apply for it every 5 years or less.

I also don't know any "Senior Operations Manager" role I've ever seen advertised that sits at an 8D or 9 level, which is what you've described in your second sentence, as nebulous a job title as that is. 8Ds and 9s are programme directors, senior strategic leadership and so on.

This is to say absolutely nothing about the number of people who get asked to "act up" into roles without being compensated. with only the hope of a role further down the line.

Are their individuals drawing a salary above their competency?  I've known a couple, absolutely.  That goes for every industry I have ever worked in.

Well there is currently two 8D internal operational roles being recruited internally on my trusts sites one for trauma and orthopaedics and the other is for neurology.

Also i said the more seniors are band 9s which are for directors cheif execs etc.

Im not quite sure what you mean about re applying every 5 years? How many consultations has your trust been through in last 10 years? I havent been through any in last 12 years last one was under a Labour government- but even if you do have to reapply which is rare they will redeploy you to another section of the trust as they very rarely offer redundancies. That wont effe t your years service unless you leave.

I think the pays all wrong - admin staff shouldn't be earning more than doctors ad nurses and thats me saying that who has been in admin. In a ideal world both could earn the same bandings but there is no money for that. You could make just make band 7s only but pay slightly more at the top of the 7s compared to what they are now. For example just under half of what a band 8 gets now

Edited August 2 by Demitri_C