Dedworth
30th July 2013, 09:18
Once again, we are left rubbing our eyes in disbelief at the utter shambles that passes for the administration of a public service.
The NHS 111 service, which answers non-emergency calls from the public, is close to collapse after its main provider pulled out.
NHS Direct, which originally won 11 of the 46 contracts to provide the service around the country, has abandoned them, saying the deals were ‘financially unsustainable’.
The 111 service has been a disaster from the start. It is staffed by people who, sometimes after as little as two weeks of training, use a computer system to assess how unwell callers are and decide whether to issue advice over the phone, call a nurse or send for an ambulance.
The call centres are typically staffed by 60 unqualified workers and up to 15 nurses.
Staff numbers decline dramatically during night and weekend shifts, leaving unqualified workers to make snap decisions about people who may be critically ill. Some managers warn that staff shortages make the service unsafe at weekends.
An undercover investigation by Channel 4’s Despatches, screened last night, found that patients can wait hours to speak to a nurse. With too few people staffing the phones, the programme’s undercover journalists were filmed being given medical advice by workers who were not clinicians.
Such is the chaos that ambulances are dispatched to deal with hangovers, coughs, colds and even cat scratches.
Deplorable as all this is, the knock-on effect on hospital accident and emergency departments has been even more catastrophic.
With calls to the 111 phone lines going unanswered, and with patients deeply reluctant to seek medical advice from non-medical call-centre staff, such people are inundating A&E departments as their first port of call.
The result, according to some doctors, is that A&E departments have turned into ‘war zones’. Call this a professional health service? The words knees-up, organise and brewery come to mind.
Yet of course the response of officialdom is robotic complacency.
Thus, Dame Barbara Hakin, NHS England’s deputy chief executive, declared: ‘Over 90 per cent of NHS 111 calls are now answered in under a minute and patients are rating the service highly.’
You do have to wonder just what it would take for someone like this to express the only possible decent reaction – horror at a breakdown of the most basic standards of professionalism and care for the sick, not to mention personal responsibility for presiding over such a shambles.
In any event, you may well also wonder about this proliferation of organisations such as NHS Direct and NHS 111. Whatever happened to the notion that – outside emergencies – if you needed medical advice or treatment you went to your GP? The answer to that question explains much of what has gone wrong with NHS.
In the late Nineties, NHS Direct was set up to deliver 24-hour medical advice on the phone by nurses and others, because people found it increasingly difficult to get to see a GP. Its successor service, NHS 111, which started last April was supposed to be more efficient and better connected to the rest of the health system.
From the start, however, this was bedevilled by problems.
In March, the British Medical Association called for it to be delayed, saying it was badly worked out, confused and would put patients at risk.
By May, the Royal College of General Practitioners said patients had already lost confidence in the system.
The real cause of the problem, however, is the reason these services were deemed necessary in the first place.
That was because GPs were no longer prepared to deliver patient care seven days a week, 24 hours a day. Some of the world’s finest doctors work in the NHS but the brutal fact is that many got greedy and selfish, and destroyed the ethic of care at the heart of the NHS.
The rot set in under the last Labour government, when the GPs pulled off an outrageous deal in which their pay rocketed upwards to more than £100,000 a year while the hours they worked plummeted.
No longer recognising an unequivocal duty to their patients, they turned themselves into 9-to-5 workers.
We know that – shockingly – more patients die at weekends because of patchy medical care. Yet recently more than half of family doctors questioned in a survey said they wanted to charge patients up to £150 for an appointment because they were so stressed they faced ‘burnout’.
This eclipse of clinical conscience in turn has gone hand in hand with a general erosion of political accountability for the NHS, with ministers out-sourcing the day-to-day running to a series of quangos.
The ostensible reason was to make the service more responsive to the public by loosening Whitehall’s controlling strings. In fact, this enabled ministers to wash their hands of responsibility if things went wrong.
The outcome was an ever-more monstrous bureaucracy in which ‘out-sourcing’ became an epidemic disease. Ministers out-sourced policy to quangocrats. GPs out-sourced out-of-hours care to NHS Direct, which out-sourced it in turn to NHS 111.
Doctors out-sourced clinical care to nurses. Nurses out-sourced humanity and compassion to the cleaning staff. And blame was even out-sourced from human beings to machines.
Apparently, the dispatch by NHS 111 of ambulances to deal with trivial complaints is the fault of something called the ‘risk-averse computer’, which sends out ambulances unnecessarily because of the fear of missing something. Computers with over-cautious dispositions! Who knew?
The result is now laid out for all to see – a mad NHS merry-go-round in which the sick are fobbed off with poor advice or left hanging on the phone for hours while ambulances are dispatched to deal with scratches from the household pet and A&E departments descend into bedlam.
And, meanwhile, knighthoods and damehoods are handed out faster than aspirin prescriptions to the bureaucrats presiding over this mess, who emerge from beneath their otherwise impenetrable shield of incomprehensible management-speak to intone unctuous pieties about everything being for the best in the NHS, the best of all possible healthcare systems.
The deeper problem behind the disaster of NHS 111 lies, in fact, with the NHS itself.
It has been obvious for years now that it is simply unable to cope with the demands being made of it.
Despite being ring-fenced and having money poured into it, the NHS still does not have enough cash and never will be able to satisfy the unstoppable and ever-expanding demand.
The idea of a centralised health care system purporting to provide out of direct taxation the same excellent level of health care for everyone free at the point of use is now demonstrably unsustainable.
On the other hand, anyone who receives treatment in France, Germany or other European countries where health care is based on social insurance systems sees that standards there are infinitely superior.
Yet British politicians are terrified of challenging the country’s most sacred – but tottering – cow.
Accordingly, they continue to propagate the myth that the NHS represents Britain’s sanctified temple of compassion and conscience.
And to insulate themselves from the lethal fallout as this temple crumbles, they have created a pyramid of out-sourcing and targets and ‘providers’ out-sourcing targets to other ‘providers’ – in which ultimately no-one takes responsibility for sending patient care down the sluice.
The 111 debacle is but a symptom of a deeper sickness – a health service in which patients are being sacrificed to an idea whose time has gone.
Read more: http://www.dailymail.co.uk/debate/article-2381028/MELANIE-PHILLIPS-Shambles-just-beggars-belief-The-111-service-disaster-start.html#ixzz2aVyMikTp
The NHS - envy of the world :NoNo:
The NHS 111 service, which answers non-emergency calls from the public, is close to collapse after its main provider pulled out.
NHS Direct, which originally won 11 of the 46 contracts to provide the service around the country, has abandoned them, saying the deals were ‘financially unsustainable’.
The 111 service has been a disaster from the start. It is staffed by people who, sometimes after as little as two weeks of training, use a computer system to assess how unwell callers are and decide whether to issue advice over the phone, call a nurse or send for an ambulance.
The call centres are typically staffed by 60 unqualified workers and up to 15 nurses.
Staff numbers decline dramatically during night and weekend shifts, leaving unqualified workers to make snap decisions about people who may be critically ill. Some managers warn that staff shortages make the service unsafe at weekends.
An undercover investigation by Channel 4’s Despatches, screened last night, found that patients can wait hours to speak to a nurse. With too few people staffing the phones, the programme’s undercover journalists were filmed being given medical advice by workers who were not clinicians.
Such is the chaos that ambulances are dispatched to deal with hangovers, coughs, colds and even cat scratches.
Deplorable as all this is, the knock-on effect on hospital accident and emergency departments has been even more catastrophic.
With calls to the 111 phone lines going unanswered, and with patients deeply reluctant to seek medical advice from non-medical call-centre staff, such people are inundating A&E departments as their first port of call.
The result, according to some doctors, is that A&E departments have turned into ‘war zones’. Call this a professional health service? The words knees-up, organise and brewery come to mind.
Yet of course the response of officialdom is robotic complacency.
Thus, Dame Barbara Hakin, NHS England’s deputy chief executive, declared: ‘Over 90 per cent of NHS 111 calls are now answered in under a minute and patients are rating the service highly.’
You do have to wonder just what it would take for someone like this to express the only possible decent reaction – horror at a breakdown of the most basic standards of professionalism and care for the sick, not to mention personal responsibility for presiding over such a shambles.
In any event, you may well also wonder about this proliferation of organisations such as NHS Direct and NHS 111. Whatever happened to the notion that – outside emergencies – if you needed medical advice or treatment you went to your GP? The answer to that question explains much of what has gone wrong with NHS.
In the late Nineties, NHS Direct was set up to deliver 24-hour medical advice on the phone by nurses and others, because people found it increasingly difficult to get to see a GP. Its successor service, NHS 111, which started last April was supposed to be more efficient and better connected to the rest of the health system.
From the start, however, this was bedevilled by problems.
In March, the British Medical Association called for it to be delayed, saying it was badly worked out, confused and would put patients at risk.
By May, the Royal College of General Practitioners said patients had already lost confidence in the system.
The real cause of the problem, however, is the reason these services were deemed necessary in the first place.
That was because GPs were no longer prepared to deliver patient care seven days a week, 24 hours a day. Some of the world’s finest doctors work in the NHS but the brutal fact is that many got greedy and selfish, and destroyed the ethic of care at the heart of the NHS.
The rot set in under the last Labour government, when the GPs pulled off an outrageous deal in which their pay rocketed upwards to more than £100,000 a year while the hours they worked plummeted.
No longer recognising an unequivocal duty to their patients, they turned themselves into 9-to-5 workers.
We know that – shockingly – more patients die at weekends because of patchy medical care. Yet recently more than half of family doctors questioned in a survey said they wanted to charge patients up to £150 for an appointment because they were so stressed they faced ‘burnout’.
This eclipse of clinical conscience in turn has gone hand in hand with a general erosion of political accountability for the NHS, with ministers out-sourcing the day-to-day running to a series of quangos.
The ostensible reason was to make the service more responsive to the public by loosening Whitehall’s controlling strings. In fact, this enabled ministers to wash their hands of responsibility if things went wrong.
The outcome was an ever-more monstrous bureaucracy in which ‘out-sourcing’ became an epidemic disease. Ministers out-sourced policy to quangocrats. GPs out-sourced out-of-hours care to NHS Direct, which out-sourced it in turn to NHS 111.
Doctors out-sourced clinical care to nurses. Nurses out-sourced humanity and compassion to the cleaning staff. And blame was even out-sourced from human beings to machines.
Apparently, the dispatch by NHS 111 of ambulances to deal with trivial complaints is the fault of something called the ‘risk-averse computer’, which sends out ambulances unnecessarily because of the fear of missing something. Computers with over-cautious dispositions! Who knew?
The result is now laid out for all to see – a mad NHS merry-go-round in which the sick are fobbed off with poor advice or left hanging on the phone for hours while ambulances are dispatched to deal with scratches from the household pet and A&E departments descend into bedlam.
And, meanwhile, knighthoods and damehoods are handed out faster than aspirin prescriptions to the bureaucrats presiding over this mess, who emerge from beneath their otherwise impenetrable shield of incomprehensible management-speak to intone unctuous pieties about everything being for the best in the NHS, the best of all possible healthcare systems.
The deeper problem behind the disaster of NHS 111 lies, in fact, with the NHS itself.
It has been obvious for years now that it is simply unable to cope with the demands being made of it.
Despite being ring-fenced and having money poured into it, the NHS still does not have enough cash and never will be able to satisfy the unstoppable and ever-expanding demand.
The idea of a centralised health care system purporting to provide out of direct taxation the same excellent level of health care for everyone free at the point of use is now demonstrably unsustainable.
On the other hand, anyone who receives treatment in France, Germany or other European countries where health care is based on social insurance systems sees that standards there are infinitely superior.
Yet British politicians are terrified of challenging the country’s most sacred – but tottering – cow.
Accordingly, they continue to propagate the myth that the NHS represents Britain’s sanctified temple of compassion and conscience.
And to insulate themselves from the lethal fallout as this temple crumbles, they have created a pyramid of out-sourcing and targets and ‘providers’ out-sourcing targets to other ‘providers’ – in which ultimately no-one takes responsibility for sending patient care down the sluice.
The 111 debacle is but a symptom of a deeper sickness – a health service in which patients are being sacrificed to an idea whose time has gone.
Read more: http://www.dailymail.co.uk/debate/article-2381028/MELANIE-PHILLIPS-Shambles-just-beggars-belief-The-111-service-disaster-start.html#ixzz2aVyMikTp
The NHS - envy of the world :NoNo: