- Pressure to not admit people – fair enough – but can be overdone and mean people are not admitted who should be
- Bad experience esp for elderly frail in hospital, especially A&E, so they wont go back even if that seems the best course for them
- Lack of capacity in emergency social care – so people have to be admitted as there is no where else for them to go
- Lack of community social care so people end up stuck in (sometimes dying in) hospital when they would rather be out
- Slow response of social care from council so that realistically most of our referrals for social care are emergency ones
- Ambulance service overwhelm so that sometimes people wait for hours on the floor or even with chest pain and we get called to cover 999 calls they can’t get to
- Housing crisis- I dictate 1-2 letters a day re people’s problems
- Stress and anxiety caused by benefits reviews and assessments. We don’t have a great deal of input strangely now into the original benefit application forms so we tend to only see the fall out eg the distress in anticipation or after the assessment
- The common finding that at review benefits assessments are reviewed in favour of the claimant but financial issues common whilst in the process of assessment
- Consequent low morale in the medical ( and other associated professions ) associated with the sense of failure to deliver adequate care when resources do not permit ,but where provision of adequate care is seen as a personal / practice responsibility
- Increasing complexity ( age new treatments etc ) and increasing cohorts with multiple morbidity / age – but no increasing resource to adequately serve that need
- Short sighted cost cutting choices – eg health visitor numbers district nurse numbers GP numbers – all below full complements –tendency for the loudest voices to be heard and consequent further entrenchment of the “ inverse care law”
- Removal / scarce resources for independent housing/benefits advice – bht are good. CAB now very hard to get appointments – but my experience is successful benefits appeals need you to be very switched on or have support from an organisation with experience of what “ boxes to tick”
First published by the War on Welfare blog
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How sad is this list? It shouldn’t be this way. Our NHS has never been 100% perfect because it involves the judgment of people, and diagnosis and treatment is not an exact science, it can be a very hit and miss affair. When we were properly funded, when extortionate PFI’s weren’t bleeding the organisation dry, we held our own, we ran it more efficiently. We are being lied to by this government, and the last Labour government did precious little to reverse this awful system whereby our own NHS ended up paying ‘multiple mortgages’ at ridiculous rates of interest. The end result is this list above, and it hurts me to realise that the people don’t really matter to those who are running this country, without a mandate I may add. I’m so angry that this has been allowed to happen, I’m so angry that it has been engineered to be this way.