Coronavirus

How would you propose the NHS 'sorts itself out'?

It has a universal duty of care. Nurses and doctors take 3-10 years to train. It has been starved for a decade. There is no silver bullet, these things take decades to do and undo.

There does seem a general feeling where I work, and with other people I know locally that mid March is pretty much the limit where lockdown should of already stated to of been eased. If not then they will no longer follow any restrictions.

General feeling is people are fed up of the goal posts shifting for beginning to ease restrictions and feel if they don’t start standing up for themselves soon we will still be in the same situation this time next year. If infection rates are still falling as well as deaths and hospital admissions then there is no excuse not too. And we can’t keep defaulting to restrictions and lockdowns as a norm every time they start to rise again.

I’m feeling pretty much the same way too now. Beyond March and in to early April if the goal posts keep moving then enough will be more than enough.

BigT said:

There is no chance majority of the public will put up with this any longer than mid March me included, 99% of people I speak with are done with this lockdown rubbish.
We need our lives and sanity back, it’s been one year by mid March, the government, NHS and schools have had long enough to sort themselves out by now, life must be allowed to go on once all the top 4 categories are done as promised at the beginning of January.
Goal posts must not be allowed to be moved.

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I do love how you suggest the NHS just sorts itself out, as though it can nip to the job centre and employ all those doctors, nurses, ODPs, Radiographers etc who are just watching day time telly at the moment.

That said I agree patience is running thin with lockdown my own included. But if you want it to end quickly then society has to accept people will die and other treatments will be delayed. We have literally converted most of the operating theatres into temporary ITU’s so there ain’t any surgeries happening.

Maybe folk will remember this when the NHS is underfunded in the future, I somehow doubt it however as everyone has already forgot how bad the governments response was only 12 months ago!

But that’s the easy answer isn’t it? Not enough nurses or doctors, not enough money, underfunded etc. etc.
The NHS budget could be double and it still wouldn’t be enough, whilst elective surgery and procedures are still allowed it has enough money in my book.

Where was the out of box thinking? Except the waste of time nightingales nothing, why were they not repatriated for other minor care?
Why can’t nurses and doctors be trained to a certain level in a year? I’m sure it’s possible, It normally takes 10 years to make a vaccine but this was done in 9 months, think outside the box, these are not normal times, we shouldn’t except normal timescales.

BigT said:

But that’s the easy answer isn’t it? Not enough nurses or doctors, not enough money, underfunded etc. etc.
The NHS budget could be double and it still wouldn’t be enough, whilst elective surgery and procedures are still allowed it has enough money in my book.

Where was the out of box thinking? Except the waste of time nightingales nothing, why were they not repatriated for other minor care?
Why can’t nurses and doctors be trained to a certain level in a year? I’m sure it’s possible, It normally takes 10 years to make a vaccine but this was done in 9 months, think outside the box, these are not normal times, we shouldn’t except normal timescales.

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Elective surgery beyond emergencies isn’t happening at the moment in most NHS Trusts. Up north we have been taking patients from the south to balance the beds in use.

The nightingales were a rush job government scheme, they were designed as large scale death houses effectively. They mostly don’t have the support facilities for other levels of care (how many convention centres do you know with basics like showers). You then have to staff them which brings us to training.

The doctors needed right now are anaesthetists, they take around 12 years to train fully. These people send your body into a deep paralysis and unconsciousness and then use machines and drugs to keep you alive. Not sure I want a 1yr apprentice doing that to me or my loved ones. Hell if you had seen an intubation occur in person you want the consultant if it has to happen to you!

You can’t train a nurse in 1 year, nurses don’t just wash and care for the sick, they administer drugs (some very dangerous drugs), they use complex medical equipment and need a good understanding of biology and chemistry. In ITU they also need to be able to manage an airway (would you want an untrained nurse looking after your airway when you are effectively paralysed and unconscious, with a 2cm wide plastic tube in your trachea the only thing keeping you alive?)

Your ODP’s again administer very dangerous drugs (doesn’t take much for many of the medications given in hospitals to go from a therapeutic dose to a lethal dose). They also support airways in patients (hence why all the ODP’s are now out of the operating theatres and in the makeshift ITU’s

Radiographers need a good grasp of physics, including quantum physics, an incredibly detailed knowledge of anatomy and are exposing people to ionising radiation and strong magnetic fields. Pretty sure you would be upset if you where given a radiation burn during a case because the radiographer had only a years training and mixed up their exposure factors. Ohh and without them none of the life saving lines or tubes can be checked for correct positioning so your ITU stops functioning (and most hospital Covid is first diagnosed using x-ray).

Physiotherapists need good knowledge of anatomy, you don’t want them dislocating a shoulder by accident.

On any given day an ITU requires:

Anaesthetists
Nurses/ ODP’s
Radiographers
Physiotherapist (they stop the lungs filling with fluid)
OT’s
Pharmacists (they don’t just sit in Boots giving out paracetamol!)
Microbiologists
Pathologists
Clinical scientists (keep the equipment going)

That’s one ITU, imagine how that extrapolates to an entire hospital. Now you could do what you suggests but again that will lead to deaths. The lockdown isn’t dictated by the NHS, it just tells you what’s it’s capable of for a given value of infections. The lockdown is dictated by societies appetite for death and disease. If society decides that they are happy with grandma not even getting into hospital because the 50 yr old with silent hypoxia is prioritised then society can reopen now.

Oh I’m sorry I thought we were talking about underfunded for years hence the elective surgery comment, if we are talking about right now then the NHS basically has an unlimited pot, whatever it needs it gets and to hell with the money, how many thousands of containers full of PPE are currently in Felixstowe blocking up the port and putting container prices through the roof?

Jesus Big T...
Are you the Donald in disguise?

BigT said:

Oh I’m sorry I thought we were talking about underfunded for years hence the elective surgery comment, if we are talking about right now then the NHS basically has an unlimited pot, whatever it needs it gets and to hell with the money, how many thousands of containers full of PPE are currently in Felixstowe blocking up the port and putting container prices through the roof?

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Pretty sure that's more to go with the Government trying to cover themselves over previous mistakes rather than anything to do with how the NHS is operating...!

You asked Dave why nurses and doctors can't be trained to a certain level within a year. I'd say he have you a very good answer as to why.

BigT said:

Oh I’m sorry I thought we were talking about underfunded for years hence the elective surgery comment, if we are talking about right now then the NHS basically has an unlimited pot, whatever it needs it gets and to hell with the money, how many thousands of containers full of PPE are currently in Felixstowe blocking up the port and putting container prices through the roof?

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It has been underfunded for years, all health economists say a hospital should never run above 80% capacity for more than a few days so they can cope with extreme scenarios (you know, like a pandemic or major incident). The NHS has run at over 80% capacity constantly for years hence the problems now, it had nowhere to expand to when the brown stuff hit the fan. Even the private sector couldn’t help as it’s never had to deal with extreme medical issues because the NHS acts as a backup for most private health care.

Unlike a factory you can’t just ramp up capacity in a few weeks/ months. It takes years because of the above staffing issues as well as supply of other medical equipment/ infrastructure needed to run hospitals.

and as for the "train people up" stuff, this is happening, St John are training volunteers on how to inject vaccines as well as resusitaction and other basic first aid. By using volunteers that frees up nurses to do other things.

Also my physiotherapy as an outpatient has been cancelled so that the physio can help in the wards to free up other nurses.
They are already moving staff and training people in new areas, but if the government had funded training new nurses and doctors properly 10 years ago we would be in a much better place.

I think one thing that needs to come from this, NHS being underfunded or not, is a drive to encourage people to improve their health. NHS is there to help us when we get sick, but we can control a lot of the chronic disease such as diabetes and heart disease through taking a bit of responsibility for our own health. We live in a nation where we need to be spoon fed, instead of getting a grip and looking after ourselves.

Sharko said:

I think one thing that needs to come from this, NHS being underfunded or not, is a drive to encourage people to improve their health. NHS is there to help us when we get sick, but we can control a lot of the chronic disease such as diabetes and heart disease through taking a bit of responsibility for our own health. We live in a nation where we need to be spoon fed, instead of getting a grip and looking after ourselves.

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Totally agree, but with society as it is now and the focus on fast food where you don’t even have to get out of your armchair to even go and get it, I don’t see the health or weight of the nation improving any time soon!

Sharko said:

I think one thing that needs to come from this, NHS being underfunded or not, is a drive to encourage people to improve their health. NHS is there to help us when we get sick, but we can control a lot of the chronic disease such as diabetes and heart disease through taking a bit of responsibility for our own health. We live in a nation where we need to be spoon fed, instead of getting a grip and looking after ourselves.

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One of the areas in health spending that has been completely decimated in the last 10 years has been public health and disease prevention. Basically the very cheap and effective ways we used to have to help improve health and reduce demand on the NHS.

So you are not wrong, but again you need to invest in education and support for those in poorer/ lower educated areas to benefit.

If anyone needs some inspiration for the home schooling, attractions designer Katapult has created a free workbook for KS2 where they design their own theme park. I think it looks quite fun.
https://www.katapult.co.uk/wp-content/uploads/2021/02/Katapult-Become-A-Theme-Park-Designer.pdf

Here’s a great article I found written by a virologist named Dr Eleanor Gaunt about reasons why we shouldn’t worry about the Oxford vaccine’s efficacy against the South Africa variant: https://apple.news/AFaG3_RgdTYKc-aNvjPwteg

It’s incredibly interesting and somewhat reassuring, in my opinion; really worth a read!

In my book, it still offers some which is better than nothing.

rob666 said:

Jesus Big T...
Are you the Donald in disguise?

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Haha very good, even I’m not that right wing.
He did have some good ideas we could steal though, a wall between England and Wales and Scotland would be nice..

Dave said:

It has been underfunded for years, all health economists say a hospital should never run above 80% capacity for more than a few days so they can cope with extreme scenarios (you know, like a pandemic or major incident). The NHS has run at over 80% capacity constantly for years hence the problems now, it had nowhere to expand to when the brown stuff hit the fan. Even the private sector couldn’t help as it’s never had to deal with extreme medical issues because the NHS acts as a backup for most private health care.

Unlike a factory you can’t just ramp up capacity in a few weeks/ months. It takes years because of the above staffing issues as well as supply of other medical equipment/ infrastructure needed to run hospitals.

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You can’t just ramp up factory production either, look at the problems the vaccine manufacturers have faced but they are working on fixing it with huge investments and good planning.
Exactly the two things that could of speeded up training and capacity in our Heath service.
Anyway a pointless argument now, that boat has sailed, should of been started last March.

Data in Israel is suggesting that the Pfizer/BioNTech vaccine does play a significant role in cutting transmission; according to the study, even those who received the first dose alone that tested positive had a viral load that was between 1.6 and 20 times lower than those who hadn’t had the vaccine: https://www.theguardian.com/science...cine-reducing-viral-load-data-israel-suggests

I know that this does suggest that there is still a viral load, but a lower viral load means that the potential for transmission is far, far lower, so that does result in a substantial cut in transmission.

It should be noted that Oxford’s study was based on similar evidence (the viral load was 67% lower in people who tested positive), and the government seemed very positive about that, so I’d say that this is a pretty good sign.

Sorry for double posting, but it would appear that Britain’s dosage strategy has now been proven effective for the Pfizer vaccine as well as the AstraZeneca vaccine, as the first dose apparently begins to work within 2 weeks and is roughly two thirds (67%) effective across all age groups: https://apple.news/Akw6AiNuSS2qmREj6Z9adZQ

I’m assuming the second dose lifts it to the full 95%? Still, I think this is very promising news!

BigT said:

Haha very good, even I’m not that right wing.
He did have some good ideas we could steal though, a wall between England and Wales and Scotland would be nice..



You can’t just ramp up factory production either, look at the problems the vaccine manufacturers have faced but they are working on fixing it with huge investments and good planning.
Exactly the two things that could of speeded up training and capacity in our Heath service.
Anyway a pointless argument now, that boat has sailed, should of been started last March.

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Come on, it takes months to increase factory capacity, it comes nowhere near the complexity of increasing hospital capacity.

You still don’t seem to be explaining how planning in March would have trained thousands of health care professionals with a method of compressing 12 years of training into 12 months? You are right that there should have been more planning for such a situation, that’s why the underfunding is a huge problem that will take years to put right, you are wrong that the impact of this underfunding can be fixed in a matter of months.