waiitng times/understaffing Flashcards
how to improve ambulance/elective care wait times
4
-TECH
-Nhs long term elective care rveise very plan (more community diagnostic centers + more AI infrastructure)
-IPADSto help triage patients to sort into categories of care
-EXPANDsurgical hubs for hip replacement/cataract replacement(where they’ve been introduce, surgery increase by fifth)
-VIRTUAL WARDS april 2022, reviewed daily by MDT,more in contorl
-Prevenative med, social prescribing,
Nhs long term 2019
bc 1in 5 gp appointments for non medic care
-british red cross, those frequently at A£E housing issues
-now more than 3500 link workers across uk
-need 6500 for long term plan
-efficiency
SDEC
urgent care without hospital admission
eg deep vein thembosis, headaches
assess, diagnose,treatment,!in one place
-more staff + allied health
reduce handover delay
(share the roles)(+improve conditions for those working so less sickness absence)
Stats for issue of Elective care
NHS consisting no longer than 18 week standard where all non urgent care compelte
-updhel till 2015 but worsening after covid
-elective care wait list now 7.6 million
(taking up beds and also increasing handover delay)
Stats for current issue of A€E
NHS has 4 hour A£E target where 95% patients should be seen in this time
(but constaicny has only been 70%, v below target)
A%E is the end result of cummulatoon orf issues
Why r there problems w wait times
so pressure at the front door and back door
-not eneough prevention,
(-falla could be avoided from social care)
(-mental health crisis could be avoided)
-problems w letting patients back into community bc lack of community care + social provision
-so staying too long, repairstaory infectoons spreading, increased mortality
why r waiting timrs a problem
-patients in pain and orr at least so doctor patient relationship affected
-likely to worsen in winter months teipledemic of flu, covid RSV and cost of living
why is understaffing an issue
(6)
current staff under pressure
-less focus on long term prevenative care bc short time slots
-misuse of resources-gp shortage so may be directed to secondary care
-less focus on resident doctor training and more on service provision
(may have to take up too many doing bloods and discharging patients)
-less long lasting continuity of care, gps leaving so less strong doctor patient relationship
-more temp staff from locums, wokring in unfamiliar environments eg dr Barwa
-patient care affected, concept of compassion fatigue, health workers burnout so less empathetic
(Bawa Garba case, 6 old died of sepsis, overworked and no break between mroning and night handover)
-health inequalities,
where needed the most there r least
-leading to widening disparity of care
INVERSE care law
-eg deprived and rural areas
solutions for understaffing
-targeted enhancement recruit
et schème 20,000 (short term)
-TRAIN:
-double med school places to 15,000 + -increase GP speciality places
RETAIN:
-improve working conditions by
RECRUIT MORW ALLIED HEALTH
(64,000 nursing associates)
-more staff in public and prevenative health
what were the results of the junior doctor strikes
partial improvement only:
(discussions started in 2022, Bma strikes happend in 2023, and sep 2024, 22.3% pay increase offered over next 2 years
-government also agreed to improve the ways additional hours reported (so keep track and make sure payed for it)
-only a real terms pay cut, (although may be taking more home, bc of inflation and cost of living, income not rlly increase)
what are the guidelines in place for striking ?
accoridng to GMC, doctors have legal right to take action,
-aslong as doesn’t compromise patient safety
-and doctors have plans and providers in place(eg safe handover, and if major casualty event eg car crash to have cover)
pros of going on strike
-staff+patients
pay restoration
(improvement in doctor welfare leads to better patient outcomes,
-can argue strikes still safe for patients bc evidence mortality the same)
-general public: long term improving status of medic profession (esp recent times number of med school applicants decrease)
cons of going on strike
-violates non maléficence
(longer waiting times, more stress,
more medical errors
(over 1.4 mill operations + appointments been cancelled from stikes, mainly outpatient appointments)
-funding
(cost nhs 1 billion, could have been sued for other medic equipment)
-conflict between staff, eg handovers
-overall affects doctor patient relationship and public perception of profession
should doctors go on strike?
-i udnertand why it happened in first place
overall idea is that short term drawbacks provide long term benefits
-not ideal soltuion + not somthing healthcare workers want to do
why is understaffing happening
-increased cost of living, minimal change in salary
-inadequate working conditions, burnout and low morale
-lack of rest faiclited and support service(eg hot food + rest when at home)
