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)
-this summer 1.2 million more A£E attendances than last summer
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 to help with preventative issues eg psychiatry and social services to get rid of beds for elderly
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)
