Restoring Britain’s health to 2014 levels could add 2% to GDP- i.e. £72 billion

I think differentiating between mental health and physical health is absolutely vital here.There is overlap, of course, any chronic pain and things like ME/ CFS are managed much better when someone's in a good place with their mental health.
But the services we need to treat / prevent problems are rather different.
Also employers should be much more flexible on return to work after a severe or long illness - shorter days at first, letting them use priority parking, working in a different place if they've broken their leg, the chance to go out & walk round the block when they feel overwhelmed if it's a mood / emotional problem, and ensuring that everyone else understands that this is not "favouritism" but a way of getting them back to share the workload when they would otherwise still be signed off sick.

There's such a lot that can be done, & it's cheaper than sick pay, benefits the country but most of all, benefits the person who's been ill.

Communication, communication, communication ......

I worked for many years in the NHS and this was a problem then. It is even more of a problem now.

I could list endless examples as I know could so many others.

This absence of efficient communication leads to so many ridiculous situations:

- duplicate tests
- long waits for results - I am still waiting for an MRI result a month later and do not even know where it is being sent to chase it up!
- bed blocking - I waited in hospital for a week for an angiogram. They thought I would probably be safe at home with a lifeline, but if I went home I would go off the urgent list and have to wait even longer and they were concerned about that.
- patient deterioration
- lost information

I too have been with the same practice for many years (37 or so). The days of having a 'family GP' are long gone, as is being able to see the same one every time, or being able to turn up without an appointment at 11.00am and sit and wait until you could be seen (useful for small children who could go 'up and down' very quickly). I don't know whether they still do home visits, but I doubt it.

On the other hand, the days of having to take time off work to attend a routine appointment are gone too - you can talk to a GP on the phone, or book early or late appointments. Nurses do a lot more of the routine things that used to take GP time, and the surgery now has machines such as ultrasound and X Ray machines, and hospital consultants hold clinics for common conditions such as endocrinology and others. The surgery employs physiotherapists, OTs, radiographers and other support staff, and a pharmacist does annual checks on patients' medication to ensure it is appropriate and up to date. I like being able to book online and summarise the issue for triage, although I understand that that system can be difficult for people who have problems with expressing themselves in text.

I would like to see a review of the relationship between the surgery and hospitals. GPs now refer patients to consultants routinely, and lose sight of progress, as the systems don't communicate. I can see test results on the NHS or surgery apps, but only if they were requested by the GP. If a consultant orders them they stay on the hospital system, to which patients don't have access. As someone who keeps a gimlet eye on my LTCs I want to know what's happening, and if I speak to a GP about it they don't know either. I would prefer to have the GP as 'project manager' of LTCs, as they have an overview of things that may overlap, and hospital departments don't communicate with one another.

IME there have been swings and roundabouts since 2014. I spend a lot more time in outpatients than I used to (not convenient and very time-consuming) and it's frustrating when it's for things like blood tests and US scans that could be done in the surgery. I assume they outsource for budgetary reasons, but the system is not patient-friendly for reasons already mentioned. I would like to speak to a GP who manages my conditions with expert advice when required, and I would very much like to see a much more 'joined up' relationship between hospitals and surgeries.

I can only speak from experience, I have had one bad GP appointment, which I lodged a complaint about and it was upheld.

My last interaction at my surgery was excellent, I was in with the nurse for one hour, and she listened to my concerns and reasons why I did not want to be blue lighted to hospital. I was then with a GP for 30 minutes, who once again listened and agreed I could go home with certain caveats.

I have been with this practice since I was 14 yrs old, there have been many changes over the years, some for the better.

Since Covid there have been big changes locally I havnt seen a GP at all it all done on the phone and if you need to go in for blood tests or vaccinations you see a nurse.

My wife had one potentially serious problem with dropping things and we were not satisfied with the explanation, or the painkillers prescribed, so booked a private consultation. We got an NHS MRI scan and the problem was obvious on our own laptop, it was an old injury, consultant explained she needed to change several activities to reduce pressure on a nerve.

A GP cannot be an expert in everything they do their best with the system they have if we had stuck to the system it would have taken a year to get an expert remedy. It cost £250 to get a definitive diagnosis, not a lot in NHS spending.

We are constantly being told that more and more are being treated.
From my own experience listening to friends and family tge reason numbers are going up is because the problem wasn’t treated properly the first/second etc time.

I’m beyond rage when it comes to the heinous waste in the NHS. There can’t be one person who either has personal experience or knows someone who has experienced this waste.

A while ago my Dr did an ECG in the surgery. The reading led him to send me to hospital then!
Taken straight in where I was wired up.
I asked what are you doing? An ECG came the answer.
But I’ve just had one 20 minutes ago at my surgery.
Came the answer: we aren’t linked up to your surgery’s system Give me strength 🤬
And on and on it goes. 😥

LemonJam All told a saving of nearly £2,000 that could have been better spent.

Repeat that many times across the NHS on so many fronts and much of the money needed could be funded from current budgets.

For elective planned surgery such as you describe M0nica- cost of your bed per night around £930. If 2 other people could have the bed on the 2 nights you didn't need it and their minor surgery treatment could be delivered in a 24 hour stay that would be a big cost saving.

As you state the issue is streamlined theatre and surgical staff capacity to conduct both minor and major surgery to maximise bed use- 52 weeks a year, even during staff holiday periods.

I agree winterwhite 16.49. We can have family line of diagnoses osteoporosis. Knowing that you can do everything possible to promote good bone health- exercise, diet, etc etc- but post menopause change in hormones will heighten your risk- and then you have it....

This principle follows for other LTC- you can take responsibility for your health but that does not mean you won't get things- but may be delay onset.

Managing the money the NHS has better, would go a long way to dealing with the problems.

I recently went in to hospital for minor day surgery, considered urgent. I was discharged 3 days later because I was on the point of discharging myself,

Why was I there 3 days? no medical reason, but because there was a build up of serious operation and the hospital had no system of feeding short minor ops in between major ops, or having a small ops theatre. I am sure there is a way round ths problem.

They also had a totally inefficient way of dealing with discharge letters. I could have been discharged hours after my op. Instead I was kept in a second night because there was no discharge letter.

I was just admitted to hospital and kept there, occupying beds that could be available for more seriously ill patients, having blood pressure, temperature etc checked every three hours. At least they saved money on feeding me. For most of the time I was in hospital I was nil by mouth.

This is not an aberration. This is the second time this has happened in two different areas of the country for the same minor op - lancing and cleaning out an abscess. 3 days in hospital. How much this cost the NHS I do not know.

winterwhite

It is improving health generally and reducing health inequalities among people of working age that is key. If we want more people living longer we have to factor in an increase in the eventual illnesses and disabilities of later old age.

Does the report between physical and mental health?

The Health Foundation report predominantly used Long Term Conditions as its measure for ill health. That could be either Physical or Health- and of course a mixture of the 2.

30% of those in the UK living with a physical LTC also suffer from chronic conditions like depression and anxiety. The health interactions often go both ways. so a need to treat both simultaneously promotes overall well being.

Long term conditions are the biggest reason for not being able to work and for PIP. claims etc

Replying to Pamela. No doubt, but we can’t be blamed for hospital waiting lists. It is not our fault if we develop long-term conditions. These things will strike however saintly our diets or rigorous or exercise. And there are many for whom life is such a struggle that they have no space for advice.

I can’t help thinking that we could be a little more responsible for ourselves!
Of course there are things that we can’t be blamed for eg. my DH has pulmonary fibrosis caused by the chemicals used during his farming career, before it was realised that respiratory aids were needed.
He should however be aware of the things he needs to do to make his life easier.
Luckily he has me to keep him on the straight and narrow😂.
I think everyone should know and have access to the information that is out there but, unfortunately, that doesn’t seem to be the case.
I’m not sure how the message gets through, I hear it loudly enough but many don’t.

It is improving health generally and reducing health inequalities among people of working age that is key. If we want more people living longer we have to factor in an increase in the eventual illnesses and disabilities of later old age.

Does the report between physical and mental health?

Healthy life expectancy and mortality rates are falling in the UK, one of only 5 countries in the world's 21 richest countries with a falling rate.

Population growth maybe ? I think if people have to wait a long time to get medical help some will just not be bothered. It is happening here as well. If you are ill the last thing you want is long boring queues. I don’t think we are affected in quite the same way here, though because the life expectancy seems to be going up ( quality of life is another issue )

Thanks for the link Petra 👍

I agree Ilovecheese that investing in reducing the NHS waiting list asap would help. Health deteriorates during the long waits.

In tandem a big surge investment in reducing waiting times for diagnostics would similarly help People are in fact on 2 waiting lists:
1) waiting times for various diagnostic procedures. The GP can order a routine or an urgent referral- but as yet the symptoms cause is likely unknown so most referrals are marked routine- unless the patient has suspected cancer symptoms
2) After one diagnostic referral wait, the result, eg from a dexa scan could show osteoporosis but also highlight another issue of concern that requires ultra sound scan
3) The USS wait could be a further 6-7 month wait
4) Meanwhile the patient's associated symptoms may have deteriorated, further symptoms have emerged and further diagnostic tests needed.
5) whilst waiting for further diagnostic tests- some have 9 month waits- the patient may go an a. surgical waiting list but the patient's health keeps deteriorating because some symptoms are yet to be diagsnosed and treated.

BOTH surgery and diagnostic waiting lists need urgent investment

I suppose perhaps the only thing that could improve things quickly is reducing the waiting list for operations that could restore health and possibly the ability to work. I am thinking of things like hip or knee replacements or heart bypass.
Longer term is about reducing poverty and encouraging more healthy lifestyles.
One problem with that though, is that if a person is working long hours for minimum income, a healthy lifestyle is a bit of an impossible dream, no time for exercise, no money for healthier food.
The higher minimum wage might possibly help, but not if it just reduces universal credit.

This was a very interesting informative listen.

www.bbc.co.uk/sounds/play/m002phn1