Quote ="Sir Kevin Sinfield"The NHS is the most efficient health system going https://www.google.co.uk/amp/s/www.bbc. ... h-40608253'" Does that mean there is no waste in the NHS which could be eliminated which was the question?

Quote ="Sir Kevin Sinfield"The NHS is the most efficient health system going https://www.google.co.uk/amp/s/www.bbc. ... h-40608253'" Does that mean there is no waste in the NHS which could be eliminated which was the question?

The best way to help the NHS and avoid early death would be to adopt healthier lifestyles and take better care of ourselves.

Very good point

Yes I am pretty much. I get around a lot of Trusts of all different kinds. They've all been cut to the bone.



Any ideas how? I mean new ones. It's not like this hasn't been looked at before.

Until very recently average life expectancy has increased year on year – so on average we are doing that.

Some interesting reading and discussion here. Regarding the NHS and how lean it is. I am sure that further savings can be made. One especially for Emergency Services. I'll give an example, outside Warrington Hospital, there is a Spar shop with a fuel station attached. Quite often, there is an ambulance on the forecourt filling up. Yes it's easy, however with the prices being ~10p a litre higher than other petrol stations. I would have thought quite a large saving could be made on fuel?

Most Ambulance services already hold bunkered stocks of diesel. However these stocks are at the main ambulance depots and these aren’t always within a suitable travelling distance given that the number of vehicles is stretched, the number of calls is massive and they have to be deployed geographically to cover wide areas, not to mention the targets of being at an emergency within a set time. It might in the example you give an idea to put a fuel bunker in at each Acute hospital. However I would expect that to be too expensive. I know Trusts that have a complete ban on any capital expenditure at the moment. Some even have bans on buying new things over £500. One I know isn't able to replace the broken projector and screen in their main meeting rooms due to costs.

It all boils down to the NHS living on the absolute edge costs wise. Unless it gets a big injection it can’t address things long term.

How much of that is driven by advances in clinical practises and drug development?

Hard to say. I imagine quite a bit. However people don't tend to smoke as much nowadays so that's one influence.

Also people having less dangerous jobs and living in cleaner environments also an impact.

Hard to measure.

Agreed - whatever anybody says its still one hell of a service.

I would love to see a refundable charge for appointments. £5 paid upfront and refunded when the patient turns up, but kept if they don't. Each missed appointment increases your deposit by £1.

It would not only reduce the number of missed appointments massively, it would also make timewasters think twice about whether they actually need to go to the GP.

According to the NHS 1 in 20 appointments are missed, that's 15.4 million costing £216 million. We should put that on the side of a bus or something.

Yes because putting stuff on the side of buses influences voting patterns



Agree with you idea only problem is the cost of administering the taking/returning of deposits

Although in most cases, people missing appointments ought to be charged for (if it could be done effectively and efficiently), it would be interesting to know how many appointments are missed now as opposed to 10 or 20 years ago ??

Although no doubt costly, these issues are usually borught up by those not wishing to dfund services properly, rather than geniune concern for the ncost.

Why should I pay £5 to see my GP when I’ve already paid more than that as a deduction from my wage each month?

Attend your appointment and you won't pay anything.

Quote ="wrencat1873"Although in most cases, people missing appointments ought to be charged for (if it could be done effectively and efficiently), it would be interesting to know how many appointments are missed now as opposed to 10 or 20 years ago ?? Although no doubt costly, these issues are usually borught up by those not wishing to dfund services properly, rather than geniune concern for the ncost.'" Everyone under the sun has spoken about the cost of missed appointments. That's the oddest argument I think I've ever heard on this subject, given the NHS themselves raise it every year and are investing massively in solutions, not something they would do if in reality it wasn't such a big issue. And they're doing plenty already. My local GP sends several email & text & app reminders ahead of any appointment. A new portal - DrDoctor - is being rolled out as we speak. https://www.england.nhs.uk/2019/01/miss ... -millions/ Anyway, google tells me there were 6.5million missed in 2007-8, versus 15 million currently. There's probably some statistical inconsistency, that seems far to large a variance but frankly I can't be bothered digging. It's a no brainer for me. Prevent missed appointments and put off time-wasters. You know, the clueless, "my little cherub has a cold and I DEMAND ANTIBIOTICS." But no doubt the usual crowd will wail "you're victimising the pooooooorrrr."

Quote ="wrencat1873"Although in most cases, people missing appointments ought to be charged for (if it could be done effectively and efficiently), it would be interesting to know how many appointments are missed now as opposed to 10 or 20 years ago ?? Although no doubt costly, these issues are usually borught up by those not wishing to dfund services properly, rather than geniune concern for the ncost.'" Everyone under the sun has spoken about the cost of missed appointments. That's the oddest argument I think I've ever heard on this subject, given the NHS themselves raise it every year and are investing massively in solutions, not something they would do if in reality it wasn't such a big issue. And they're doing plenty already. My local GP sends several email & text & app reminders ahead of any appointment. A new portal - DrDoctor - is being rolled out as we speak. https://www.england.nhs.uk/2019/01/miss ... -millions/ Anyway, google tells me there were 6.5million missed in 2007-8, versus 15 million currently. There's probably some statistical inconsistency, that seems far to large a variance but frankly I can't be bothered digging. It's a no brainer for me. Prevent missed appointments and put off time-wasters. You know, the clueless, "my little cherub has a cold and I DEMAND ANTIBIOTICS." But no doubt the usual crowd will wail "you're victimising the pooooooorrrr."

To listen to some people, the only thing you need to win any election or referendum is a message on a bus.



It would add work hours and systems expense, no doubt, but any investment would be repaid many times over within a few weeks. There are hundreds of fast & simple payment systems out there now that could do the job. Take the £5, hold the funds, then bank or release according to whether the patient turns up.

I can't believe paying for missed appointments isn't already in place. It would recoup millions.

My wife works for the NHS, and people not turning up for appointments, or turning up late then demanding to be seen straight away is a regular occurrence.

People think that because it's a free service, there are no financial implications when they miss their appointments.

Yes, there will be implementation costs, and it will require a level of administration, but in a 24/7 digital age I would think there's a reasonably successful solution.

I don't disagree with the idea of efficiency and effectiveness measures - although working directly with many Trusts, it's undoubtedly the case that most are well past that and are now into the arena of cutting essential services; and the cause of that is, without question, the failure of Government to fund it properly. There could be an argument about whether that's deliberate or not, but when the Health Secretary is promoting an app that effectively privatises GP's and defunds existing surgeries, it's reasonable to err on the side of the former.

All that said, I do agree that a big drain on the NHS is the general public failing to look after themselves properly - smoking, alcohol and health conditions caused by obesity are costing £billions, and are in most cases entirely avoidable - but given the endless public health campaigns and the massive amount of information that is available to people these days, it does seem that great swathes of us just don't care enough to take appropriate steps.

Maybe the old maxim that familiarity breeds contempt comes into play - we're so used to the NHS picking up the pieces when we break ourselves, that we don't value it any more in the way we ought to? If certain Tories get their way and we do end up with a privatised system, we will quickly realise how good we had it.

Looking at other countries, like the good ol' USofA, where being ill can be quite expensive it doesn't seem to make much of a difference, in fact they are worse than us. I certainly don't have any ready answers, but connecting people with the production of food they eat might be a start,

A large chunk of the population has health insurance - a bit like us so why would their behaviour be any different - sadly?

The figures I have read are that between 33-50 million Americans don't have health insurance - between half to 3/4 of our population. It is estimated 45,000 die as a result each year. They spend twice as much per capita on health than the world average but are ranked 34th in the healthiest countries in the world. Highly processed food & a lack of exercise are killers.

Completely agree - the point I was referring to is your assumption that because health care is very expensive people will take a different view to their lifestyle - its obvious they don't.

I think I was saying the opposite but as they haven't found a cure for memory loss I'm not sure.

A big problem is the NHS unilaterally sending out appointment letters with no thought for whether the patient can make it. Although they have got better in many cases and liaise there are still many ludicrous examples. For example, a few months ago a letter arrived one morning saying my daughter had a hospital appointment at 2.00pm that day when they are aware she resides nearly 200 miles away and has to be collected! I and others I know have recently received short notice appointments via letter and the next day received a second letter changing the day by a couple of days. In fact, often receive two or three letters on the same day! My guess is this is deliberate so they can massage their stats / waiting lists by saying that people cancelled / didn't turn up?